MONTANA SELF INSURERS' ASSOCIATION

August 2021 Update

Virtual Meeting on AMA Guides 6th Edition Updates 9/22 @ 1:00p
September 29 MSIA Business and Annual Meeting – Proxy Statement Available
MSIA Issues Survey - LMAC – Dues
Hearing on Joint Petitions Rule Change – Sept 9
Draft Proposed Rule Change on Independent Contractors
ERD Announces Meeting on 6th Edition of AMA Guides Updates – September 22 at 1:00p

Montana workers’ compensation law (MCA 39-71-711) requires the use of the 6th Edition of the American Medical Association Guides to the Evaluation of Permanent Impairment (AMA Guides) for the impairment ratings used within our system. Montana is far from alone in relying on the AMA Guides for impairment ratings – some 40 states reference at least one edition of the AMA Guides as the basis for impairment ratings used in their systems. Last month, the AMA announced updates to the 6th Edition of the AMA Guides (AMA Guides Sixth 2021) effective July 1 to address mostly mental and behavioral conditions. This is the first update to the AMA Guides since their initial release in 2008.

Based on the July 9 AMA Press Release associated with the announcement (AMA announces update to guidance for permanent impairment ratings | American Medical Association (ama-assn.org)), “The new content was proposed by the American Psychiatric Association and the American Psychological Association to align AMA Guides Sixth 2021 with terminology and methodology changes to the “Diagnostic and Statistical Manual of Mental Disorders” (DSM)—the authoritative guide to the diagnosis of mental disorders for health care professionals around the world.” The updated content eliminates the use of the Global Assessment of Functioning (GAF) rating scale, “due to questionable psychometrics and lack of conceptual clarity.” Further, “New psychological tests and batteries have been published since the AMA Guides Sixth Edition was released in 2008. Updates available in AMA Guides Sixth 2021 keep pace with the changes that occurred over time to the standard practice of neuropsychological assessment and utilities newer batteries that have been developed and are more commonly employed in standard neuropsychological practice.” To generate more accurate impairment ratings, a combination for the Brief Psychiatric Rating Scale and Psychiatric Impairment Rating Scale will be used. Prior to the change, all three, including the GAF results were used. This update adopts the current Diagnostics and Statistics Manual of Mental Disorders version five (DSM-V) approach, which was updated and eliminated the use of the GAF in 2013.

The AMA Guides Sixth 2021, as does the DSM-V, eliminates the word “malingering” while discussing complexities in patient motivations and recovery.

What does it all mean? I cannot tell you that I know yet. The Montana law does not reference the AMA Guides Sixth 2021. It is possible to adopt the change, legislative action will be required.

The Montana Department of Labor, Employment Relations Division (ERD) is hosting a virtual meeting on September 22, with Dave Sosnow from the AMA to discuss the changes and will provide stakeholder Q & A time. The meeting will be from 1:00p – 2:30. Click here to join the meeting (on September 22). Or you can call in at 312-319-1510 (for audio only) Phone Conference ID: 348 514 318#. There may be changes, in part, depending on how many people are interested in attending. MSIA will keep you informed as information is available.

MSIA Business and Annual Meeting – September 29

Your 2021 -22 MSIA Business and Annual Meeting will be held (in person!!!) as part of the Governor’s Conference in West Yellowstone on September 29. The Business and Annual Meeting is sponsored by Browning, Kaleczyc, Berry and Hoven, with our breakfast is sponsored by Definiti Comp Solutions. The members only Business meeting and will start at 8:30a. At 9:00a, Bob Wilson, President and CEO of workerscompensation.com will join us for a discussion on what he sees as the issues in workers compensation around the country. Wilson is never short of stories, interesting ideas and different approaches and he captivates audiences whenever he speaks. Other Conference attendees will be invited to join us to hear from Wilson starting at 9:00.

The 8:30a members only Business meeting will go through our financials and budget, review our public policy positions, plans for the coming year and review any bylaw changes that might be necessary for the Association to consider. Your attendance is vital to our continuing to run the MSIA at such a high level. If you cannot make the meeting – please use the Proxy form at the bottom of this Update so we can count you as part of the quorum!

MSIA Issues Survey Coming Soon

MSIA will again be putting together a public policy survey asking members what issues are important to you and what positions we might want to take on them. The survey will accept members opinions only and will cover issues likely to be discussed during the interim and with regulatory agencies. We will ask you what’s keeping you up at night about our workers’ compensation system. Your leadership would also like to hear how we can better serve you. What additional things can your MSIA be doing to help you, help your business or improve the system? Law and rule changes can have a significant impact on our ability to do business, if not remain in business. We need your advice on what positions to take and what is important to Montana business.

Look for the MSIA Issues Survey coming to your email box soon and please let us know your thoughts on the issues. Individual member responses will be kept in the strictest of confidence and results will be aggregated so there will be no individual member or member type identification. We appreciate your membership, input and support.

Governor encouraged to re-appoint LMAC

MSIA has taken a leadership position in encouraging Governor Gianforte’s appointment of a successor Labor Management Advisory Council. The Governor responded to the MSIA call with a challenge to create an ad hoc LMAC, and to ask ERD to assist in stakeholder directed research and facilitate working groups to address the issues in the system. With your input through the survey, we will work with business and labor to do exactly that. The best way to improve any workers’ compensation system is to talk to each other and lean what we can from each other’s perspective. Sometimes, as was the case with HB 199 below, it works well – other times, not so much. But, if we keep talking with each other we create the opportunity. When we stop talking with each other we only create misunderstanding and the opportunities for mis-communication multiply.

Dues

Your membership dues keep the MSIA going and strong. If you have not yet paid your 2021 dues from July, please do so at your earliest convenience, make your check payable to MSIA at the address below, use the credit card feature on the MSIA website Montana Self Insurers' Association (mtselfinsurers.org) or contact us about setting up an EFT process. Almost 90% of membership has paid or has made the commitment to pay and we continue to attract new members! Get your dues payment in now!

Hearing on Joint Petitions Rule Change – Sept. 9 – 9:00a

Part of LMAC’s bill (HB 199) was a proposal to eliminate the need for medical information when there is agreement between the employer/insurer and injured worker that benefits need to continue after five years. The bill was signed into law and the joint petition section was effective upon signature, March 25. The Montana Department of Labor, Employment Relations Division (ERD) has been informally permitting joint petitions to go forward with an explanation of the medical benefits provided, as opposed to the detailed medical records. ERD has now proposed new rules to formally enact the provisions of the new law.

The public hearing will be held on September 9, 2021 starting at 9:00a. The hearing will be held electronically, by Zoom, https://mt-gov.zoom.us/j/89600508521, Meeting ID: 896 0050 8521, Passcode: 858389; or by telephone, +1 406 444 9999 or +1 646 558 8656, Meeting ID: 896 0050 8521, Passcode: 858389. MSIA will be submitting comments in support of the change prior to the Hearing. There was no opposition to the bill during the legislative committee process and it passed with minimal no votes.

Draft Proposed Rule Change on Independent Contractors

ERD has also released DRAFT language on potential rules regarding the change prohibiting the lack of an Independent Contractor Exemption Certificate (ICEC) to mean the individual or company has an employment relationship with the contractor. SB 367 was a bill MSIA monitored and was signed into law on April 30 to be effective October 1. The new draft language released for comment from interested parties deletes prior rule language which provides that absent an ICEC, there is an employment relationship. The language also provides language which addresses those instances where an ICEC application was pending, where a forged ICEC was provided, where the hiring authority has documentation demonstrating affirmative steps to verify the worker was an independent contractor and where the ICEC expired during the working relationship. A copy of the draft proposal is attached. MSIA does not have a known concern regarding the proposed rule changes.

SAVE THE DATE - - SEPTEMBER 29 at 8:30a Mountain time for the Members Only MSIA Business meeting sponsored by Browning Kaleczyc, Berry & Hoven with breakfast sponsored by Definiti Comp Solutions. The MSIA Annual Meeting for Members and Guests will immediately follow.

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PROXY STATEMENT

I, _______________________________(your name), representing ___________________________________ (MSIA Member) hereby provide my PROXY for quorum purposes only to the MSIA Board of Directors to conduct the Business Meeting scheduled for September 29, 2020.