Frequently Asked Questions About Workers’ Compensation

A claimant can only obtain medical benefits for a period of 60 months after the date of the injury or diagnosis. This limitation is set out under Section 39-71-704(f), MCA. This 60-month limitation can be waived by the Department of Labor and Industry and does not apply if the injured worker is permanently totally disabled. A claimant who is permanently totally disabled will continue to receive medical benefits as long as he or she is considered permanently totally disabled.

Injured workers in Montana may be eligible for Permanent Partial Disability (PPD) benefits under Section 39-71-703, MCA and vocational benefits under Section 39-71-1003, MCA. There are certain criteria that must be met before the claimant is eligible for benefits under these statutes. To be eligible for benefits under Section 39-71-703, MCA, an injured worker must show that he or she is unable to return to the time of injury job and has realized an actual wage loss, and suffered an injury qualifying for an impairment rating. An injured worker who meets these criteria will be eligible for either wage loss compensation of less than $2 per hour or wage loss compensation greater than $2 per hour. Once these criteria are determined, a claimant’s entitlement to compensation can be figured using a formula which considers the impairment rating, amount of wage loss, and lifting restrictions. These benefits can be paid out on a bi-weekly basis or in a lump sum.

If your claim has been denied, you can appeal the insurance carrier’s decision to the Montana Department of Labor and Industry (DLI). Under Montana law, the DLI has jurisdiction over workers compensation disputes until a mediator from the DLI has rendered his or her recommendation.

A claim cannot be filed with the Workers Compensation Court until this process has been completed. You do not have to have a lawyer to complete the mediation process. The mediator’s recommendation is not binding and merely begins the process of a worker’s compensation claim.

If you have been injured at work and are unable to return to work, you are likely entitled to Temporary Total Disability (TTD) benefits under Section 39-71-701, MCA. TTD benefits are calculated by taking the workers four previous pay periods and determining the Average Weekly Wage (AWW). Once the AWW is determined, the TTD rate is calculated multiplying the AWW by 2/3. Tax deductions are not withheld from the TTD funds received by the injured employee. These benefits are paid on a bi-weekly basis.

If your claim has been accepted, or accepted on a conditional basis under Section 39-71-615, MCA, your medical benefits will be paid by the workers compensation insurance carrier. You will be provided a workers compensation claim number which you can provide to the health care provider. The provider will pay the provider directly.

It depends. Montana law distinguishes between an industrial injury and an occupational disease. An industrial injury is defined as an incident that occurs during a single work shift. In contrast, an occupational disease occurs over more than one work shift. A claimant has different deadlines depending upon whether the injury occurred over a single work shift or more than one work shift. If you have suffered an injury that occurred during a single shift it is an industrial injury and the deadline for reporting the injury is under Section 39-71-603, MCA Under Section 39-71-603, MCA, a claimant must notify his or her employer of a workplace injury within 30 days of the incident.

Under 39-71-601, MCA, a claimant must file a written claim with either the Department of Labor and Industry, the employer, or the insurer within 12 months of the incident. This time limit is extended to 24 months if the claimant can establish lack of knowledge of disability, latent injury; or equitable estoppel.

If your injuries occurred over more than a single shift, you have suffered an occupational disease. As such, the 30-day reporting period does not apply.