Senate Bill No. 62
Introduced By sprague
By Request of the Department of Labor and Industry
A Bill for an Act entitled: An Act clarifying the process for paying rehabilitation benefits to disabled Workers' Compensation claimants injured on or before June 30, 1997; limiting funding for certain rehabilitation benefit payments; providing for direct payment of rehabilitation benefits by insurers to disabled workers injured on or after July 1, 1997; amending sections 39-71-1003, 39-71-1004, 39-71-1006, 39-71-1011, 39-71-1014, 39-71-1031, and 39-71-1032, MCA; repealing section 39-71-1013, MCA; and providing an effective date.
Be it enacted by the Legislature of the State of Montana:
Section 1. Section 39-71-1003, MCA, is amended to read:
Eligibility Payment for vocational rehabilitation expenses for injuries occurring on or before June 30,
1997. (1) Upon certification by the department of public health and human services For injuries occurring on or before June
30, 1997, a disabled worker may be paid vocational rehabilitation expenses from funds provided in 39-71-1004, in addition
to benefits payable under the Workers' Compensation Act. (2) The appeal process provided for in 53-7-106 is the exclusive remedy for an injured worker aggrieved in the receipt of
vocational rehabilitation services provided by the department of public health and human services."
Section 2. Section 39-71-1004, MCA, is amended to read:
"39-71-1004. Industrial accident rehabilitation account. (1) The payments provided in 39-71-1003 must be made from
the industrial accident rehabilitation account in the state special revenue fund. Payments to the account must be made
before July 1 of each year upon an assessment by the department as follows:
(a) by each employer operating under the provisions of plan No. 1 of the Workers' Compensation Act, an amount to be assessed by the department, not exceeding 1% of the compensation paid to the employer's injured employees in Montana for the preceding fiscal year;
(b) by each insurer insuring employers under the provisions of plan No. 2 of the Workers' Compensation Act, an amount to be assessed by the department, not exceeding 1% of the compensation paid to injured employees of its insured in Montana during the preceding fiscal year;
(c) by the
department state fund, an amount to be determined assessed by the department, not exceeding 1% of the
compensation paid by the state fund to injured employees in Montana from the industrial insurance expendable trust fund
and the occupational disease expendable trust fund for during the preceding fiscal year.
(2) Separate accounts of the amounts that were collected and disbursements that were made from the industrial accident rehabilitation account in the state special revenue fund must be kept for each of the plans. If in any fiscal year the amount that was collected from the employers under any plan exceeds the amount of payments for employees of the employers under the plan, the assessment against the employers under the plan for the following year must be reduced.
(3) The payments provided for in this section must be made to the department, which shall credit the sums paid to the
industrial accident rehabilitation account in the custody of the state treasurer. Disbursements from the account must be
made after approval by the department
of public health and human services and upon audit and approval by the department
(4) The funds allocated or contributed as provided in this section may not be used for payment of administrative expenses
of the department
or department of public health and human services.
(5) The methods and processes used to disburse rehabilitation expense payments to eligible disabled workers are procedural and do not affect the substantive rights of those disabled workers."
Section 3. Section 39-71-1006, MCA, is amended to read:
"39-71-1006. Rehabilitation benefits. (1) A disabled worker as defined in 39-71-1011 is eligible for rehabilitation benefits if:
(a) the worker has an actual wage loss as a result of the injury;
(b) a rehabilitation provider, as designated by the insurer, certifies that the
injured worker has reasonable vocational goals
and reemployment opportunity and will have a reasonable reduction in the worker's actual wage loss with rehabilitation;
(c) a rehabilitation plan is agreed upon by the
injured worker and the insurer is filed with the department and a written
copy of the plan is provided to the worker. The plan must take into consideration the worker's age, education, training,
work history, residual physical capacities, and vocational interests. The plan must specify a beginning date and a
completion date. If the plan calls for the expenditure of funds under 39-71-1004, the department shall authorize the
department of public health and human services to use the funds The plan must specify the cost of tuition, fees, books, and
other reasonable and necessary retraining expenses required to complete the plan.
After filing the rehabilitation plan with the department, the A disabled worker is entitled to receive biweekly
compensation benefits at the injured worker's temporary total disability rate. The benefits must be paid for the period
specified in the rehabilitation plan, not to exceed 104 weeks. The rehabilitation plan must be completed within 26 weeks of
the completion date specified in the plan. Rehabilitation benefits must be paid biweekly while the worker is satisfactorily
progressing in the agreed-upon rehabilitation plan. Benefits under this section are not subject to the lump-sum provisions of
(3) In addition to rehabilitation benefits payable under subsection (2), a disabled worker who was injured on or after July 1, 1997, is entitled to receive payment for tuition, fees, books, and other reasonable and necessary retraining expenses, excluding travel and living expenses paid pursuant to the provisions of 39-71-1025, as set forth in department rules and as specified in the rehabilitation plan. Expenses must be paid directly by the insurer.
(3)(4) A worker may not receive temporary total benefits and the benefits under subsection (2) during the same period of
time. (4)(5) A rehabilitation provider authorized by the insurer shall continue to assist the injured worker until the rehabilitation
plan is completed. (5)(6) To be eligible for benefits under this section, a worker is required to begin the rehabilitation plan within 78 weeks of
reaching maximum medical healing. (6)(7) A worker may not receive both wages and rehabilitation benefits without the written consent of the insurer. A
worker who receives both wages and rehabilitation benefits without written consent of the insurer is guilty of theft and may
be prosecuted under 45-6-301."
Section 4. Section 39-71-1011, MCA, is amended to read:
"39-71-1011. Definitions. As used in this chapter, the following definitions apply:
(1) "Board of rehabilitation certification" means the nonprofit, independent, fee-structured organization that is a member of the national commission for health certifying agencies and that is established to certify rehabilitation practitioners.
(2) "Disabled worker" means a worker who has a permanent impairment, established by objective medical findings, resulting from a work-related injury that precludes the worker from returning to the job the worker held at the time of the injury or to a job with similar physical requirements and who has an actual wage loss as a result of the injury.
(3) "Rehabilitation benefits" means benefits provided in
39-71-1003, 39-71-1006 , and 39-71-1025.
(4) "Rehabilitation plan" means
an a written individualized plan that assists a disabled worker in acquiring skills or
aptitudes to return to work through job placement, on-the-job training, education, training, or specialized job modification
and that reasonably reduces the worker's actual wage loss.
(5) "Rehabilitation provider" means a rehabilitation counselor certified by the board for rehabilitation certification and
designated by the insurer
to the department or a department of public health and human services counselor when a worker
has been certified by the department of public health and human services under 39-71-1003.
(6) "Rehabilitation services" means a program of evaluation, planning, and implementation of a rehabilitation plan to assist a disabled worker to return to work."
Section 5. Section 39-71-1014, MCA, is amended to read:
"39-71-1014. Rehabilitation services -- required and provided by insurers
and department of public health and
human services. (1) Rehabilitation services are required for disabled workers and may be initiated by:
(a) an insurer by designating a rehabilitation provider
and notifying the department; (b) the department by requiring the insurer to designate a rehabilitation provider; or (c)(b) a disabled worker through a request to the department. The department shall then require the insurer to designate a
(2) Rehabilitation services provided under this part must be delivered
: (a) through a rehabilitation counselor certified by the board of rehabilitation certification ; (b) by a vocational rehabilitation counselor employed by the department of public health and human services; or (c) by both. (3) A disabled worker served by the department of public health and human services may receive only those vocational
rehabilitation services as provided in Title 53, chapter 7, parts 1 and 2."
Section 6. Section 39-71-1031, MCA, is amended to read:
"39-71-1031. Exchange of information. The
department of public health and human services, the insurer's designated
rehabilitation provider , and the department shall provide to one another case information as necessary to carry out the
purposes of this part."
Section 7. Section 39-71-1032, MCA, is amended to read:
"39-71-1032. Termination of benefits for noncooperation with rehabilitation provider -- department hearing and
appeal. (1) If an insurer believes that a worker is refusing unreasonably to cooperate with the rehabilitation provider, the
insurer, with 14 days' written notice to the worker and the department
on a form approved by the department, may
terminate any benefits, except medical benefits and the impairment award, that the worker is receiving until the worker
(2) The worker may contest the insurer's termination of benefits by filing a written exception to the department within 20 working days after the date of the 14-day notice. The worker or insurer may request a hearing before the department. The department shall hold a hearing within 30 days of receipt of the request. The department shall issue an order within 15 days of the hearing.
(3) If the worker prevails at a hearing before the department, it may award attorney fees and costs to the worker under 39-71-612.
(4) Within 30 days after the department mails its order to the party's last-known address, a party may appeal to the workers' compensation court."
Section 8. Repealer. Section 39-71-1013, MCA, is repealed.
Section 9. Saving clause. [This act] does not affect rights and duties that matured, penalties that were incurred, or proceedings that were begun before [the effective date of this act].
Section 10. Effective date. [This act] is effective July 1, 1997.