Montana Petition for Settlement - Injury/OD, Medical Closed on an Accepted Claim (also letter-size)

State:
Montana
Control #:
MT-SKU-0596
Format:
PDF
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Petition for Settlement - Injury/OD, Medical Closed on an Accepted Claim (also letter-size) The Montana Petition for Settlement — Injury/OD, Medical Closed on an Accepted Claim (also letter-size) is a form used by individuals who have sustained an injury or occupational disease that has been accepted for workers’ compensation in the state of Montana. The form is used to petition for payment of medical bills or other expenses that have been incurred as a result of the injury or occupational disease. The form asks for information such as the name and address of the petitioner, the date of injury, the type of injury, details of the medical treatment, and any other expenses that the petitioner has incurred as a result of the injury. The form must be signed by the petitioner and mailed or hand-delivered to the Montana State Fund. There are two types of Montana Petition for Settlement — Injury/OD, Medical Closed on an Accepted Claim (also letter-size): the Original Petition and the Supplemental Petition. The Original Petition is used when filing the initial claim or when making changes to the original claim, such as adding additional medical bills or expenses. The Supplemental Petition is used when additional medical bills or expenses have been incurred after the initial claim has been accepted.

The Montana Petition for Settlement — Injury/OD, Medical Closed on an Accepted Claim (also letter-size) is a form used by individuals who have sustained an injury or occupational disease that has been accepted for workers’ compensation in the state of Montana. The form is used to petition for payment of medical bills or other expenses that have been incurred as a result of the injury or occupational disease. The form asks for information such as the name and address of the petitioner, the date of injury, the type of injury, details of the medical treatment, and any other expenses that the petitioner has incurred as a result of the injury. The form must be signed by the petitioner and mailed or hand-delivered to the Montana State Fund. There are two types of Montana Petition for Settlement — Injury/OD, Medical Closed on an Accepted Claim (also letter-size): the Original Petition and the Supplemental Petition. The Original Petition is used when filing the initial claim or when making changes to the original claim, such as adding additional medical bills or expenses. The Supplemental Petition is used when additional medical bills or expenses have been incurred after the initial claim has been accepted.

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Montana Petition for Settlement - Injury/OD, Medical Closed on an Accepted Claim (also letter-size)