Learn how to file a claim and get maximum benefits after an injury
Teachers are unsung heroes who selflessly see to the educational and emotional needs of our children day in and out. But sometimes, it’s our teachers who need the help, especially after an injury on the job.
Fortunately, Montana workers who are injured on the job are entitled to medical and financial benefits. Injured teachers may receive coverage for their medical expenses and time off from work if they file a workers’ compensation claim.
Most Montana employers are required to carry workers’ compensation insurance to provide these benefits to employees who are injured in a work-related accident.
Who is eligible to file a workers’ compensation claim?
The workers’ compensation process is available to workers who are legally classified as employees. To qualify for workers’ comp, the worker must have a work-related injury or illness.
While workers’ comp is no-fault insurance (meaning that workers don’t have to prove their employer was at fault to get compensation), workers’ comp can be denied if the injured worker was under the influence of drugs or alcohol at the time of the accident.
Why Was My Workers’ Compensation Claim Denied?
Top 9 Reasons
Possible reasons why an injured workers’ compensation claim might be denied or rejected by an employer or their insurance company in Montana. Learn how to avoid these situations.
Types of injuries covered by workers’ comp
Workers’ compensation covers any injuries and illnesses that occur within the scope and course of a worker’s job.
- Wet floors or cluttered hallways could cause a teacher to fall and sustain a bone fracture, bruise or soft tissue injury.
- Teachers who work in stressful settings or who experience traumatic events may require treatment for anxiety, depression or post-traumatic stress disorder (PTSD).
- Schools may also expose teachers to occupational hazards like cleaning chemicals, glues, adhesives and chemistry lab solutions.
- Mold, lead paint and other environmental toxins may also cause illness among school workers.
Teachers may also be injured in violent confrontations or exposed to contagious illnesses while at work.
Catastrophic injuries in the workplace also include:
- Traumatic brain injury (TBI)
- Burn injuries
- Vision loss
- Repetitive stress injuries (carpal tunnel or complex regional pain syndrome)
Filing a claim for workers’ compensation
The process of filing for workers’ comp is intended to be relatively fast and generally straightforward for injured teachers.
In the event of a work-related injury or illness, teachers should take the following steps:
- Seek medical attention. Always seek medical attention as soon as possible after a work injury or illness to prevent your condition from getting worse and to ensure you have the necessary documentation to connect your injury or illness to your job.
- Report the injury to their employer. Montana requires injured workers to notify their employer of the accident that caused their injury within 30 days of the date the accident happened or they became aware of the injury or illness.
- Verify that your employer filed a claim. State law requires the injured worker’s employer to file a First Report of Injury (FROI) within 6 days of receiving notification of the injury. After receiving an FROI, the employer’s insurer has 30 days to either accept or deny the claim.
- Contact an attorney if your claim is denied. If your workers’ comp claim is denied or you believe you’re not being offered the compensation you deserve, contact an attorney to help you with your claim.
How long before I receive workers’ comp after my claim is approved?
Upon acceptance, the injured worker may receive compensation for time off from work after the 5th day of the worker losing wages due to the injury. Employees who are unable to work for 21 days or longer may receive retroactive compensation from the 1st day the worker lost income due to taking time off from work because of the injury.
Types of workers’ compensation benefits
Injured Montana teachers are entitled to the following benefits:
- Medical benefits to cover all necessary medical expenses, including doctor and emergency room visits, rehabilitation, medications, surgeries and medical equipment
- Wage loss benefits to cover two-thirds of your average weekly wage while you recover from your injury
- Death benefits to certain dependents if an employee die from their work injury
Workers’ comp claim challenges
Most employers and employees find the workers’ comp process to be relatively efficient and reliable. Nevertheless, workers sometimes encounter challenges at various steps in the process.
- Difficult employers. In some cases, an employer may not file the FROI on the injured employee’s behalf. Employees who encounter this challenge may file the form directly with their employer’s workers’ comp insurance provider. However, your employer’s refusal to file the claim is a good indication that you should contact a workers’ comp attorney to help protect your rights.
- Delayed symptoms. Certain injuries or illnesses may not produce detectable symptoms within 30 days of the work-related incident that causes the condition. Employees who were reasonably unable to detect their injury within 30 days of the incident must notify their employer within 1 year of the date the work-related injury or illness was diagnosed.
- Insufficient settlement or medical treatment. Injured workers who do not agree with the award amount of benefits received or with the date the doctor approves them to return to work can file an appeal with the state’s Workers’ Compensation Court. Montana law allows workers to file an appeal within 2 years of the date the original claim was terminated or denied.
Negotiating a workers’ comp settlement
At some stage in the process, the employer’s insurance company may offer to settle the injured worker’s claim by paying a 1-time sum to close the case. This is offered as an alternative to paying benefits weekly.
In most cases, acceptance of a settlement offer means the worker can no longer file for additional compensation arising from the same claim. Any promises to pay the worker additional compensation at a later date should be written into the settlement agreement.
The worker should thoroughly discuss the potential need for future treatments with their doctor before agreeing to settle a case. We highly recommend consulting with a Great Falls workers’ comp attorney before accepting any settlement offer.
Pros & Cons of Settling Your Montana Workers’ Comp Claim
The biggest question an injured Montana worker must ask themself is, “Should I settle?” This guide will help weigh the pros and cons of a workers’ comp claim.
Contact an experienced Montana workers’ compensation attorney
As a teacher, you’re busy taking care of others every day. If you become injured on the job, you deserve to be taken care of as well. If you need help filing a claim or your claim is denied, let the experienced workers’ compensation attorneys at Murphy Law Firm help you get the compensation you deserve.
Our Great Falls, Montana, workers’ compensation lawyers have more than 75 years of experience helping workers across Montana get maximum compensation after a work-related injury or illness.
