Provide for workers' compensation coverage of PTSD for first responders

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AN ACT PROVIDING FOR WORKERS' COMPENSATION COVERAGE OF POSTTRAUMATIC STRESS
DISORDER FOR FIRST RESPONDERS; PROVIDING A DEFINITION; AMENDING SECTIONS 39-71-105, 39-
71-116, AND 39-71-119, MCA; AND PROVIDING AN EFFECTIVE DATE AND AN APPLICABILITY DATE.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA:
Section 1. Coverage for posttraumatic stress disorder for first responders -- definitions. (1) A
first responder may have a compensable claim under Montana's workers' compensation and occupational
disease laws relating to posttraumatic stress disorder as provided in this section.
(2) A first responder must be diagnosed with posttraumatic stress disorder, according to the most
recent edition that is in publication as of July 1, 2025, of the Diagnostic and Statistical Manual of Mental
Disorders published by the American psychiatric association. The diagnosis for posttraumatic stress disorder
must find that the injury or occupational disease arises out of the course and scope of employment of the first
responder.
(3) A claim for posttraumatic stress disorder is subject to the provisions of Title 39, chapter 71,
unless the context requires otherwise.
(4) For the purposes of this section, the term "first responder" means:
(a) a firefighter;
(b) a law enforcement officer; or
(c) an emergency care provider as defined in 50-6-202(2).
Section 2. Section 39-71-105, MCA, is amended to read:
"39-71-105. (Temporary) Declaration of public policy. For the purposes of interpreting and
applying this chapter, the following is the public policy of this state:
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(1) An objective of the Montana workers' compensation system is to provide, without regard to
fault, wage-loss and medical benefits to a worker suffering from a work-related injury or disease. Wage-loss
benefits are not intended to make an injured worker whole but are intended to provide assistance to a worker at
a reasonable cost to the employer. Within that limitation, the wage-loss benefit should bear a reasonable
relationship to actual wages lost as a result of a work-related injury or disease.
(2) It is the intent of the legislature to assert that a conclusive presumption exists that recognizes
that a holder of a current, valid independent contractor exemption certificate issued by the department is an
independent contractor if the person is working under the independent contractor exemption certificate. The
holder of an independent contractor exemption certificate waives the rights, benefits, and obligations of this
chapter unless the person has elected to be bound personally and individually by the provisions of
compensation plan No. 1, 2, or 3.
(3) A worker's removal from the workforce because of a work-related injury or disease has a
negative impact on the worker, the worker's family, the employer, and the general public. Therefore, an
objective of the workers' compensation system is to return a worker to work as soon as possible after the
worker has suffered a work-related injury or disease.
(4) Montana's workers' compensation and occupational disease insurance systems are intended to
be primarily self-administering. Claimants should be able to speedily obtain benefits, and employers should be
able to provide coverage at reasonably constant rates. To meet these objectives, the system must be designed
to minimize reliance upon lawyers and the courts to obtain benefits and interpret liabilities.
(5) This chapter must be construed according to its terms and not liberally in favor of any party.
(6) It is the intent of the legislature that:
(a) except as provided in [section 1], a stress claim, often referred to as a "mental-mental claim" or
a "mental-physical claim", is not compensable under Montana's workers' compensation and occupational
disease laws. The legislature recognizes that these claims are difficult to objectively verify and that the claims
have a potential to place an economic burden on the workers' compensation and occupational disease system.
The legislature also recognizes that there are other states that do not provide compensation for various
categories of stress claims and that stress claims have presented economic problems for certain other
jurisdictions. In addition, not all injuries are compensable under the present system, and it is within the
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legislature's authority to define the limits of the workers' compensation and occupational disease system.
However, it is also within the legislature's authority to recognize the public service provided by firefighters and
to join with other states that have extended a presumptive occupational disease recognition to firefighters.
(b) for occupational disease or presumptive occupational disease claims, because of the nature of
exposure, workers should not be required to provide notice to employers of the disease as required of injuries
and that the requirements for filing of claims reflect consideration of when the worker knew or should have
known that the worker's condition resulted from an occupational disease or a presumptive occupational
disease. The legislature recognizes that occupational diseases in the workplace are caused by events
occurring on more than a single day or work shift and that the legislature has the authority to define an
occupational disease or a presumptive occupational disease and establish the causal connection to the
workplace. (Void on occurrence of contingency--sec. 7, Ch. 158, L. 2019.)
39-71-105. (Effective on occurrence of contingency) Declaration of public policy. For the
purposes of interpreting and applying this chapter, the following is the public policy of this state:
(1) An objective of the Montana workers' compensation system is to provide, without regard to
fault, wage-loss and medical benefits to a worker suffering from a work-related injury or disease. Wage-loss
benefits are not intended to make an injured worker whole but are intended to provide assistance to a worker at
a reasonable cost to the employer. Within that limitation, the wage-loss benefit should bear a reasonable
relationship to actual wages lost as a result of a work-related injury or disease.
(2) It is the intent of the legislature to assert that a conclusive presumption exists that recognizes
that a holder of a current, valid independent contractor exemption certificate issued by the department is an
independent contractor if the person is working under the independent contractor exemption certificate. The
holder of an independent contractor exemption certificate waives the rights, benefits, and obligations of this
chapter unless the person has elected to be bound personally and individually by the provisions of
compensation plan No. 1, 2, or 3.
(3) A worker's removal from the workforce because of a work-related injury or disease has a
negative impact on the worker, the worker's family, the employer, and the general public. Therefore, an
objective of the workers' compensation system is to return a worker to work as soon as possible after the
worker has suffered a work-related injury or disease.
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(4) Montana's workers' compensation and occupational disease insurance systems are intended to
be primarily self-administering. Claimants should be able to speedily obtain benefits, and employers should be
able to provide coverage at reasonably constant rates. To meet these objectives, the system must be designed
to minimize reliance upon lawyers and the courts to obtain benefits and interpret liabilities.
(5) This chapter must be construed according to its terms and not liberally in favor of any party.
(6) It is the intent of the legislature that:
(a) except as provided in [section 1], stress claims, often referred to as "mental-mental claims" and
"mental-physical claims", are not compensable under Montana's workers' compensation and occupational
disease laws. The legislature recognizes that these claims are difficult to objectively verify and that the claims
have a potential to place an economic burden on the workers' compensation and occupational disease system.
The legislature also recognizes that there are other states that do not provide compensation for various
categories of stress claims and that stress claims have presented economic problems for certain other
jurisdictions. In addition, not all injuries are compensable under the present system, and it is within the
legislature's authority to define the limits of the workers' compensation and occupational disease system.
(b) for occupational disease claims, because of the nature of exposure, workers should not be
required to provide notice to employers of the disease as required of injuries and that the requirements for filing
of claims reflect consideration of when the worker knew or should have known that the worker's condition
resulted from an occupational disease. The legislature recognizes that occupational diseases in the workplace
are caused by events occurring on more than a single day or work shift and that it is within the legislature's
authority to define an occupational disease and establish the causal connection to the workplace."
Section 3. Section 39-71-116, MCA, is amended to read:
"39-71-116. Definitions. Unless the context otherwise requires, in this chapter, the following
definitions apply:
(1) "Actual wage loss" means that the wages that a worker earns or is qualified to earn after the
worker reaches maximum healing are less than the actual wages the worker received at the time of the injury.
(2) "Administer and pay" includes all actions by the state fund under the Workers' Compensation
Act necessary to:
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(a) investigation, review, and settlement of claims;
(b) payment of benefits;
(c) setting of reserves;
(d) furnishing of services and facilities; and
(e) use of actuarial, audit, accounting, vocational rehabilitation, and legal services.
(3) "Aid or sustenance" means a public or private subsidy made to provide a means of support,
maintenance, or subsistence for the recipient.
(4) "Beneficiary" means:
(a) a surviving spouse living with or legally entitled to be supported by the deceased at the time of
injury;
(b) an unmarried child under 18 years of age;
(c) an unmarried child under 22 years of age who is a full-time student in an accredited school or is
enrolled in an accredited apprenticeship program;
(d) an invalid child over 18 years of age who is dependent, as defined in 26 U.S.C. 152, upon the
decedent for support at the time of injury;
(e) a parent who is dependent, as defined in 26 U.S.C. 152, upon the decedent for support at the
time of the injury if a beneficiary, as defined in subsections (4)(a) through (4)(d), does not exist; and
(f) a brother or sister under 18 years of age if dependent, as defined in 26 U.S.C. 152, upon the
decedent for support at the time of the injury but only until the age of 18 years and only when a beneficiary, as
defined in subsections (4)(a) through (4)(e), does not exist.
(5) "Business partner" means the community, governmental entity, or business organization that
provides the premises for work-based learning activities for students.
(6) "Casual employment" means employment not in the usual course of the trade, business,
profession, or occupation of the employer.
(7) "Child" includes a posthumous child, a dependent stepchild, and a child legally adopted prior to
the injury.
(8) (a) "Claims examiner" means an individual who, as a paid employee of the department, of a
plan No. 1, 2, or 3 insurer, or of an administrator licensed under Title 33, chapter 17, examines claims under
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chapter 71 to:
(i) determine liability;
(ii) apply the requirements of this title;
(iii) settle workers' compensation or occupational disease claims; or
(iv) determine survivor benefits.
(b) The term does not include an adjuster as defined in 33-17-102.
(9) (a) "Construction industry" means the major group of general contractors and operative
builders, heavy construction (other than building construction) contractors, and special trade contractors listed
in major group 23 in the North American Industry Classification System Manual.
(b) The term does not include office workers, design professionals, salespersons, estimators, or
any other related employment that is not directly involved on a regular basis in the provision of physical labor at
a construction or renovation site.
(10) "Days" means calendar days, unless otherwise specified.
(11) "Department" means the department of labor and industry.
(12) "Direct result" means that a diagnosed condition was caused or aggravated by an injury or
occupational disease.
(13) "Fiscal year" means the period of time between July 1 and the succeeding June 30.
(14) "Health care provider" means a person who is licensed, certified, or otherwise authorized by
the laws of this state to provide health care in the ordinary course of business or practice of a profession.
(15) (a) "Household or domestic employment" means employment of persons other than members
of the household for the purpose of tending to the aid and comfort of the employer or members of the
employer's family, including but not limited to housecleaning and yard work.
(b) The term does not include employment beyond the scope of normal household or domestic
duties, such as home health care or domiciliary care.
(16) (a) "Indemnity benefits" means any payment made directly to the worker or the worker's
beneficiaries, other than a medical benefit. The term includes payments made pursuant to a reservation of
rights.
(b) The term does not include stay-at-work/return-to-work assistance, auxiliary benefits, or
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expense reimbursements for items such as meals, travel, or lodging.
(17) "Insurer" means an employer bound by compensation plan No. 1, an insurance company
transacting business under compensation plan No. 2, or the state fund under compensation plan No. 3.
(18) "Invalid" means one who is physically or mentally incapacitated.
(19) "Limited liability company" has the meaning provided in 35-8-102.
(20) "Maintenance care" means treatment designed to provide the optimum state of health while
minimizing recurrence of the clinical status.
(21) "Medical stability", "maximum medical improvement", "maximum healing", or "maximum
medical healing" means a point in the healing process when further material functional improvement would not
be reasonably expected from primary medical services.
(22) "Objective medical findings" means medical evidence, including range of motion, atrophy,
muscle strength, muscle spasm, or other diagnostic evidence, substantiated by clinical findings.
(23) (a) "Occupational disease" means harm, damage, or death arising out of or contracted in the
course and scope of employment caused by events occurring on more than a single day or work shift.
(b) The Except as provided in [section 1], the term does not include a physical or mental condition
arising from emotional or mental stress or from a nonphysical stimulus or activity.
(24) "Order" means any decision, rule, direction, requirement, or standard of the department or any
other determination arrived at by the department.
(25) "Palliative care" means treatment designed to reduce or ease symptoms without curing the
underlying cause of the symptoms.
(26) "Payroll", "annual payroll", or "annual payroll for the preceding year" means the average annual
payroll of the employer for the preceding calendar year or, if the employer has not operated a sufficient or any
length of time during the calendar year, 12 times the average monthly payroll for the current year. However, an
estimate may be made by the department for any employer starting in business if average payrolls are not
available. This estimate must be adjusted by additional payment by the employer or refund by the department,
as the case may actually be, on December 31 of the current year. An employer's payroll must be computed by
calculating all wages, as defined in 39-71-123, that are paid by an employer.
(27) "Permanent partial disability" means a physical condition in which a worker, after reaching
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maximum medical healing:
(a) has a permanent impairment, as determined by the sixth edition of the American medical
association's Guides to the Evaluation of Permanent Impairment, that is established by objective medical
findings for the ratable condition. The ratable condition must be a direct result of the compensable injury or
occupational disease and may not be based exclusively on complaints of pain.
(b) is able to return to work in some capacity but the permanent impairment impairs the worker's
ability to work; and
(c) has an actual wage loss as a result of the injury.
(28) "Permanent total disability" means a physical condition resulting from injury as defined in this
chapter, after a worker reaches maximum medical healing, in which a worker does not have a reasonable
prospect of physically performing regular employment. Lack of immediate job openings is not a factor to be
considered in determining if a worker is permanently totally disabled.
(29) "Primary medical services" means treatment prescribed by the treating physician, for conditions
resulting from the injury or occupational disease, necessary for achieving medical stability.
(30) "Prosthetic device" or "prosthesis" means an artificial substitute for a missing body part.
(31) "Public corporation" means the state or a county, municipal corporation, school district, city, city
under a commission form of government or special charter, town, or village.
(32) "Reasonably safe place to work" means that the place of employment has been made as free
from danger to the life or safety of the employee as the nature of the employment will reasonably permit.
(33) "Reasonably safe tools or appliances" are tools and appliances that are adapted to and that are
reasonably safe for use for the particular purpose for which they are furnished.
(34) "Regular employment" means work on a recurring basis performed for remuneration in a trade,
business, profession, or other occupation in this state.
(35) (a) "Secondary medical services" means those medical services or appliances that are
considered not medically necessary for medical stability. The services and appliances include but are not
limited to spas or hot tubs, work hardening, physical restoration programs and other restoration programs
designed to address disability and not impairment, or equipment offered by individuals, clinics, groups,
hospitals, or rehabilitation facilities.
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(b) (i) As used in this subsection (35), "disability" means a condition in which a worker's ability to
engage in gainful employment is diminished as a result of physical restrictions resulting from an injury. The
restrictions may be combined with factors, such as the worker's age, education, work history, and other factors
that affect the worker's ability to engage in gainful employment.
(ii) Disability does not mean a purely medical condition.
(36) "Sole proprietor" means the person who has the exclusive legal right or title to or ownership of
a business enterprise.
(37) "State's average weekly wage" means the mean weekly earnings of all employees under
covered employment, as defined and established annually by the department before July 1 and rounded to the
nearest whole dollar number.
(38) "Temporary partial disability" means, except as provided in [section 1], a physical condition
resulting from an injury, as defined in 39-71-119, in which a worker, prior to maximum healing:
(a) is temporarily unable to return to the position held at the time of injury because of a medically
determined physical restriction;
(b) returns to work in a modified or alternative employment; and
(c) suffers a partial wage loss.
(39) "Temporary service contractor" means a person, firm, association, partnership, limited liability
company, or corporation conducting business that hires its own employees and assigns them to clients to fill a
work assignment with a finite ending date to support or supplement the client's workforce in situations resulting
from employee absences, skill shortages, seasonal workloads, and special assignments and projects.
(40) "Temporary total disability" means, except as provided in [section 1], a physical condition
resulting from an injury, as defined in this chapter, that results in total loss of wages and exists until the injured
worker reaches maximum medical healing.
(41) "Temporary worker" means a worker whose services are furnished to another on a part-time or
temporary basis to fill a work assignment with a finite ending date to support or supplement a workforce in
situations resulting from employee absences, skill shortages, seasonal workloads, and special assignments
and projects.
(42) "Treating physician" means the person who, subject to the requirements of 39-71-1101, is
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primarily responsible for delivery and coordination of the worker's medical services for the treatment of a
worker's compensable injury or occupational disease and is:
(a) a physician licensed by the state of Montana under Title 37, chapter 3, and has admitting
privileges to practice in one or more hospitals, if any, in the area where the physician is located;
(b) a chiropractor licensed by the state of Montana under Title 37, chapter 12;
(c) a physician assistant licensed by the state of Montana under Title 37, chapter 20, if there is not
a treating physician, as provided for in subsection (42)(a), in the area where the physician assistant is located;
(d) an osteopath licensed by the state of Montana under Title 37, chapter 3;
(e) a dentist licensed by the state of Montana under Title 37, chapter 4;
(f) for a claimant residing out of state or upon approval of the insurer, a treating physician defined
in subsections (42)(a) through (42)(e) who is licensed or certified in another state; or
(g) an advanced practice registered nurse licensed by the state of Montana under Title 37, chapter
8.
(43) "Work-based learning activities" means job training and work experience conducted on the
premises of a business partner as a component of school-based learning activities authorized by an
elementary, secondary, or postsecondary educational institution.
(44) "Year", unless otherwise specified, means calendar year."
Section 4. Section 39-71-119, MCA, is amended to read:
"39-71-119. Injury and accident defined. (1) "Injury" or "injured" means:
(a) internal or external physical harm to the body that is established by objective medical findings;
(b) damage to prosthetic devices;
(c) damage to appliances, except for damage to eyeglasses, contact lenses, dentures, or hearing
aids; or
(d) posttraumatic stress disorder as provided in [section 1]; or
(d)(e) death.
(2) An Except as provided in [section 1], an injury is caused by an accident. An accident, except as
provided in [section 1], is:
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(a) an unexpected traumatic incident or unusual strain;
(b) identifiable by time and place of occurrence;
(c) identifiable by member or part of the body affected; and
(d) caused by a specific event on a single day or during a single work shift.
(3) "Injury" Except as provided in [section 1], "injury" or "injured" does not mean a physical or
mental condition arising from:
(a) emotional or mental stress; or
(b) a nonphysical stimulus or activity.
(4) "Injury" or "injured" does not include a disease that is not caused by an accident.
(5) (a) A cardiovascular, pulmonary, respiratory, or other disease, cerebrovascular accident, or
myocardial infarction suffered by a worker is an injury only if the accident is the primary cause of the physical
condition in relation to other factors contributing to the physical condition.
(b) "Primary cause", as used in subsection (5)(a), means a cause that, with a reasonable degree of
medical certainty, is responsible for more than 50% of the physical condition."
Section 5. Codification instruction. [Section 1] is intended to be codified as an integral part of Title
39, chapter 71, and the provisions of Title 39, chapter 71, apply to [section 1].
Section 6. Severability. If a part of [this act] is invalid, all valid parts that are severable from the
invalid part remain in effect. If a part of [this act] is invalid in one or more of its applications, the part remains in
effect in all valid applications that are severable from the invalid applications.
Section 7. Effective date. [This act] is effective July 1, 2025.
Section 8. Applicability. [This act] applies to claims for workers' compensation in which a diagnosis
finds that the injury or occupational disease of posttraumatic stress disorder was caused by events occurring on
or after [the effective date of this act].
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I hereby certify that the within bill,
SB 394, originated in the Senate.
___________________________________________
Secretary of the Senate
___________________________________________
President of the Senate
Signed this _______________________________day
of____________________________________, 2025.
___________________________________________
Speaker of the House
Signed this _______________________________day
of____________________________________, 2025.
SENATE BILL NO. 394
INTRODUCED BY C. NEUMANN, J. REAVIS, G. HUNTER, W. MCKAMEY, D. HARVEY, M. YAKAWICH, B.
USHER, P. FLOWERS
AN ACT PROVIDING FOR WORKERS' COMPENSATION COVERAGE OF POSTTRAUMATIC STRESS
DISORDER FOR FIRST RESPONDERS; PROVIDING A DEFINITION; AMENDING SECTIONS 39-71-105, 39-
71-116, AND 39-71-119, MCA; AND PROVIDING AN EFFECTIVE DATE AND AN APPLICABILITY DATE.