Injured at Work? Frequently Asked Questions About Montana Workers’ Compensation

Any injury that happens at work is eligible for workers' compensation benefits in Montana. That applies to a slip and fall, auto accident, gradually developing condition like carpal tunnel syndrome or mesothelioma, or any other kind of injury. If it's the direct result of your working conditions or an occurrence at work, it would be covered under workers' compensation insurance.

Montana law requires that employers carry workers' compensation for every employee, whether full- or part-time. An independent contractor, however, isn't required to be covered. While there are some specific exemptions, if you're employed by a person or company in Montana, you should be included.

Anywhere you're performing tasks related to your job is considered your “workplace” for the purposes of workers' compensation coverage. That means if you're on a job site outside your regular location, at dinner with a client, running errands for your boss, or on the way to or from any of these places (in your own or a company-owned vehicle), you'd be covered.

However, you're NOT covered during your commute to and from work, or if you leave work for a lunch break. But other tasks during the work day when you're “on the clock” and acting at your boss' direction are included.

You have 30 days to report your injury to your employer. Your employer is required to report the injury to the Montana Department of Labor & Industry within 6 days from when it received notice. If you need to file a workers' compensation claim, you must do so within 1 year of the date of injury or diagnosis.

If your injury or illness isn't the result of a specific accident or incident but is one that has happened gradually, the clock would begin to run on the date the condition was diagnosed — or when you reasonably should've known you had a work-related injury.

Montana workers' compensation covers occupational illnesses and injuries that aren't the result of a specific accident or incident.

An occupational disease is one that develops over time because of exposure to a condition or hazard in the workplace. Exposure to toxins or chemicals can cause effects from which you might not experience symptoms for years or decades.

If you've been diagnosed with a condition like asthma, industrial dermatitis, or certain respiratory illnesses, ask your medical provider if it might be job-related. Depending on the nature of your profession and level of exposure to some substances, even a diagnosis after you're retired could be eligible for workers' compensation.

There are other conditions that develop gradually, too.

Carpal tunnel syndrome can be a repetitive motion injury (RMI) that might occur if you've spent a lot of time typing, slicing food, performing assembly line functions, driving, or doing other tasks that are continuous and repetitive. But there are additional injuries that happen from repetitive lifting or other movements, such as back or neck injuries, torn ligaments or tendons, and others.

Medical treatment. Workers' compensation provides benefits for the costs associated with medical treatment. This includes any physician or hospital visits, prescription medication, diagnostics, necessary therapies, adaptive equipment, and other related costs.

Wage loss compensation. You can also recover costs from past and future lost wages based on time off from work because of your injury. You can recover wages beginning on the 5th day of wage loss. If you're unable to work for more than 21 days, you can be paid retroactively from the beginning of the period of lost wages.

Death benefits. If you've lost a family member from a work-related injury or illness, you might be eligible for survivor's benefits for up to 500 weeks, along with burial and funeral expenses.

When you go to the first doctor for diagnosis, you may visit the physician of your choice (or your primary care physician). Once the insurer has accepted liability, the insurer can designate a physician to manage your treatment, or it could approve your chosen doctor.

Once you've filed a claim, the claim examiner is allowed to schedule you for periodic independent medical examinations. That means that you would need to be seen by another doctor who will also be tracking your progress and treatment.

Workers' compensation is no-fault insurance, which means you're entitled to workers' comp benefits for your injury regardless of whether it was a “pure” accident or due to negligence (yours, a co-worker's, or the company's).

However, if your injury was caused by a third party, you might have a civil cause of action against that entity.

For example, if you were in a car accident that happened while you were traveling for your job, you might be able to get workers' comp benefits for medical treatment and wage loss, but you'd sue the driver of the other car (if that person was negligent) for replacement or repair to your vehicle.

If you were injured because of a manufacturing defect in equipment used on the job or faulty personal protective equipment (harnesses, protective shoes, etc.), you might be able to sue the manufacturer in a product liability claim.

Your health care provider is required to use the Montana Utilization and Treatment Guidelines for your care. If there's a particular treatment or service that's denied by your workers' compensation insurer, you may request additional review by the Medical Director of Montana L&I. If the Medical Director doesn't approve the request, you can request a mediation. If that happens, it's a good idea to have a Montana workers' compensation lawyer along with you. Your lawyer will help advocate for your needs so that you have your medical expenses covered.

If your employer doesn't have workers' compensation coverage, contact the Montana Uninsured Employers Fund. The employer will ultimately still be held liable for all of your medical and wage loss benefits, but the UEF exists to ensure that employees can receive the benefits they need without relying solely on the employer. The Montana L&I Department will handle penalties and payments from your employer, and you can deal directly with the fund.