All workers’ compensation claims are handled at the state level. Employees who get hurt on the job or develop occupational illnesses can file a North Dakota workers’ compensation claim using the process we’ve outlined below. We’ll also explain what specific benefits may be available to you under two different types of North Dakota workers’ compensation claims: wage-loss and medical only.
How the North Dakota Workers’ Compensation Process Works
All North Dakota workers’ compensation claims are handled exclusively through the North Dakota Workforce Safety & Insurance (WSI) program. Most employers in the state are automatically enrolled in North Dakota workers’ compensation coverage through WSI, which is an employer-financed state insurance fund. In fact, state law requires any company doing significant work in North Dakota to cover contractors as well as employed local residents. This policy protects employees and employers alike if a workplace accident or occupational illness occurs.
Steps to Apply for North Dakota Workers’ Compensation Benefits
Follow these steps to apply for benefits:
- Seek appropriate medical attention immediately and then notify your employer. State law requires notification within 7 days (the WSI recommends filing your claim within the first 24 hours, if possible).
- Submit a First Report of Injury (FROI) form to get your claim number within 24 hours. Give your claim number in any communications with WSI or your doctor.
- Your claims adjuster will either accept or deny your claim and notify you by mail.
- If approved, your claim pays either wage-loss or medical only benefits.
- Wage-loss claims cover employees who miss 5+ days of work. Periodically, you’ll receive an injured worker income and work status letter (form FL214). Submit this completed form to WSI to avoid any benefit interruptions. Get a Capability Assessment form (C3) for your doctor. Once complete, ask for two copies: one for WSI and one for your employer.
- Medical only claims apply if you miss less than 5 work days. Your employer’s insurer only pays all relevant medical bills.
- If denied, your mailed notice explains why. You have 30 days to appeal.
- To appeal, submit a letter to WSI stating your dispute. Include your claim number, any additional information to consider and what relief you seek (i.e., lost wages or medical expenses).
- Then, the WSI will either award you benefits or issue an administrative order explaining why.
- If you disagree, you have 30 days to contact the Decision Review Office for help. You may also request an appeal hearing before an Administrative Law Judge. After your hearing, the ALJ typically issues a decision within 30 days.
Since every workers’ compensation claim is different, your own experience might vary. The statute of limitations for filing any North Dakota workers’ compensation claim is one year.
What Workers’ Compensation Benefits Are Available?
If the WSI accepts your claim and your injury or illness keeps you out of work for five consecutive days or longer, there are three categories of wage-replacement benefits you may qualify for:
- Temporary Total Disability (TTD) – If you have a temporary, yet total disability, you’ll receive a TTD wage-loss benefit. You may also get an additional $15 per week for each dependent child you support.
- Temporary Partial Disability (TPD) – if an injured employee returns to work and is unable to earn an equivalent wage prior to becoming disabled, the employee receives a temporary partial benefit equivalent to 60% of the difference between pre-injury and post-injury earnings.
- Permanent Partial Disability (PPD) – If your wages are reduced due to an injury-related physical limitation, you may qualify for a PPD wage-loss benefit. These benefits help cover your lost earnings until you’re able to regain at least 90% of your gross weekly wages earned prior to your illness or injury. (The maximum length of time you can receive TPD benefits is five years after the date of your incident.)
- Permanent Total Disability (PTD) – Totally disabled employees who cannot work at all may receive PTD benefits. Whether or not PTD benefits are appropriate in your case is entirely up to the WSI.
You May Qualify for Legal Assistance
After a workplace accident or occupational illness, you may find it beneficial to consult with a workers’ compensation attorney in your area. This is especially true if you believe your claim might get denied or you are already seeking to appeal a denied claim. Regardless, an experienced legal professional always gives you the best chance of winning workers’ compensation benefits. The right legal representative to help you will understand how the process works. An attorney can negotiate with your employer’s insurance provider, help you gather medical paperwork to support your claim and handle your appeal hearing, if it comes to that. Legal professionals working on a contingency basis will charge you nothing upfront for help; in fact, you’ll pay no fees whatsoever unless you win benefits.
Ready to see if you may qualify? Click the button below to start your free online benefits evaluation now!