Panel weighs adding physical therapists as workers’ compensation treating physicians

The Senate Business, Labor and Economic Affairs Committee heard extensive testimony for and against Senate Bill 109, which would add physical therapists licensed under Title 37, chapter 11, to the statutory list of treating physicians for workers’ compensation claims.

Sponsor Senator Greg Hertz said adding physical therapists would speed care and reduce costs by allowing injured workers to see a trusted PT promptly rather than waiting for a physician appointment. Proponents emphasized Montana already allows direct access to PTs in private insurance settings; they said the workers’‑comp process creates avoidable delays in starting active rehabilitation.

Emily Herndon, president of the Montana chapter of the American Physical Therapy Association, said PTs have doctoral training, routinely order imaging and refer when they detect conditions that require physician care, and can often get workers back to function quickly. Lorena Pettet Payne and other PT witnesses cited internal data and clinical guidelines showing optimal timelines for early PT intervention (7–14 days) versus observed delays to PT in workers’‑comp (roughly 26–28 days in their examples). Firefighter and employer witnesses said delays caused higher overtime and personnel‑coverage costs.

Opponents included self‑insured employers, Montana State Fund representatives and medical associations. Peter Strauss (Montana Self Insurers Association) and other insurers argued workers’ compensation differs from general health care: treating physicians under workers’‑comp not only provide treatment but also coordinate care, order labs and imaging, make determinations of maximum medical improvement (MMI) and impairment ratings, and can admit patients to hospitals — duties PTs do not perform. Opponents warned that making PTs treating physicians could add administrative complications, unintended costs and delay access to those legal/administrative determinations. The Montana Medical Association and orthopedic surgeons' representatives urged the committee to maintain the existing statutory list and instead pursue other solutions to access problems.

Informational witnesses (Montana State Fund and Department of Labor) supplied utilization data showing substantial PT use under workers’ comp and noted utilization and treatment guidelines that typically allow an initial set of visits with later review. Committee members asked whether adding PTs would cause an influx of claims or add delay; PT proponents said they would refer quickly if a patient did not improve and that the biggest delay today is getting the initial access to the right provider.

Sponsor Senator Hertz closed by arguing the measure increases choice and speeds return to work; the committee requested follow‑up details and said it would consider executive action later.

What’s next: Committee staff and stakeholders will likely work on language to ensure the statutory change aligns with administrative rules and preserves the ability to make workers’‑comp legal determinations when needed.