North Dakota Workers' Comp Claims: Eligibility, Filing, and Appeals
Know your rights under the workers' compensation system in North Dakota.
In North Dakota, virtually all employers must carry workers’ compensation insurance through the state. The workers’ compensation system in North Dakota is a no-fault system that compensates injured workers for medical bills, lost wages, and permanent impairments resulting from their injuries. North Dakota Workforce Safety & Insurance (WSI) administers and pays out claims.
Who Is Eligible for Workers’ Comp Benefits?
Most employees are covered by workers’ compensation in North Dakota. However, there are a few exceptions for employees engaged in certain types of work. For example, workers’ comp does not cover farm workers, domestic workers, and licensed real estate brokers.
Workers’ compensation covers all injuries or illnesses that happen in the course and scope of employment, including traumatic injuries and occupational illnesses. Traumatic injuries are those that result from a one-time accident at work, such as a broken bone from a slip and fall. Occupational diseases are injuries or illnesses that occur over a period of time, including injuries caused by repetitive movements at work (such as carpal tunnel syndrome) and illnesses developed from exposure to toxic substances at the workplace (such as cancer from exposure to asbestos).
What Should I Do if I’m Injured at Work?
To receive workers’ comp benefits, you must report your injury to your employer. You should do so as soon as possible, but no later than seven days after your injury. Your claim for benefits may be denied if you fail to give notice. Once your employer has notice of your injury, it should submit a First Report of Injury to the North Dakota Workforce Safety & Insurance (WSI) within seven days. This is the official start of your claim. You must make sure that your claim is filed within one year of your injury, or you will lose your right to collect benefits.
How Do I Get Medical Treatment?
If you need emergency medical treatment, you can go to the nearest hospital or urgent care center. For non-emergency care, you will need to check with your employer first. In North Dakota, employers may select a designated medical provider (DMP) to treat injured workers. If your employer has a DMP, you must treat with that doctor (or doctors) for thirty days—unless you gave your employer written notice of your preferred doctor before your work injury occurred. After thirty days, you can request a change of doctors from WSI.
What Benefits Can I Receive?
All reasonable and necessary medical treatment related to your work injury will be covered through workers’ comp in North Dakota, including the cost of doctors’ visits, hospital bills, prescriptions, and prosthetic devices. You’ll also be reimbursed for the mileage you incur in traveling to and from medical appointments. In addition to medical benefits, you will also be eligible to receive disability benefits.
Temporary Disability Benefits
If you need time off from work while you are recovering from your injuries, you can receive temporary total disability benefits. These benefits are two-thirds of your average weekly wages, up to a maximum set by state law each year. For 2016, the weekly maximum is $1,214. If you have dependent children, you can also receive up to $15 per week for each child. You will receive these benefits until you are able to return to work or until your doctor finds that your condition has improved as much as it is going to (this is called “maximum medical improvement”).
If you are able to work while recovering from your injury, but you’re earning less than 90% of your pre-injury wages, you can receive temporary partial disability benefits. These benefits are two-thirds of the difference between your pre-injury wages and post-injury earning capacity, subject to the same maximum mentioned above.
Permanent Disability Benefits
Once you reach maximum medical improvement (MMI), your doctor will evaluate you to determine whether you have a permanent disability. If your injury has left you permanently and totally disabled, you can receive permanent total disability benefits. These benefits are available only for the most serious injuries and are paid at the same rate as temporary total disability benefits for the rest of the worker’s life.
If you have a permanent impairment, but you are not totally disabled, you can receive permanent partial disability benefits. How much you will receive depends on the impairment rating assigned by your doctor. In 2016, you will receive $340 times an impairment multiplier set out in North Dakota’s schedule. For example, if your doctor gives you a whole body impairment rating of 50%, you would receive an impairment multiplier of 260, according to the schedule. You would then multiply $340 by 260, to get $88,400.
What If My Claim Is Denied?
If your claim is denied, you can ask WSI to reconsider its decision or to grant you an administrative hearing before a workers’ comp judge. If you disagree with the judge’s decision, you will have an opportunity to appeal the decision. For more information on the appeals process, see our article on appealing a denial of your North Dakota workers’ comp claim.