Workers' Compensation

Accidents / Injuries

Workers' compensation insurance is provided for all employees to cover occupational injury or illness arising out of and in the course of employment.

Very important: Injuries must be reported to the immediate supervisor within 24 hours of injury. To file a claim, employees must fill out the Accident / Injury Form and submit completed forms to Human Resources. If a timely notice of an accident/injury is not provided, the accident/injury may not be compensable under workers' compensation (MCA 39-71-603).

To digitally sign forms, download, and/or open with Adobe PDF Reader.

First Report of Injury or Occupational Disease Instructions

First Report of Injury Form (Print to sign; return to departmenth@ci.missoula.mt.us)

Incident Report

Medical Status Form

Prescription Payment Authorization

Temporary Modified Duty Assignment

Contact

Mike Brady                                
Risk and Safety Manager              
Phone: 406-552-6278

Email Mike Brady

Workers' Compensation Carrier

Montana State Fund
P.O. Box 4759
Helena, MT 59604-4759
Phone: 800-332-6102 / 406-495-5000