The Rating Says You’re Hurt, But the Check Never Comes
Key Takeaways: Since Montana’s 2011 statutory revision, § 39-71-703, MCA generally provides a stand-alone impairment award only when the impairment is rated Class 2 or higher with no wage loss. A Class 1 rating with a return to full pay typically results in no award. Impairment class comes from the AMA Guides, 6th edition, assigned by an examining physician. In Hensley v. Montana State Fund, 2020 MT 317, a plurality upheld the exclusion under rational basis review. The fiscal note behind House Bill 334 estimated roughly 1,600 workers annually would lose awards, saving about $8 million. Because both class assignment and wage loss calculation are fact-specific and can be miscalculated, a denial may warrant review.
Since 2011, Montana law has generally provided stand-alone impairment awards only to injured workers whose impairment falls in Class 2 or higher when there’s no wage loss. If your doctor rates you at Class 1 and you returned to work at the same pay, the insurer may close the file.
If you got a rating and then got nothing, call Miller Tourtlotte Law at 406-888-2222 or reach out to our team to have someone review your paperwork.
How the 39-71-703 Class 1 Impairment Award Montana Rule Actually Works
Montana’s permanent partial disability statute sets up two separate doors, and Class 1 workers with no wage loss may find both shut. Under § 39-71-703(1), MCA, a worker may qualify for PPD with "(a) an actual wage loss as a result of the injury; and (b) a permanent impairment rating as determined by the sixth edition of the AMA Guides." Door two is § 39-71-703(2), MCA, which covers a worker who "receives a Class 2 or greater class of impairment" and "has no actual wage loss."
A Class 1 rating with no wage loss slips through the gap. The 2011 revision provided no-wage-loss impairment awards only to Class Two or greater workers. The Montana Supreme Court addressed this in Barnhart v. Montana State Fund, 2022 MT 250, ¶ 11, holding that § 39-71-703(2), MCA, may entitle a worker with Class 2 or greater impairment to an award even without wage loss.
The math reinforces the outcome. Under § 39-71-703(4)-(5), MCA, the PPD percentage is built by adding statutory factors, age, education, wage loss, and physical restriction, to the whole-person impairment rating. The wage loss factor provides that "if a worker has no actual wage loss as a result of the industrial injury, 0%." Add zero for wage loss to a Class 1 rating, and the claim often doesn’t qualify for stand-alone payment.
Where "Impairment Class" Even Came From
The class system comes from the AMA Guides to the Evaluation of Permanent Impairment, 6th edition, which uses five classes of severity numbered zero through four, ranging from no functional problem to complete functional loss. Montana wrote those classes directly into its statute.
The class is assigned by a physician, not by a computer. Two doctors examining the same shoulder can reach different conclusions depending on how they apply the Guides, what records they review, and what they’re asked to evaluate. At the Class 1 line, the rating itself determines the outcome.
The IME Problem
Insurers frequently arrange their own medical examination before a rating becomes final. These insurer-arranged exams can be adversarial and sometimes produce a lower impairment class. Montana law permits insurers to request reasonable examinations, and unreasonably refusing may lead to suspended benefits. Before attending, talk to a lawyer.
💡 Pro Tip: Ask your treating provider which edition and table they used to reach your class. If the rating relied on incomplete records or skipped a ratable condition, that may be fixable.
Hensley and the Constitutional Fight Over Class 1
The Montana Supreme Court looked at this, and Class 1 workers lost by narrow margin. In Hensley v. Montana State Fund, 2020 MT 317, 477 P.3d 1065, a plurality upheld § 39-71-703(2), MCA, against equal protection challenge under rational basis review, reasoning that using impairment classes to gauge injury severity bore a rational relationship to directing awards toward workers with significant loss of physical function.
The facts show what’s at stake. Susan Hensley’s shoulder injury was rated 4% whole person impairment and placed in Class One. Under pre-2011 law she would have received approximately $5,192; under the amended statute, she received nothing. Justice Gustafson’s dissent noted that Montana appeared to be the only state using impairment classes this way.
The Money Behind the Change
The legislative record suggests cost savings drove the revision. The fiscal note for House Bill 334 estimated that roughly 1,600 of the 3,000 injured workers per year who receive a rating below Class Two but have no wage loss would no longer receive an impairment award, producing estimated savings of roughly $8 million annually.
Analysis published in the Montana Law Review argues the exclusion undermines the quid pro quo that workers’ compensation is built on. Drawing on Stratemeyer v. Lincoln County, 276 Mont. 67, 915 P.2d 175 (1996), the article argues that placing Class One workers outside the Act’s boundaries could mean tort claims against employers become available, and Justice Sandefur’s dissent, 477 P.3d at 1097, warned that the revision erodes that bargain. No Montana court has adopted this argument.
Why Wage Loss Is the Hinge Point
Montana ties indemnity benefits to what you actually lost, not solely to how much your body was damaged. Section 39-71-105(1), MCA, states that wage-loss benefits "are not intended to make an injured worker whole" and "should bear a reasonable relationship to actual wages lost as a result of a work-related injury or disease." The Court quoted this in Barnhart at ¶ 23.
"Disability" itself carries a wage-based meaning. In Barnhart, ¶ 15, the Court quoted Tinker v. Montana State Fund, 2009 MT 218, stating the term is "tied to a wage loss or impairment in the ability to earn wages through employment." The Barnhart decision also reversed the Workers’ Compensation Court on rate calculation, holding at ¶ 24 that the benefit rate was properly based on the claimant’s average weekly wage of $281.91 from the job where she actually suffered wage loss at maximum medical improvement.
| Your situation | Stand-alone impairment award under § 39-71-703, MCA |
|---|---|
| Class 1 rating, no actual wage loss | Generally not available |
| Class 2 or greater, no actual wage loss | Generally available under subsection (2) |
| Any ratable impairment plus actual wage loss | May qualify under subsection (1), subject to the statutory factors |
What "No Wage Loss" Really Means in Practice
Do not assume the adjuster’s wage loss conclusion is correct. Wage loss is a factual question that turns on details easily overlooked:
- Whether you returned to the same hours, or fewer, or with restricted overtime
- Whether your pre-injury wage calculation included all concurrent jobs and shift differentials
- Whether your restrictions realistically allow you to keep the job long-term
- Whether every ratable condition was actually rated
- Whether the class assignment matches the medical findings
A second look at the wage math or rating sometimes moves a claim across the line. Our breakdown of Montana wage loss benefits walks through TTD, TPD, PPD, and PTD in plain terms.
When It Makes Sense to Bring in Help
Most people don’t call a lawyer over an impairment rating, and that’s the problem. A Class 1 designation looks final on paper but may not be, because the rating, wage calculation, and scope of accepted conditions can all be examined and challenged.
Watch for These Signals
Certain patterns show up before denials. A sudden push to schedule an insurer exam. A rating done quickly by a provider you’ve never met. A settlement offer with a friendly phone call and deadline. A fast offer is not necessarily fair.
Workers’ comp is its own body of law. Our workers comp lawyer Montana team focuses on this system, including denied treatment, disputed ratings, and long-term disability claims. Benefit disputes generally must go through the Department of Labor and Industry’s mediation process before reaching the Workers’ Compensation Court, which applies its own procedures and deadlines strictly.
💡 Pro Tip: Keep your own copy of every rating report, wage statement, and denial letter. The person with the organized file is often in the better position.
Frequently Asked Questions
1. Can I get anything at all with a Class 1 impairment and no wage loss?
Under the current statute, a stand-alone impairment award generally is not available. Medical benefits for your accepted condition are separate and may continue subject to statutory limits. Whether your rating or wage loss determination is accurate is worth reviewing.
2. What if my class rating seems too low?
Impairment class is a medical determination applied under the AMA Guides, 6th edition, and can be disputed. Additional records, a rating of every accepted condition, or a different qualified evaluation may change the result.
3. Does going back to work automatically kill my claim?
Returning to work does not necessarily end your claim, but it affects whether you have actual wage loss. Reduced hours, lost overtime, or a lower-paying position may still count. The wage comparison is fact-specific and can be miscalculated.
4. Can a Class 1 worker sue an employer instead?
That question is unsettled in Montana, and the Act’s exclusive remedy provisions remain a significant obstacle. Commentary drawing on Stratemeyer v. Lincoln County, 915 P.2d 175 (1996), argues that workers pushed outside the Act’s coverage may retain tort rights, but no controlling Montana decision has established that path. Get individual legal advice before considering it.
5. How long do I have to challenge a denial?
Workers’ compensation disputes carry their own filing and mediation deadlines separate from ordinary civil statutes of limitations. Courts generally interpret exceptions and extensions narrowly. If you have a denial letter, confirm specific deadlines with an attorney.
The Bottom Line for Montana Workers Holding a Class 1 Rating
Montana’s current statute generally provides stand-alone impairment awards to workers with no wage loss only at Class 2 or above. That line was drawn in 2011 with an $8 million savings estimate attached. Hensley upheld it through a plurality opinion, with dissents questioning whether the deal injured workers signed up for still holds. Before accepting a denied award, have someone check whether your class rating and wage loss numbers were calculated correctly.
If your impairment award was denied and something doesn’t sit right, Miller Tourtlotte Law is here to look at it. Call 406-888-2222 or get in touch today and we’ll go through your paperwork together.
Disclaimer: This content is for informational purposes only and is not legal advice. Every case is unique, and results may vary. Consult an attorney about your specific circumstances.
