Insurer/Medical Provider Resources
Resources
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Data
Electronic Prior Claim (EPC) History System
Electronic Prior Claim (EPC) History System... Read More
Historical Fee Schedule Conversion Factors for 2003-2007
Pursuant to section 39-71-704 (4), MCA, and an administrative rules change to 24.29.1572, and 1582, ARM, on July 1, 2002, the Department adopted the following conversion factors, effective July 1, 2002, for use with the unit... Read More
Meals, Lodging and Mileage
Section 39-71-704(1) (d), MCA, directs WC Insurers to reimburse workers for reasonable travel expenses pursuant to rates allowed for state employees. When determining the reimbursement, please refer to 39-71-704(1), MCA and ARM 24.29.1409... Read More
Third Party Administrator Notification
Montana statute requires insurers to notify the Department of Labor & Industry of any changes of third party administrators with respect to the handling of Montana workers’ compensation claims. The insurer must notify the department in writing 14 days... Read More
Workers' Compensation Benefits Summary
The information in these pamphlets is a summary of the most commonly requested information on workers' compensation wage loss and medical benefits available to covered employees injured on the job. It is not all-inclusive... Read More
Workers' Compensation Claim Reporting by Insurers
All insurers are to file a complete report of every injury or occupational disease to the department, either on a paper claim form or by electronic means within specified timelines. Electronic reporting is required... Read More
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Forms
Claim Reporting
Used by an injured worker, employer or insurer/adjuster to report an injury or occupational disease... Read More
Electronic Data Interchange (EDI)
Used by insurers and adjusters as a quick, efficient method of communicating data to the Department... Read More
First Report of Injury (FROI) Forms
Used by an injured worker to report an injury or occupational disease to his/her employer... Read More
Independent Medical Review Form
The forms listed below are those commonly used in the Medical Regulation Unit functions of the workers' compensation system... Read More
Insurers - Third Party Administrators Reporting Forms
Used to report changes in adjuster, claim administrator, or third party administrators... Read More
Medical Status Form
The REVISED Medical Status Form is now available. Based on feedback from medical providers, the Department determined there was a need to revise the form. The revised form reflects... Read More
Petition for Mediation Conference Form
Under Montana law, parties must attempt to resolve their disputes BEFORE seeking mediation. Mediation is required in most cases before a petition may be filed in the Workers' Compensation Court... Read More
Petition for Settlement Forms
The forms listed below are those commonly used in the Claims Assistance Units Functions of the workers' compensation system... Read More
Subsequent Injury Fund
The department manages the Subsequent Injury Fund, a program designed to assist individuals with disabilities obtain employment... Read More
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Information
Domiciliary Care
When a worker suffers from a condition that requires 24-hour care and that results from the accident but that requires domiciliary care other than as provided in Title 37, chapter 8, the care... Read More
The purpose of mediation is to prevent, when possible, the filing in the Workers' Compensation Court of disputes by injured workers or insurers if a fair and reasonable resolution can be reached at an earlier stage... Read More
Medical Regulations
The Medical Regulations Unit is responsible for publishing updates to the Montana Professional Fee Schedule and the various Montana Facility Fee Schedule components on the Department’s website... Read More
Stay at Work/Return to Work Project
Minimize avoidable disruption caused by work-related injury or occupational disease and assist the injured worker to return as soon as possible to... Read More
Workers' Compensation Frequently Asked Questions
The following are frequently asked questions and answers, you may also find answers in the Benefits Summary. Nothing on this website is intended as legal advice... Read More