Workers' Compensation FAQs

Frequently Asked Questions (FAQs) by Topic

Reporting a Workplace Injury

Q: What do I do if I’m injured at work?

A: If injured within the course and scope of your work, please report the incident to your supervisor and fill out a First Report of Injury (FROI) as soon as possible, but not to exceed 30 days. Occupational diseases/ repetitive motion injuries should be reported when the worker first suspects their symptoms may be work-related, and within 1 year. If you are unsure of eligibility, reach out to the MSU workers’ comp coordinator or file a FROI anyway.

Q: Do I have to wait to complete a FROI before seeking medical care?
A: No. You may seek medical treatment right away. The FROI should be completed as soon as possible afterward by you or, if you are incapacitated, by someone acting on your behalf. Notify your supervisor as soon as you are able.

Q: My supervisor doesn’t want to report my injury. What should I do?
A: Contact the MSU Claims Coordinator at (406) 994-6889. You may still file a FROI even if your supervisor is hesitant. Concerns about retaliation can be discussed with the Claims Coordinator and/or confidentially with Human Resources and/or Campus Civil Rights. Most hesitations stem from misunderstandings about the process—we are happy to help.

Q: Should I report an injury even if I don’t seek medical care?
A: Yes. All work-related injuries should be promptly reported and documented with a FROI, even if no treatment is sought. If you end up seeking medical care down the road, it will help to have that timely report on file.

Q: I filled out a First Report of Injury, but my confirmation letter shows that I have something called an EIR instead of a FROI. Why is that?

A: An Employee Injury Report (EIR) is still a type of FROI used for internal tracking when no medical care is initially sought. If you later decide to seek treatment, notify your supervisor so the EIR can be converted to a medical-seeking FROI. Failure to update this may result in billing and coverage issues.

Q: I was injured just outside my working hours near my workplace, walking to or from work. Is that considered workers’ compensation?

A: Please inform your supervisor and file a FROI. Depending on the circumstances, it may be an eligible claim.

Seeking medical attention/ medical bills

Q: Can I choose my own medical provider?  

A: Yes, for the initial visit you may choose your own provider, as long as it is appropriate for the injury. Follow-up care may be coordinated with the claims administrator. If first seen in an ER, you will need a non-ER provider for ongoing treatment.

Q: What should I do when I get to the provider’s location to avoid having my personal account/ insurance billed?

A: Inform them this is an MSU workers’ compensation claim and that a claim number will be assigned soon. Request a Medical Status Form (MSF) or work status note and give a copy to your supervisor.

Q: The provider immediately wants insurance information and a claim number.
A: Claim numbers and confirmation letters are typically issued within 7–10 days by mail. If needed sooner, the MSU Claims Coordinator can usually access it within 2 business days. Update the provider once you receive it.

Q: I am receiving medical bills associated with my active workers’ compensation claim. What should I do?

A: Contact the billing department or relevant contact, and explain the charges are part of an MSU workers’ compensation claim, not your personal insurance. Provide your claim number information; it may be helpful to have your Intermountain Claims acknowledgement letter handy.

Q: Can I get a second opinion or change providers?
A: It depends on the situation and it is the decision of your Intermountain claims adjuster. Discuss the situation with your claims adjuster for consideration.

Q: Will other services that can help in my recovery be covered by workers’ compensation, such as physical therapy, special scans like MRI’s, and so on?

A: It is possible other services recommended by your treating provider will be covered, but they do require preauthorization from Intermountain Claims. X-rays and other care needed for direction of treatment and diagnosis can generally be done immediately with probable cause (i.e. x-rays or specialty scans for suspected bone fracture/ trauma). Providers are generally aware of the steps needed to work within workers’ compensation claims.

Q: Do I have to attend an appointment scheduled by the adjuster?

A:Generally yes if you do not want your coverage impacted. Claims examiners can schedule periodic independent medical evaluations (IME’s), however, the employee’s ability to attend at the time and provider location should be taken into consideration. Promptly discuss any hardships to attend with your claims adjuster as applicable.

Q: My provider scheduled a follow up appointment or scan, but I’m feeling much better. Do I still have to go?

A: If you have follow up care prescribed/ scheduled but feel you do not need to continue care, you should discuss it with your Intermountain claims adjuster. Failure to attend recommended continued care may impact your workers' comp coverage.

Supervisor Responsibilities

Q: What are my responsibilities as a supervisor?
A: Key responsibilities include:

1. Encourage the employee to complete a FROI within 30 days and complete the supervisor portion promptly.
2. It is not a requirement, but you may attend the initial appointment if appropriate and the employee feels it would be helpful.
3. Respond promptly to follow-up questions from the MSU Claims Coordinator.
4. Track appointments and collect Medical Status Forms (MSFs) after each, and submit to the MSU Claims Coordinator.
5. Inform the MSU Claims Coordinator if work restrictions listed on the MSF can be accommodated. Supervisors who are unsure if restrictions can be accommodated can consult with the ADA & Leave Coordinator at adacoordinator@montana.edu.
6. Check in regularly to ensure duties remain within restrictions and the employee is handling their workload ok given their injury.
7. Consider accommodation tools when appropriate and consult the ADA & Leave Coordinator at adacoordinator@montana.edu if needed (i.e. transcription software for typing with a hand injury).
8. If your injured supervisee is out of work, please still continue periodic check-ins to make sure you are aware of future follow up appointments and continue to collect Medical Status Forms.
9. Please remember that employees are protected by HIPAA--Do not request private medical details. You may request general medical information such as dates of next appointments/ procedures/ or surgeries, and for copies of Medical Status Forms or other similar documentation discussing working restrictions. 

Q: I was listed as the supervisor on the FROI, but I don’t feel I’m the appropriate person, and/or have a position where I can be very difficult to reach. Can someone else be made the supervisor?

A: Please reach out to the MSU claims coordinator via email or at (406) 994-6889 to discuss if a different individual may be better. Oftentimes in cases where a supervisor may be challenging to reach such as if they’re doing field work or are temporarily out of the country, someone else (different supervisor, office manager, etc.) can fulfill the designated supervisor role temporarily or for the duration of that open claim.

Benefits

Q: What injuries are covered?
A: Coverage generally includes:

• Workplace accidents
• Repetitive motion/occupational diseases related to job duties
• Injuries during approved MSU travel or off-site work
  All must occur within the course and scope of employment.

Q: What services are covered?

A: Approved medical care spanning various approved specialties and providers, wage loss benefits, rehabilitation, and Return-to-Work/Stay-at-Work assistance. In specialty cases, additional services may be warranted such as disability benefits & nurse case management.

Q: My case is being investigated by my claims adjuster and I and others are being asked questions. Does this mean that they don’t believe me or my case is going to be rejected?

A: No. Every medical-seeking workers’ compensation case is investigated to make sure it meets the qualifications for coverage of a workers’ compensation claim. Please anticipate investigatory questions and follow up promptly.

Eligibility

Q: Who is covered for MSU workers’ compensation benefits?

A: MSU, MT Ag Experiment Station, Extension Service, and Fire Service Training School employees are provided with workers’ compensation coverage through the Montana University System Workers’ Compensation Program. This coverage is provided at no cost to employees, and there is no waiting period for coverage.

Q: I am a student, volunteer, or visitor of MSU and was injured. Am I covered?

A: Only paid employees are covered. This does not include students, interns, volunteers, or visitors, and generally does not include subcontracted employees, paid guest speakers/ consultants, and so on. Those who are not covered and are injured at an MSU campus/ facility, or during an MSU-affiliated activity should fill out or have filled out on their behalf, a Report of Incident Form within 5 business days.

Q: What happens if I am not hurt within the course and scope of my MSU work, but I am injured and it impacts my ability to perform my job?

A: Even if your job is impacted, being hurt outside the course and scope of your MSU work would not be considered workers’ compensation. However, you should still work with your supervisor and Human Resources if your job is impacted by an injury or illness. You may want to reach out MSU’s Employee & Labor Relations/ ADA & Leave Coordinator to discuss reasonable accommodations.

Pay, Leave, & Job Protections

Q: If I have to be off of work due to my injury, will I be paid my full salary, and/or do I need to use my own leave?

A:Per State of Montana statute, there is a 4-workday/ 32-hour (whichever is less) waiting period after the date of injury, before workers’ compensation time loss benefits can be utilized. If your provider prescribes you time off or reduced hours, or has you on work restrictions that cannot be fully accommodated by your supervisor/ employer, you would likely be eligible for time/wage loss benefit after the waiting period. In cases where the injury has an employee out for 21+ consecutive working days, it is possible the waiting period can be retroactively waived.

Q: Can you tell me more about time loss benefits for lost wages related to workers’ compensation injuries?

A: Once an injured employee is eligible for time loss benefits, workers’ compensation time loss benefit typically pays 2/3rds of the employee’s gross hourly (before taxes) wages. This is because workers’ compensation time loss benefit is not taxed, and the 2/3rds calculation typically brings pay close to an employee’s after-tax hourly pay. To get an idea of time loss benefit calculations, multiply your gross hourly pay by 2/3 or .667.

Time loss benefit is paid to the employee via physical check (typically to their home address) about every 2 weeks for as long as the employee is eligible, usually until they’re back to their full hours. Please note the 2/3rds calculation cannot exceed the State of Montana’s average weekly wage.  

Q: Do I have to use time loss benefit for lost work hours due to my workers’ compensation injury?

A: Employees are welcome to use their own paid leave or even leave without pay, or can use a combination of time loss benefit and paid leave.

Q: What are the benefits and drawbacks to using time loss benefit for lost work hours due to a workers’ compensation injury?

A: Use of this benefit prevents the employee from having to expend their own paid leave while missing hours due to their workplace injury.

Potential drawbacks: 1.) The 2/3rds calculation could be below their usual take-home pay, or the benefit may be capped below their 2/3rds pay due to Montana's average weekly wage cap. 2.) Sick and annual leave does not necessarily accrue while an employee is at 0 hours worked/ leave without pay status. Check with your department’s HRBP for specifics. 3.) Time loss benefit will always remain at the same rate, calculated at the date of the employee’s injury, so if utilizing it down the road, such as after a raise or promotion, employees may be taking a pay cut. 4.) If claim investigation is still ongoing, there may be a slight delay before time loss benefit can be utilized.

Q: Can time loss benefit be used for lost hours associated with appointments?
A: Time loss benefit is only for provider-prescribed time off or when restrictions reduce hours, not for associated medical appointments. Section 39-71-712, MCA

Q: I have been cleared to return to work after my latest provider appointment, but I am not feeling well as a result of my injury. Would missed time in this instance be covered by time loss benefit? 

A: Unfortunately without paperwork from your treating provider to support your missed hours, you would not be eligible for workers' compensation time loss benefit for lost hours/ wages, and you would need to use your own leave and follow standard leave practices. You can discuss concerns with your claims adjuster or your treating provider, however. 

Q: Why would I consider FMLA/ADA protections along with workers’ comp when I’m out of work for my injury?
A: These provide additional job protections that workers’ comp alone may not. Email adacoordinator@montana.edu to discuss further.

Q: Can I be fired for getting hurt on the job associated with workers’ compensation?

A: Employees generally cannot be fired for being hurt on the job unless extenuating factors like gross negligence are shown, or employees have been out of work for a prolongued period of time, exceeding the length of time of their job protections. An employer may fill a position due to an employee being off work for a prolonged amount of time because of their injury; when an injured worker is capable of returning to work within 2 years from the date of injury and has received a medical release to return to work, the worker should be given preference for a comparable position that becomes vacant.

Q: If I leave MSU, do workers’ compensation benefits stop?
A: No. Benefits continue as claim remains active, but you must submit paperwork directly to your adjuster or claims coordinator rather than to your previous or new supervisor.

Q:  I was told that because of my working restrictions, I cannot return to my regular position at this time and was provided with a different temporary assignment at similar or more pay. Do I have to accept this job?

A: No, an employee has the right to refuse to work an alternative position offered to them as part of a Return-to-Work option, however, please know that in doing so, there may be a termination of time loss (lost wages) benefits. Please discuss with your claims adjuster and/or MSU claims coordinator for further clarification.

Q: I work multiple jobs—how is pay calculated?
A: Wages from all legally-held positions are considered in the pay rate calculation. Inform your adjuster of all current employment.

Q: My time loss / wage loss payments are late or inconsistent. What can be done?

A: Eligible time loss benefits should be paid about every 2 weeks. If you’ve already expressed concern to your claims adjuster, please make sure your MSU claims coordinator is also aware and looking into the matter. MCA 39-71-107

Reopening a closed claim

Q: Can a closed claim be reopened?
A: Possibly—within 5 years of injury if additional treatment is needed due to the original condition. Contact your previous adjuster or the MSU Claims Coordinator. If unsuccessful in working with your original claims adjuster, you can also work with the Montana Department of Labory & Industry and read more about the process here. 

Other links & Resources

Please see the Benefits Summary Brochure, FAQs, Claims Assistance, and/or other information at Montana’s Division of Labor & Industry (DLI), MSU’s Workers’ Compensation Benefits, the MSU Workers’ Compensation Policy, and/or OCHE’s Workers Compensation information to read additionally on coverage and general and specific information that may be helpful to you.

Please know each case may be unique and this is not an exhaustive list of all scenarios, questions, and processes, so please feel free to reach out to your MSU Workers’ Compensation Claims Coordinator/ Insurance Specialist at (406) 994-6889 or your claims adjuster to discuss further.