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MONTANA SELF INSURERS' ASSOCIATION

September 2025 UPDATE

MSIA Business & Annual Meeting – Dr. Claire Muselman

Sponsored by Browning Kaleczyc, Berry & Hoven, Definiti Comp Solutions/Definiti Rx and Wrenwell Claims div of Midland Claims Service

It is rare that our Business & Annual Meeting and the Governor’s Conference are held early enough in the month for a review in our September UPDATE. We concluded our meetings last week in Billings where membership approved last year’s meeting minutes, reviewed our financial positions and approved the proposed budget for this year. Documents are available through the Members Only section of the website, Montana Self Insurers' Association. 

We also re-elected three Board members, Donna Haeder with NorthWestern Energy as Chair, Kevin Bartsch with MT Schools Group and Erica Grinde with Missoula County, both as at-large members to our Board. 

Those who able to join us were treated to an outstanding presentation on the human side of workers’ compensation and got a chance to see Dr. Claire Muselman in action. She was amazing – absolutely amazing - and kicked off the Governor’s Conference extraordinarily well! Muselman’s presentation is available to MSIA members, also through the Members Only section of the website, under Annual Meetings. Muselman got us engaged in audience participation and taught us all something about human behavior and how we can be better at what we do. The presentation deck is very good, but if you have the opportunity to see Dr. Muselman live, particularly in a small setting like our meeting – you have to. 

We will be posting the Business meeting minutes as soon as they are complete. Our members engaged in one of the best discussions regarding mental-mental injuries, specifically the issues surrounding the vetoed SB 394 – providing for PTSD coverage for Montana first responders – I have ever been part of. MSIA was the lead opponent to the bill during this last session, and the Governor attached our letter to his veto message. However, the issue is not going away and we will have to address what is ultimately a broader societal issue. With this discussion and ideas generated through our conversation, we may have a reasonable path forward. Do not be mistaken, the issue will come back and those Republican votes we lost, we will not get back. The proponents know this as well – we will be taking a much more proactive approach before the next session to address the bigger problem, likely with a bigger solution. A copy of our letter to the Governor, urging his veto to SB 394, is attached.

Governor’s Conference - MSIA Members Highlighted!

This year’s Governor’s Conference was another big hit in a string of hits the last few years. Jason Swant, the current Comp Laude Regulator of the Year, started us off with a brief history of the Montana workers’ compensation system. His presentation set the stage well for the rest of the conference in that it provided a solid base of knowledge of why the system is what it is and operates the way it does. Churchill is credited with saying, ‘Those who can not learn from the past are condemned to repeat it.’ Swant started us off by sharing our history, so we can learn from past efforts. 

James Benham followed and took us into the fascinating world of AI applications in insurance. We are already using AI much more than anyone really knows – except maybe those who are working with carriers, TPAs, other vendors and public policymakers to implement some of the tools it provides. for all of us. Benham is a leader in AI applications for insurance and offered us a glimpse into that fascinating, and sometimes scary world. 

Brian Holmes, with the Tennessee Division of Workers’ Compensation helped us understand that as a leader, it is our responsibility to make sure the people we work with – particularly injured workers – but everyone, knows that they have been heard. Our jobs then are to respond appropriately and within the bounds of the law, do what we can – even if sometimes that is out of the ordinary for the workers’ compensation system. Out of the ordinary, is not necessarily inappropriate. When we work with people – again, particularly injured workers - Did you really hear what they needed to say? 

Dr. Gary Franklin, Medical Director for WA Dept of Labor & Industry kicked us off the second day. Franklin was one of the first to identify the opioid crisis and lead the changes we have seen based on objective information and studies in WA, which then lead to other studies and changes in how we address opioids. One of his points is that the WC system contributes (still) to the greater societal issues regarding opioids and disability and we have an obligation to identify them and take action. Franklin used the WA Prescription Drug Monitoring Program (PDMP) – something available in every state which records every prescription filled in the state. By comparing PDMP opioid records to WC claims, he was able to isolate those already on opioids at the time of a FROI. He clearly tracked their recoveries with those not on opioids – either as a result of the WC claim, or otherwise, and they were significantly longer and more costly. 

However, big pharma is no slouch – and regulators seem too eager to appease their desire to make money. Example # 1 is the CDC relaxation of the daily MED dosage recommendations from 50 or 90 MED/day to urging physicians to be cautious and attentive to potential problems when prescribing opioids. While we do not have access to PDMP records in Montana, physicians do - - and we can ask them to check the records for WC injured workers to make sure we all know what we are dealing with. That doesn’t mean they will check the records, but in asking we can raise their awareness of potential issues. 

Dr. Jennifer Jutte, is the first psychologist within a workers’ compensation regulatory agency in the country. Her message was that here too – with PTSD we have a larger societal problem and we have an obligation to be part of the solution. WA is the first state to adopt utilization and treatment guidelines for mental mental injuries (PTSD). Even so, they are likely inadequate to thoroughly address the issues – but they are the first step.  

Amanda Frickle with AFL/CIO and Nick Mazanec with MSF reviewed the workers’ compensation legislation and legislative process this past session and shared their perspectives on the different bills. Having been there in the mix with them, they did a professional job of relating some of the ins and outs of the session and their respective positions on the issues. The MSIA initiative legislation this year was discussed and did not generate significant labor opposition. 

MSIA member Amy Rolando with MinWorx Health provided a perspective on a new surgical technique to address carpal tunnel and trigger finger issues. The procedure results in significantly less lost time (surgery on Friday, back to work on Monday). While the procedure is not fully accepted yet, there is a practitioner in Montana already performing it. As well, the procedure has the promise of addressing other issues as well, including shoulders. However, that may be a little bit away. 

I moderated a panel on the implementation of SB 109 – permitting Physical Therapists (PTs) to be treating physicians with Samantha Scmidt of Alpine PT, Tom Little of Move First Ergonomics and Lorena Pettet Payne with APTA – MT. In my research of this issue, prior to the last session, we identified that not much changed in how people utilized PTs nor in how PTs operated within the workers’ compensation system when other states enacted similar language. While MSIA was the lead opponent to the bill, in fairness, it can have a positive impact on how fast people – particularly with MSK injuries – are seen and get treatment. There is some buzz about this change, and that is exciting, but do not know how much real change we will see in the system. We will have to be diligent about PTs as treating physicians and the potential costs – but with the right treatment at the right time, this could be a positive change. At the same time, I brought up that very few people think about going to a PT when they are first injured, versus their physician, urgent care or the emergency department. A closer relationship between employers and local PTs might not be a bad result of this change. 

MSIA member Dr. Lisa Fitzpatrick with XcelABLE talked about her experiences in the health care system – let alone workers’ compensation. Dr. Fitzpatrick may be unique in that she is a medical professional and has a rare blood issue that went undiagnosed for waaaaaay too long. The impact on her emotional well-being, her family and ultimately her experience with incorrect medical providers is fascinating, and scary. Her personal story reminds us we are working with individuals with individual stories, lives, children, loved spouses and families. We cannot take them for granted, and as part of the system, we have an obligation to work FOR them, not just with them or worse. This was another moving and very personal presentation at this Conference. 

One of the golden nuggets Fitzpatrick left with us is - the most important questions we can ask those we work with, is “How are you doing?” and “Are you OK?” Dr. Fitzpatrick has written a book about her ordeal in our healthcare system and the necessary resilience and perseverance she had to muster to continue to live. 

The annual Governor’s Achievement Awards recognized Private and Public sector employers who demonstrate their high level of commitment to safety in the workplace as well as a Rising Star for an individual who, while still relatively new to our field, demonstrates outstanding qualities in helping those they work with. MSIA member Lauren Marsh, with Wrenwell Claims, the WC Division of Midland Claims Service was recognized as the Distinguished Workers’ Compensation Shooting Star. Marsh has been an insurance producer for over 10 years and was instrumental in creating the first individual state program within the WorkCompCollege.com program. Hers was the first program where the state recognized the training as meeting their requirements for Examiner licensure. As well, she is a new mother to Von, one of the cutest babies in the world. 

Dr. Tyrone Spears, Division Chief of Workers’ Compensation for the city of Los Angeles, an employer with over 45,000 employees that is self insured and self administered. Spears has created a program where the results are simply amazing. While in comparison to private employers, who do not have to deal with firefighter or police union contracts, their results are less than optimal, for a public entity of such size they are nothing less than amazing. His approach to use common sense, push physicians to identify what “they cannot do anything” might actually mean, and to demand that City Department heads appreciate that a workers’ compensation claim is not an excuse to eliminate someone who was a bad hire in the first place. Injured workers are already trained and they bring value to their position (presumably). Departments do not need to create a light duty job – they may, and only may, need to modify the job they currently have to meet the individual’s needs while they recover. More to the point – helping them by putting them back to work, helps them heal, eases the emotional issues and helps eliminate otherwise unnecessary claim costs. 

Bob Wilson, friend of MSIA and head of WorkCompCollege.com provided his perspective on the system and again, focused on the role of AI in our work, both now and in the future. Wilson (a guest speaker at the 2022 MSIA Annual Meeting) is always entertaining and thoughtful. Blending common sense with a high level of intelligence and humor, Wilson always makes us think about how our system operates, why it operates that way and how we can help it work better. Wilsons message is no matter what else we do, we need to always, always, always, focus on the recovery of the injured worker. For Wilson, it is not a workers’ compensation system - - it is a workers’ recovery system and the more we focus on bringing that person back to full health and their families, the better everyone is. 

Montana Workers’ Compensation Court Judge Lee Bruner provided his perspective on the new law which moved the Workers’ Compensation Court to the Judiciary from the Department of Labor. MSIA ultimately supported this proposal once there was a process to fund the Court through the existing the DOLI assessments versus leaving the funding out of the discussion. We need a functioning court and leaving it to the Judiciary budget process – particularly that late in the session - was not going to provide adequate funding. The ultimate advantage for employers – as well as injured workers - is the ability to use the electronic filing system already in place in the Judiciary that was not available and too costly to implement through DOLI. 

The MSIA Bus & Ann Meeting / the Governor’s Conference will be in West Yellowstone in early October, 2026.

MSIA Webinar – 9/23 @ 10a - Ethical Communication with Treating    Providers: Malcomson v. Liberty Northwest Ten Years Later

Sponsored by Clarus IME & Medivest

The next MSIA CE Ethics Webinar is set for September 23, at 10a MDT and will be a discussion of the Montana Supreme Court decision in Malcomson, providing a strong Constitutional protection of privacy - and at the same time preventing employers from having direct conversations with medical providers about the treatment in workers’ compensation cases. Advance registration is required by Sept 22 – use this link – 

Ethical Communication with Treating Providers: Malcomson v. Liberty Northwest Ten Years Later, 

presented by W. Dean Blackaby of Montana Work Comp Solutions.

As always, MSIA members (anyone receiving this email) have access to unlimited seats to the webinar. 

Ethics credit for the MT Claims Examiner license has been approved. MSIA has applied for Ethics CE credit for the MT Insurance Producer/Adjuster* license through the CSI process. 

This MSIA webinar will review the Malcomson decision – one of the landmark decisions by the Montana Supreme Court involving ex parte contact with a treating physician in a workers’ compensation claim. Malcomson is a question of third party communication with personal medical providers and the Montana Constitutional Right to Privacy. Blackaby will go through the decision, the Court’s rationale as well as the impacts to the current Montana system. Malcomson remains the operative law regarding communication with treating physicians today. Using real and hypothetical examples, Blackaby explores the basis and the impact of the limitations on Ethical Communication with Treating Providers in the Montana workers’ compensation system.

This MSIA Ethics CE Webinar is made possible by:

Jere Kolstad at jerekolstad@clarusime.com or 406-926-6950     

Carol LaFollette clafollette@medivest.com or 818-730-8539

Advance registration is required by September 22 - Ethical Communication with Treating Providers

Welcome New Member – JME Claims

JME Claims was started by Josh Ewing in 2014. After being an underwriter and loss control consultant, Josh brought his approach and background to workers’ compensation claims management. At JME Claims, Quality Over Quantity is more than an expression – it is the way we do business. Our motto reflects our commitment to providing exceptional claims services that go beyond simply processing paperwork. Our team provides quality services throughout the west – AZ, CO, ID, UT, AK, NV, NM, OR and of course – Montana. 

At JME Claims, we create partnerships with our clients, working together to proactively manage claims and minimize costs. Our goal is to provide comprehensive, personalized solutions that are tailored to each client’s unique needs. We believe that by focusing on quality, rather than quantity, we can make a real difference in the lives of our clients. We invite you to explore our website to learn more about our services, and we look forward to the opportunity to work with you. Thank you for considering us for your claims management needs. For more information, contact Josh Ewing at JoshEwing@JMEClaims.com or 208-476-9555.

MSF Approves $38.5 million Dividend

A Montana State Fund (MSF) Board Committee this morning approved a $38.5 million dividend to policyholders who had at least 6 months of continuous coverage during calendar year 2024. This represents 23% of premium collected, which is about where the MSF dividends have been since 2016. There is every reason to believe the full Board will accept the Committee recommendation and formally approve the dividend distribution. Since 2016, according to the MSF consulting actuary MSF has distributed over $300 million. (Ed. Note – my company is an MSF policyholder and will receive a dividend). 

The MSF dividend program is much more of a marketing tool than it had been in the past. The current program is a straight percentage of premium and is distributed to all policyholders who meet the minimum coverage requirement. In the past, MSF had used their dividend program to reward policyholders who had a better safety record during a specific policy period. While more detailed and cumbersome, the former dividend program provided a direct economic incentive for better results. While a vast majority of policyholders qualified under the former program, not all did. While this process is much simpler, and in fairness transparent, it is not in any way focused on safety. 

The MSF financial position is strong – while it has been strong in the past, it may be even stronger now. Losses are coming down, and the MSF leadership has taken the position that reserve take-downs – the release of reserves – is appropriate. Since this new leadership has been in place, that has been their approach. Also important, perhaps is the expectation by the MSF consulting actuary (Willis Towers Watson) that the MSF financial position is strong enough to warrant this take down approach – as well as an expectation that over the next 2-3 years, they expect that to be an industry-wide practice. 

If that is true, rather than seeing an easing of pricing in the marketplace, we may have to expect a continued very competitive market for workers’ compensation. As workers’ compensation has been the most profitable P & C line, that may not be an unreasonable expectation. The reverse seemed to hold true in California where the Insurance Commissioner in that state approved the first significant rate/loss cost increase we have seen in some time. 

MinWorx Health Presentation at the Governor’s Conference

MSIA member Amy Rolando with MinWorx Health presented at the Governor’s Conference last week and provided a perspective on a minimally invasive surgical technique to address carpal tunnel and trigger finger issues. The procedure can result in significantly less lost time for injured workers (surgery on Friday, back to work on Monday). The technique is supported by extensive clinical data, with more than 43,000 procedures performed nationally, demonstrating both safety and efficacy. A practitioner in Montana is already performing this procedure, giving injured workers access to a less invasive option that helps reduce lost workdays and claim costs. The approach also holds promise for application in other musculoskeletal areas, such as shoulders, as training and adoption expand.

In my reporting on the Governor’s Conference earlier this week, I did not accurately report on the MinWorx Health presentations. My apologies for the errors which are mine alone. I also appreciate the correction.