Bill to allow physical therapists as workers' comp treating physicians draws mixed testimony

Senate Bill 109, sponsored in the House by Sen. Greg Hertz, would add licensed physical therapists to the statutory list of treating physicians under Montana’s workers' compensation law, allowing PTs to serve as initial treating providers for appropriate workplace injuries.

Supporters — including the Montana chapter of the American Physical Therapy Association (APTA) and firefighter and labor representatives — said the change would reduce delays in care and help injured workers return to work sooner. Sam Schmidt (APTA‑MT) described a case in which a patient waited almost two months for physical therapy under the current referral model; he said direct access would cut that time and lower overall cost. Emily Herndon, president of APTA‑MT, said physical therapists now hold doctoral degrees and routinely perform musculoskeletal evaluations, order imaging when indicated, and refer to other specialists.

Proponents cited published guidance and cross‑state practice: the transcript records proponents saying direct PT access exists in other jurisdictions and listing states that permit some form of direct access for workers' comp providers. Andy Zimmerman of Montana Professional Firefighters said earlier access to PT shortened a firefighter’s return to full duty from six weeks to a potential three to four weeks.

Opponents — including representatives of large self‑insured employers and insurers (Peter Strauss of the Montana Self Insurers Association; Amy Grimales for APCIA) — urged caution. They told the committee workers' compensation differs from private health care because of no deductibles, statutory prompt‑pay obligations and state requirements for impairment ratings and maximum medical improvement determinations. Opponents warned that allowing PTs to be treating physicians could delay referrals in some cases, increase utilization of PT services and raise costs; they recommended further study and pointed to existing provider shortages in some areas.

Department of Labor legal counsel Quinlan O’Connor and State Fund representative Nick Mazanec provided informational context about the claims process and the fiscal note; Mazanec said State Fund contributed to the fiscal note. Supporters and opponents agreed the issue is a policy choice balancing faster access to PT versus systemwide cost and administrative impacts. Sen. Hertz closed by noting research he said supports earlier PT access and by listing states that allow PTs to serve in a similar role. The committee did not record a vote during the hearing.