In 2011, sweeping changes were adopted for Montana Workers’ Compensation in 39-71-704 MCA including adoption of fee schedules, U&T Guidelines, Medical Status Form and the 60-month termination of medical benefits. This closure applies to claims with a date of injury on or after July 1, 2011. Injured workers may petition to re-open closed medical benefits by using:
Petition to Reopen Closed Medical Benefits
Regular Petition Form
Only the injured worker or their legal representative is eligible to complete this form and the purpose of the form is to:
- Allow the injured worker the opportunity to reopen medical benefits which could allow him/her to stay at work or return to work.
- Obtain the necessary information for the Department to review the request and when appropriate approve the petition
Joint Agreement and Petition to Reopen Closed Medical Benefits
Joint Petition Form
The purpose of this form is to:
- Facilitate a fast and easy way for medical benefits to be reopened that both the injured worker and the insurer agree to and will help the injured worker stay at work or return the injured worker to work.
- Obtain the necessary information for the Department to review the request and when appropriate approve the petition.
INSURANCE ADJUSTORS: May submitted medical records to Maximus through the MOVEit XChange Secure File Transfer at http://edi.maximus.com or can fax at 585-869-3344.
The reopening of medical benefits DOES NOT apply to:
- Medical benefits that are closed by settlement or court order, or
- Permanent total disability, or
- Those with a prosthesis