The workers' compensation system in Montana is a no-fault system that compensates injured workers for medical bills, lost wages, and permanent impairments resulting from their injuries. Workers’ compensation insurance is required for most types of employment. To take advantage of these benefits, injured workers must follow certain procedures required by Montana law.
For most people going through their first Workers’ Compensation claim, the process can be quite confusing with a lot of terminology and acronyms that might not immediately make sense. We’ve compiled a list of the most common items used when working with a Workers’ Compensation claim in the state of Montana.
The AWW is a method that may be used in calculating entitlement to wage loss benefits. The average earnings, by week, for a fixed period of time are calculated and wage loss benefits are computed according to that amount.
Following an injury that occurred on the job, employers are usually required to file a first report of injury with the state administrative agency that oversees workers' compensation. In Montana, this is the Montana Department of Labor & Industry.
An IR (sometimes called a physical impairment rating) is a medical assessment of a claimant's injury represented by a percentage value determined by the American Medical Association Guides to the Evaluation of Permanent Impairment.. The IR is determined once a claimant has reached maximum healing and it must be expressed as a percentage of the whole person.The rating may then be used to calculate the workers' compensation benefits owed to a claimant. Impairment ratings are particularly important in determining permanent partial disability benefits.
An IME is an insurer's medical examination allowed by law and is a procedure by which the insurer schedules an examination of the claimant with a physician of the insurer's choice.
MMI is defined as "a point in the healing process when further material functional improvement would not be reasonably expected from primary medical services." (Mont. Code Ann. § 39-71-116(21)). In simple terms, MMI means that your work-related injury or condition is as good as it is going to get, even though you may not have fully recovered from your injuries.
A list of medical providers designated in a health plan for a particular employer which limits the choice of physicians to a network of participating providers.
PPD benefits are payable to an employee who has sustained a permanent, but not total disability. There are multiple factors considered in determining the amount of PPD due. Permanent Total Disability (PTD) PTD benefits are available if an injured employee is permanently and totally disabled from work. Again there are multiple factors used to determine the extent of PTD benefits available, if any.
SSDI benefits are payable to disabled individuals through the Social Security Administration. Many state workers' compensation statutes have specific provisions that dictate whether an injured employee may receive both workers' compensation benefits and SSDI benefits at the same time. Generally, if both benefits are appropriate for the same individual, a complex calculation will be performed to "offset" the benefits so that the individual does not receive more money than they are entitled to from both programs.
TPD benefits are typically payable prior to MMI and the claimant returns to work in a modified or alternative employment and suffers a partial wage loss.
TTD benefits are when the worker suffers a total loss of wages as a result of an injury and typically paid until the worker reaches maximum healing or until the worker has been released to return to the employment in which the worker was engaged at the time of the injury or to employment with similar physical requirements.
A civil lawsuit brought against a third-party (not the employer or the injured employee), whose conduct causes, at least in part, a work-related accident or illness.
Wage loss benefits are the TPD, TTD, or PTD compensation benefits generally paid on a weekly basis based on 66 2/3 % of wages received at the time of injury. The maximum weekly compensation benefits may not exceed the state's average weekly wage at the time of injury.
If you have been injured at work and have questions about your workers' compensation rights, our workers' compensation lawyers have extensive experience in this space. At Odegaard Kovacich Snipes, we can advise you about your coverage and guide you through your options and opportunities. Contact us for a free consultation.
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