Benefits: Medical Benefits: Prescriptions

Hiett v. Missoula County Public Schools, 2003 MT 213 The phrase “achieving” medical stability and “achieved” medical stability as used in sections 39-71-116(25) and 39-71-704(1)(f), MCA (1995), respectively, mean the sustainment of medical stability. Given this interpretation, a claimant is entitled to such “primary medical services” as are necessary to permit him or her to sustain medical stability, which includes prescriptions for pain and depression prescribed for a claimant who has reached maximum medical healing, was not employed, and may well fall out of maximum healing without medication.

Koch v. Employers Ins. Group [05/19/14] 2014 MTWCC 14 Even if Petitioner had reached MMI, under Hiett, the insurer was still required to pay for her medications prescribed to treat her work-related injuries.

Hiett v. MSGIA [9/6/01] 2001 MTWCC 52 Claimant is not entitled to continued coverage of prescription medications were she has reached MMI, is not working, and is unlikely to work. Prescription coverage as a medical benefit must arise under section 39-71-704, MCA (1995). While statutes regarding medical services are poorly written, the medications are not within provisions authorizing primary medical services since those services are available only prior to MMI, 39-71-116(25), MCA (1995), or provisions authorizing secondary medical services, since those services are available only if there is a "clear demonstration of cost-effectiveness of the services in returning the injured worker to actual employment." 39-71-704(1)(b), MCA (1995). The medications are also not within provisions allowing for palliative and maintenance care. 39-71-704(1)(f)-(g), MCA (1995). Hiett v. Missoula County Public Schools, 2003 MT 213