MONTANA SELF INSURERS' ASSOCIATION
2021 MSIA Member Survey
Last year we instituted a member survey to help guide the Association in taking public policy positions. We found your input very helpful in identifying what was important and where we should spend our time and efforts. In a non-legislative year, we spend time with public policymakers on rules and educating them on issues so when they come to Helena for the legislative session, there is some knowledge of how to improve the workers’ compensation system for injured workers and business.
Below is the 2021 MSIA Members Survey. You will notice many of the same issues identified previously, because the issues have not gone away. Some were not addressed during the legislative session or some are opposed to the way the system operates. For example, the choice of physician has been addressed in Montana. Despite the facts that it has led to faster recoveries, less downtime, and lower costs, some continue to argue the choice of provider should revert to the employee.
Please consider your positions and share your thoughts with us. Please email your responses by September 22, prior to the Annual Meeting on September 29. There is no requirement to fill everything out and you do not have to provide significant or documented reasons for your positions.
Your input helps MSIA consider positions to take and why. As well, we ask you what are the top three issues you have in the Montana workers’ compensation system. All responses will be considered. Your Board of Directors will also weigh in on potential positions for the Association.
All responses will be held in the strictest confidence. Any responses received are for internal MSIA purposes only and will not be distributed in any manner to anyone outside the Association. We will also not share individual responses with anyone inside or outside the Association.
When there is a proposal which may impact individual members, or the membership as a whole, I will reach out to you to update you on the proposal through email, telephone or text. Your responsiveness on those issues has been greatly appreciated and has helped us on a number of issues.
With a new administration and the executive branch making changes, we have a unique opportunity to help explain our perspectives and interests in keeping the Montana system and overall economy in good shape. We bring the on-the-ground, real-world experience to the table and assist in public policy discussions from that perspective.
Mental-Mental Injuries & PTSD
Montana law does not recognize mental-mental injuries as compensable under the workers’ compensation law. There must be a physical injury as part of an event that supports a workers’ compensation claim. PTSD type of disabilities or impairments are not covered unless they arose from an incident with a compensable physical injury. Laws are changing around the country, particularly for law enforcement and first responders. MT is one of 15 states that do not recognize mental-mental claims within the system. In 2021 six states expanded their mental health coverage for various first responders and West Virginia provided coverage for the first time for first responders. We have seen legislative activity in Montana in the past but nothing has passed as yet.
Should Montana recognize mental-mental injuries?
Should Montana limit recognition for mental-mental injuries for first responders and others (like 911 dispatchers or in the field social workers)?
Should Montana limit recognition for mental-mental injuries for law enforcement only?
Why do you take this position?
COVID Coverage Presumptions
During the last session, there were two House bills which had hearings on providing COVID coverage presumptions within the Montana system. The first would have guaranteed workers’ compensation coverage to any working nurse should they contract COVID, regardless of the circumstances. The second, more along the lines of laws in other states, would have provided a rebuttable presumption for coverage that first responders and essential personnel, should they contract COVID did so as a result of their work and therefore coverage would be available. Both proposals died in committee. In 2020 18 states by either Executive Order or statute provided some kind of COVID coverage presumptions. In 2021, an additional four states and DC provided COVID presumptions. South Dakota changed their law to clarify that COVID was not an occupational disease.
Currently, the Montana workers compensation system requires some relationship between work and a disease or injury. As a result, absent clear indication that COVID was contracted as a result of work, most of the claims have been denied. This is not unusual in other states’ workers compensation systems – most COVID claims are denied based on non-responsiveness to questions regarding how it was contracted, negative testing or no clear indication the disease was contracted as a result of work. Some insurers have voluntarily chosen to pay for COVID testing, without accepting claims, to confirm the disease.
Should Montana provide presumptive coverage for first responders and essential personnel for COVID?
Should Montana specifically provide that infectious diseases, unless clearly contracted at work, are not compensable under the system?
Should Montana provide presumptive coverage for a more limited group of workers?
Why do you take this position?
Fraud
Plan 2 workers’ compensation fraud cases are investigated and prosecuted through the State Auditor’s office. Plan 3 fraud allegations are the purview of the Attorney General’s office. There does not appear to be a home for Plan 1, self-insured fraud allegations.
Should self-insurers support proposals to fund and create a special investigations unit and prosecutorial services somewhere in the Montana Executive Branch?
If so, should the Plan 1 fraud services be combined with either of the existing Plan 2 or Plan 3 programs, of both, or should a new service be created for all three plans?
Why do you take this position?
Benefit Change Delays
In every system, including Montana, there are stories about injured workers and plaintiff attorneys who delay, object to or postpone medical treatments dates, Independent Medical Exams (IME) or Impairment Rating (IR) appointments without sound basis. The result, according to benefit payers, is increased costs, delayed care and additional friction in the system.
Are you aware of any programs from other systems that seem to have effectively addressed this concern?
Are there statutory or regulatory steps that can be taken to address this issue in the Montana system?
Other Issues & What Keeps You Up at Night?
There are several issues not surveyed that are routinely subjects of legislative consideration. Typically they include the choice of physician, increasing benefits, increasing access to benefits, eliminating the Subsequent Injury Fund, increasing penalties for hiring Independent Contractors who do not have a valid ICEC and eliminating the State Fund to replace it with a residual market mechanism. MSIA has typically opposed these efforts, with the exception that we do not take a position on the operations of the state fund. If you are aware of other efforts with a potential impact on the workers’ compensation system, please let me know the background and any details you might have regarding the proposals.
What are your top three issues in the Montana workers’ compensation system?
1.
2.
3.
What other things about the Montana Workers’ Compensation system need to be addressed or are keeping you up at night?
All responses will be held in the strictest confidence. Any responses received are for internal MSIA purposes only and will not be distributed in any manner to anyone outside the Association. We will also not share individual responses with anyone inside or outside the Association.
Thank you for your time and input. Please provide your responses by September 22, before the Annual Meeting. We will review survey responses at the members only Business Meeting on starting at 8:30a September 29.