Petition For Settlement (Injury And Or Occupational Disease - Medical Benefits Reserved) | Pdf Fpdf Doc Docx | Montana

 Montana   Workers Compensation 
Petition For Settlement (Injury And Or Occupational Disease - Medical Benefits Reserved) | Pdf Fpdf Doc Docx | Montana

Last updated: 5/31/2024

Petition For Settlement (Injury And Or Occupational Disease - Medical Benefits Reserved)

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Description

PETITION FOR SETTLEMENT INJURY/OCCUPATIONAL DISEASE MEDICAL BENEFITS RESERVED. This form is used in Montana for settling workers' compensation or occupational disease claims where the insurer has accepted liability. It allows the claimant and insurer to settle all compensation payments through a lump sum payment. The form reserves medical benefits depending on the injury date and outlines the conditions under which medical benefits may terminate or be reopened. By signing this form, the claimant agrees that the settlement is final, releases the insurer from further compensation payments, and understands that the settlement cannot be reopened. www.FormsWorkflow.com

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