North Dakota Workers’ Compensation Benefits Process

Important: We updated this article in June 2024 after reviewing state law that governs North Dakota workers’ compensation benefits. 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.

North Dakota Workers’ Compensation Insurance Coverage: How Does It Work?

The North Dakota Workforce Safety & Insurance (WSI) program is the only way for businesses that operate in this state to secure coverage. State law requires any company doing significant work in North Dakota to cover the following types of employees:

• Full time
• Part time
• Seasonal
• Occasional

This coverage begins on your first day of employment and costs nothing out of your own paycheck. For this reason, most employers automatically enroll with WSI, which is an employer-financed state insurance fund. This policy protects employees and employers alike if a workplace accident or occupational illness occurs.

Which Employees Are Automatically Exempt from North Dakota Workers’ Compensation Coverage Requirements Under State Law?

These employees are automatically exempt from North Dakota workers’ compensation benefits unless they choose to purchase elective coverage:

• Business owners, their spouses, partners, corporate officers, and any of their children they employ if they’re younger than 22
• Certain licensed real estate brokers
• Domestic workers employed in private households
• Farm and ranch laborers, along with certain custom farm operations employees
• Newspaper delivery workers
• Sole proprietors
• Workers whose sole duty is operating a place of worship

Important: Federal workers are also exempt from automatic coverage and cannot elect to purchase their own insurance through the state. Injured railroad workers, USPS delivery carriers and other federal employees must follow a different workers’ compensation process.

Steps to Apply for North Dakota Workers’ Compensation Benefits

Follow these steps to apply for benefits:

1. For a life-threatening work-related injury or illness, seek urgent medical attention first.

In such cases, you can go to the nearest hospital, ER, or urgent care clinic for emergency medical care. Be sure to tell the provider you see that your injury or illness happened at work. However, if your injury isn’t life-threatening, state law says that you must notify your employer before you see a doctor.

2. If your work-related injury isn’t life threatening, then notify your employer first.

Tell your supervisor that you got hurt on the job and ask to see a list of Designated Medical Providers (DMP) authorized to treat you. No DMP list available from your employer? Then you’re free to seek treatment from any doctor you choose. However, if your employer does have a DMP list to offer you, then one of those doctors must treat your injury.

If you fail to notify your employer within a year of your accident, then you cannot claim any North Dakota workers’ compensation benefits.

Pro Tip: Seeing your own doctor for care without prior authorization may leave you stuck paying those medical bills yourself.

3. Your employer should submit notification of your work-related injury or illness to the WSI within 7 days of your job accident.

Ideally, your employer should notify the WSI within 24 hours after you submit your notification. If your employer fails to do this step, then you can notify them directly via a First Report of Injury (FROI) form. You can submit it yourself to the WSI by mail at: WSI, P.O. Box 5585, Bismarck, ND 58506-5585.

Once the WSI has this form on file, you should receive your North Dakota workers’ compensation claim number. Have questions for the WSI? Call 1-800-777-5033 during normal weekday business hours.

Important: Be sure to provide this claim number during any communications you have with the WSI or your treating physician.

3. Your WSI claims adjuster will either deny or accept your claim and notify you of their decision by mail.

If you can return to work within 5 days of your accident, then you’ll only qualify for medical benefits. This means your North Dakota workers’ compensation benefits will only cover your medical bills, not paid time off.

4. Once your workers’ comp doctor says you must miss 5+ days of work, you’ll qualify for lost-wage benefits.

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 to sign as well. Once that form is complete, ask your doctor for two copies: One for WSI, and one for your employer.

5. If WSI denies your claim, you should receive a letter in the mail explaining their decision.

You can appeal your denial within 45 days after you receive the WSI decision letter in the mail. To do this, contact the Decision Review Office (DRO) at 1611 E. Century Ave., Ste 402; Bismarck, ND 58503-0780. You may also call the DRO directly at 701-328-9900, toll-free at 1-800-701-4932, or email [email protected].

Since every workers’ compensation claim is different, your own experience might vary. You can learn more by reading the WSI Quick Reference Guide for Workers.

What North Dakota Workers’ Compensation Benefits Are Available to Replace Lost Wages?

If the WSI accepts your claim and your doctor says you cannot work for five consecutive days or longer, you may qualify for wage-loss payments. Here are the various wage-loss payments that North Dakota workers’ compensation benefits can offer injured workers:

Temporary Total Disability (TTD) Benefits

If you cannot work at all for a short time due to your workplace injury, then you may receive TTD benefits. These payments stop once you return to work or reach maximum medical improvement (MMI). These particular North Dakota workers’ compensation benefits pay 2/3 of your gross average weekly wage. However, that amount is subject to the state’s annual maximum and minimum benefit payment rules.

Important: If you have children at home, you can also get an extra $15 per week for each eligible dependent.

Temporary Partial Disability (TPD) Benefits

These payments can cover a portion of your salary if your employer must reduce your work earnings, specifically due to your injury. You can receive TPD benefits until your current wages return to 90% of your pre-accident job income. Injured workers in North Dakota can receive TPD benefits for no more than 5 years from their accident date.

Permanent Partial Disability (PPD) Benefits

This is a lump-sum award WSI pays out only after you reach maximum medical improvement and can no longer earn your pre-injury job wages. In most cases, WSI calculates this amount using the following formula:

35% of North Dakota’s current average weekly wage (AWW) x permanent impairment multiplier % listed in the Century Code.

Permanent Total Disability (PTD) Benefits

Totally disabled North Dakota employees who cannot work at all in any job for life may receive PTD benefits. Whether or not PTD benefits are appropriate in your case is entirely up to the WSI. The WSI will review the following factors when determining whether you qualify and your PTD amount:

• Injury type
• Degree of disability
• Education
• Work history
• Wage earning capacity
• Vocational rehab potential

Death Benefits

If a worker dies while on the job, then their widowed spouse may qualify for North Dakota workers’ compensation benefits. These death benefits from the WSI can include:

• Up to $10,000 for funeral and burial expense costs
• No more than $300,000 in total TTD benefits paid to all eligible survivors on a deceased worker’s behalf

How to Get Help Qualifying for North Dakota Workers’ Compensation Benefits

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 quiz now:

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