Montana Workers' Compensation Information



Please Note: for Claims assistance or questions about coverage and exemptions You will need to call one of the numbers listed below.

Also be aware that the Workers' Compensation Assistance Offices in different states may go by different names such as "Industrial Accidents".
These are the only numbers that we are aware of and have available for Montana Workers' Compensation.

Montana Workers' Compensation Telephone Directory


Workers' Compensation Claims Assistance: 406-444-6543

Claims Assistance Unit: 406-444-6541

Vocational Rehabilitation - Toll Free: 877-296-1197

Subsequent Injury Fund: 406-444-6604

Safety & Health Bureau - Safety Complaint: 406-247-7494

Mediation Unit: 406-444-6534

Silicosis Unit: 406-444-6534

Uninsured Employers Fund: 406-444-6543

Fraud Hotline: 888-682-7463

WC Court: 406-444-7794

Independent Medical Review (IMR) Regulation Officer: 406-444-1701

Drug Free Workplace Info: 800-223-4044

Managed Care Organizations Operations Bureau: 406-444-0776

Petitions to Reopen Closed Medical Benefits: 406-444-1752

Workers' Compensation Section Manager: 406-444-6543

Claims Compliance Specialist: 406-444-1523

Claims Compliance Specialist: 406-444-6537

Claims Compliance Specialist: 406-444-6535

Claims Examiner Certification: 406-444-7751

Data Management Section Manager: 406-444-1600

WC Judge Honorable David M. Sandler: 406-444-7794

WC Deputy Administrator : 406-444-6541

Questions Re: MCO Certifications: 406-444-0776

Insurance Compliance - Plan 1 Self-Insurance: 406-444-1555

Professional Employer Licensure: 406-444-0776

Insurance Compliance - Plan 2 Private Insurance: 406-444-6543

Electronic Data Interchange: 406-444-3089

Electronic Data Interchange: 406-444-1600

WC Research: 406-444-1675

WC Research: 406-444-6527

WC Third Party (TPA) Research: 406-444-3089

Dispute Resolution Section - Legal Administrative Assistant: 406-444-6534

Chief Administrative Law Judge Judy Bovington: 406-444-4662

Insurance Office Commissioner Troy Downing: 406-444-2040

Insurance Office - Toll Free: 800-332-6148

Insurance (State) Fraud: 406-444-2040

Safety & Health Bureau - Safety Consultation: 406-494-0324

Vocational Rehabilitation (State) : 406-265-6933

Workforce Services Division - Incumbent Worker Training: 406-444-3351

OSHA - Billings Area Ofc. - Federal OSHA covers private Employers/Employees in MT: 406-247-7494

Employment Relations Division of Department of Labor (mailing): 406-444-6543

Employment Relations Division of Department of Labor : 406-444-6543

Forms & Publications


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(froi) First Report of Injury and Occupational Disease (FROI) 5/16
(sroi) Subsequent Report of Injury (SROI) 2/10
(mediation) Petition for Workers' Compensation Mediation Conference 2/20
(wcc003) Petition Instructions Settlement of Permanent Partial Disability 10/11
(wcc008) Petition Instructions Settlement of Medical Benefits on an Accepted Claim 10/11
(epc) Electronic Prior Claims History Access Agreement N/D
(attorneyretainer) Attorney Retainer Agreement 5/95
(wcc031) Request for Jurisdiction Assigned Number (JAN) 12/21
(wcc046) EPC Carrier Assignments 9/08
(setdispute) Petition for Settlement / Disputed Initial Compensability 7/11
(medprovider) Medical Providers Billing Request Form N/D
(wcc029) Medical Status Form 12/13
(mr034) (IMR) Request Form - Independent Medical Review Request Form N/D
(setreserved) Petition for Settlement - Injury/OD, Medical Benefits Reserved 10/11
(setptd) Petition For Settlement - PTD Injury/OD Medical Benefits Reserved 10/11
(wcc011) Summary Instructions Summary of Settlement of Medical Benefits 4/19
(set-med) Summary of Settlement of Medical Benefits 4/19
(recap) Settlement/Advance Recap Sheet N/D
(advance) Petition for Advance & C​hecklist for Advance Requirements 5/09
(noticeaccess) Notice Entry Access Agreement 9/21
(beneficiaries) Beneficiaries' Claim for Compensation 9/08
(domicilliaryreferral) Physician's Referral to Domiciliary Care 3/01
(Petition-od) Petition For Hearing (Occupational Disease) 3/13
(Petition-inj) Petition For Hearing (Injury) 3/13
(petreopen) Petition To Reopen Closed Medical Benefits 9/17
(jointagree) Joint Agreement and Petition To Reopen Closed Medical Benefits 8/16
(wcc007) Petition for Settlement Injury/OD Medical Closed by Settlement on an Accepted Claim 10/11
(PretrialOrder) Pretrial Order N/D
(Appeal) Notice of Appeal From The Department Of Labor (ARM 24.5.350) N/D
(appeal 610) Notice of Appeal From The Department of Labor(ARM 24.5.314 - � 39-71-610, MCA) N/D
(subpoena-deposition) Subpoena-Deposition N/D
(subduces) Subpoena Duces Tecum N/D
(subpoena) Trial Subpoena N/D
(Petition ICCU Revocation) Petition Disputing ICCU Revocation Of Independent Contractor Exemption N/D
(petdetermine) Petition Disputing Independent Contractor Determination N/D
(Petition ICCU Denial) Petition Disputing Denial Of Independent Contractor Exemption Certificate N/D
(setinjuryod) Petition for Settlement - Injury/OD, Disputed Medical Closed 10/11
(sifapp) Subsequent Injury Fund Application for Certification 1/22
(SIF-records-release) Authorization for The Release Of Subsequent Injury Fund Certification Status 12/13
(annualreconciliationinst) Annual Reconciliation Report 2/06
(annrecon) Annual Workers' Compensation Expenditure Reconciliation Report Form 2/06
(wcr023) General QER Instructions N/D
(qer) Quarterly Expenditure Report Form 10/19
(wcr032 ) Certificat of Deposit Agreement N/D
(wcr049) Corporate Resolution (Plan 1) 12/00
(wcr047) Book Entry N/D
(qerinst) Expenditure Report Instructions N/D
(wcr041) Group Assumption 12/00
(wcr040) Group Resolution 12/00
(wcr042) Irrevocable Assignment (Plan 1) 12/00
(wcr050) Letter Credit 12/00
(wcr051) Memorandum of Understanding 12/00
(wcr045) Surety Bond 12/00
(wcr046) Trust Agreement 12/00
(wcr044) Parental Agreement of Assumption and Guarantee of Workers' Compensation and Occupational Disease Liabilities 12/00
(wcr039.xls) Workers' Compensation Self-Insurance Financial / Loss Update 1/18
(wcr009) Self-Insurance Application 3/22
(wcr038) Montana Department of Labor & Industry Self-Insurance Workers’ Compensation Application- General Instructions 3/22
(wcr026) Sample Memorandum of Agreement N/D
(wcr003) Application for Independent Contractor Exemption CertificateVALID FOR TWO (2) YEARS 4/18
(surcharge-qtly) Workers Compensation Surcharge Quarterly Remittal Form FY 2022 2/22
(crapplication) Construction Contractor's Registration Application 3/18
(waiver-corp-officers-mbr) Independent Contractor Exemption Certificate Affidavit for Sole Proprietor, Partnership or LLP, and Member-Managed Limited Liability Companies 10/11
(waiver-corp-officers) Independent Contractor Exemption Certificate Affidavit for Corporate Officers and Managers of Manager Managed Limited Liability Companies 10/11
(corpofficerstatus) Requirements For Corporate Officers Of A Corporation And Managers Of A Manager-Managed Limited Liability Company 7/07
(adjuster) Third Party Administrator/Adjuster Change Form 1/18
(tpaprofile) Third Party Administrator Profile 1/18
(tradingpartner) (EDI) Trading Partner Agreement N/D
(tpaattachment) (EDI) Trading Partner Profile Attachment -List of Insurers and/or Employers 5/14
(tpprofile) Trading Partner Profile N/D
(erdtpprofile) DLI/ERD Trading Partner Profile N/D
(benefitssummary) Brochure - Workers Compensation Benefits Summary 2018

Chapter 5 Rules of the Workers' Compensation Court (24.5.101 - 24.5.360)

Chapter 28 Workers' Compensation Mediation (24.28.101 - 24.28.112)

Chapter 29 Workers' Compensation and Occupational Disease (24.29.101 - 24.29.4339)

Chapter 33 Construction Contractors and Home Inspectors (24.33.101 - 24.33.151)

Chapter 35 Independent Contractors (24.35.101 - 24.35.303)

Title 33. - Chapter 16. Rates -- Rating and Advisory Organizations (33-16-1001 - 33-16-1036)

Title 33. - Chapter 22. Disability Insurance (33-22-111)

Title 39. - Chapter 71. Workers' Compensation (39-71-101 - 39-71-4004)

Title 39. - Chapter 72. Occupational Disease Act (39-72-101 - 39-72-714 Repealed)

Title 39. - Chapter 73. Silicosis Benefits (39-73-101 - 39-73-111)

The Employment Relationship

Interstate Mutual Aid Compact

Misc. Related Statutes