Explanation of SB 109 – Changes to Physical Therapy Access for the Injured Worker
As of October 1, 2025 Physical Therapists may serve as the Primary Treating Physician for employees injured on the job without need for referral. This new legislation will significantly reduce waiting periods, simplify access to care, and keep workers at work safely when possible. When serving as a Primary Treating Physician, Physical Therapist responsibilities include:
- Managing and directing return-to-work rehabilitation plans, including identifying required modifications.
- Referrals indicated which may include but are not limited to imaging, pharmacological interventions, psychological consultations, and or other specialists.
- Scheduling and conducting on-site workplace visits and functional job analyses when appropriate.
How you and your employees benefit
The current referral process in the U.S. can delay physical therapy access by an average of 16 days (estimated at 21 days in Montana). Montana Utilization and Treatment Guidelines recommend physical therapy access within 7-10 days.This change in legislation will allow for greatly reduced wait times and overall improved access for employees injured on the job.
There is extensive evidence to suggest that early access to Physical Therapy can dramatically reduce the total costs of a claim. In addition to reduced costs, early intervention has also been shown to significantly diminish opioid use, utilization of surgery, and prevent long term disabilities from taking hold.
Musculoskeletal injuries are the most frequently experienced injuries in a workplace setting. Physical Therapists are uniquely designed to fill the role of Primary Treating Physician for musculoskeletal injuries that occur on the job. Physical Therapists in Montana hold advanced training in musculoskeletal assessment and treatment, allowing them to diagnose and manage a wide range of conditions affecting muscles, joints, and movement.
There is extensive evidence to suggest that early access to Physical Therapy can dramatically reduce the total costs of a claim. In addition to reduced costs, early intervention has also been shown to significantly diminish opioid use, utilization of surgery, and prevent long term disabilities from taking hold.
Musculoskeletal injuries are the most frequently experienced injuries in a workplace setting. Physical Therapists are uniquely designed to fill the role of Primary Treating Physician for musculoskeletal injuries that occur on the job. Physical Therapists in Montana hold advanced training in musculoskeletal assessment and treatment, allowing them to diagnose and manage a wide range of conditions affecting muscles, joints, and movement.
Alpine PT Occupational Health Team
Occupational Health promotes and maintains the highest level of safety and physical well-being for optimal performance within a specific job setting. At Alpine PT, we offer several components to build a safe and effective working environment as well as prepare and clear employees for best fitted positions.
Current research demonstrates significant reduction with on the job injury and unnecessary disability when occupational health is used for pre placement testing, safety in lifting, early interventions, and early active intervention.
Current research demonstrates significant reduction with on the job injury and unnecessary disability when occupational health is used for pre placement testing, safety in lifting, early interventions, and early active intervention.
Alpine's Occupational Health Services
Alpine offers a range of occupational health services. Click on the expandable list below to learn more about how our occupational health specialists can help your company.
PTs as Primary Treating Physician
Physical Therapy for the injured Worker
Physical therapy emphasizes restoring mobility, strength, and physical function after injury. PTs design evidence-based programs to reduce pain, improve range of motion, and rebuild musculoskeletal capacity needed for job performance. Treatment often includes therapeutic exercise, manual therapy, and job-specific conditioning to prepare the worker for safe return to work. The focus is on restoring physical capacity and resilience so employees can handle the physical demands of their work environment without risk of re-injury.
Occupational Therapy for the Injured Worker
Occupational therapy focuses on helping injured workers regain the practical skills they need to return to work safely and effectively. Through customized treatment plans, OTs address challenges such as fine motor coordination, upper extremity strength, endurance, and cognitive demands of specific job tasks. Occupational Therapy emphasizes functional activities and job simulations, ensuring workers can meet the physical and task-specific requirements of their role while preventing re-injury.
Functional Job Analysis
We routinely perform functional job analyses, which define the “critical demands” portion of the job description. It outlines the physical requirements necessary to perform the key tasks of the job. An evaluation of the critical demands will define the tasks being done, how often they are being done, and the weights and forces the employee must generate when completing the tasks.
Injury prevention education
The Alpine Occupational Health Team can evaluate the physical capabilities of your newly hired employees or employee candidates. This testing is done to effectively test whether or not the employee possesses the necessary physical abilities to perform the minimum job responsibilities safely and efficiently. These can be scheduled onsite or at the clinic for week of appointments.
Pre and post offer work screening
Occupational therapy focuses on helping injured workers regain the practical skills they need to return to work safely and effectively. Through customized treatment plans, OTs address challenges such as fine motor coordination, upper extremity strength, endurance, and cognitive demands of specific job tasks. Occupational Therapy emphasizes functional activities and job simulations, ensuring workers can meet the physical and task-specific requirements of their role while preventing re-injury.
Creating custom work screens for employers to align with specific job duties, ensuring employees are properly matched to their roles and reducing the risk of workplace injuries.
Get started
Call Alpine today to discuss the ways our injury specialists can help you and your organization with work injury management.
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