1. (1) A petition to the department for lump-sum conversion of biweekly permanent total disability benefits for all dates of injury must include a description of the lump-sum proposal, including but not limited to:

   1. (a) analysis of the worker's current financial conditions as described in (3);
   2. (b) analysis of the worker's financial condition under the proposed lump-sum conversion, that includes a description of the use of the lump-sum and how this use will contribute to financially sustaining the worker over the same period biweekly payments would have been paid;
   3. (c) analysis of financial condition that would be reasonably expected had the worker not been injured; and
   4. (d) an affidavit signed by the worker attesting to the validity of information provided in the written petition.
2. (2) A petition to the department for conversion of biweekly permanent partial disability benefits to a lump-sum payment must include an analysis of current financial conditions as described in (3) only for a claim with a date of injury prior to July 1, 1991.
3. (3) "Analysis of current financial condition" for purposes of (1) shall include a detailed list of all the worker's assets, liabilities, sources of income, and monthly obligations.
4. (4) A petition for lump-sum conversion of permanent total benefits that involves the partial or total elimination of existing delinquent or outstanding debts must include a plan for debt consolidation.
5. (5) If a permanent total benefit lump-sum proposal involves a business venture, the proposal must include a business plan that shows the net income available to the worker after business expenses are paid.

6. (6) A request for lump-sum settlement of medical benefits must include the following completed forms:

   1. (a) "Petition for Settlement Injury/Occupational Disease Medical Benefits Closed On An Accepted Claim" form signed by the claimant, a witness, and the insurer or the insurer's authorized representative;
   2. (b) "Recap Sheet" form signed by the claimant and the insurer or the insurer's authorized representative; and
   3. (c) "Summary of Settlement of Medical Benefits" form signed by the claimant and the insurer or the insurer's authorized representative.
7. (7) The total value of the workers' compensation benefits may be discounted at the current rate established by the department when an insurer calculates a conversion to a lump-sum payment. For claims with dates of injury between April 15, 1985 and June 30, 1987, the lump-sum payment may be discounted by 7%, compounded annually.

Authorizing statute(s): 39-71-203, MCA

Implementing statute(s): 39-71-741, MCA

History: NEW, 1985 MAR p. 1564, Eff. 10/18/85; AMD, 2013 MAR p. 841, Eff. 5/24/13; AMD, 2024 MAR p. 1066, Eff. 5/11/24.