This page provides answers to the following questions:
You should report any on-the-job injuries or illnesses to your insurer or employer as soon as possible. You have thirty (30) days to give notice of your accident, or one year from the date you would have learned about any conditions or illnesses resulting from your work. Don't hesitate to report your injury; the Department recommends you report any injury, regardless of the scope or severity.
In addition to providing notice of your work-related injury or illness, you must provide a written and signed First Report of Injury form to either your employer, the workers' compensation insurance provider at your place of employment, or the Department. This form must be submitted within twelve (12) months from the date of the accident or diagnosis of the occupational disease. Take note that establishing a work-related injury is different from establishing an occupational disease. An occupational disease or condition requires a finding based on objective medical evaluation, where your employment is the major contributing cause of the condition.
In Montana, workers' compensation insurance is required for most types of employment. Your employer may purchase insurance coverage through an insurer authorized to provide workers' compensation coverage plans in Montana, or may be granted the authority to become self-insured.
In the event you are injured or you are diagnosed with an occupational illness or disease, you or your employer will submit your First Report of Injury form to your employer's insurance provider. The insurance provider will evaluate your claim and will make a determination to accept or deny liability for your claim within thirty days.
If your employer is uninsured, you may eligible to receive benefits from the state uninsured employers' fund. You should contact the Department to determine your eligibility.
In Montana, workers' compensation is a no fault system. This means the employee is entitled to workers' compensation as an exclusive remedy. Complying with the procedures and requirements for submitting a claim with the Department is the best way to ensure your eligibility for benefits.
However, the circumstances specific to your claim may challenge or change the amount of benefits you may be entitled to. For example, your ability to return to work; whether you currently receive state or federal benefits such as social security; the severity and scope of your injury or illness.
Depending on the extent of your injuries, you may be entitled to one or more of the following types of benefits:
If you are unsatisfied with your insurer's decision regarding your claim and benefits, you may request a meditation through the Department's Employment Relations Division.
The mediation process is an opportunity for you, the injury employee, and your employer and/or employer's insurance provider to resolve any disputes that may have arisen during the course of your claim. The mediator works to facilitate the potential dispute resolution. These mediation conferences are informal and confidential, but not necessarily binding. They are an opportunity to come to a settlement without the need for formal litigation.
If a mediation does not result in a settlement or resolution of the issues of your claim, the mediator will provide a written recommendation to both parties within 10 working days specifying what the mediator understands to be the best solution to the issue. Once you receive the recommendation, you have twenty-five (25) days to respond as to whether you agree or not. If you remain unsettled with the recommendation, you or your employer or your employer's insurance provider may file your claim to be heard at the Workers' Compensation Court.
To move your claim to the Workers' Compensation Court, you will be required to submit a petition to the court outlining the circumstances and facts of your case, including the claims you bring forward and the relevant evidence and medical information related to your injury or illness. You may also request an emergency trial in this petition by providing a basis for why the claim constitutes an emergency situation. The opposing party is expected to respond to the petition within twenty (20) days of receiving notice of the initial filing of the petition with the court. A proceeding within the Workers' Compensation Court is conducted similarly to a trial in any other court. It is highly recommended that you seek the guidance and counsel of an attorney to help you in this process. A decision of the court is certified as a final decision and determination. These decisions may be appealed within the Department of Labor and Industry.
If after exhausting all of the administrative proceedings available through the Workers' Compensation Court, you remain unhappy with the determination of your claim, you may appeal to the state Supreme Court in regards to issues of law that may have been applied or considered in error against your claim.
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