The Montana Petition for Settlement — Injury/OD, Medical Benefits Reserved (also letter-size) is a form used by injured workers in Montana to file a claim for medical benefits associated with an on-the-job injury or occupational disease. This form is used when a worker has been injured and is unable to work, but has not received the medical benefits they are entitled to. The form must be completed in full, signed and notarized, and submitted to the Montana Department of Labor and Industry. It contains detailed information about the injury or illness, the date of injury, medical history, and the medical benefits requested. There are two types of Montana Petition for Settlement — Injury/OD, Medical Benefits Reserved (also letter-size): the standard form and the form for claimants with preexisting conditions. The standard form is used for injuries or illnesses that were not preexisting and the form for claimants with preexisting conditions is used for injuries or illnesses that were preexisting at the time of the injury or illness. Both forms require the claimant to provide evidence to support their claim for medical benefits.
Montana Petition for Settlement - Injury/OD, Medical Benefits Reserved (also letter-size)
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How to fill out Montana Petition For Settlement - Injury/OD, Medical Benefits Reserved (also Letter-size)?
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