Employees of Montana State University, Montana Agricultural Experiment Stations, Extension Service and Fire Service Training School are covered by Workers' Compensation insurance coverage through MSU’s participation in the Montana University System Self-Funded Workers’ Compensation Program. Benefits prescribed by state law for qualifying job-related injuries or occupational diseases include related expenses for medical treatment, wage compensation, Stay-at-Work/Return-to-Work (SAW/RTW) assistance, rehabilitation costs and disability compensation. This coverage is provided at no cost to employees.
Individuals are covered by workers’ compensation when an injury/illness arises accidently and within the course and scope of paid work for the university. Activities and injuries/illnesses incurred during uncompensated activities are not covered by workers’ compensation. Additionally, MSU volunteers are not covered by workers’ compensation.
The Workers' Compensation program emphasizes fostering a safety culture throughout the Montana University System by focusing on the prevention of injuries and illnesses, the value of each employee, providing an equitable outcome in the event of a work-related injury or occupational disease and returning employees to productive work after they are medically released by their treating physician. It is recognized that returning to the work environment as soon as possible after an on the job injury or illness occurs has a positive impact upon the healing process, and is in the best interests of the employee and employer alike.
Injured workers who are returned to productive work after being medically released to do so heal faster and better, require less medical care, experience less disruption to their personal lives, maintain full earning capacity and financial stability, experience less interruption of MSU benefits (e.g. annual/sick leave accrual; employer-paid portion of medical insurance), and they maintain positive self-esteem that comes from being a productive member of the university community.
MSU Safety & Risk Management is responsible for administering the university’s Workers’ Compensation program. The campus claims coordinator is the specific individual within SRM to assist employees and supervisors in accessing, completing, and submitting a work comp claim. The claim coordinator is available to coordinate the claim process but is not a claim adjuster and does not determine the acceptability or the compensability of a claim. MSU employees work directly with the claim adjuster throughout their claim process.
A. Reporting Process
1) Report all work related injuries to your supervisor or the claim coordinator as soon as possible, but in no case over 30 days from the date of injury (MCA 39-71-603 (1). Your claim may be denied if you do not report work-related injuries to your supervisor within 30 days.
2) To claim an occupational disease you must notify your supervisor and submit a First Report of Injury within one year from the date you knew, or should have known your symptoms resulted from work related conditions.
3) Montana law requires completion of the First Report of Injury within six days after notice of every work related accident, injury and/or occupational disease by a worker; however, the form must be completed immediately if the injured employee has sought, or plans to seek medical treatment. The claim form must be submitted even if the supervisor questions whether or not the reported injury is work related, but they are given the opportunity to relay concerns, if any. The form is in two parts and requires both the employee and the supervisor to participate. Once the employee has completed his/her portion, an email with instructions is automatically generated to his/her supervisor who then completes the remaining information. The entire electronic reporting process is encrypted. If electronic signatures are not used, the original signed report must be mailed to the claim coordinator via Campus Mail; or for off-campus locations to 1160 Research Drive, Bozeman MT 59718.
4) Be sure to explain the cause in detail (e.g., “cut left index finger” instead of “cut finger”).
5) Injured employees may seek medical treatment with the provider of their choice for the first visit only. This may be their personal physician, an urgent care facility, or the emergency room if necessary. If subsequent visits to your personal physician, referral providers, etc. are not preauthorized, Intermountain Claims may decline to pay the charges.
6) We want you to report minor injuries whether or not you seek professional medical treatment. Early reporting of minor incidents and injuries sustained in the workplace can help prevent serious injuries to others. MSU Safety & Risk Management is interested in preventing similar incidents and may conduct additional incident investigation in order to identify and correct any hazards.
7) Contact the claim coordinator at (406) 994-6889 or [email protected] if you have questions or to request assistance. In the event of a fatality or serious injury requiring hospitalization, notify the claim coordinator immediately.
8) The claim coordinator will review and finalize the claim and submit it to the third-party adjusting company retained by the MUS Self-Funded Workers’ Compensation Program.
9) If you seek medical treatment before a claim number has been assigned by the adjuster, inform the treating physician that your injury is work related and that the adjusting company responsible for managing the university’s work comp claims is Intermountain Claims. They can be reached at (866) 722-4421.
10) Ensure your treating physician completes a Medical Status Form following every office visit and give a copy to your supervisor. The form is necessary to ensure understanding of work abilities and work restrictions. Always follow all of your treating physician’s directions, at home as well as at work.
11) All medical appointments must be kept or immediately rescheduled. Failure to keep appointments may result in termination of workers’ compensation benefits and/or withdrawal of SAW/RTW transitional employment (MCA 39-71-605 (1) (a)).
12) Maintain all records and correspondence with regard to your claim.
B. Time Loss
In some cases, employees require ongoing medical care and may require time away from work. Best outcomes are achieved when the affected parties involved work as a team. The makeup of the team will vary but typically includes the injured employee, the home department supervisor (along with other appropriate department personnel), the claim coordinator and the claims adjuster. Additionally, the employee’s treating physician and/or managed care representatives may be included, depending on the unique circumstances of each claim. Regular communication throughout the team is especially important with these more complex cases. Indemnity (time loss) benefits may be available to employees medically precluded from working.
1) Stay in touch with your supervisor and the claim coordinator.
2) If you are temporarily unable to work, you might be eligible to receive weekly compensation of 66 2/3% of your gross wages at the time of injury, calculated over four pay periods prior to the date of injury, up to the maximum weekly rate determined annually by the MT Department of Labor & Industry. Taxes are not taken out of Work comp indemnity payments.
3) Compensation will not be paid for the first 32 hours or 4 days loss of wages, whichever is less, that the worker is totally disabled and unable to work because of an injury (MCA 39-71-736 (1) (a)). If the worker is totally disabled and unable to work in any capacity for 21 days or longer, compensation may be paid retroactively to the first day of total wage loss (but will be required to repay any sick/annual leave if it was used). In some cases, injured workers may incur the 32 hours over the course of several months. Supervisors should use the Work Comp Time Tracking form to help track and verify these hours. Once 32 hours are reached, send the form to the claim coordinator, and continue to send them every two weeks as long as the employee is off work to ensure that the injured employee receives timely benefits.
4) Employees may use sick leave, annual leave or comp time during the 4 day/32 hour waiting period; and may continue to use it afterwards, if needed, unless they choose to have time loss covered by work comp indemnity benefits. Keep in mind that for extended absences from work, MSU benefits continue to accrue when employees use annual or sick leave but they do not when they are completely off work and receiving work comp time loss benefits.
The 2011 Legislature established SAW/RTW assistance to be made available upon request to help injured employees return to meaningful, productive employment as soon as it is safe to do so following a compensable work-related injury or occupational disease, even if they are not yet able to perform 100% of their regular work duties.
It is the policy of Montana State University to provide assistance to help employees who are predicted to eventually return to their regular position to stay at or return to meaningful, productive employment following an injury or illness. If an injured employee is not capable of immediately returning to his/her regular position, assistance provided may place the employee in a temporary assignment in which the employee’s regular position or hours are modified to accommodate the employee’s temporary physical abilities, or identify alternate work that is better suited to the employee’s temporary physical abilities.
SAW/RTW may be available for injured employees that have been released by their treating physician to perform light or modified duty. If working reduced hours they may also receive workers’ compensation benefits for the reduced earnings.
1) If not expressly prohibited by labor agreements, current positions may be temporarily modified to fit the physical limitations of injured employees by modifying workstations, altering specific tasks or working reduced hours.
2) MSU departments must make every effort to identify transitional employment that conforms to the physical abilities identified on the injured employee’s most recent Medical Status Form. Transitional employment may include part-time work, existing jobs with different physical requirements, or alternated job tasks to accommodate physical limitations.
3) Job modifications or initial transitional employment assignments will only be provided for a specified period of time (with an option to extend), and have a typical duration of six to twelve weeks. Extensions are considered on a case-by-case basis. If the injured employee chooses to decline a temporary transitional employment assignment it may result in loss of workers’ compensation time loss benefits (MCA 39-71-1042 (5) (a)).
4) Try to maintain a positive attitude. Research shows that your emotional well-being plays a significant role in your recovery.
For additional information with regard to benefits available to an injured worker please see the MUS Self-Funded Workers’ Compensation Program website.
For another excellent resource visit the Montana Department of Labor (DLI) Benefits Summary.
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