Note.

See section 65-02-01.1, as amended by section 3 of chapter 561, Session Laws 2003, regarding the name change of “workers’ compensation bureau”.

CHAPTER 65-01 General Provisions

65-01-01. Purposes of workforce safety and insurance law — Police power.

The state of North Dakota, exercising its police and sovereign powers, declares that the prosperity of the state depends in a large measure upon the well-being of its wageworkers, and, hence, for workers injured in hazardous employments, and for their families and dependents, sure and certain relief is hereby provided regardless of questions of fault and to the exclusion of every other remedy, proceeding, or compensation, except as otherwise provided in this title, and to that end, all civil actions and civil claims for relief for those personal injuries and all jurisdiction of the courts of the state over those causes are abolished except as is otherwise provided in this title. A civil action or civil claim arising under this title, which is subject to judicial review, must be reviewed solely on the merits of the action or claim. This title may not be construed liberally on behalf of any party to the action or claim.

Source:

S.L. 1919, ch. 162, § 1; 1925 Supp., § 396a1; R.C. 1943, § 65-0101; S.L. 1985, ch. 82, § 158; 1989, ch. 69, § 73; 1995, ch. 605, § 1; 2003, ch. 561, § 3.

Notes to Decisions

In General.

It was purpose of legislature to ensure relief to an employee injured in course of his employment in all cases where he would have had right of action at common law, and in addition thereto to extend his rights to recover in other cases, regardless of questions of negligence, contributory negligence, or assumption of risk. Pace v. North Dakota Workmen's Compensation Bureau, 51 N.D. 815, 201 N.W. 348, 1924 N.D. LEXIS 90 (N.D. 1924).

Workers’ compensation fund is not health or life insurance fund, nor accident insurance fund, except to limited degree. Sandlie v. Workmen's Compensation Bureau, 70 N.D. 449, 295 N.W. 497, 1940 N.D. LEXIS 192 (N.D. 1940).

The Workers’ Compensation Act is to be construed liberally with the view of extending its benefit provisions to all who can fairly be brought within them. Syverson v. North Dakota Workmen's Compensation Bureau, 406 N.W.2d 688, 1987 N.D. LEXIS 321 (N.D. 1987).

Constitutionality.

Workers’ compensation act is valid exercise of police power. Federal Farm Mortgage Corp. v. Berzel, 69 N.D. 760, 291 N.W. 550, 1940 N.D. LEXIS 205 (N.D. 1940).

Actions Abolished.

Title 65 does not provide for an action against an employer or fellow employee by an injured worker where the employer has contributed premiums to the workers’ compensation fund. Olson v. American Oil Co., 474 F. Supp. 560, 1978 U.S. Dist. LEXIS 13912 (D.N.D. 1978), aff'd, 604 F.2d 26, 1979 U.S. App. LEXIS 13462 (8th Cir. N.D. 1979).

Attack on Constitutionality.

Once claimant has asserted rights based solely on workers’ compensation act, he may not challenge constitutionality of provisions authorizing the relief obtained. Ethen v. North Dakota Workmen's Compensation Bureau, 62 N.D. 394, 244 N.W. 32, 1932 N.D. LEXIS 193 (N.D. 1932).

Comprehensive Nature of Act.

It is significant that section 32-03-10 is not part of this title. The courts have previously said that “the North Dakota work[ers’] compensation program is mandatory, comprehensive, and exclusive. All rights and obligations under the program are determined by Title 65, N.D.C.C.” Because the Workers’ Compensation Act is comprehensive, the courts do not look to other portions of the Century Code when defining rights and obligations pursuant to it or when construing its provisions. Effertz v. North Dakota Workers' Compensation Bureau, 481 N.W.2d 218, 1992 N.D. LEXIS 28 (N.D. 1992).

Conflict of Laws.

Rights conferred on employers and employees under workers’ compensation statutes are controlled by statutes of state of primary employment. Breitwieser v. State, 62 N.W.2d 900, 1954 N.D. LEXIS 65 (N.D. 1954).

Coverage of Act.

Where there is a question as to whether an employer should be exempt from workers’ compensation coverage, the doubt should be resolved in favor of the laborer, since it was for him that the workers’ compensation act was passed. Morel v. Thompson, 225 N.W.2d 584, 1975 N.D. LEXIS 207 (N.D. 1975).

Disability Benefits.

The continuing right to disability benefits under the Workers’ Compensation Act is a “property” right protected by the due process clause. Beckler v. North Dakota Workers Compensation Bureau, 418 N.W.2d 770, 1988 N.D. LEXIS 35 (N.D. 1988).

The decision in Beckler v. North Dakota Workers Compensation Bureau, 418 N.W.2d 770 (N.D. 1988), should be applied retrospectively only to those claims that were pending in the appeal process as of the date of that decision, and in which the issue was raised before the bureau and on appeal either by the specifications of error or trial by agreement of the parties. Forster v. North Dakota Workers Compensation Bureau, 447 N.W.2d 501, 1989 N.D. LEXIS 193 (N.D. 1989).

Election of Remedies.

Where workman injured in the course of his employment elects to proceed under workers’ compensation act, he is thereby precluded from maintaining an action at law against his employer. Nyland v. Northern Packing Co., 56 N.D. 624, 218 N.W. 869, 1928 N.D. LEXIS 180 (N.D. 1928).

Generally, when an employer complies with the workers’ compensation statutes, the employee’s exclusive remedy against the employer is limited to recovery under the workers’ compensation statutes. Barsness v. General Diesel & Equip. Co., 422 N.W.2d 819, 1988 N.D. LEXIS 108 (N.D. 1988).

Exclusive Remedy Doctrine.
—In General.

The exclusivity provisions of the Workers’ Compensation Act are embodied in this section and N.D.C.C. § 65-01-08. Westman v. Dessellier, 459 N.W.2d 545, 1990 N.D. LEXIS 155 (N.D. 1990).

—Not Applicable.

An employer foregoes the protections of the exclusive remedy doctrine when he enters into an indemnity contract with someone other than the employee who is later injured. Sorensen v. Tenneco Oil Co., 609 F. Supp. 838, 1985 U.S. Dist. LEXIS 19479 (D.N.D. 1985).

The exclusive remedy rule prohibiting a third-party tortfeasor from getting contribution from the employer does not prohibit enforcement of an employer’s contractual agreement to indemnify a third-party tortfeasor. Barsness v. General Diesel & Equip. Co., 422 N.W.2d 819, 1988 N.D. LEXIS 108 (N.D. 1988).

Trial court erred in concluding that plaintiff’s claims against a school district for negligent supervision and retention were barred by the exclusive remedy provisions of the Workforce Safety and Insurance Act. Even if plaintiff’s allegations of sexual harassment constituted an injury by accident, the district failed to show plaintiff had suffered an injury that was compensable under the Act. Richard v. Washburn Pub. Sch., 2011 ND 240, 809 N.W.2d 288, 2011 N.D. LEXIS 239 (N.D. 2011).

—Particular Cases.

Employee who along with his son was employed by same employer, and who was injured in the course of employment in a one-vehicle accident while riding as a passenger in his own vehicle, which was being driven by his son, could not recover under the general liability and under insurance provisions of his own automobile insurance policies where the policy language clearly and unambiguously provided that he was entitled to benefits only if he was “legally entitled to recover” or his son was “legally liable to pay,” since his son was statutorily immune under the exclusive remedy provisions of the Workers' Stuhlmiller v. Nodak Mut. Ins. Co., 475 N.W.2d 136, 1991 N.D. LEXIS 169 (N.D. 1991).

Supreme Court exercised its discretionary, supervisory power to accept jurisdiction by supervisory writ under N.D. Const. Art. VI, § 2 because an important public interest in the workers’ compensation immunity provisions of N.D.C.C. tit. 65 was present and the employer’s related company had no adequate alternative remedy in that the company could not appeal the denial of its summary judgment motion. Trinity Hosps. v. Mattson, 2006 ND 231, 723 N.W.2d 684, 2006 N.D. LEXIS 237 (N.D. 2006).

District court did not err in dismissing an employee’s negligence action because an employee and coworker were immune from suit under the Workforce Safety and Insurance Act’s exclusive remedy provisions; the determinations in California administrative proceedings were irrelevant for deciding statutory immunity because the employer paid Workforce Safety and Insurance premiums to secure coverage on the employee’s behalf, and the employee received benefits throughout the California proceedings. Brock v. Price, 2019 ND 240, 934 N.W.2d 5, 2019 N.D. LEXIS 251 (N.D. 2019).

Independent Contractor.

A person who is an independent contractor rather than an employee does not fall within the scope of this act. Schaefer v. North Dakota Workers Compensation Bureau, 462 N.W.2d 179, 1990 N.D. LEXIS 223 (N.D. 1990).

Insurance.

The workers’ compensation fund is like an accident insurance fund in that it is a fund made available when an injury occurs. However, the workers’ compensation fund is unlike an accident insurance fund in that (1) it is governmentally created and administered, (2) the injury must be work-related, and (3) because it is work-related questions of fault are irrelevant. Thus the workers’ compensation fund is not a health or accident insurance fund. Beyer's Cement v. North Dakota Ins. Guar. Ass'n, 417 N.W.2d 370, 1987 N.D. LEXIS 454 (N.D. 1987).

The statutory references to insurance in the workers’ compensation laws do not make the protections provided by a workers’ compensation board into insurance as contemplated in N.D.C.C. ch. 26.1-42, governing the guaranty association. The funds provided by the workers compensation board are not insurance; they are workers compensation, and are derived from a statutorily created scheme designed to protect workers injured in the course of their employment. Beyer's Cement v. North Dakota Ins. Guar. Ass'n, 417 N.W.2d 370, 1987 N.D. LEXIS 454 (N.D. 1987).

Liability of Employer.

To hold an employer liable for contribution in an action by the injured employee against a negligent third party, based on common-law liability, would be contrary to the expressed purpose to remove the common-law liability of the employer. White v. McKenzie Electric Cooperative, Inc., 225 F. Supp. 940, 1964 U.S. Dist. LEXIS 6497 (D.N.D. 1964).

While leaving open issue of whether or not an employee may institute civil action against his employer for an intentionally caused injury, an employee covered by workmen’s compensation may not institute civil action against his employer for an accidental injury resulting from an intentional tort. Schreder v. Cities Serv. Co., 336 N.W.2d 641, 1983 N.D. LEXIS 388 (N.D. 1983).

Liability of Third Persons.

Final clause of this section abolishes liability of third persons for injuries in course of employment, except as set forth in act. Tandsetter v. Oscarson, 56 N.D. 392, 217 N.W. 660, 1928 N.D. LEXIS 225 (N.D. 1928).

In situations where an employer and a third-party tortfeasor both negligently cause an employee’s injuries, liability is imposed on the third-party tortfeasor for the negligence of the third party and the employer without permitting the third-party tortfeasor to get contribution from the employer. Barsness v. General Diesel & Equip. Co., 422 N.W.2d 819, 1988 N.D. LEXIS 108 (N.D. 1988).

Injured worker received workers' compensation benefits as a trailer lessee's employee and sued the trailer owner for negligence after the trailer exploded, causing injuries. Reviewing the principles of North Dakota's workers' compensation law and noting that exclusions in an insurance policy at issue limited the policy coverage to liabilities that were not excluded by the remedy of workers' compensation, the court determined that if the trailer owner was acting as a common law independent contractor, North Dakota law will apparently permit the employee to recover in the negligence action. Great West Cas. Co. v. Nat'l Cas. Co., 807 F.3d 952, 2015 U.S. App. LEXIS 21129 (8th Cir. N.D. 2015).

Liberal Construction.

Provisions of workers’ compensation act will be construed, if possible, so as to avoid forfeiture and afford relief. Bordson v. North Dakota Workmen's Compensation Bureau, 49 N.D. 534, 191 N.W. 839, 1922 N.D. LEXIS 84 (N.D. 1922).

The workers’ compensation act must be liberally construed to promote the ends intended to be secured by its enactment. Erickson v. North Dakota Workmen's Compensation Bureau, 123 N.W.2d 292, 1963 N.D. LEXIS 110 (N.D. 1963).

In accordance with policy set forth in this section, act must be liberally construed to promote ends intended to be secured by its enactment. Brown v. North Dakota Workmen's Compensation Bureau, 152 N.W.2d 799, 1967 N.D. LEXIS 92 (N.D. 1967).

The purpose and intent of this title is to protect the injured worker and ensure the prosperity of the state by protecting its wage workers; as such, the provisions of this title should be liberally construed in favor of the worker. 409 N.W.2d 344.

The purpose of workers’ compensation is to protect workers from the hazards of employment by providing sure and certain relief for workers injured in their employment. To that end, the provisions of this title are construed liberally, with the view of extending its benefit provisions to all who can fairly be brought within them. Holmgren v. North Dakota Workers Compensation Bureau, 455 N.W.2d 200, 1990 N.D. LEXIS 101 (N.D. 1990).

The Workers’ Compensation Act is to be liberally construed with the view of extending its benefit provisions to all who can fairly be brought within them. However, liberal construction does not mean the court can ignore the terms of the intent of the provisions with the Act. Effertz v. North Dakota Workers' Compensation Bureau, 481 N.W.2d 218, 1992 N.D. LEXIS 28 (N.D. 1992).

Because appellant was unable to show a causal connection between her unexplained fall at work and her employment, the administrative law judge properly denied her request for workers’ compensation. The Supreme Court of North Dakota refused to apply the positional risk doctrine, because the doctrine was inconsistent with the North Dakota Workforce Safety and Insurance Act, N.D.C.C. § 65-01-01, which provided that the Act not be construed liberally. Fetzer v. N.D. Workforce Safety & Ins., 2012 ND 73, 815 N.W.2d 539, 2012 N.D. LEXIS 70 (N.D. 2012).

Loss of Consortium.

This section and N.D.C.C. § 65-05-06 bar the recovery of damages for loss of consortium by the spouse of an injured worker in an action against the injured worker’s employer. Wald v. Grafton, 442 N.W.2d 910, 1989 N.D. LEXIS 144 (N.D. 1989).

Medical Evidence.

Because the adversary concept has only limited application to claims for workers’ compensation benefits, the workers compensation bureau may not rely only upon that part of inconsistent medical evidence which is favorable to the bureau’s position without attempting to clarify the inconsistency. Syverson v. North Dakota Workmen's Compensation Bureau, 406 N.W.2d 688, 1987 N.D. LEXIS 321 (N.D. 1987).

Power of Legislature.

All rights and obligations under the North Dakota Workers’ Compensation Act are wholly statutory. The legislature may change those rights and obligations and the legislature may afford remedies for violations of workers’ compensation statutes or may not. At any rate, common-law contract principles cannot be used to expand either the statutory rights of the claimant or statutory obligations of the Bureau. Effertz v. North Dakota Workers' Compensation Bureau, 481 N.W.2d 223, 1992 N.D. LEXIS 27 (N.D. 1992).

Standing to Sue.

Workers’ compensation statutes contain no provisions authorizing the bureau to pay contribution or indemnification to an insurance company that provides coverage for an out-of-state workmen’s compensation program; insurance company which provided benefits to claimant under the Minnesota compensation program did not have standing to sue the North Dakota bureau for contribution or indemnification on grounds that North Dakota was the primary situs of employment and primarily liable. United States Fidelity & Guar. Co. v. North Dakota Workmen's Compensation Bureau, 275 N.W.2d 618, 1979 N.D. LEXIS 216 (N.D. 1979).

Suit for Wrongful Discharge.

Under former N.D.C.C. § 32-03-07, a suit for wrongful discharge in retaliation for seeking workers’ compensation is the kind of tort claim which allows exemplary damages. Krein v. Marian Manor Nursing Home, 415 N.W.2d 793, 1987 N.D. LEXIS 435 (N.D. 1987).

An employee can sue an employer for a wrongful discharge in retaliation for seeking workers’ compensation. Krein v. Marian Manor Nursing Home, 415 N.W.2d 793, 1987 N.D. LEXIS 435 (N.D. 1987).

True Intentional Injury.

The North Dakota Workers Compensation Act does not preclude recovery for true intentional injuries, and an employee can pursue a civil cause of action against his employer for a true intentional injury. Zimmerman v. Valdak Corp., 1997 ND 203, 570 N.W.2d 204, 1997 N.D. LEXIS 261 (N.D. 1997).

An employer is deemed to have intended to injure if the employer had knowledge an injury was certain to occur and willfully disregarded that knowledge. Zimmerman v. Valdak Corp., 1997 ND 203, 570 N.W.2d 204, 1997 N.D. LEXIS 261 (N.D. 1997).

Collateral References.

Workmen’s compensation act as furnishing exclusive remedy for master’s failure to inform servant of disease or physical condition disclosed by medical examination, 69 A.L.R.2d 1213.

Right to maintain malpractice suit against injured employee’s attending physician notwithstanding receipt of workmen’s compensation award, 28 A.L.R.3d 1066.

Homeowners’ or personal liability insurance as providing coverage for liability under workmen’s compensation laws, 41 A.L.R.3d 1306.

Workmen’s compensation provision as precluding employee’s action against employer for fraud, false imprisonment, defamation, or the like, 46 A.L.R.3d 1279.

Farmowners’ liability insurance risks and coverage, 93 A.L.R.3d 472.

What conduct is willful, intentional, or deliberate within workmen’s compensation act provision authorizing tort action for such conduct, 96 A.L.R.3d 1064.

Modern status of effect of state workmen’s compensation act on right of third-person tortfeasor to contribution or indemnity from employer of injured or killed workman, 100 A.L.R.3d 350.

Construction and application of provisions of liability insurance policy expressly excluding injuries intended or expected by insured, 31 A.L.R.4th 957.

Liability insurance: intoxication and other mental incapacity avoiding application of clause in liability policy specifically exempting coverage of injury or damage caysed intentionally by or at direction of insured, 33 A.L.R.4th 983.

Criminal conviction as rendering conduct for which insured convicted within provision of liability insurance policy expressly excluded coverage for damage or injury intended or expected by insured, 35 A.L.R.4th 1063.

Workmen’s compensation law as precluding employee’s suit against employer for third person’s criminal attack, 49 A.L.R.4th 926.

Workers’ compensation: sexual assaults as compensable, 52 A.L.R.4th 731.

Workers’ compensation: incarceration as terminating benefits, 54 A.L.R.4th 241.

Prejudicial effect of bringing to jury’s attention fact that plaintiff in personal injury or death action is entitled to workers’ compensation benefits, 69 A.L.R.4th 131.

Automobile uninsured motorist coverage: “legally entitled to recover” clause as barring claim compensable under workers’ compensation statute, 82 A.L.R.4th 1096.

Pre-emption by workers’ compensation statute of employee’s remedy under state “whistleblower” statute, 20 A.L.R.5th 677.

Workers’ compensation: law enforcement officer’s recovery for injury sustained during exercise or physical recreation activities, 44 A.L.R.5th 569.

Workers’ compensation as precluding employee’s suit against employer for sexual harassment in the workplace, 51 A.L.R.5th 163.

Violation of employment rule barring claim for worker’s compensation, 61 A.L.R.5th 375.

Right to workers’ compensation for emotional distress or like injury suffered by claimant as result of nonsudden stimuli — Right to compensation under particular statutory provisions, 97 A.L.R.5th 1.

Contractual waiver of exclusivity of workers’ compensation remedy, 117 A.L.R.5th 441.

Postaccident conduct by employer, employer’s insurer, or employer’s employees in relation to workers’ compensation claim as waiving, or estopping employer from asserting, exclusivity otherwise afforded by workers’ compensation statute, 120 A.L.R.5th 513.

Validity, Construction, and Application of Provisions of Workers’ Compensation Act for Additional Compensation Because of Failure To Comply with Specific Requirement of Statute or Regulation by Public for Protection of Workers, 31 A.L.R.6th 199.

Construction and Application of Exclusive Remedy Rule Under State Workers’ Compensation Statutes with Respect to Liability for Injury or Death of Employee as Passenger in Employer-Provided Vehicle — Requisites for, and Factors Affecting, Applicability and Who May Invoke Rule. 42 A.L.R.6th 545.

Construction and Application of Exclusive Remedy Rule under State Workers’ Compensation Statute With Respect to Liability for Injury or Death of Employee as Passenger in Employer-Provided Vehicle — Against Whom May Rule Be Invoked and Application of Rule to Particular Situations and Employees. 43 A.L.R.6th 375.

Exclusive Remedy Provision of State Workers’ Compensation Statute as Applied to Injuries Sustained During or as the Result of Horseplay, Joking, Fooling, or the Like. 44 A.L.R.6th 545.

Law Reviews.

A Time for Recognition: Extending Workmen’s Compensation Coverage to Inmates, 61 N.D. L. Rev. 403 (1985).

An introduction to North Dakota workers’ compensation, 64 N.D. L. Rev. 173 (1988).

Summary of significant decisions rendered by the North Dakota Supreme Court in 1989 relating to workers’ compensation, 65 N.D. L. Rev. 597 (1989).

Summary of significant decisions rendered by the North Dakota Supreme Court in 1990 relating to workers’ compensation, 66 N.D. L. Rev. 881 (1990).

Summary of the 1991 North Dakota Supreme Court decisions on Workers Compensation, 68 N.D. L. Rev. 815 (1992).

Workers’ Compensation: The Assault on the Shield of Immunity — Coming to Blows with the Exclusive-Remedy Provisions of the North Dakota Workers’ Compensation Act, 70 N.D. L. Rev. 905 (1994).

Constitutional Law — Haney v. North Dakota Workers Compensation Bureau, 518 N.W.2d 195 (N.D. 1994), 71 N.D. L. Rev. 781 (1995).

Federal Pre-Emption and State Exclusive Remedy Issues in Employment Litigation, 72 N.D. L. Rev. 325 (1996).

Are Employees Obtaining “Sure and Certain Relief” Under the 1995 Legislative Enactments of the North Dakota Workers’ Compensation Act?, 72 N.D. L. Rev. 349 (1996).

65-01-01.1. Civil liability for intentional injuries.

The sole exception to an employer’s immunity from civil liability under this title, except as provided in chapter 65-09, is an action for an injury to an employee caused by an employer’s intentional act done with the conscious purpose of inflicting the injury.

Source:

S.L. 1999, ch. 549, § 1.

Collateral References.

Right to workers’ compensation for emotional distress or like injury suffered by claimant as result of sudden stimuli involving nonpersonnel action — Compensability under particular circumstances, 84 A.L.R.5th 249.

Notes to Decisions

Summary Judgment.

District court properly granted a decedent's former employer summary judgment dismissing a widow's wrongful death action because sufficient facts had not been alleged to raise a genuine issue of material fact that the employer engaged in an intentional act with the conscious purpose of inflicting the decedent's injuries pursuant to the Workforce Safety and Insurance Act Bartholomay v. Plains Grain & Agronomy, LLC, 2016 ND 138, 881 N.W.2d 249, 2016 N.D. LEXIS 120 (N.D. 2016).

District court did not err in dismissing an employee’s negligence action as a matter of law because an employee and coworker were immune from suit under the Workforce Safety and Insurance Act’s exclusive remedy provisions; determinations in California administrative proceedings were irrelevant for deciding immunity since the employer paid Workforce Safety and Insurance premiums to secure coverage on the employee’s behalf, and the employee received benefits throughout the California proceedings. Brock v. Price, 2019 ND 240, 934 N.W.2d 5, 2019 N.D. LEXIS 251 (N.D. 2019).

65-01-02. Definitions. [Effective through August 31, 2022]

In this title:

  1. “Acute care” means a short course of intensive diagnostic and therapeutic services provided immediately following a work injury with a rapid onset of pronounced symptoms.
  2. “Adopted” or “adoption” refers only to a legal adoption effected prior to the time of the injury.
  3. “Allied health care professional” includes a health care provider, pharmacist, audiologist, speech language pathologist, or naturopath or any recognized practitioner who provides skilled services pursuant to the prescription of, or under the supervision or direction of any of these individuals.
  4. “Artificial members” includes a device that is a substitute for a natural part, organ, limb, or other part of the body. The term includes a prescriptive device that is an aid for a natural part, organ, limb, or other part of the body if the damage to the prescriptive device is accompanied by an injury to the body. A prescriptive device includes prescription eyeglasses, contact lenses, dental braces, and orthopedic braces.
  5. “Artificial replacements” means mechanical aids, including braces, belts, casts, or crutches as may be reasonable and necessary due to compensable injury.
  6. “Average weekly wage” means the weekly wages the injured employee was receiving from all employments for which coverage is required or otherwise secured at the date of first disability. The average weekly wage determined under this subsection must be rounded to the nearest dollar. If the injured employee’s wages are not fixed by the week, they must be determined by using the first applicable formula from the schedule below:
    1. For seasonal employment, during the first consecutive days of disability up to twenty-eight days the average weekly wage is calculated pursuant to the first applicable formula in subdivisions b through g, and after that are calculated as one-fiftieth of the total wages from all occupations during the twelve months preceding the date of first disability or during the tax year preceding the date of first disability, or an average of the three tax years preceding the date of first disability, whichever is highest and for which accurate, reliable, and complete records are readily available.
    2. The “average weekly wage” of a self-employed employer is determined by the following formula: one fifty-second of the average annual net self-employed earnings reported the three preceding tax years or preceding fifty-two weeks whichever is higher if accurate, reliable, and complete records for those fifty-two weeks are readily available.
    3. Hourly or daily rate multiplied by number of hours or days worked per seven-day week.
    4. Monthly rate multiplied by twelve months and divided by fifty-two weeks.
    5. Biweekly rate divided by two.
    6. The usual wage paid other employees engaged in similar occupations.
    7. A wage reasonably and fairly approximating the weekly wage lost by the injured employee during the period of disability.
  7. “Average weekly wage in the state” means the determination made of the average weekly wage in the state by job service North Dakota on or before July first of each year, computed to the next highest dollar.
  8. “Board” means the workforce safety and insurance board of directors.
  9. “Brother” and “sister” include a stepbrother and a stepsister, a half brother and a half sister, and a brother and sister by adoption. The terms do not include a married brother or sister unless that person actually is dependent.
  10. “Child”, for determining eligibility for benefits under chapter 65-05, means a legitimate child, a stepchild, adopted child, posthumous child, foster child, and acknowledged illegitimate child who is under eighteen years of age and resides with the injured employee; or is under eighteen years of age and does not reside with the injured employee but a duty of support is substantiated by an appropriate court order; or is between eighteen and twenty-two years of age and enrolled as a full-time student in any accredited educational institution and dependent upon the injured employee for support; or is eighteen years of age or over and is physically or mentally incapable of self-support and is actually dependent upon the injured employee for support. A child does not include a married child unless actually dependent on the injured employee as shown on the preceding year’s income tax returns.
  11. “Compensable injury” means an injury by accident arising out of and in the course of hazardous employment which must be established by medical evidence supported by objective medical findings.
    1. The term includes:
      1. Disease caused by a hazard to which an employee is subjected in the course of employment. The disease must be incidental to the character of the business and not independent of the relation of employer and employee. Disease includes effects from radiation.
      2. An injury to artificial members.
      3. Injuries due to heart attack or other heart-related disease, stroke, and physical injury caused by mental stimulus, but only when caused by the employee’s employment with reasonable medical certainty, and only when it is determined with reasonable medical certainty that unusual stress is at least fifty percent of the cause of the injury or disease as compared with all other contributing causes combined. Unusual stress means stress greater than the highest level of stress normally experienced or anticipated in that position or line of work.
      4. Injuries arising out of employer-required or supplied travel to and from a remote jobsite or activities performed at the direction or under the control of the employer.
      5. An injury caused by the willful act of a third person directed against an employee because of the employee’s employment.
      6. A mental or psychological condition caused by a physical injury, but only when the physical injury is determined with reasonable medical certainty to be at least fifty percent of the cause of the condition as compared with all other contributing causes combined, and only when the condition did not pre-exist the work injury.
    2. The term does not include:
      1. Ordinary diseases of life to which the general public outside of employment is exposed or preventive treatment for communicable diseases, except that the organization may pay for preventive treatment for a health care provider as defined in section 23-07.5-01, firefighter, peace officer, correctional officer, court officer, law enforcement officer, emergency medical technician, or an individual trained and authorized by law or rule to render emergency medical assistance or treatment that is exposed to a bloodborne pathogen as defined in section 23-07.5-01 occurring in the course of employment and for exposure to rabies occurring in the course of employment.
      2. A willfully self-inflicted injury, including suicide or attempted suicide, or an injury caused by the employee’s willful intention to injure or kill another.
      3. Any injury caused by the use of intoxicants, including recreational marijuana use, or the illegal use of controlled substances.
      4. An injury that arises out of an altercation in which the injured employee is an aggressor. This paragraph does not apply to public safety employees, including law enforcement officers or private security personnel who are required to engage in altercations as part of their job duties if the altercation arises out of the performance of those job duties.
      5. An injury that arises out of an illegal act committed by the injured employee.
      6. An injury that arises out of an employee’s voluntary nonpaid participation in any recreational activity, including athletic events, parties, and picnics, even though the employer pays some or all of the cost of the activity.
      7. Injuries attributable to a pre-existing injury, disease, or other condition, including when the employment acts as a trigger to produce symptoms in the pre-existing injury, disease, or other condition unless the employment substantially accelerates its progression or substantially worsens its severity. Pain is a symptom and may be considered in determining whether there is a substantial acceleration or substantial worsening of a pre-existing injury, disease, or other condition, but pain alone is not a substantial acceleration or a substantial worsening.
      8. A nonemployment injury that, although acting upon a prior compensable injury, is an independent intervening cause of injury.
      9. A latent or asymptomatic degenerative condition, caused in substantial part by employment duties, which is triggered or made active by a subsequent injury.
      10. A mental injury arising from mental stimulus.
  12. “Date of first disability” means the first date the injured employee was unable to work because of a compensable injury.
  13. “Date of maximum medical improvement” or “date of maximum medical recovery” means the date after which further recovery from, or lasting improvement to, an injury or disease can no longer reasonably be anticipated based upon reasonable medical probability.
  14. “Director” means the director of the organization.
  15. “Disability” means loss of earnings capacity and may be permanent total, temporary total, or partial.
  16. “Employee” means an individual who performs hazardous employment for another for remuneration unless the individual is an independent contractor under the common-law test.
    1. The term includes:
      1. All elective and appointed officials of this state and its political subdivisions, including municipal corporations and including the members of the legislative assembly, all elective officials of any county, and all elective peace officers of any city.
      2. Aliens.
      3. Human service zone general assistance workers, except those who are engaged in repaying to human service zones or the department of human services moneys the human service zones or the department of human services have been compelled by statute to expend for general assistance.
      4. Minors, whether lawfully or unlawfully employed. A minor is deemed sui juris for the purposes of this title, and no other person has any claim for relief or right to claim workforce safety and insurance benefits for any injury to a minor worker, but in the event of the award of a lump sum of benefits to a minor employee, the lump sum may be paid only to the legally appointed guardian of the minor.
    2. The term does not include:
      1. An individual whose employment is both casual and not in the course of the trade, business, profession, or occupation of that individual’s employer.
      2. An individual who is engaged in an illegal enterprise or occupation.
      3. The spouse of an employer or the child under the age of twenty-two of an employer. For purposes of this paragraph and section 65-07-01, “child” means any legitimate child, stepchild, adopted child, foster child, or acknowledged illegitimate child.
      4. A real estate broker or real estate salesperson, provided the individual meets the following three requirements:
        1. The salesperson or broker must be a licensed real estate agent under section 43-23-05.
        2. Substantially all of the salesperson’s or broker’s remuneration for the services performed as a real estate agent must be directly related to sales or other efforts rather than to the number of hours worked.
        3. A written agreement must exist between the salesperson or broker and the person for which the salesperson or broker works, which agreement must provide the salesperson or broker will not be treated as an employee but rather as an independent contractor.
      5. The members of the board of directors of a business corporation who are not employed in any capacity by the corporation other than as members of the board of directors.
      6. An individual delivering newspapers or shopping news, if substantially all of the individual’s remuneration is directly related to sales or other efforts rather than to the number of hours worked and a written agreement exists between the individual and the publisher of the newspaper or shopping news which states the individual is an independent contractor.
      7. An employer.
  17. “Employer” means a person that engages or received the services of another for remuneration unless the person performing the services is an independent contractor under the common-law test. The term includes:
    1. The state and all political subdivisions thereof.
    2. All public and quasi-public corporations in this state.
    3. Every person, partnership, limited liability company, association, and private corporation, including a public service corporation.
    4. The legal representative of any deceased employer.
    5. The receiver or trustee of any person, partnership, limited liability company, association, or corporation having one or more employees as herein defined.
    6. The president, vice presidents, secretary, or treasurer of a business corporation, but not members of the board of directors of a business corporation who are not also officers of the corporation.
    7. The managers of a limited liability company.
    8. The president, vice presidents, secretary, treasurer, or board of directors of an association or cooperative organized under chapter 6-06, 10-12, 10-13, 10-15, 36-08, or 49-21.
    9. The clerk, assessor, treasurer, or any member of the board of supervisors of an organized township, if the person is not employed by the township in any other capacity.
    10. A multidistrict special education unit.
    11. An area career and technology center.
    12. A regional education association.
  18. “Fee schedule” means the payment formulas established in the organization publication entitled “Medical and Hospital Fees”.
  19. “Fund” means the workforce safety and insurance fund.
  20. “Hazardous employment” means any employment in which one or more employees are employed regularly in the same business or in or about the establishment except:
    1. Agricultural or domestic service.
    2. Any employment of a common carrier by railroad.
    3. Any employment for the transportation of property or persons by nonresidents, where, in such transportation, the highways are not traveled more than seven miles [11.27 kilometers] and return over the same route within the state of North Dakota.
    4. All members of the clergy and employees of religious organizations engaged in the operation, maintenance, and conduct of the place of worship.
  21. “Health care provider” means a doctor of medicine or osteopathy, chiropractor, dentist, optometrist, podiatrist, or psychologist acting within the scope of the doctor’s license, a physical therapist, an advanced practice registered nurse, or a certified physician assistant.
  22. “Medical marijuana” means the use of all parts of the plant of the genus cannabis, the seeds of the plant, the resin extracted from any part of the plant, and every compound, manufacture, salt, derivative, mixture, or preparation of the plant, the seeds of the plant, or the resin extracted from any part of the plant as a physician-recommended form of medicine or herbal therapy. The term does not include treatments or preparations specifically approved by the United States food and drug administration as a drug product.
  23. “Noncompliance” means failure to follow the requirements of chapter 65-04. An employer may be in noncompliance regardless of the employer’s insured or uninsured status with the organization.
  24. “Organization” means workforce safety and insurance, or the director, or any department head, assistant, or employee of workforce safety and insurance designated by the director, to act within the course and scope of that person’s employment in administering the policies, powers, and duties of this title.
  25. “Parent” includes a stepparent and a parent by adoption.
  26. “Payroll report” means the mechanism created by the organization and used by employers to report all employee payroll required by the organization.
  27. “Permanent impairment” means the loss of or loss of use of a member of the body existing after the date of maximum medical improvement and includes disfigurement resulting from an injury.
  28. “Permanent total disability” means disability that is the direct result of a compensable injury that prevents an injured employee from performing any work and results from any one of the following conditions:
    1. Total and permanent loss of sight of both eyes;
    2. Loss of both legs or loss of both feet at or above the ankle;
    3. Loss of both arms or loss of both hands at or above the wrist;
    4. Loss of any two of the members or faculties in subdivision a, b, or c;
    5. Permanent and complete paralysis of both legs or both arms or of one leg and one arm;
    6. Third-degree burns that cover at least forty percent of the body and require grafting;
    7. A medically documented brain injury affecting cognitive and mental functioning which renders an injured employee unable to provide self-care and requires supervision or assistance with a majority of the activities of daily living; or
    8. A compensable injury that results in a permanent partial impairment rating of the whole body of at least twenty-five percent pursuant to section 65-05-12.2.
  29. “Rehabilitation services” means nonmedical services reasonably necessary to restore a disabled employee to substantial gainful employment as defined by section 65-05.1-01 as near as possible. The term may include vocational evaluation, counseling, education, workplace modification, vocational retraining including training for alternative employment with the same employer, and job placement assistance.
  30. “Seasonal employment” includes occupations that are not permanent or that do not customarily operate throughout the entire year. Seasonal employment is determined by what is customary with respect to the employer at the time of injury.
  31. “Spouse” includes only the decedent’s husband or wife who was living with the decedent or was dependent upon the decedent for support at the time of injury.
  32. “Subcontractor” means a person that agrees to perform all or part of the work for a contractor or another subcontractor.
  33. “Temporary total disability” means disability that results in the inability of an injured employee to earn wages as a result of a compensable injury for which disability benefits may not exceed a cumulative total of one hundred four weeks or the date the injured employee reaches maximum medical improvement or maximum medical recovery, whichever occurs first.
  34. “Uninsured” means failure of an employer to secure mandatory coverage with the organization or failure to pay premium, assessment, penalty, or interest, as calculated by the organization, which is more than forty-five days past due. An uninsured employer is subject to chapter 65-09.
  35. “Utilization review” means the initial and continuing evaluation of appropriateness in terms of both the level and the quality of health care and health services provided a patient, based on medically accepted standards. The evaluation must be accomplished by means of a system that identifies the utilization of medical services, based on medically accepted standards, and which refers instances of possible inappropriate utilization to the organization to obtain opinions and recommendations of expert medical consultants to review individual cases for which administrative action may be deemed necessary.
  36. “Valid functional capacities examination” means:
    1. The results of a physical examination consisting of a battery of standardized assessments that offer reliable results in performance-based measures and demonstrate the level and duration an injured employee may return to work.
    2. The conclusions of medical experts, following observations of other activities the medical expert determines similarly predictive, when the results of the physical examination in subsection a are not obtained or reliable.
    1. “Wages” means:
      1. An injured employee’s remuneration from all employment reportable to the internal revenue service as earned income for federal income tax purposes.
      2. For members of the national guard who sustain a compensable injury while on state active duty, “wages” includes income from federal employment and may be included in determining the average weekly wage.
      3. For purposes of chapter 65-04 only, “wages” means all gross earnings of all employees. The term includes all pretax deductions for amounts allocated by the employee for deferred compensation, medical reimbursement, retirement, or any similar program, but may not include dismissal or severance pay.
    2. The organization may consider postinjury wages for which coverage was not required or otherwise secured in North Dakota for purposes of determining appropriate vocational rehabilitation options or entitlement to disability benefits under this title.

If the injured employee has not reached maximum medical improvement within one hundred four weeks, the injured employee may receive a permanent partial impairment rating if a rating will assist the organization in assessing the injured employee’s capabilities. Entitlement to a rating is solely within the discretion of the organization.

Source:

S.L. 1919, ch. 162, § 2; 1921, ch. 142, § 1; 1925, ch. 222, § 1; 1925 Supp., § 396a2; S.L. 1935, ch. 286, § 1; 1941, ch. 303, § 1; 1941, ch. 305, § 1; 1943, ch. 274, §§ 1, 13; R.C. 1943, § 65-0102; S.L. 1945, ch. 337, § 1; 1947, ch. 375, § 1; 1949, ch. 354, § 1; 1951, ch. 341, § 1; 1955, ch. 354, § 6; 1957, ch. 390, § 1; 1957 Supp., § 65-0102; S.L. 1961, ch. 388, § 1; 1965, ch. 451, § 1; 1967, ch. 483, §§ 1, 2; 1969, ch. 558, § 1; 1971, ch. 597, § 1; 1971, ch. 598, § 1; 1975, ch. 579, §§ 1, 2; 1977, ch. 579, § 2; 1981, ch. 639, § 1; 1981, ch. 640, § 1; 1983, ch. 695, §§ 1, 2; 1985, ch. 82, § 159; 1985, ch. 685, §§ 1, 2; 1987, ch. 298, § 3; 1987, ch. 750, § 1; 1989, ch. 69, § 74; 1989, ch. 295, § 4; 1989, ch. 765, § 1; 1991, ch. 54, § 30; 1991, ch. 713, § 1; 1991, ch. 714, § 23; 1993, ch. 45, § 22; 1993, ch. 54, § 105; 1993, ch. 613, §§ 1, 5; 1993, ch. 614, §§ 1, to 3; 1993, ch. 615, § 1; 1993, ch. 616, § 1; 1993, ch. 617, § 1; 1995, ch. 456, § 24; 1995, ch. 606, § 1; 1995, ch. 607, § 1; 1995, ch. 608, § 1; 1995, ch. 609, § 1; 1995, ch. 610, § 1; 1997, ch. 527, § 1; 1997, ch. 528, § 1; 1997, ch. 530, § 1; 1999, ch. 550, § 1; 1999, ch. 551, § 1; 2001, ch. 574, § 1; 2001, ch. 575, § 1; 2003, ch. 561, §§ 1, 3; 2003, ch. 562, §§ 1, 2; 2005, ch. 235, § 6; 2005, ch. 610, § 1; 2005, ch. 611, § 1; 2009, ch. 163, § 4; 2009, ch. 607, § 1; 2009, ch. 608, § 1; 2013, ch. 498, § 1; 2013, ch. 499, § 1; 2015, ch. 334, § 11, eff August 1, 2015; 2015, ch. 480, § 1, eff August 1, 2015; 2017, ch. 434, § 1, eff August 1, 2017; 2017, ch. 438, § 1, eff August 1, 2017; 2019, ch. 391, § 137, eff January 1, 2020; 2019, ch. 523, § 2, eff August 1, 2019; 2019, ch. 524, § 1, eff August 1, 2019; 2019, ch. 525, § 1, eff July 1, 2019; 2021, ch. 500, § 1, eff July 1, 2021; 2021, ch. 501, § 1, eff August 1, 2021.

Note.

Section 13 of chapter 500, S.L. 2021, provides, “ APPLICATION. This Act applies to all claims regardless of date of injury.”

Section 10 of chapter 525, S.L. 2019 provides, “ APPLICATION. Sections 1, 2, 4, 6, 7, and 8 of this Act apply to all claims regardless of date of injury.”

Section 65-01-02 was amended 3 times by the 2021 Legislative Assembly. Pursuant to Section 1-02-09.1 , the section is printed above to harmonize and give effect to the changes made in Section 1 of Chapter 500, Session Laws 2021 , House Bill 1084; Section 1 of Chapter 501, Session Laws 2021, Senate Bill 2148; and Section 508 of Chapter 352, Session Laws 2021, House Bill 1247.

Cross-References.

Word defined by statute always has same meaning, see N.D.C.C. § 1-01-09.

Notes to Decisions

In General.

Although the Workers’ Compensation Act must be liberally construed in favor of workers so that its benefit provisions can be extended to all who can fairly be brought within them, the court is not free to ignore the plain and ordinary language of the statute. Pleinis v. North Dakota Workers Compensation Bureau, 472 N.W.2d 459, 1991 N.D. LEXIS 128 (N.D. 1991).

Compensable injury.
—Unusual stress.

In a workers’ compensation action, the ALJ erred in ordering payment of death benefits to the employee’s family member after the employee died following a injury sustained when the truck he was driving tipped because the ALJ improperly applied this section, and made no finding as to unusual stress as required by this section. State v. Felan, 2021 ND 97, 960 N.W.2d 805, 2021 N.D. LEXIS 102 (N.D. 2021).

Actual Wage Loss.

Using the definition of “wage” found in N.D.C.C. § 65-01-02 in the context of “actual wage loss” under N.D.C.C. § 65-05-08(1)(b), the claimant must prove that he has sustained an actual loss of remuneration from employment which would be reportable to the IRS as earned income for federal income tax purposes. To demonstrate an actual loss of wages or remuneration as a result of a change in the claimant’s compensable medical condition, the claimant must necessarily first demonstrate that he was earning wages from employment when the change in his medical condition occurred and must then show that the change caused at least a partial loss of those wages. Beckler v. Workforce Safety & Ins. (In re Beckler), 2005 ND 33, 692 N.W.2d 483, 2005 N.D. LEXIS 39 (N.D. 2005).

Artificial Replacement.

Adaptive equipment on an injured party’s van was an “artificial replacement” under the statute. Meyer v. North Dakota Workers Compensation Bureau, 512 N.W.2d 680, 1994 N.D. LEXIS 46 (N.D. 1994).

Average Weekly Wage.

Workforce Safety and Insurance correctly interpreted the plain language of N.D.C.C. § 65-01-02 and did not err in calculating the claimant’s average weekly wage, because the reviewing court could not agree with the suggestion that some deductions were to be added to net profit from Schedule C of a self-employed worker’s federal tax return to calculate average weekly wage, when the 2003 statutory amendment expressly removed the provision requiring that certain business deductions and depreciation be added back in. Olson v. Workforce Safety & Ins., 2008 ND 59, 747 N.W.2d 71, 2008 N.D. LEXIS 59 (N.D. 2008).

District court did not err in applying N.D.C.C. § 65-01-02 and a reasoning mind could have determined that the ALJ’s findings were proven by the weight of the evidence from the entire record; the ALJ’s decision in determining the worker’s average weekly wage of $722 was affirmed. Carlson v. Workforce Safety & Ins., 2012 ND 203, 821 N.W.2d 760, 2012 N.D. LEXIS 211 (N.D. 2012).

Compensable Injury.
—Aggravation of Disease.

Acceleration of preexisting disease to fatal conclusion by excessive artificial heat under which employee labored, was an injury within workers’ compensation act. Pace v. North Dakota Workmen's Compensation Bureau, 51 N.D. 815, 201 N.W. 348, 1924 N.D. LEXIS 90 (N.D. 1924); Pfeiffer v. North Dakota Workmen's Compensation Bureau, 57 N.D. 326, 221 N.W. 894, 1928 N.D. LEXIS 132 (N.D. 1928).

Employee did not suffer a compensable injury to the back under this section because the injury was attributable to a preexisting injury suffered in a car accident; moreover, the employee was unable to establish that the condition was substantially accelerated or worsened by the conditions of employment, which included standing, lifting, and walking. Myhre v. N.D. Workers Comp. Bureau, 2002 ND 186, 653 N.W.2d 705, 2002 N.D. LEXIS 239 (N.D. 2002).

Worker's compensation claimant's medical benefits claim was properly denied as he failed to show his work activities substantially accelerated the progression or substantially worsened the severity of a preexisting condition because the evidence showed that the claimant had substantial back pain prior to beginning work at his former employer, and that when the claimant had back pain in August 2010, it was substantially similar to prior times, including the time before he started working for his former employer. Frith v. N.D. Workforce Safety & Ins., 2014 ND 93, 845 N.W.2d 892, 2014 N.D. LEXIS 95 (N.D.), cert. denied, 574 U.S. 1027, 135 S. Ct. 719, 190 L. Ed. 2d 442, 2014 U.S. LEXIS 7974 (U.S. 2014).

—Burden of Proof.

A claimant must show, by a simple preponderance of the evidence, a compensable injury in order to participate in the workers compensation fund. Moses v. North Dakota Workers Compensation Bureau, 429 N.W.2d 436, 1988 N.D. LEXIS 255 (N.D. 1988).

The presumed fact is that the condition was suffered in the line of duty and is not a preexisting disease, and the statute shifts the burden to the bureau to prove “that the nonexistence of the presumed fact is more probable than its existence.” Flermoen v. North Dakota Workers Compensation Bureau, 470 N.W.2d 220, 1991 N.D. LEXIS 100 (N.D. 1991).

Because an administrative law judge (ALJ) did not apply the correct standard when evaluating conflicting medical opinions on causation where the ALJ’s rationale for discounting the opinion favorable to the claimant relied upon the importance of supporting a medical opinion with another scientific authority, such as a treatise or a published report of a study and neither the statutes nor case law imposed such a requirement, and because the court was unpersuaded by the ALJ’s speculation as to factual errors in the opinions, the court reversed an order affirming a decision of the Workforce Safety & Insurance Fund denying benefits for treatment of a worker’s back injury. The court also noted that it did not understand the ALJ’s reference to a “particularly heavy burden” and stated that the claimant need only prove it was more likely than not that his injuries were caused by his employment. Swenson v. Workforce Safety & Ins. Fund, 2007 ND 149, 738 N.W.2d 892, 2007 N.D. LEXIS 151 (N.D. 2007).

—Causal Relationship.

Preexisting high blood pressure was cause of stroke suffered by an employee, even though stroke occurred shortly after an argument in course of employment, so there was no compensable injury. Sandlie v. Workmen's Compensation Bureau, 70 N.D. 449, 295 N.W. 497, 1940 N.D. LEXIS 192 (N.D. 1940).

Though an injury is compensable if received in course of employment, disease from which a worker dies must be one proximately caused by the employment to be compensable. McKinnon v. North Dakota Workmen's Compensation Bureau, 71 N.D. 228, 299 N.W. 856, 1941 N.D. LEXIS 158 (N.D. 1941).

Hemorrhage of an ulcer was not compensable where evidence tending to show relationship to employment was purely speculative. Wobbe v. Workmen's Compensation Bureau, 73 N.D. 256, 13 N.W.2d 712, 1944 N.D. LEXIS 57 (N.D. 1944).

Death due to cerebral hemorrhage was not compensable where evidence failed to establish that hemorrhage was fairly traceable to pneumonia caused by exposure during employment. Feist v. North Dakota Workmen's Compensation Bureau, 80 N.W.2d 100, 1956 N.D. LEXIS 163 (N.D. 1956).

Lack of evidence linking worker’s lung condition to fumes and particles in the workplace supported Workers Compensation Bureau’s finding that the lung condition was neither caused nor aggravated by his employment. Engebretson v. North Dakota Workers Compensation Bur., 1999 ND 112, 595 N.W.2d 312, 1999 N.D. LEXIS 96 (N.D. 1999).

The supreme court declined to make findings regarding whether multiple chemical sensitivity is a disease; the claimant failed to prove that any condition resulting in injury was fairly traceable to her employment. Elshaug v. Workforce Safety & Ins., 2003 ND 177, 671 N.W.2d 784, 2003 N.D. LEXIS 190 (N.D. 2003).

But-for reasoning of the positional risk doctrine is inconsistent with N.D.C.C. § 65-01-02(10) [now subsec. (11)], which requires claimants to prove a causal connection between their employment and injury. Because the positional risk doctrine requires a claimant only to show that an injury was sustained while at work, the doctrine directly contravenes both the language of N.D.C.C. § 65-01-02(10) [now subsec. (11)] and the legislature’s stated intent in adding the “arising out of” element. Fetzer v. N.D. Workforce Safety & Ins., 2012 ND 73, 815 N.W.2d 539, 2012 N.D. LEXIS 70 (N.D. 2012).

Because appellant was unable to show a causal connection between her unexplained fall at work and her employment, the administrative law judge properly denied her request for workers’ compensation. Appellant did not meet her burden of showing an injury “arising out of” her employment for purposes of N.D.C.C. § 65-01-02(10). Fetzer v. N.D. Workforce Safety & Ins., 2012 ND 73, 815 N.W.2d 539, 2012 N.D. LEXIS 70 (N.D. 2012).

—Conflicting Evidence.

Where expert testimony was conflicting as to whether disease causing death could have been caused by back strain incurred in course of employment, bureau’s finding that there was no relationship was justified. Mickelson v. North Dakota Workmen's Compensation Bureau, 89 N.W.2d 89, 1958 N.D. LEXIS 71 (N.D. 1958).

Where conflicting medical testimony was given by two physicians on issue of whether work-related injuries aggravated or accelerated the progression of claimant’s congenital spondylolisthesis and Worker’s Compensation Bureau adequately explained its reasons for accepting one physician’s opinion, Supreme Court would not make independent findings or substitute its judgment for that of the Bureau. Hibl v. North Dakota Workers Compensation Bureau, 1998 ND 198, 586 N.W.2d 167, 1998 N.D. LEXIS 215 (N.D. 1998).

Workers Compensation Bureau sufficiently clarified conflicting reports among the four doctors who examined the claimant and thus the Bureau’s determination that injuries to the claimant’s neck, back and shoulder were caused by her degenerative disc disease rather than her fall at work was supported by a preponderance of the evidence. Hein v. North Dakota Workers Compensation Bureau, 1999 ND 200, 601 N.W.2d 576, 1999 N.D. LEXIS 208 (N.D. 1999).

Administrative law judge (ALJ) correctly denied a worker's claim for workforce safety and insurance benefits because (1) the ALJ found no specific incident occurred resulting in the worker's injury, (2) the worker did not relate the worker's symptoms to work activities, (3) the worker presented no objective medical findings supporting a medical opinion that the worker's repetitive work activities caused or accelerated the progression of, or substantially worsened the severity of, the worker's hernia, and (4) a contrary opinion contained details showing the worker's job was neither the cause of the hernia, nor a substantial contributing factor. Kershaw v. Workforce Safety & Ins., 2013 ND 186, 838 N.W.2d 429, 2013 N.D. LEXIS 185 (Oct. 22, 2013).

—Control of Employer.

An activity which is a substantial part of the service for which the worker is employed is an activity performed under the control of the employer. Diegel v. North Dakota Workers Compensation Bureau, 469 N.W.2d 151, 1991 N.D. LEXIS 87 (N.D. 1991).

—Controlled Substances.

Bureau’s dismissal of claimant’s claim as noncompensable was upheld where evidence was presented from which a reasonable mind could conclude that claimant had illegal drugs in his system on the date of injury and those drugs were the cause of claimant’s injuries. Smith v. North Dakota Workers Compensation Bureau, 2000 ND 51, 608 N.W.2d 250, 2000 N.D. LEXIS 40 (N.D. 2000).

—Course of Employment.

Intentional shooting of an employee by third person while employee was actively engaged in her work resulted in a compensable injury even though motive for shooting had no relation to employment. Lippmann v. North Dakota Workmen's Compensation Bureau, 79 N.D. 248, 55 N.W.2d 453, 1952 N.D. LEXIS 117 (N.D. 1952).

An injury arises in the course of employment if it occurs within the period of employment at a place where the employee may reasonably be and while he was engaged in performing the duties of his contract or is engaged in something incident thereto and contemplated thereby. Westman v. North Dakota Workers Compensation Bureau, 459 N.W.2d 540, 1990 N.D. LEXIS 167 (N.D. 1990).

The decision in Beckler v. North Dakota Workers Compensation Bureau, 418 N.W.2d 770 (N.D. 1988), should be applied retrospectively only to those claims that were pending in the appeal process as of the date of that decision, and in which the issue was raised before the bureau and on appeal either by the specifications of error or trial by agreement of the parties. Forster v. North Dakota Workers Compensation Bureau, 447 N.W.2d 501, 1989 N.D. LEXIS 193 (N.D. 1989).

—Exposure to Weather.

Death due to pneumonia caused by exposure to cold and wet weather during course of employment was compensable. TWETEN v. NORTH DAKOTA WORKMEN'S COMPENSATION BUR., 69 N.D. 369, 287 N.W. 304, 1939 N.D. LEXIS 163 (N.D. 1939).

—Fairly Traceable to Employment.

Reports favorable to plaintiff’s claim that gas and exhaust fumes in school bus that she drove made her ill did not adequately take into account her sensitivity to certain fragrances prior to her employment with the school district, nor her years of smoking cigarettes; the record contained sufficient evidence to conclude that a reasonable mind could reasonably find that her illness was not “fairly traceable” to employment with the school district, or that her employment, at most, “triggered” a preexisting condition, but did not substantially aggravate or accelerate her illness. Halseth v. North Dakota Workers Compensation Bureau, 514 N.W.2d 371, 1994 N.D. LEXIS 79 (N.D. 1994).

—Heart Attack.

A heart attack caused by exertion is in itself an accident, not a disease, and therefore it is immaterial that a preexisting disease contributed to the death; subdivision 7a (now subdivision 10(a)) of this section was not applicable where myocardial infarction was an accident, and thus claimant was entitled to recover despite preexisting disease contention made by bureau. Stout v. North Dakota Workmen’s Comp. Bureau, 236 N.W.2d 889 (N.D. 1975), overruled on other grounds, Balliet v. North Dakota Workmen’s Comp. Bureau, 297 N.W.2d 791 (N.D. 1980), decided prior to the amendment to this section by Session Laws 1977, ch. 579.

Fact that an employee may have physical conditions or personal habits which make him more prone to a heart disease is not a reason for denying a claim if the preponderance of the evidence indicates that the heart attack was causally related to the workers’ employment, with reasonable medical certainty, and was precipitated by unusual stress. Nelson v. North Dakota Workmen's Compensation Bureau, 316 N.W.2d 790, 1982 N.D. LEXIS 211 (N.D. 1982).

Testimony by widow and fellow worker of deceased that deceased had been under unusual emotional stress related to his employment was insufficient to establish that fatal heart attack suffered by deceased while at work was precipitated by unusual stress. Nelson v. North Dakota Workmen's Compensation Bureau, 316 N.W.2d 790, 1982 N.D. LEXIS 211 (N.D. 1982).

This subsection was amended by chapter 579, section 2, 1977 N.D. Session Laws, to allow benefit awards for heart attacks only where there is evidence of “unusual” stress. Nelson v. North Dakota Workmen's Compensation Bureau, 316 N.W.2d 790, 1982 N.D. LEXIS 211 (N.D. 1982).

Employee was not entitled to benefits for an injury due to a heart attack where she failed to prove by weight of evidence that neither work-related stress over four-year course of her employment as a kitchen helper nor on day of her heart attack constituted an unusual or out-of-the-ordinary stress; and thus she failed to prove her heart attack was precipitated by unusual stress in course of her employment. Ganske v. North Dakota Workmen's Compensation Bureau, 355 N.W.2d 800, 1984 N.D. LEXIS 385 (N.D. 1984).

In order to prove that a heart attack is a compensable injury, the claimant must also prove that the attack was causally related to the worker’s employment, with reasonable and medical certainty. Christianson v. North Dakota Workers Compensation Bureau, 470 N.W.2d 613, 1991 N.D. LEXIS 114 (N.D. 1991).

In order to satisfy the “unusual stress” requirement, the work causing the heart attack need not be different in nature from the claimant’s usual work. Rather, so long as the conditions of performing the work are such that an exceptional strain is imposed on the worker so great that his heart is affected and damaged thereby, the requirement of unusual or excessive strain is satisfied. Christianson v. North Dakota Workers Compensation Bureau, 470 N.W.2d 613, 1991 N.D. LEXIS 114 (N.D. 1991).

In a worker’s compensation matter involving a claim by a surviving spouse for death benefits, the administrative law judge (ALJ) did not err in concluding decedent died as a result of a heart attack caused by work-related stress, which was compensable under N.D.C.C. § 65-01-02(10)(a)(3), as the ALJ relied on the testimony of the decedent’s primary care physician, who testified that long-term pain that the decedent suffered caused extraordinary stress, that long-term stress was a risk factor for heart attacks, and that stress was at least fifty percent of the cause of the decedent’s fatal heart attack as compared to all other factors. The ALJ clarified inconsistencies in the evidence and adequately explained his reasons for disregarding the testimony of the employer’s experts. Workforce Safety & Ins. v. Auck, 2010 ND 126, 785 N.W.2d 186, 2010 N.D. LEXIS 127 (N.D. 2010).

—Injury by Accident.

A back injury may satisfy the “injury by accident” requirement of this section not only if the cause of the injury was of accidental character, but also if the cause is routine and the result is not foreseen, intended, or anticipated; thus, an injury such as acute disc syndrome, which can be medically related to repeated stress or strain in a claimant’s usual work exertions, is a compensable injury under the workers’ compensation act. Satrom v. North Dakota Workmen's Compensation Bureau, 328 N.W.2d 824, 1982 N.D. LEXIS 393 (N.D. 1982).

Issues decided by the administrative law judge (ALJ) on remand were included in the issues the supreme court sent back and, therefore, the ALJ did not go beyond the terms of the mandate; the supreme court’s decision only required the ALJ to determine and make consistent sufficient findings as to whether an employee sustained a “compensable injury,” and the ALJ’s revised order included additional specific findings on the medical evidence and determined the employee sustained a compensable injury. State v. Sandberg, 2021 ND 39, 956 N.W.2d 342, 2021 N.D. LEXIS 39 (N.D. 2021).

Administrative law judge (ALJ) properly found that an employee had sustained a compensable injury and was entitled to benefits because the ALJ made specific findings regarding the ALJ’s consideration of the evidence presented at the hearing, weighed the doctors’ competing opinions; because the ALJ had the opportunity to observe witnesses and the responsibility to assess the credibility of witnesses and resolve the conflicts in the evidence, the supreme court would not reweigh the evidence. State v. Sandberg, 2021 ND 39, 956 N.W.2d 342, 2021 N.D. LEXIS 39 (N.D. 2021).

—Jurisdiction.

A worker’s compensation claimant, when appealing to a district court, has the burden to show that the court has jurisdiction. Boyko v. North Dakota Workmen's Compensation Bureau, 409 N.W.2d 638, 1987 N.D. LEXIS 379 (N.D. 1987).

—Legislative Intent.

The language in former paragraph 9 a (4) of N.D.C.C. § 65-01-02 (see present paragraph 10.a.(4) for similar provisions) was added in 1989. The intent in adding the language was to clarify and be more specific as to what is, and is not, considered a compensable injury. Diegel v. North Dakota Workers Compensation Bureau, 469 N.W.2d 151, 1991 N.D. LEXIS 87 (N.D. 1991).

—Medical Evidence.

Where the only medical evidence in the record showed that the claimant had a permanent partial impairment, both physicians discerned pain and its effect, and they identified objective evidence indicative of impairment, the workers compensation bureau erred in denying compensation solely because the claimant’s impairment was not substantiated by objective medical evidence under the American medical association’s guides to the evaluation of permanent impairment. Accordingly, the action was remanded for further proceedings by the bureau to determine the extent of impairment. Kroeplin v. North Dakota Workmen's Compensation Bureau, 415 N.W.2d 807, 1987 N.D. LEXIS 440 (N.D. 1987).

Administrative law judge’s findings were not sufficient to understand the basis for the decision that the claimant sustained a compensable injury because the administrative law judge did not cite any medical evidence supported by objective medical findings in the record to support a determination that the claimant’s repetitive work activities did not merely trigger symptoms, but rather substantially worsened the severity of his preexisting degenerative disc disease. State v. Sandberg, 2019 ND 198, 931 N.W.2d 488, 2019 N.D. LEXIS 210 (N.D. 2019).

—Mental Injury.

Because workers’ compensation benefits are not available for mental injury resulting from termination of employment, an employee whose employment is terminated can pursue other remedies. Choukalos v. North Dakota Workers' Compensation Bureau, 427 N.W.2d 344, 1988 N.D. LEXIS 186 (N.D. 1988).

Employee was properly denied workers' compensation benefits for treatment of anxiety and depression because he failed to establish that his physical injury caused at least 50 percent of his anxiety and depression as compared with all other contributing causes, as required by N.D.C.C. § 65-01-02(10)(a)(6) [now N.D.C.C. § 65-01-02(11)(a)(6)]; the evidence established that his relationship with the employer was a contributing cause of his anxiety and depression. Davenport v. Workforce Safety & Ins. Fund, 2013 ND 118, 833 N.W.2d 500, 2013 N.D. LEXIS 123 (July 18, 2013).

—Part-of-Service Exception.

Whether a journey itself is part of service to the employer is not dependent upon compensation. Diegel v. North Dakota Workers Compensation Bureau, 469 N.W.2d 151, 1991 N.D. LEXIS 87 (N.D. 1991).

A reasoning mind could not reasonably conclude that an employee’s daily journey to West Fargo to pick up co-workers was not part of the service for which he was employed, given the special degree of inconveniences under which the journey was made, the evidence of the employer’s expectations of the employee, and the benefits derived by the employer. The evidence showed that the employer became upset with the claimant and “chewed him out” on one occasion when the claimant failed to drive the company vehicle to the job-site and told him, on that occasion, that if he couldn’t get the company vehicle to the job-site each morning he “might as well not even come.” Diegel v. North Dakota Workers Compensation Bureau, 469 N.W.2d 151, 1991 N.D. LEXIS 87 (N.D. 1991).

The crux of the part-of-service exception is that the travel of the employee is itself a part of the work within the employer/employee relationship. The employer/employee relationship is defined largely by the element of control. Diegel v. North Dakota Workers Compensation Bureau, 469 N.W.2d 151, 1991 N.D. LEXIS 87 (N.D. 1991).

—Personal Habits.

Just because personal habits make a worker more prone to certain injuries does not mean the bureau can deny a claim when the evidence indicates with reasonable medical certainty that work conditions are causally connected to the particular injury. McDaniel v. North Dakota Workers Compensation Bureau, 1997 ND 154, 567 N.W.2d 833, 1997 N.D. LEXIS 173 (N.D. 1997).

—Preexisting Condition.

The statutory language unambiguously describes when compensation is allowed for injuries attributable to both a latent underlying condition and an underlying condition which clearly manifested itself prior to the compensable injury. In both situations injuries attributable to the preexisting condition are compensable if employment substantially aggravates or accelerates the condition. Pleinis v. North Dakota Workers Compensation Bureau, 472 N.W.2d 459, 1991 N.D. LEXIS 128 (N.D. 1991).

Remand was necessary to determine whether worker’s employment trigger substantially aggravated previously asymptomatic arthritic condition where plaintiff’s medical evidence indicated the injury was triggered by her employment and the Workers’ Compensation Bureau failed to explain its disregard of plaintiff’s favorable medical evidence. Geck v. North Dakota Workers Compensation Bureau, 1998 ND 158, 583 N.W.2d 621, 1998 N.D. LEXIS 156 (N.D. 1998).

Workforce safety and insurance benefits were denied because a claimant did not establish that his increased pain, increased need for medical care, and increased need for medication constituted a substantial worsening or acceleration of his preexisting back condition under N.D.C.C. § 65-01-02(10)(b)(7) [now N.D.C.C. § 65-01-02(11)(b)(7)]; the inconsistencies in the medical opinions were adequately addressed, and adequate reasons were given for disregarding evidence favorable to the claimant. Bergum v. N.D. Workforce Safety & Ins., 2009 ND 52, 764 N.W.2d 178, 2009 N.D. LEXIS 33 (N.D. 2009).

Employee did not prove that he suffered a compensable work related injury because the employee had symptoms consistent with a disc herniation before the claimed date of injury, and he was engaged in non-work activities that could have caused or contributed to the disc herniation. An expert testified the events and activities noted in the employee’s medical records, such as playing football or laying carpet, could have caused a disc condition to become more symptomatic. Schoch v. N.D. Workforce Safety & Ins., 2010 ND 25, 778 N.W.2d 542, 2010 N.D. LEXIS 26 (N.D. 2010).

Where claimant suffered off-the-job injuries to her lower back and had degenerative disc disease, picking up a band-aid at work triggered a preexisting condition within the meaning of N.D.C.C. § 65-01-02(10)(b) [now N.D.C.C. § 65-01-02(11)(b)(7)] but did not substantially accelerate or worsen her condition. Claimant was not entitled to benefits. Curran v. N.D. Workforce Safety & Ins., 2010 ND 227, 791 N.W.2d 622, 2010 N.D. LEXIS 230 (N.D. 2010).

Reasoning mind could have found that the claimant failed to establish, by a preponderance of the evidence, that the claimant’s right shoulder pain was substantially accelerated or substantially worsened by the claimant’s work injury and vocational training, which meant that the claimant did not have a N.D.C.C. § 65-01-11 compensable injury. The injury was not compensable because N.D.C.C. § 65-01-02(10)(b)(7) [now N.D.C.C. § 65-01-02(11)(b)(7)] excluded preexisting injuries unless they substantially accelerated or substantially worsened a claimant’s prior injury, which the claimant was not able to show. Johnson v. N.D. Workforce Safety & Ins. Fund, 2012 ND 87, 816 N.W.2d 74, 2012 N.D. LEXIS 88 (N.D. 2012).

Administrative law judge (ALJ) misapplied the definition of a compensable injury set forth in N.D.C.C. § 65-01-02(10) [now N.D.C.C. § 65-01-02(11)(b)(7)]. The ALJ’s decision focused on whether the claimant’s degenerative disc disease itself worsened without considering whether the underlying injury, disease, or other condition would likely have progressed similarly in the absence of the claimant’s employment. Mickelson v. N.D. Workforce Safety & Ins., 2012 ND 164, 820 N.W.2d 333, 2012 N.D. LEXIS 172 (N.D. 2012).

Employment substantially accelerates the progression or substantially worsens the severity of a preexisting injury, disease, or other condition when the underlying condition likely would not have progressed similarly in the absence of employment. Mickelson v. N.D. Workforce Safety & Ins., 2012 ND 164, 820 N.W.2d 333, 2012 N.D. LEXIS 172 (N.D. 2012).

Medical evidence did not establish a causal relationship under N.D.C.C. ??65-01-02(10)(b)(7) [now N.D.C.C. ??65-01-02(11)(b)(7)] between an employee's work injuries and the pain from his degenerative lower back condition; an independent medical examination provided evidence that his condition, including his pain symptoms, would have progressed similarly in the absence of the work injuries. Davenport v. Workforce Safety & Ins. Fund, 2013 ND 118, 833 N.W.2d 500, 2013 N.D. LEXIS 123 (July 18, 2013).

Administrative law judge misapplied the law in finding the injury was attributable to the worker's preexisting condition because it made him more susceptible to injury; the worker's susceptibility to the injury because of his preexisting condition did not make the injury attributable to the preexisting condition, and instead, there had to be some evidence that the injury triggered symptoms in the worker's preexisting condition or some other evidence that his current condition was attributable to the preexisting condition. Parsons v. Workforce Safety & Ins. Fund, 2013 ND 235, 841 N.W.2d 404, 2013 N.D. LEXIS 254 (Dec. 19, 2013).

Preponderance of the evidence established the pain was not a symptom of the preexisting condition and the injury did not trigger symptoms of his preexisting condition, and the evidence established a causal relationship between the work injury and the worker's condition for which he sought treatment, and thus the administrative law judge erred in finding that the worker failed to prove he sustained a compensable injury. Parsons v. Workforce Safety & Ins. Fund, 2013 ND 235, 841 N.W.2d 404, 2013 N.D. LEXIS 254 (Dec. 19, 2013).

Administrative law judge’s findings were not sufficient to understand the basis for the decision that the claimant sustained a compensable injury because the administrative law judge’s decision stated that the claimant’s work activities increased the severity of the symptom of pain from his preexisting degenerative disc disease, but the language of this statute stated that pain alone was not a substantial acceleration or a substantial worsening of a preexisting injury, disease, or other condition. State v. Sandberg, 2019 ND 198, 931 N.W.2d 488, 2019 N.D. LEXIS 210 (N.D. 2019).

—Physical Impact.

Physical impact is not necessary prerequisite to compensable injury. Pace v. North Dakota Workmen's Compensation Bureau, 51 N.D. 815, 201 N.W. 348, 1924 N.D. LEXIS 90 (N.D. 1924).

—Traveling to and from Work.

An injury sustained while an employee was on his way home after work was not compensable even though caused by action of horses he was required to furnish for employment. Kary v. North Dakota Workmen's Compensation Bureau, 67 N.D. 334, 272 N.W. 340, 1937 N.D. LEXIS 86 (N.D. 1937); Fink v. Workmen's Compensation Bureau, 68 N.D. 531, 282 N.W. 505, 1938 N.D. LEXIS 143 (N.D. 1938).

An injury sustained while an employee was on his way home after work was not compensable even though it was within hours that he normally worked. Fink v. Workmen's Compensation Bureau, 68 N.D. 531, 282 N.W. 505, 1938 N.D. LEXIS 143 (N.D. 1938).

An injury sustained on employee’s own premises during her lunch hour was compensable if contract of employment required her to go to her own home for lunch. Desautel v. North Dakota Workmen's Compensation Bureau, 72 N.D. 35, 4 N.W.2d 581, 1942 N.D. LEXIS 108 (N.D. 1942).

A reasoning mind reasonably could have determined that the worker’s injury was not in any way employment related, where the undisputed evidence disclosed that he was riding on his own motorcycle; that he was not on the employer’s premises; that he was, in fact, on a public highway; that he was driving home after work hours, and was not being compensated for traveling to and from work at the time of his injury. Cody v. North Dakota Workmen's Compensation Bureau, 413 N.W.2d 316, 1987 N.D. LEXIS 409 (N.D. 1987).

By reporting for duty, claimant (a helper to a driver of a moving van) commenced employment. By riding in the moving van en route to his destination, claimant was engaged in employment, even though no delivery was made and no loading or unloading was performed. Westman v. North Dakota Workers Compensation Bureau, 459 N.W.2d 540, 1990 N.D. LEXIS 167 (N.D. 1990).

As a general rule, injuries occurring while traveling to and from work are noncompensable. There are several exceptions to this general rule, one of which is when the travel is an integral part of the service for which the worker is employed. Diegel v. North Dakota Workers Compensation Bureau, 469 N.W.2d 151, 1991 N.D. LEXIS 87 (N.D. 1991).

Claimant’s travel to work was neither employer supplied nor employer required where he was merely commuting to work with his roommate who was also employed by the same construction firm; furthermore, despite being paid a higher wage for working out-of-town, none of claimant’s wages was intended as travel expenses and the fact that claimant was paid upon arrival at work did not indicate that travel to the job site was an integral part of service. Hoffner v. North Dakota Workers Compensation Bureau, 2000 ND 123, 612 N.W.2d 263, 2000 N.D. LEXIS 132 (N.D. 2000).

—Triggering Injury in Another State.

Although the claimant’s North Dakota employment acted as a substantial contributing factor in the development of the underlying dormant degenerative disc disease, where but for a June, 1988, triggering injury in Wisconsin, the claimant could have continued to work without medical treatment as before the injury, the Wisconsin injury caused the disability the claimant sustained. Sloan v. North Dakota Workers Compensation Bureau, 462 N.W.2d 638, 1990 N.D. LEXIS 230 (N.D. 1990).

—Unusual Stress.

Appellant’s testimony of high temperatures, unusual work duties as masonry foreman, emotional anxiety related to being behind schedule, and fear attributable to the movement of a crane overhead was not convincing enough for the North Dakota supreme court to conclude that the bureau’s finding of no “unusual stress” was not supported by a preponderance of the evidence. Grace v. North Dakota Workmen's Compensation Bureau, 395 N.W.2d 576, 1986 N.D. LEXIS 425 (N.D. 1986).

Self-employed appliance, service, and refrigerator technician who worked in a garage which did not provide for any fresh air ventilation, failed to prove by the weight of the evidence from the entire record that the heart attack which he suffered while working was causally related to his employment and was precipitated by unusual stress, so as to entitle him to compensation. Schmalz v. North Dakota Workers Compensation Bureau, 449 N.W.2d 817, 1989 N.D. LEXIS 241 (N.D. 1989) (decided prior to 1989 amendments to this section).

—Usual Exertion Rule.

Where preponderance of the evidence suggests a holding that work-connected “usual” exertion precipitated injury or death, there may be recovery even though the injury or death was contributed to by preexisting defect or disability; no distinction between “usual” exertion and “unusual” exertion is to be observed in this state. Stout v. North Dakota Workmen’s Comp. Bureau, 236 N.W.2d 889 (N.D. 1975), overruled on other grounds, Balliet v. North Dakota Workmen’s Comp. Bureau, 297 N.W.2d 791 (N.D. 1980), decided prior to the amendment to this section by Session Laws 1977, ch. 579.

This subsection was amended by chapter 579, section 2, 1977 N.D. Session Laws, to allow benefit awards for heart attacks only where there is evidence of “unusual” stress; the distinction between “unusual” and “usual” exertion is now required by statute. Nelson v. North Dakota Workmen's Compensation Bureau, 316 N.W.2d 790, 1982 N.D. LEXIS 211 (N.D. 1982).

—Voluntary Intoxication.

A claim for benefits cannot be barred on the basis of voluntary intoxication where the only evidence of intoxication is the test of a blood sample taken from the employee’s body three hours after death and there were inadequate safeguards to the sample’s integrity between the time it was taken and the time it was tested. Erickson v. North Dakota Workmen's Compensation Bureau, 123 N.W.2d 292, 1963 N.D. LEXIS 110 (N.D. 1963).

Providing an excuse for voluntarily drinking cannot be a substantial contributing factor to alcoholism. Thus, employee’s voluntary activities in drinking to excess following a bad performance review broke the causal link necessary to establish an injury arising out of and in the course of employment, and the bureau could have reasonably determined that employee’s employment was not a substantial contributing factor to his recurrent alcoholism. Darnell v. North Dakota Workers Compensation Bureau, 450 N.W.2d 721, 1990 N.D. LEXIS 6 (N.D. 1990).

The bureau’s findings that the claimant was substantially impaired by his voluntary consumption of alcohol when he was injured and his alcohol-induced impairment was a cause of the injury were supported by a preponderance of the evidence. Hust v. North Dakota Workers Compensation Bureau (Moos Trucking), 1998 ND 20, 574 N.W.2d 808, 1998 N.D. LEXIS 9 (N.D. 1998).

—Willful Injury.

An injury is not willfully self-inflicted merely because it resulted from negligence of injured employee. Moen v. Melin, 59 N.D. 582, 231 N.W. 283, 1930 N.D. LEXIS 176 (N.D. 1930).

Words “including an injury caused by the willful act of a third person directed against an employee because of his employment” do not preclude compensation for an injury caused by willful act of third person that has no relation to the employment. Lippmann v. North Dakota Workmen's Compensation Bureau, 79 N.D. 248, 55 N.W.2d 453, 1952 N.D. LEXIS 117 (N.D. 1952).

Under the provisions of the workers’ compensation act in effect in 1974, willful or intentional injuries inflicted on an employee by his employer or fellow employees was within the coverage of the act. Schlenk v. Aerial Contractors, 268 N.W.2d 466, 1978 N.D. LEXIS 258 (N.D. 1978).

Correct Legal Standard.

Where the administrative law judge may have improperly added a condition to compensability not present in the statute at the time of the claimant’s injury, it cannot be determined whether the correct legal standard was applied, and the matter would be remanded for further proceedings. Loberg v. North Dakota Workers Compensation Bureau, 1998 ND 64, 575 N.W.2d 221, 1998 N.D. LEXIS 66 (N.D. 1998).

Disability.
—Ability to Return to Work.

A worker who is medically able to return to work does not have an inability to work and thus is not totally disabled. Risch v. North Dakota Workers Compensation Bureau, 447 N.W.2d 308, 1989 N.D. LEXIS 198 (N.D. 1989) (decided prior to 1989 amendments to this section).

It was not error for the bureau to deny disability benefits to employee who injured her back while working as a dishwasher and cook’s helper but whom medical experts had determined was capable of performing employment-related activities and had the ability to return to gainful employment, even though the employee continued to complain of pain. Hintz v. North Dakota Workers Compensation Bureau, 450 N.W.2d 727, 1990 N.D. LEXIS 1 (N.D. 1990).

An employee’s continued entitlement to disability benefits is linked to the employee’s maximum medical recovery and to physical and vocational ability to return to work. Frohlich v. North Dakota Workers Compensation Bureau, 556 N.W.2d 297, 1996 N.D. LEXIS 258 (N.D. 1996).

A worker who is medically able to return to work is not totally disabled. Saakian v. North Dakota Workers Compensation Bureau, 1998 ND 227, 587 N.W.2d 166, 1998 N.D. LEXIS 223 (N.D. 1998).

Former employee’s claim for benefits was properly denied because the evidence showed that the employee was still able to work after tripping over objects during the course of employment; therefore, it was determined that the employee did not suffer a total or partial disability. Lesmeister v. N.D. Workers Comp. Bureau, 2003 ND 60, 659 N.W.2d 350, 2003 N.D. LEXIS 74 (N.D. 2003).

—Inability to Perform Work.

Physical impairment alone does not justify an award of disability benefits, and the claimant must demonstrate that as a result of a physical inability to perform certain work the employee has suffered a loss of earning capacity that is causally related to the disability. Ollom v. North Dakota Workers Compensation Bureau, 529 N.W.2d 876, 1995 N.D. LEXIS 74 (N.D. 1995).

—Qualification for Light Work.

Bureau’s finding that the evidence did not show that claimant’s work injury led employers to refuse her employment or precluded her from obtaining employment held supported by the evidence where she was qualified for secretarial to light clerical work. Perman v. North Dakota Workers Compensation Bureau, 458 N.W.2d 484, 1990 N.D. LEXIS 146 (N.D. 1990).

—Refusal to Return to Work.

By refusing to return to work when she was determined to be able to do so, claimant failed to establish the extent of her disability, if any, and prevented the bureau from determining her actual loss of earning capacity that was causally related to the disability. Thus she failed to prove that she was partially disabled. Risch v. North Dakota Workers Compensation Bureau, 447 N.W.2d 308, 1989 N.D. LEXIS 198 (N.D. 1989) (decided prior to 1989 amendments to this section).

Employee.
—Casual Employment.

Employment of a carpenter in dismantling a barn, salvaging the material, and constructing a garage on farm by the farmer, who had no other trade, business, profession, or occupation, is casual employment within the meaning of the workers’ compensation act. Kipp v. Jalbert, 110 N.W.2d 825, 1961 N.D. LEXIS 93 (N.D. 1961).

—Coal Mining.

Coal miner who was subject to discharge at any time and whose work was subject to control by mining company was an employee of company even though he provided his own tools and was paid by the ton. Lilly v. Haynes Coop. Coal Mining Co., 50 N.D. 465, 196 N.W. 556, 1923 N.D. LEXIS 126 (N.D. 1923).

—Contract for Hire.

The contract for hire must ripen into actual work; the employee must be engaged in work in order for the employment relationship to exist. Westman v. North Dakota Workers Compensation Bureau, 459 N.W.2d 540, 1990 N.D. LEXIS 167 (N.D. 1990).

—Contractor's Employees.

A general contractor is viewed as the employer of a subcontractor’s employees and responsible for workers’ compensation premiums until the subcontractor or independent contract has secured the necessary coverage and paid the premium. Boettner v. Twin City Constr. Co., 214 N.W.2d 635, 1974 N.D. LEXIS 249 (N.D. 1974).

This section imposes no liability upon a general contractor other than for payment of premiums, but it does not specifically negative any liability of the general contractor for the negligence of its employees. Boettner v. Twin City Constr. Co., 214 N.W.2d 635, 1974 N.D. LEXIS 249 (N.D. 1974).

Relation of employer and employee does not exist between county which contracted with an individual for work on courthouse and person employed by the latter. Kronick v. McLean County, 52 N.D. 852, 204 N.W. 839, 1925 N.D. LEXIS 152 (N.D. 1925).

Person employed by general contractor to work on building was not an employee of owner of building. State ex rel. North Dakota Workmen's Compensation Bureau v. Broadway Inv. Co., 85 N.W.2d 251, 1957 N.D. LEXIS 148 (N.D. 1957).

A general contractor is deemed the employer of employees of subcontractors and independent contractors operating under agreements with the general contractor only until the subcontractor or independent contractor obtains workmen’s compensation coverage. Boettner v. Twin City Constr. Co., 214 N.W.2d 635, 1974 N.D. LEXIS 249 (N.D. 1974).

Where plaintiff was an employee of an engineering firm which had been engaged by the county to design bridge, and plaintiff was “inspector and engineer” on the construction site, plaintiff was not the statutory employee of the prime contractor or subcontractor, both complying employers, because the engineering firm by which plaintiff was employed was not “operating under an agreement” with the prime contractor, but rather with the county. Schultz & Lindsay Constr. Co. v. Erickson, 352 F.2d 425, 1965 U.S. App. LEXIS 4107 (8th Cir. N.D. 1965).

—Course of Employment.

A carpenter employed by a farmer specially to assist in dismantling a barn, salvage material, and construct a garage on the farm of the farmer who had no other trade, business, profession or occupation, was not an employee within the workers’ compensation act, and he could not recover damages for injuries sustained in the course of such employment from his uninsured employer under the provisions of N.D.C.C. § 65-09-01. Kipp v. Jalbert, 110 N.W.2d 825, 1961 N.D. LEXIS 93 (N.D. 1961).

Widow of carpenter who suffered fatal myocardial arrest following normal activity on first day of job, including loading heavy tool box into his car at home, did not present a sufficient showing that the death was compensable as one which occurred following exertion or strain excessive or unusual for the individual. Foss v. North Dakota Workmen’s Comp. Bureau, 214 N.W.2d 519 (N.D. 1974), decided prior to the amendment to N.D.C.C. § 28-39-19, by Session Laws 1977, ch. 287.

—Engaged in Employment.

One who was injured on employer’s premises while on way to work for first time, but without an enforceable contract of employment, was not “engaged in employment” within meaning of the workmen’s compensation act. State ex rel. Kusie v. Weber, 72 N.D. 705, 10 N.W.2d 741, 1943 N.D. LEXIS 108 (N.D. 1943).

—Gratuitous Services.

Where a wife, without contract of employment or agreement for compensation, voluntarily drove for her husband in car furnished by his employer, she was not an employee. Groff v. State, 72 N.D. 554, 9 N.W.2d 406, 1943 N.D. LEXIS 90 (N.D. 1943).

—Insurance Agents.

Insurance agents were not employees of insurance company where company had no right of control over details of their work other than right to accept or reject insurance policies and such controls as were necessary to protect company against violations of law by agents. Mutual Life Ins. Co. v. State, 71 N.D. 78, 298 N.W. 773, 1941 N.D. LEXIS 138 (N.D. 1941).

—Intermittent Employment.

Carpenter was employee of elevator company, even though employment was intermittent, where he was paid by hour, his work was subject to control by company, and he was sometimes assisted by other employees of company. Gotchy v. North Dakota Workmen's Compensation Bureau, 49 N.D. 915, 194 N.W. 663, 1923 N.D. LEXIS 42 (N.D. 1923).

—Liability of General Contractor and Subcontractor.

Under this section and N.D.C.C. § 65-01-08, the employee of one contractor injured by the negligence of an employee of another contractor on the same project is not foreclosed from suing the employee of the other contractor and the other contractor for negligence. Boettner v. Twin City Constr. Co., 214 N.W.2d 635, 1974 N.D. LEXIS 249 (N.D. 1974).

—Maintenance.

Building maintenance and remodeling work are within the course of the trade, business, profession, or occupation of the business which occupies the building; thus manual labor in remodeling a warehouse was employment in the course of the trade, business, profession, or occupation of a beer distributor. Courchene v. Delaney Distribs., 421 N.W.2d 811, 1988 N.D. LEXIS 80 (N.D. 1988).

—Minors.

Fact that one engaged in hazardous employment was a minor does not preclude him from being an “employee” within terms of compensation law. Denius v. North Dakota Workmen's Compensation Bureau, 68 N.D. 506, 281 N.W. 361, 1938 N.D. LEXIS 140 (N.D. 1938).

—Officials of This State.

Officials of this state hold their positions by election or appointment, are paid from public funds, and perform duties of a continuous nature which are defined by statute and are related to the administration of state government. Holmgren v. North Dakota Workers Compensation Bureau, 455 N.W.2d 200, 1990 N.D. LEXIS 101 (N.D. 1990).

A juror is a public official for purposes of workers’ compensation. Holmgren v. North Dakota Workers Compensation Bureau, 455 N.W.2d 200, 1990 N.D. LEXIS 101 (N.D. 1990).

—Partner Not Employee.

A partner in a business is an owner and is not covered by workers’ compensation unless he proceeds under N.D.C.C. § 65-07-01, a provision under which the employer may secure coverage for himself. Dunn v. North Dakota Workmen's Compensation Bureau, 191 N.W.2d 181, 1971 N.D. LEXIS 122 (N.D. 1971).

—Partnership Employee.

Workman hired by member of partnership to work as mechanic in garage owned and operated by partnership was an employee of partnership even though his wages were paid by member who hired him out of his share of net profits of the partnership earnings. Klemmens v. North Dakota Workmen's Compensation Bureau, 54 N.D. 496, 209 N.W. 972, 1926 N.D. LEXIS 48 (N.D. 1926).

—Peace Officers.

Policeman is employee within meaning of compensation act. Fahler v. Minot, 49 N.D. 960, 194 N.W. 695, 1923 N.D. LEXIS 46 (N.D. 1923).

Night watchman employed by village was “employee” within meaning of compensation act. Bergstrand v. North Dakota Workmen's Compensation Bureau, 69 N.D. 447, 287 N.W. 631, 1939 N.D. LEXIS 171 (N.D. 1939).

—Presumption of Status.

One who performs services for another is presumed to be an employee, but when evidence is introduced as to agreement under which employment is performed, evidence is controlling. Starkenberg v. North Dakota Workmen's Compensation Bureau, 73 N.D. 234, 13 N.W.2d 395, 1944 N.D. LEXIS 56 (N.D. 1944).

—Repayment of Poor Relief.

One who receives poor relief from county, and in payment works on repair of county highways at fixed wage, pursuant to an authorization of board of county commissioners, is an “employee” within meaning of workmen’s compensation act. Clark v. North Dakota Workmen's Compensation Bureau, 66 N.D. 17, 262 N.W. 249, 1935 N.D. LEXIS 165 (N.D. 1935).

—Tests of Status.

Whether person for whom work is performed has right to exercise control over performance thereof and has right to discharge workman without liability are important factors in determining whether workman is an independent contractor or a servant. State ex rel. Woods v. Hughes Oil Co., 58 N.D. 581, 226 N.W. 586, 1929 N.D. LEXIS 252 (N.D. 1929).

One of the most important tests to be applied in determining whether a person who is doing work for another is an employee or an independent contractor is whether person for whom work is done has right to control not merely result, but also manner in which work is done and method used. Janneck v. Workmen's Compensation Bureau, 67 N.D. 303, 272 N.W. 188, 1937 N.D. LEXIS 83 (N.D. 1937); Mutual Life Ins. Co. v. State, 71 N.D. 78, 298 N.W. 773, 1941 N.D. LEXIS 138 (N.D. 1941); Burkhardt v. State, 78 N.D. 818, 53 N.W.2d 394, 1952 N.D. LEXIS 80 (N.D. 1952).

Test to determine whether one is an independent contractor or an employee under workers’ compensation act is employer’s retained power of control or superintendence over contractor or employee. Starkenberg v. North Dakota Workmen's Compensation Bureau, 73 N.D. 234, 13 N.W.2d 395, 1944 N.D. LEXIS 56 (N.D. 1944).

Factors to be considered in determining whether an employed person is an independent contractor or an employee are: right to hire and discharge workmen, mode, method, or basis of payment, attitude and intention of parties, furnishing of tools, supplies and materials, and whether work is a part of regular business of employer. Burkhardt v. State, 78 N.D. 818, 53 N.W.2d 394, 1952 N.D. LEXIS 80 (N.D. 1952).

Where an employee was to cease working for one employer on June thirtieth but evidence showed he was still working on July first under the direction and control of that management, he was still an employee. Lacy v. Grinsteinner, 190 N.W.2d 11, 1971 N.D. LEXIS 140 (N.D. 1971).

Subdivision 5(b)(3) (see now 16(b)(5)) of this section is not an unconstitutional grant of special privileges or immunities even though it does not apply to partners but only to executive officers of corporations. Dunn v. North Dakota Workmen's Compensation Bureau, 191 N.W.2d 181, 1971 N.D. LEXIS 122 (N.D. 1971).

While the examining physician could not pinpoint the precise origin of the worker’s shoulder condition, he considered the worker’s employment to be a substantial contributing factor in the development of his arthritis, and the condition was thus a compensable injury under subsection 8 (formerly 7) of this section. Syverson v. North Dakota Workmen's Compensation Bureau, 406 N.W.2d 688, 1987 N.D. LEXIS 321 (N.D. 1987).

An employee was not eligible for workers’ compensation benefits where injuries occurred while going to or from work simply because at one point in the employer/employee relationship, the employer paid subsistence and travel pay. Cody v. North Dakota Workmen's Compensation Bureau, 413 N.W.2d 316, 1987 N.D. LEXIS 409 (N.D. 1987).

An evidentiary hearing before termination of workers’ compensation benefits would unduly burden the governmental interest because medical records will usually resolve whether the claimant can work. Rather, opportunity to respond should be limited to a written submission as an initial check against an erroneous decision. Beckler v. North Dakota Workers Compensation Bureau, 418 N.W.2d 770, 1988 N.D. LEXIS 35 (N.D. 1988).

Where a claimant performed a variety of tasks in her job in addition to floral design, and in the past she had done other work, her dermatitis did not prevent those activities, as only floral arranging required contact with irritating chemicals, and it was not error to deny her disability status. In re Claim of Olson, 419 N.W.2d 894, 1988 N.D. LEXIS 57 (N.D. 1988).

Mental injury resulting from the termination of one’s employment is not compensable. Choukalos v. North Dakota Workers' Compensation Bureau, 427 N.W.2d 344, 1988 N.D. LEXIS 186 (N.D. 1988).

—Traveling Salesman.

Where traveling salesman returned the previous evening from his sales territory to his home, stayed overnight, and was in a public street on his way to business to report and bill out sales made during the previous week and to attend a compulsory sales meeting when an auto accident occurred, he was “engaged in employment”. Lacy v. Grinsteinner, 190 N.W.2d 11, 1971 N.D. LEXIS 140 (N.D. 1971).

—Truck Driver.

Decedent’s transporting of company’s products to its customers was integral part of company’s business so that decedent was employee rather than independent contractor when tractor he was driving collided with freight train as decedent returned from delivering trailer load of company’s products in one of company’s trailers; fact that company’s signs covered decedent’s name on cab of tractor and that decedent was paid monthly rather than at end of each trip were significant in determining status; modern tendency is to find employment when work being done is integral part of regular business of employer and when worker, relative to employer, does not furnish independent business or professional service. Brown v. North Dakota Workmen's Compensation Bureau, 152 N.W.2d 799, 1967 N.D. LEXIS 92 (N.D. 1967).

Commercial honey producer which constructed hives and gathered, processed, packaged, stored and sold honey was not in the business of agriculture, and was subject to the workmen’s compensation statute. Morel v. Thompson, 225 N.W.2d 584, 1975 N.D. LEXIS 207 (N.D. 1975).

Employer
—In General.

Employer’s related company was immune from liability in wrongful death action because decedent’s surviving spouse had received Workforce Safety and Insurance (WSI) benefits and for WSI exclusive remedy purposes, the employer and related company were the same entity as determined by the WSI in its authority and thus, the company was a contributing employer under N.D.C.C. § 65-01-08. Therefore, the decedent’s estate representative was not permitted to proceed against the company under N.D.C.C. § 65-01-09 for third party liability. Trinity Hosps. v. Mattson, 2006 ND 231, 723 N.W.2d 684, 2006 N.D. LEXIS 237 (N.D. 2006).

In a case in which an individual appealed a district court’s affirmation of an administrative law judge’s (ALJ) finding the ALJ correctly determined that the individual was an employer under N.D.C.C. § 65-01-02(17) and that the individual was aware workers’ compensation coverage was required for all employees and that he intentionally tried to avoid the responsibility to provide coverage. The Individual was personally liable for past premiums and penalties owed to Workforce Safety and Insurance. Muldoon v. N.D. Workforce Safety & Ins. Fund, 2012 ND 244, 823 N.W.2d 761, 2012 N.D. LEXIS 251 (N.D. 2012).

—Corporate Officers.

The Workers’ Compensation Bureau’s purpose and the legislature’s intent in this section was to exclude business owners who incorporated and named themselves as corporate officers from mandatory workers’ compensation insurance coverage and to provide them the opportunity to elect optional coverage if they chose to do so; the legislature did not intend to exclude from mandatory workers’ compensation insurance coverage a person who, although invested with a corporate officer’s title, was a wage earner engaged in covered employment with no ownership interest in the corporation. Schumacher v. North Dakota Workers Compensation Bureau, 536 N.W.2d 355, 1995 N.D. LEXIS 143 (N.D. 1995).

Hazardous Employment.
—Constitutionality.

The agricultural exemption in the workers’ compensation law does not violate the equal protection guarantee of the North Dakota Constitution. Haney v. North Dakota Workers Compensation Bureau, 518 N.W.2d 195, 1994 N.D. LEXIS 129 (N.D. 1994).

—Agriculture.

An employee of owner of combine used in commercial threshing under contract to harvest and thresh another’s grain, who was injured while working with combine, was engaged in agriculture and was not entitled to compensation. Lowe v. North Dakota Workmen's Compensation Bureau, 66 N.D. 246, 264 N.W. 837, 1936 N.D. LEXIS 168 (N.D. 1936).

Farm employment can be covered only upon farmer’s compliance with requirements of act as to electing to be covered, payment of premiums into compensation fund, and posting notice of such election in conspicuous place at farm. Rosebear v. Anderson, 143 F. Supp. 721, 1956 U.S. Dist. LEXIS 3021 (D.N.D. 1956), aff'd, 245 F.2d 673, 1957 U.S. App. LEXIS 3269 (8th Cir. N.D. 1957).

A carpenter employed by a farmer specially to dismantle barn, salvage material, and construct a garage on farm is not engaged in an agricultural service so as to exempt employer from being required to carry workers’ compensation coverage. Kipp v. Jalbert, 110 N.W.2d 825, 1961 N.D. LEXIS 93 (N.D. 1961).

Permanent Impairment.

Employee was not entitled to permanent total disability benefits for having a permanent impairment rating of at least 25% because it was error to find the employee had a 50% permanent impairment rating. State v. Beaulieu, 2018 ND 213, 917 N.W.2d 211, 2018 N.D. LEXIS 217 (N.D. 2018).

—In General.

This section and former N.D.C.C. § 65-05-12 are construed to adopt the “most recent” and “most current” edition of the AMA Guides in existence at the time of their enactment. McCabe v. North Dakota Workers Compensation Bureau, 1997 ND 145, 567 N.W.2d 201, 1997 N.D. LEXIS 146 (N.D. 1997); McCollum v. North Dakota Workers Compensation Bureau, 1997 ND 163, 567 N.W.2d 811, 1997 N.D. LEXIS 182 (N.D. 1997); Coleman v. North Dakota Workers Compensation Bureau, 1997 ND 168, 567 N.W.2d 853, 1997 N.D. LEXIS 187 (N.D. 1997).

When this section was amended in 1989, the “most recent” and the “most current” edition of the AMA Guides was the Third Edition, which was first printed in November, 1988. McCollum v. North Dakota Workers Compensation Bureau, 1997 ND 163, 567 N.W.2d 811, 1997 N.D. LEXIS 182 (N.D. 1997); Coleman v. North Dakota Workers Compensation Bureau, 1997 ND 168, 567 N.W.2d 853, 1997 N.D. LEXIS 187 (N.D. 1997).

—Chronic Pain.

Bureau’s finding under this section and former N.D.C.C. § 65-05-12 that worker was not entitled to chronic pain evaluation was supported by evidence; while the claimant presented evidence of pain, the claimant did not establish that he suffered from chronic pain. Hoyem v. North Dakota Workers Compensation Bureau, 1998 ND 86, 578 N.W.2d 117, 1998 N.D. LEXIS 99 (N.D. 1998).

Seasonal Employment.

It was proper for the North Dakota Workers Compensation Bureau to infer that the claimant was engaged in seasonal employment; from the claimant’s testimony, the bureau could have inferred that the claimant worked in occupations with periods of 45 consecutive days where the claimant did not receive wages. Meljie v. N.D. Workers Comp. Bureau, 2002 ND 174, 653 N.W.2d 62, 2002 N.D. LEXIS 223 (N.D. 2002).

District court erred in affirming the decision of the administrative law judge (ALJ) that an electrician's employment with a contractor was not seasonal employment because the ALJ failed to correctly apply the language of subsection (27) [now subsec. (30)] to the contractor's employment of electricians; the contractor hired 719 electricians in a five-year period, and the transfer of nine electricians did not establish what was customary for it. Indus. Contrs., Inc. v. Taylor, 2017 ND 183, 899 N.W.2d 680, 2017 N.D. LEXIS 186 (N.D. 2017).

Use of the phrase “includes occupations” in subsection (27) [now subsec. (30)] enlarges the plain and ordinary meaning of “seasonal employment” to include occupations (1) that are not permanent or (2) that do not customarily operate throughout the year; the two alternatives are separated by “or” indicating the alternatives are disjunctive, and the first alternative indicates seasonal employment can be non-permanent employment, which is not customarily limited to certain times of the year. Indus. Contrs., Inc. v. Taylor, 2017 ND 183, 899 N.W.2d 680, 2017 N.D. LEXIS 186 (N.D. 2017).

Under the language in the second sentence of subsection (27) [now subsec. (30)], “seasonal employment” is not a generic term, but can vary depending upon what is customary with the employer; nothing in the statute imposes a time limitation on seasonal employment. Indus. Contrs., Inc. v. Taylor, 2017 ND 183, 899 N.W.2d 680, 2017 N.D. LEXIS 186 (N.D. 2017).

Wages.

Although not specifically mentioned in this definition, “wages” include monetary remuneration for services rendered on an hourly basis as well as monetary remuneration for services rendered on other than an hourly basis such as on mileage rate. Brown v. North Dakota Workmen's Compensation Bureau, 152 N.W.2d 799, 1967 N.D. LEXIS 92 (N.D. 1967).

DECISIONS UNDER PRIOR LAW

Occupational Diseases of Firefighters and Law Enforcement Officers Presumed in Line of Duty.

Analysis

—Constitutionality.

Even if former subdivision 12(d) of this section was unconstitutional, the remedy lied in invalidating this section rather than extending its benefits to all employees. Kroh v. North Dakota Workers Compensation Bureau, 425 N.W.2d 899, 1988 N.D. LEXIS 146 (N.D. 1988).

—Firefighter or Law Enforcement Officer.

There was a presumption in favor of firemen and law enforcement officers. Procedurally, the presumption operated to shift the burden of proof from the claimant to the bureau. Sunderland v. North Dakota Workmen's Compensation Bureau, 370 N.W.2d 549, 1985 N.D. LEXIS 345 (N.D. 1985).

A claimant seeking workers’ compensation benefits from the bureau had the burden of proving by a preponderance of the evidence that he was entitled to participate in the fund. However, former subsection (17)(d), created a limited exception to this general rule which shifted the burden of proof from the claimant to the bureau in cases involving specified conditions or impairments of health suffered by a fireman or law enforcement officer. Flermoen v. North Dakota Workers Compensation Bureau, 470 N.W.2d 220, 1991 N.D. LEXIS 100 (N.D. 1991).

To demonstrate that an occupational cancer was involved, the fireman claimant need only have shown that the type of cancer he had was linked to exposure to smoke, fumes, or other hazardous substances incurred by firemen in the line of duty or that such exposure had been linked to an increased risk of incurring the type of cancer suffered by the claimant. If the claimant demonstrated this linkage by a preponderance of the evidence, the presumption arose under former subsection (17)(d), that the claimant incurred his cancer in the line of duty and was entitled to benefits. The burden then shifted to the bureau to prove otherwise. Flermoen v. North Dakota Workers Compensation Bureau, 470 N.W.2d 220, 1991 N.D. LEXIS 100 (N.D. 1991).

In order to prevail, the workers’ compensation bureau had to establish that an illness was not work related, overcoming the presumption it was work related. Burrows v. North Dakota Workers' Compensation Bureau, 510 N.W.2d 617, 1994 N.D. LEXIS 13 (N.D. 1994).

—Full-Time Paid Firefighter.

Former subsection 17(d) of this section, created a limited exception to the general rule by shifting the burden of proof from the claimant to the bureau in cases involving specified conditions or impairments of health suffered by a full-time paid fireman. Christianson v. North Dakota Workers Compensation Bureau, 470 N.W.2d 613, 1991 N.D. LEXIS 114 (N.D. 1991).

The specific presumptions set forth in former subsection (17)(d) did not apply to all municipal employees, they only applied to full-time municipal firemen. This section of law was not ambiguous and thus was not susceptible to any other interpretation. Therefore, according to the plain language of the statute, the presumption did not apply to volunteer firefighters or those who were not full-time paid firemen. Christianson v. North Dakota Workers Compensation Bureau, 470 N.W.2d 613, 1991 N.D. LEXIS 114 (N.D. 1991).

—Lung Disease.

Carcinoma of the lung qualified as a lung disease. Sunderland v. North Dakota Workmen's Compensation Bureau, 370 N.W.2d 549, 1985 N.D. LEXIS 345 (N.D. 1985).

Where the workers’ compensation bureau proved lack of relationship between claimant’s occupation and his lung cancer, the question of whether the cancer preexisted his employment was irrelevant. Burrows v. North Dakota Workers' Compensation Bureau, 510 N.W.2d 617, 1994 N.D. LEXIS 13 (N.D. 1994).

—Rebuttable Presumption.

Former subdivision 12(d) contained two rebuttable components. In order for the bureau to rebut the presumption in its entirety, it had to show that the disease was preexisting and that it was not work-related. Sunderland v. North Dakota Workmen's Compensation Bureau, 370 N.W.2d 549, 1985 N.D. LEXIS 345 (N.D. 1985).

Bureau had to introduce evidence of nonwork-related causation in order to rebut the presumption created thereby. Sunderland v. North Dakota Workmen's Compensation Bureau, 370 N.W.2d 549, 1985 N.D. LEXIS 345 (N.D. 1985).

Medical opinion which was inconclusive as to the relationship between police officer’s occupation and his lung cancer constituted insufficient evidence to sustain the bureau’s burden of proving that his cancer was not work-related. Sunderland v. North Dakota Workmen's Compensation Bureau, 370 N.W.2d 549, 1985 N.D. LEXIS 345 (N.D. 1985).

Medical evidence that police officer’s death from lung cancer was due to cigarette smoking, together with evidence that the officer’s employment and alleged exposure to radon, radar, and asbestos were not a significant contributing factor to his lung cancer, rebutted the presumption of job-related causation. Elter v. North Dakota Workers Compensation Bureau, 1999 ND 179, 599 N.W.2d 315, 1999 N.D. LEXIS 199 (N.D. 1999) (applying 1993 version of statute).

Collateral References.

Constitutional or statutory provisions referring to “employees” as including public officers, 5 A.L.R.2d 415, 418.

Voluntary payment of compensation under statute of one state as bar to claim or ground for reduction of claim of compensation under statute of another state, 8 A.L.R.2d 628.

Injury while crossing or walking along railroad or street railway tracks, going to or from work, as arising out of and in course of employment, 50 A.L.R.2d 363.

Suicide as compensable under workmen’s compensation act, 15 A.L.R.3d 616.

Use of medical books or treatises as independent evidence, 17 A.L.R.3d 993.

“Dependency” within workmen’s compensation act, 18 A.L.R.3d 900.

Wife’s right of action for loss of consortium, 36 A.L.R.3d 900.

Injury sustained while attending employer-sponsored social affair as arising out of and in the course of employment, 47 A.L.R.3d 566.

Employer’s liability for injury caused by food or drink purchased by employee in plant facilities, 50 A.L.R.3d 505.

What conduct is willful, intentional, or deliberate within workmen’s compensation act provision authorizing tort action for such conduct, 96 A.L.R.3d 1064.

Employer’s tort liability to worker for concealing workplace hazard or nature or extent of injury, 9 A.L.R.4th 778.

Cancer as compensable under workers’ compensation acts, 19 A.L.R.4th 639.

“Dual capacity doctrine” as basis for employee’s recovery from employer in tort, 23 A.L.R.4th 1151.

Workers’ compensation immunity as extending to one owning controlling interest in employer corporation, 30 A.L.R.4th 948.

Recovery for discharge in retaliation for filing claim, 32 A.L.R.4th 1221.

Liability of successive employers for disease or condition allegedly attributable to successive employments, 34 A.L.R.4th 958.

Workers’ compensation: sexual assaults as compensable, 52 A.L.R.4th 731.

Workers’ compensation: student athlete as “employee” of college or university providing scholarship or similar financial assistance, 58 A.L.R.4th 1259.

Workers’ compensation: injuries incurred during labor activity, 61 A.L.R.4th 196.

Workers’ compensation: injuries incurred while traveling to or from work with employer’s receipts, 63 A.L.R.4th 253.

Prejudicial effect of bringing to jury’s attention fact that plaintiff in personal injury or death action is entitled to workers’ compensation benefits, 69 A.L.R.4th 131.

Tort liability for window washer’s injury or death, 69 A.L.R.4th 207.

Workers’ compensation: effect of allegation that injury was caused by, or occurred during course of, worker’s illegal conduct, 73 A.L.R.4th 270.

Workers’ compensation: third-party tort liability of corporate officer to injured workers, 76 A.L.R.4th 365.

Workers’ compensation statute as barring illegally employed minor’s tort action, 77 A.L.R.4th 844.

Ownership interest in employer business as affecting status as employee for workers’ compensation purposes, 78 A.L.R.4th 973.

Workers’ compensation: compensability of injuries incurred traveling to or from medical treatment of earlier compensable injury, 83 A.L.R.4th 110.

Workers’ compensation: bonus as factor in determining amount of compensation, 84 A.L.R.4th 1055.

Right to workers’ compensation for injuries suffered after termination of employment, 10 A.L.R.5th 245.

Workers’ compensation: Coverage of employee’s injury or death from exposure to the elements — modern cases, 20 A.L.R.5th 346.

Jurors as within coverage of workers’ compensation acts, 13 A.L.R.5th 444.

Workers’ compensation: recovery for carpal tunnel syndrome, 14 A.L.R.5th 1.

Workers’ compensation: lyme disease, 22 A.L.R.5th 246.

Presumption or inference that accidental death of employee engaged in occupation of manufacturing or processing arose out of and in course of employment, 47 A.L.R.5th 801.

Validity, construction, and effect of statutory exemptions of proceeds of workers’ compensation awards, 48 A.L.R.5th 473.

Workers’ compensation as precluding employee’s suit against employer for sexual harassment in the workplace, 51 A.L.R.5th 163.

Handling, preparing, presenting, or trying workers’-compensation claims or cases as practice of law, 58 A.L.R.5th 449.

What constitutes “agricultural” or “farm” labor within social-security or unemployment-compensation acts, 60 A.L.R.5th 459.

Employee’s injuries sustained in use of employer’s restroom as covered by workers’ compensation, 80 A.L.R.5th 417.

Right to workers’ compensation for emotional distress or like injury suffered by claimant as a result of sudden emotional stimuli involving personnel action, 82 A.L.R.5th 149.

Right to worker’s compensation for emotional distress or like injury suffered as a result of sudden stimuli involving nonpersonnel action, 83 A.L.R.5th 103.

Right to workers’ compensation for emotional distress or like injury suffered by claimant as result of nonsudden stimuli — Requisites of, and factors affecting, compensability, 106 A.L.R.5th 111.

Right to workers’ compensation for physical injury or illness suffered by claimant as result of sudden mental stimuli — Compensability under particular circumstances, 107 A.L.R.5th 441.

Right to workers’ compensation for emotional distress or like injury suffered by claimant as result of nonsudden stimuli — Compensability under particular circumstances, 108 A.L.R.5th 1.

Right to workers’ compensation for physical injury or illness suffered by claimant as result of sudden mental stimuli — Right to compensation under particular statutory provisions and requisites of, and factors affecting, compensability, 109 A.L.R.5th 161.

Award of workers’ compensation benefits to professional athletes, 112 A.L.R.5th 365.

Right to workers’ compensation for physical injury or illness suffered by claimant as result of nonsudden mental stimuli — Compensability of particular physical injuries or illnesses, 112 A.L.R.5th 509.

Compensability under occupational disease statutes of emotional distress or like injury suffered by claimant as result of nonsudden stimuli, Occupational Disease — Nonsudden. 113 A.L.R.5th 115.

Application of workers’ compensation laws to illegal aliens, 121 A.L.R.5th 523.

Right to workers’ compensation for physical injury or illness suffered by claimant as result of nonsudden mental stimuli - Right to compensation under particular statutory provisions, 122 A.L.R. 5th 653.

Right to workers’ compensation for physical injury or illness suffered by claimant as result of nonsudden mental stimuli-Requisites of, and factors affecting, compensability, 13 A.L.R.6th 209.

Right to workers’ compensation for injury suffered by worker en route to or from worker’s home where home is claimed as “work situs.”,15 A.L.R.6th 633.

Right to Workers’ Compensation for Physical Injury or Illness Suffered by Claimant as Result of Sudden Mental Stimuli - Compensability of Particular Injuries and Illnesses. 20 A.L.R.6th 641.

Recovery of Workers’ Compensation for Acts of Terrorism. 20 A.L.R.6th 729.

Workers’ Compensation: Validity, Construction, and Application of Statutes Providing that Worker Who Suffers Workplace Injury and Subsequently Tests Positive for Alcohol Impairment or Illegal Drug Use Is Not Eligible for Workers’ Compensation Benefits. 22 A.L.R.6th 329.

Right to Workers’ Compensation for Injury Suffered by Employee While Driving Employer’s Vehicle, 28 A.L.R.6th 1.

Right to Workers’ Compensation for Physical Injury or Illness Suffered by Claimant as Result of Nonsudden Mental Stimuli — Compensability under Particular Circumstances. 39 A.L.R.6th 445.

Validity, Construction, and Application of Statutory Provisions Exempting or Otherwise Restricting Farm and Agricultural Workers from Worker’s Compensation Coverage. 40 A.L.R.6th 99.

Law Reviews.

Compensation for Disease Caused by Conditions of Employment, 2 Dak. L. Rev. 337 (1929).

Evidence in Workmen’s Compensation Cases, Daniel E. Buchanan, 54 N.D. L. Rev. 173 (1977).

A Time for Recognition: Extending Workmen’s Compensation Coverage to Inmates, 61 N.D. L. Rev. 403 (1985).

Workers’ Compensation: The Assault on the Shield of Immunity — Coming to Blows with the Exclusive-Remedy Provisions of the North Dakota Workers’ Compensation Act, 70 N.D. L. Rev. 905 (1994).

Constitutional Law — Workers Compensation: Equal Protection Challenge to the Agriculture Exemption and Use of Rational Basis Scrutiny in Haney v. North Dakota Workers Compensation Bureau, 518 N.W.2d 195 (N.D. 1994), 71 N.D. L. Rev. 781 (1995).

Summary of North Dakota Supreme Court Decisions on Constitutional Law — Workers’ Compensation, 71 N.D. L. Rev. 856 (1995).

65-01-02. Definitions. [Effective September 1, 2022]

In this title:

  1. “Acute care” means a short course of intensive diagnostic and therapeutic services provided immediately following a work injury with a rapid onset of pronounced symptoms.
  2. “Adopted” or “adoption” refers only to a legal adoption effected prior to the time of the injury.
  3. “Allied health care professional” includes a health care provider, pharmacist, audiologist, speech language pathologist, or naturopath or any recognized practitioner who provides skilled services pursuant to the prescription of, or under the supervision or direction of any of these individuals.
  4. “Artificial members” includes a device that is a substitute for a natural part, organ, limb, or other part of the body. The term includes a prescriptive device that is an aid for a natural part, organ, limb, or other part of the body if the damage to the prescriptive device is accompanied by an injury to the body. A prescriptive device includes prescription eyeglasses, contact lenses, dental braces, and orthopedic braces.
  5. “Artificial replacements” means mechanical aids, including braces, belts, casts, or crutches as may be reasonable and necessary due to compensable injury.
  6. “Average weekly wage” means the weekly wages the injured employee was receiving from all employments for which coverage is required or otherwise secured at the date of first disability. The average weekly wage determined under this subsection must be rounded to the nearest dollar. If the injured employee’s wages are not fixed by the week, they must be determined by using the first applicable formula from the schedule below:
    1. For seasonal employment, during the first consecutive days of disability up to twenty-eight days the average weekly wage is calculated pursuant to the first applicable formula in subdivisions b through g, and after that are calculated as one-fiftieth of the total wages from all occupations during the twelve months preceding the date of first disability or during the tax year preceding the date of first disability, or an average of the three tax years preceding the date of first disability, whichever is highest and for which accurate, reliable, and complete records are readily available.
    2. The “average weekly wage” of a self-employed employer is determined by the following formula: one fifty-second of the average annual net self-employed earnings reported the three preceding tax years or preceding fifty-two weeks whichever is higher if accurate, reliable, and complete records for those fifty-two weeks are readily available.
    3. Hourly or daily rate multiplied by number of hours or days worked per seven-day week.
    4. Monthly rate multiplied by twelve months and divided by fifty-two weeks.
    5. Biweekly rate divided by two.
    6. The usual wage paid other employees engaged in similar occupations.
    7. A wage reasonably and fairly approximating the weekly wage lost by the injured employee during the period of disability.
  7. “Average weekly wage in the state” means the determination made of the average weekly wage in the state by job service North Dakota on or before July first of each year, computed to the next highest dollar.
  8. “Board” means the workforce safety and insurance board of directors.
  9. “Brother” and “sister” include a stepbrother and a stepsister, a half brother and a half sister, and a brother and sister by adoption. The terms do not include a married brother or sister unless that person actually is dependent.
  10. “Child”, for determining eligibility for benefits under chapter 65-05, means a legitimate child, a stepchild, adopted child, posthumous child, foster child, and acknowledged illegitimate child who is under eighteen years of age and resides with the injured employee; or is under eighteen years of age and does not reside with the injured employee but a duty of support is substantiated by an appropriate court order; or is between eighteen and twenty-two years of age and enrolled as a full-time student in any accredited educational institution and dependent upon the injured employee for support; or is eighteen years of age or over and is physically or mentally incapable of self-support and is actually dependent upon the injured employee for support. A child does not include a married child unless actually dependent on the injured employee as shown on the preceding year’s income tax returns.
  11. “Compensable injury” means an injury by accident arising out of and in the course of hazardous employment which must be established by medical evidence supported by objective medical findings.
    1. The term includes:
      1. Disease caused by a hazard to which an employee is subjected in the course of employment. The disease must be incidental to the character of the business and not independent of the relation of employer and employee. Disease includes effects from radiation.
      2. An injury to artificial members.
      3. Injuries due to heart attack or other heart-related disease, stroke, and physical injury caused by mental stimulus, but only when caused by the employee’s employment with reasonable medical certainty, and only when it is determined with reasonable medical certainty that unusual stress is at least fifty percent of the cause of the injury or disease as compared with all other contributing causes combined. Unusual stress means stress greater than the highest level of stress normally experienced or anticipated in that position or line of work.
      4. Injuries arising out of employer-required or supplied travel to and from a remote jobsite or activities performed at the direction or under the control of the employer.
      5. An injury caused by the willful act of a third person directed against an employee because of the employee’s employment.
      6. A mental or psychological condition caused by a physical injury, but only when the physical injury is determined with reasonable medical certainty to be at least fifty percent of the cause of the condition as compared with all other contributing causes combined, and only when the condition did not pre-exist the work injury.
    2. The term does not include:
      1. Ordinary diseases of life to which the general public outside of employment is exposed or preventive treatment for communicable diseases, except that the organization may pay for preventive treatment for a health care provider as defined in section 23-07.5-01, firefighter, peace officer, correctional officer, court officer, law enforcement officer, emergency medical technician, or an individual trained and authorized by law or rule to render emergency medical assistance or treatment that is exposed to a bloodborne pathogen as defined in section 23-07.5-01 occurring in the course of employment and for exposure to rabies occurring in the course of employment.
      2. A willfully self-inflicted injury, including suicide or attempted suicide, or an injury caused by the employee’s willful intention to injure or kill another.
      3. Any injury caused by the use of intoxicants, including recreational marijuana use, or the illegal use of controlled substances.
      4. An injury that arises out of an altercation in which the injured employee is an aggressor. This paragraph does not apply to public safety employees, including law enforcement officers or private security personnel who are required to engage in altercations as part of their job duties if the altercation arises out of the performance of those job duties.
      5. An injury that arises out of an illegal act committed by the injured employee.
      6. An injury that arises out of an employee’s voluntary nonpaid participation in any recreational activity, including athletic events, parties, and picnics, even though the employer pays some or all of the cost of the activity.
      7. Injuries attributable to a pre-existing injury, disease, or other condition, including when the employment acts as a trigger to produce symptoms in the pre-existing injury, disease, or other condition unless the employment substantially accelerates its progression or substantially worsens its severity. Pain is a symptom and may be considered in determining whether there is a substantial acceleration or substantial worsening of a pre-existing injury, disease, or other condition, but pain alone is not a substantial acceleration or a substantial worsening.
      8. A nonemployment injury that, although acting upon a prior compensable injury, is an independent intervening cause of injury.
      9. A latent or asymptomatic degenerative condition, caused in substantial part by employment duties, which is triggered or made active by a subsequent injury.
      10. A mental injury arising from mental stimulus.
  12. “Date of first disability” means the first date the injured employee was unable to work because of a compensable injury.
  13. “Date of maximum medical improvement” or “date of maximum medical recovery” means the date after which further recovery from, or lasting improvement to, an injury or disease can no longer reasonably be anticipated based upon reasonable medical probability.
  14. “Director” means the director of the organization.
  15. “Disability” means loss of earnings capacity and may be permanent total, temporary total, or partial.
  16. “Employee” means an individual who performs hazardous employment for another for remuneration unless the individual is an independent contractor under the common-law test.
    1. The term includes:
      1. All elective and appointed officials of this state and its political subdivisions, including municipal corporations and including the members of the legislative assembly, all elective officials of any county, and all elective peace officers of any city.
      2. Aliens.
      3. Human service zone general assistance workers, except those who are engaged in repaying to human service zones or the department of health and human services moneys the human service zones or the department of health and human services have been compelled by statute to expend for general assistance.
      4. Minors, whether lawfully or unlawfully employed. A minor is deemed sui juris for the purposes of this title, and no other person has any claim for relief or right to claim workforce safety and insurance benefits for any injury to a minor worker, but in the event of the award of a lump sum of benefits to a minor employee, the lump sum may be paid only to the legally appointed guardian of the minor.
    2. The term does not include:
      1. An individual whose employment is both casual and not in the course of the trade, business, profession, or occupation of that individual’s employer.
      2. An individual who is engaged in an illegal enterprise or occupation.
      3. The spouse of an employer or the child under the age of twenty-two of an employer. For purposes of this paragraph and section 65-07-01, “child” means any legitimate child, stepchild, adopted child, foster child, or acknowledged illegitimate child.
      4. A real estate broker or real estate salesperson, provided the individual meets the following three requirements:
        1. The salesperson or broker must be a licensed real estate agent under section 43-23-05.
        2. Substantially all of the salesperson’s or broker’s remuneration for the services performed as a real estate agent must be directly related to sales or other efforts rather than to the number of hours worked.
        3. A written agreement must exist between the salesperson or broker and the person for which the salesperson or broker works, which agreement must provide the salesperson or broker will not be treated as an employee but rather as an independent contractor.
      5. The members of the board of directors of a business corporation who are not employed in any capacity by the corporation other than as members of the board of directors.
      6. An individual delivering newspapers or shopping news, if substantially all of the individual’s remuneration is directly related to sales or other efforts rather than to the number of hours worked and a written agreement exists between the individual and the publisher of the newspaper or shopping news which states the individual is an independent contractor.
      7. An employer.
  17. “Employer” means a person that engages or received the services of another for remuneration unless the person performing the services is an independent contractor under the common-law test. The term includes:
    1. The state and all political subdivisions thereof.
    2. All public and quasi-public corporations in this state.
    3. Every person, partnership, limited liability company, association, and private corporation, including a public service corporation.
    4. The legal representative of any deceased employer.
    5. The receiver or trustee of any person, partnership, limited liability company, association, or corporation having one or more employees as herein defined.
    6. The president, vice presidents, secretary, or treasurer of a business corporation, but not members of the board of directors of a business corporation who are not also officers of the corporation.
    7. The managers of a limited liability company.
    8. The president, vice presidents, secretary, treasurer, or board of directors of an association or cooperative organized under chapter 6-06, 10-12, 10-13, 10-15, 36-08, or 49-21.
    9. The clerk, assessor, treasurer, or any member of the board of supervisors of an organized township, if the person is not employed by the township in any other capacity.
    10. A multidistrict special education unit.
    11. An area career and technology center.
    12. A regional education association.
  18. “Fee schedule” means the payment formulas established in the organization publication entitled “Medical and Hospital Fees”.
  19. “Fund” means the workforce safety and insurance fund.
  20. “Hazardous employment” means any employment in which one or more employees are employed regularly in the same business or in or about the establishment except:
    1. Agricultural or domestic service.
    2. Any employment of a common carrier by railroad.
    3. Any employment for the transportation of property or persons by nonresidents, where, in such transportation, the highways are not traveled more than seven miles [11.27 kilometers] and return over the same route within the state of North Dakota.
    4. All members of the clergy and employees of religious organizations engaged in the operation, maintenance, and conduct of the place of worship.
  21. “Health care provider” means a doctor of medicine or osteopathy, chiropractor, dentist, optometrist, podiatrist, or psychologist acting within the scope of the doctor’s license, a physical therapist, an advanced practice registered nurse, or a certified physician assistant.
  22. “Medical marijuana” means the use of all parts of the plant of the genus cannabis, the seeds of the plant, the resin extracted from any part of the plant, and every compound, manufacture, salt, derivative, mixture, or preparation of the plant, the seeds of the plant, or the resin extracted from any part of the plant as a physician-recommended form of medicine or herbal therapy. The term does not include treatments or preparations specifically approved by the United States food and drug administration as a drug product.
  23. “Noncompliance” means failure to follow the requirements of chapter 65-04. An employer may be in noncompliance regardless of the employer’s insured or uninsured status with the organization.
  24. “Organization” means workforce safety and insurance, or the director, or any department head, assistant, or employee of workforce safety and insurance designated by the director, to act within the course and scope of that person’s employment in administering the policies, powers, and duties of this title.
  25. “Parent” includes a stepparent and a parent by adoption.
  26. “Payroll report” means the mechanism created by the organization and used by employers to report all employee payroll required by the organization.
  27. “Permanent impairment” means the loss of or loss of use of a member of the body existing after the date of maximum medical improvement and includes disfigurement resulting from an injury.
  28. “Permanent total disability” means disability that is the direct result of a compensable injury that prevents an injured employee from performing any work and results from any one of the following conditions:
    1. Total and permanent loss of sight of both eyes;
    2. Loss of both legs or loss of both feet at or above the ankle;
    3. Loss of both arms or loss of both hands at or above the wrist;
    4. Loss of any two of the members or faculties in subdivision a, b, or c;
    5. Permanent and complete paralysis of both legs or both arms or of one leg and one arm;
    6. Third-degree burns that cover at least forty percent of the body and require grafting;
    7. A medically documented brain injury affecting cognitive and mental functioning which renders an injured employee unable to provide self-care and requires supervision or assistance with a majority of the activities of daily living; or
    8. A compensable injury that results in a permanent partial impairment rating of the whole body of at least twenty-five percent pursuant to section 65-05-12.2.
  29. “Rehabilitation services” means nonmedical services reasonably necessary to restore a disabled employee to substantial gainful employment as defined by section 65-05.1-01 as near as possible. The term may include vocational evaluation, counseling, education, workplace modification, vocational retraining including training for alternative employment with the same employer, and job placement assistance.
  30. “Seasonal employment” includes occupations that are not permanent or that do not customarily operate throughout the entire year. Seasonal employment is determined by what is customary with respect to the employer at the time of injury.
  31. “Spouse” includes only the decedent’s husband or wife who was living with the decedent or was dependent upon the decedent for support at the time of injury.
  32. “Subcontractor” means a person that agrees to perform all or part of the work for a contractor or another subcontractor.
  33. “Temporary total disability” means disability that results in the inability of an injured employee to earn wages as a result of a compensable injury for which disability benefits may not exceed a cumulative total of one hundred four weeks or the date the injured employee reaches maximum medical improvement or maximum medical recovery, whichever occurs first.
  34. “Uninsured” means failure of an employer to secure mandatory coverage with the organization or failure to pay premium, assessment, penalty, or interest, as calculated by the organization, which is more than forty-five days past due. An uninsured employer is subject to chapter 65-09.
  35. “Utilization review” means the initial and continuing evaluation of appropriateness in terms of both the level and the quality of health care and health services provided a patient, based on medically accepted standards. The evaluation must be accomplished by means of a system that identifies the utilization of medical services, based on medically accepted standards, and which refers instances of possible inappropriate utilization to the organization to obtain opinions and recommendations of expert medical consultants to review individual cases for which administrative action may be deemed necessary.
  36. “Valid functional capacities examination” means:
    1. The results of a physical examination consisting of a battery of standardized assessments that offer reliable results in performance-based measures and demonstrate the level and duration an injured employee may return to work.
    2. The conclusions of medical experts, following observations of other activities the medical expert determines similarly predictive, when the results of the physical examination in subsection a are not obtained or reliable.
    1. “Wages” means:
      1. An injured employee’s remuneration from all employment reportable to the internal revenue service as earned income for federal income tax purposes.
      2. For members of the national guard who sustain a compensable injury while on state active duty, “wages” includes income from federal employment and may be included in determining the average weekly wage.
      3. For purposes of chapter 65-04 only, “wages” means all gross earnings of all employees. The term includes all pretax deductions for amounts allocated by the employee for deferred compensation, medical reimbursement, retirement, or any similar program, but may not include dismissal or severance pay.
    2. The organization may consider postinjury wages for which coverage was not required or otherwise secured in North Dakota for purposes of determining appropriate vocational rehabilitation options or entitlement to disability benefits under this title.

If the injured employee has not reached maximum medical improvement within one hundred four weeks, the injured employee may receive a permanent partial impairment rating if a rating will assist the organization in assessing the injured employee’s capabilities. Entitlement to a rating is solely within the discretion of the organization.

Source:

S.L. 1919, ch. 162, § 2; 1921, ch. 142, § 1; 1925, ch. 222, § 1; 1925 Supp., § 396a2; S.L. 1935, ch. 286, § 1; 1941, ch. 303, § 1; 1941, ch. 305, § 1; 1943, ch. 274, §§ 1, 13; R.C. 1943, § 65-0102; S.L. 1945, ch. 337, § 1; 1947, ch. 375, § 1; 1949, ch. 354, § 1; 1951, ch. 341, § 1; 1955, ch. 354, § 6; 1957, ch. 390, § 1; 1957 Supp., § 65-0102; S.L. 1961, ch. 388, § 1; 1965, ch. 451, § 1; 1967, ch. 483, §§ 1, 2; 1969, ch. 558, § 1; 1971, ch. 597, § 1; 1971, ch. 598, § 1; 1975, ch. 579, §§ 1, 2; 1977, ch. 579, § 2; 1981, ch. 639, § 1; 1981, ch. 640, § 1; 1983, ch. 695, §§ 1, 2; 1985, ch. 82, § 159; 1985, ch. 685, §§ 1, 2; 1987, ch. 298, § 3; 1987, ch. 750, § 1; 1989, ch. 69, § 74; 1989, ch. 295, § 4; 1989, ch. 765, § 1; 1991, ch. 54, § 30; 1991, ch. 713, § 1; 1991, ch. 714, § 23; 1993, ch. 45, § 22; 1993, ch. 54, § 105; 1993, ch. 613, §§ 1, 5; 1993, ch. 614, §§ 1, to 3; 1993, ch. 615, § 1; 1993, ch. 616, § 1; 1993, ch. 617, § 1; 1995, ch. 456, § 24; 1995, ch. 606, § 1; 1995, ch. 607, § 1; 1995, ch. 608, § 1; 1995, ch. 609, § 1; 1995, ch. 610, § 1; 1997, ch. 527, § 1; 1997, ch. 528, § 1; 1997, ch. 530, § 1; 1999, ch. 550, § 1; 1999, ch. 551, § 1; 2001, ch. 574, § 1; 2001, ch. 575, § 1; 2003, ch. 561, §§ 1, 3; 2003, ch. 562, §§ 1, 2; 2005, ch. 235, § 6; 2005, ch. 610, § 1; 2005, ch. 611, § 1; 2009, ch. 163, § 4; 2009, ch. 607, § 1; 2009, ch. 608, § 1; 2013, ch. 498, § 1; 2013, ch. 499, § 1; 2015, ch. 334, § 11, eff August 1, 2015; 2015, ch. 480, § 1, eff August 1, 2015; 2017, ch. 434, § 1, eff August 1, 2017; 2017, ch. 438, § 1, eff August 1, 2017; 2019, ch. 391, § 137, eff January 1, 2020; 2019, ch. 523, § 2, eff August 1, 2019; 2019, ch. 524, § 1, eff August 1, 2019; 2019, ch. 525, § 1, eff July 1, 2019; 2021, ch. 500, § 1, eff July 1, 2021; 2021, ch. 501, § 1, eff August 1, 2021; 2021, ch. 352, § 508, eff September 1, 2022.

65-01-03. Individual performing service for remuneration presumed an employee.

  1. Each individual who performs services for another for remuneration is presumed to be an employee of the person for which the services are performed, unless it is proven that the individual is an independent contractor under the common-law test. The person that asserts that an individual is an independent contractor under the common-law test, rather than an employee, has the burden of proving that fact.
  2. In the case of commercial motor vehicles whose gross vehicle weight rating is more than twenty-six thousand pounds [11793.40 kilograms], with an individual operating a licensed truck or licensed tractor for a motor carrier of property, the presumption in subsection 1 is successfully rebutted if all of the following factors are present:
    1. The individual owns, leases, or enters a purchase agreement to purchase a truck or tractor. The lease or purchase agreement must represent reasonably the value of the lease or purchase of the truck or tractor. The lease or purchase agreement may be with the carrier of property. An unreasonable lease or purchase agreement with a third party, unaffiliated with the carrier, does not affect this factor.
    2. The individual is responsible for the maintenance and repair of the truck or tractor.
    3. The individual bears the principal burden of operating costs, including fuel, supplies, vehicle insurance, and personal expenses.
    4. The individual is responsible for supplying the necessary personal services to operate the truck or tractor.
    5. Income taxes are not withheld from the individual’s compensation.
    6. The individual generally determines the details and means of performing the services, in conformance with statutory or regulatory requirements, operating procedures of the carrier, and specifications of the shipper.
    7. The individual enters a written agreement with the motor carrier outlining the nature of the relationship.

Source:

S.L. 1941, ch. 305, § 1; R.C. 1943, § 65-0103; S.L. 1947, ch. 375, § 2; 1957 Supp., § 65-0103; S.L. 1977, ch. 579, § 3; 1991, ch. 533, § 3; 1993, ch. 347, § 4; 1997, ch. 527, § 2; 2009, ch. 609, § 1.

Notes to Decisions

Claimant Found to be an Employee.

Summary judgment quieting title to oil field company’s pipeline in a suit against its former manager was proper because the manager did not carry his statutory burden to show that he was an independent contractor and the factors indicated he was an employee, including, inter alia, that he earned a weekly salary and employment benefits, he had filled out a Form W-4 and the company had withheld and paid employment taxes, and the company had retained the right to direct his work. Oil & Gas Transfer L.L.C. v. Karr, 928 F.3d 1120, 2019 U.S. App. LEXIS 20337 (8th Cir. N.D. 2019).

Employer was entitled to supervisory writs directing a district court to grant the employer summary judgment barring civil liability for deceased and injured workers’ injuries because Workforce and Safety Insurance’s unappealed decision that the workers were employees was res judicata. Plains Trucking, LLC v. Hagar, 2019 ND 226, 932 N.W.2d 541, 2019 N.D. LEXIS 227 (N.D. 2019).

Claimant Not Found to be an Employee.

Claimant was not an employee of the bar but rather an owner or partner based on his tax returns and business records showing his partnership interest and income from the bar as well as evidence that claimant attempted to document himself as an employee for the express purpose of receiving benefits. Berger v. North Dakota Workers Compensation Bureau, 2000 ND 224, 620 N.W.2d 576, 2000 N.D. LEXIS 273 (N.D. 2000).

In a worker’s compensation case, a benefits claimant and other similarly situated welders were properly found to be independent contractors under the common law test. Inter alia, the claimant and other welders used their own equipment, tools, trucks, and paid their expenses; moreover, a rig foreman instructed the welders, there was no continuing relationship between the employer and the claimant, there was no set work schedule, and the claimant worked for other companies. State v. Larry's On Site Welding, 2014 ND 81, 845 N.W.2d 310, 2014 N.D. LEXIS 86 (N.D. 2014).

Cleaning Machine Dealer.

Finding that dealer of multipurpose home cleaning machines was employee of area distributor for workers’ compensation purposes was sufficiently supported by evidence, where distributor had the right to discipline dealer, including termination at any time without liability, and to control sales of product to customers, and distributor trained dealers and facilitated financing and closing of sales; contractual designation of dealer as an independent contractor was not binding on the parties. Schaefer v. North Dakota Workers Compensation Bureau, 462 N.W.2d 179, 1990 N.D. LEXIS 223 (N.D. 1990).

Evidence Controlling.

One who performs services for another is presumed to be an employee but presumption is not evidence of fact and when evidence is introduced as to agreement under which employment is performed, evidence is controlling. Starkenberg v. North Dakota Workmen's Compensation Bureau, 73 N.D. 234, 13 N.W.2d 395, 1944 N.D. LEXIS 56 (N.D. 1944).

Test of Status.

Although the right-to-control test is the primary test to be used under this section, the bureau is not precluded from using the relative-nature-of-the-work test as an additional aid in judging worker status, particularly when application of the right-to-control test is not clearly determinative. Schaefer v. North Dakota Workers Compensation Bureau, 462 N.W.2d 179, 1990 N.D. LEXIS 223 (N.D. 1990).

Truck Driver.

Decedent’s transporting of company’s products to its customers was integral part of company’s business so that decedent was employee rather than an independent contractor when tractor he was driving collided with freight train as decedent returned from delivering trailer load of company’s products in one of company’s trailers; fact that company’s signs covered decedent’s name on cab of tractor and that decedent was paid monthly rather than at end of each trip were significant in determining his status; modern tendency is to find employment when work being done is integral part of regular business of employer and when worker, relative to employer, does not furnish an independent business or professional service. Brown v. North Dakota Workmen's Compensation Bureau, 152 N.W.2d 799, 1967 N.D. LEXIS 92 (N.D. 1967).

Collateral References.

Workers’ compensation: student athlete as “employee” of college or university providing scholarship or similar financial assistance, 58 A.L.R.4th 1259.

Tort liability for window washer’s injury or death, 69 A.L.R.4th 207.

Award of workers’ compensation benefits to professional athletes, 112 A.L.R.5th 365.

Right to Workers’ Compensation for Injury Suffered by Employee While Driving Employer’s Vehicle, 28 A.L.R.6th 1.

Workers’ Compensation: Nonathlete Students as Covered Employees, 33 A.L.R.6th 251.

65-01-04. Computation of weekly wages in compensation matters. [Repealed]

Repealed by S.L. 1969, ch. 558, § 6.

Collateral References.

Workers’ Compensation: Value of Employer-Provided Room, Board, or Clothing as Factor in Determining Basis for or Calculation of Amount of Compensation Under State Workers’ Compensation Statute. 48 A.L.R.6th 387.

65-01-05. Employment of those unprotected by insurance unlawful — Effect of failure to secure compensation — Penalty — Injunction. [Repealed]

Repealed by S.L. 2001, ch. 578, § 17.

65-01-06. Exempting certain flying employees.

Pilots, copilots, stewardesses, and other regular flying employees of a regularly established airline operating under a certificate of convenience and necessity granted by the competent authorities of the United States of America and operating regularly scheduled flights in interstate or foreign commerce shall be exempt from the compulsory provisions of this title while engaged in work, the duties of which primarily involve interstate or foreign flying operations. Employees not regularly engaged in interstate or foreign flying operations, and the flying employees of any such airline as has its principal operating base in North Dakota, shall not be included in this exemption.

Source:

S.L. 1941, ch. 304, § 1; R.C. 1943, § 65-0106.

65-01-07. Employer must keep record of injuries to employees — Reports required — Contents — Penalty. [Repealed]

Repealed by S.L. 1975, ch. 106, § 673.

65-01-08. Contributing employer and staffing service relieved from liability for injury to employee.

  1. If a local or out-of-state employer secured the payment of compensation to that employer’s employees by contributing premiums to the fund, the employee, and the parents in the case of a minor employee, or the representatives or beneficiaries of either, do not have a claim for relief against the contributing employer or against any agent, servant, or other employee of the employer for damages for personal injuries, but shall look solely to the fund for compensation.
  2. If a client company contracts with a staffing service for an employee’s services, the client company and the staffing service are immune from any claim for relief by that employee or by another employee of the client company or staffing service, to the same extent granted under this title to contributing employers if the client company or staffing service secured the payment of compensation in accordance with this title. Although an account must include the name of the staffing service, the employee is considered an employee of the client company and staffing service for purposes of application of immunity for injuries incurred by or caused by that employee.
  3. For purposes of this section:
    1. “Client company” means a person that contracts to receive services within the course of that person’s usual business from a staffing service or that contracts to lease any or all of that person’s employees from a staffing service.
    2. “Staffing service” means an employer in the business of providing the employer’s employees to persons to perform services within the course of that person’s usual businesses. The term includes professional employer organizations’ staff leasing companies, employee leasing organizations, and temporary staffing companies. The term “staffing service” must be broadly construed to encompass entities that offer services provided by a professional employer organization, staff leasing company, employee leasing organization, or temporary staffing company regardless of the term used.
      1. Within the meaning of staffing service as used in this section, “temporary staffing” or “temporary staffing service” means an arrangement by which an employer hires its own employees and assigns the employees to a client company to support or supplement the client company’s workforce in a special work situation, including:
        1. An employee absence;
        2. A temporary skill shortage;
        3. A seasonal workload; or
        4. A special assignment or project with a targeted end date.
      2. The term does not include arrangements in which the majority of the client company’s workforce has been assigned by a temporary staffing service for a period of more than twelve consecutive months.
  4. A staffing service that provides only temporary staffing services is the employee’s employer. The temporary staffing service shall maintain a workforce safety and insurance account in the temporary staffing service’s name and report the wages for those workers annually to the organization. All other staffing services shall:
    1. Report payroll detail as directed by the organization for each North Dakota client company.
    2. Maintain complete and separate records of the payroll of the staffing service’s client companies. Claims must be separately identified by the staffing service for each client company.
    3. Share employer responsibilities with the client company, including retention of the authority to hire, terminate, discipline, and reassign employees. If the contractual agreement between a staffing service and a client company is terminated, the employees become the sole employees of the client company.
    4. Notify the organization of the client company’s name, workforce safety and insurance account number, and the date the staffing service began providing services to the client company. The staffing service shall provide this information upon entering an agreement with a client company, but no later than fifteen days from the effective date of the written agreement.
    5. Supply the organization with a copy of the agreement between the staffing service and client company.
    6. Notify the organization upon termination of any agreement with a client company, but no later than fifteen days from the effective date of termination.
    7. Notify the staffing service’s client companies of an uninsured status for failure to pay workforce safety and insurance premiums within fifteen days of notice by the organization.
  5. A staffing service that provides both temporary and long-term employees is subject to the reporting requirements associated with the type of employee provided to the client company.
    1. The organization shall maintain all employer data for each client company requiring coverage under this title. If a client company enters an agreement with a staffing service, the organization shall generate a master billing for the staffing service detailing the staffing service’s client companies.
    2. Rate classifications for employees provided by a staffing service must be those which would apply as if the work were performed by the employees of the client company. A client company is eligible for organization safety discount and dividend programs. If a client company enters an agreement with a staffing service, the client company shall retain the client company’s experience rate, if applicable.
    3. Both a staffing service and client company under this section are considered employers for purposes of section 65-04-26.1. A staffing service that provides employees to a client company that has been determined to be uninsured or ineligible for coverage under sections 65-04-27.1 and 65-04-33 may not secure workforce safety and insurance coverage for those employees.
    1. The organization shall determine whether an entity is a staffing service. If the organization determines an entity is a staffing service, the organization may further determine if the entity is a temporary staffing service. In rendering either determination, the organization may issue a decision under section 65-04-32. If the organization determines an entity is not a staffing service, the client company shall maintain a workforce safety and insurance account and pay the premium for coverage of the employees.
    2. The factors the organization may consider in determining whether an entity is a staffing service include the number of client companies handled by the staffing service, the length of time the staffing service has been in existence, the extent to which the staffing service extends services to the general public, the degree to which the client company and staffing service are separate and unrelated business entities, the repetition of officers or managers between the client company and staffing service, and the extent to which a client company has an ownership or other interest in the staffing service. The organization also may consider the scope of the services provided by the staffing service, the relationship between the staffing service and the client company’s workers, the written agreement between the staffing service and the client company, and any other factor deemed relevant by the organization.
    3. The organization may require information from any staffing service, including a list of current client company accounts, staffing assignments, payroll information, and rate classification information. A client company shall provide any information requested by the organization regarding any staffing service.
  6. The organization may adopt rules consistent with this section which further define client company and staffing service and which provide a procedure by which the organization may determine whether an entity meets these definitions.

Source:

S.L. 1919, ch. 162, § 6; 1925 Supp., § 396a6; R.C. 1943, § 65-0108; S.L. 1951, ch. 342, § 1; 1957 Supp., § 65-0108; S.L. 1985, ch. 82, § 160; 1999, ch. 552, § 1; 2003, ch. 561, § 3; 2003, ch. 563, § 1; 2019, ch. 524, § 2, eff August 1, 2019.

Cross-References.

Word defined by statute always has same meaning, see N.D.C.C. § 1-01-09.

Notes to Decisions

Co-Employees.

Co-employees retain their status as co-employees and their immunity from tort liability so long as they are acting in the course of their employment; the most satisfactory test to determine course of employment for purposes of co-employee immunity is the same course-of-employment test used to determine basic compensation coverage. Under that standard, in determining co-employee immunity, the test is whether the negligent co-employee would have been entitled to receive workers’ compensation benefits if that co-employee had been injured in the same incident. Mitchell v. Sanborn, 536 N.W.2d 678, 1995 N.D. LEXIS 150 (N.D. 1995).

Compensation in Lieu of Right of Action.

Truck driver who had received workers’ compensation for injuries was precluded from raising question of employment status in subsequent tort action against employer and fellow employee and thus had no right of action against either of them for same injuries and his wife had no right of action for loss of consortium. Lovelette v. Braun, 293 F. Supp. 41, 1968 U.S. Dist. LEXIS 11855 (D.N.D. 1968).

This section grants immunity from a suit for negligence only to the employer and fellow employees of an injured employee; therefore, an employee of one subcontractor was not precluded by this section from suing both an employee of a second subcontractor and the second subcontractor for damages arising from the alleged negligence of the employee of the second subcontractor. Boettner v. Twin City Constr. Co., 214 N.W.2d 635, 1974 N.D. LEXIS 249 (N.D. 1974).

Dual Capacity Doctrine.

Employee who applied for and received workers’ compensation for an injury caused by the shattering of a steel pin manufactured by his employer for use in the employer’s business was barred from bringing an action against the contributing employer for the injury, and by failing to prove that the steel pin was manufactured for sale to the public rather than for the employer’s own use, the employee failed to establish any exception that would entitle him to maintain an action against his employer under the dual capacity doctrine that the employer was also liable as a manufacturer of a defective product. Latendresse v. Preskey, 290 N.W.2d 267, 1980 N.D. LEXIS 203 (N.D. 1980).

Worker’s products liability and negligence claims against the manufacturer and the employer were barred by the workers’ compensation exclusive remedy rule because, after a merger between the employer and manufacturer, the employer was the sole surviving entity and the employer complied with its obligations under the North Dakota Workers’ Compensation Act so as to avail itself of the exclusive remedy rule; the district court declined to apply the dual capacity exception, because the employer did not have second capacity obligations in addition to and independent of its primary capacity as employer. Scott v. Key Energy Servs., 990 F.3d 1101, 2021 U.S. App. LEXIS 6938 (8th Cir. N.D. 2021).

Election Not to File Compensation Claim.

Nonresident employee injured in this state, whose employment was such that his employer provided workers’ compensation coverage in this state as well as another state so that employee had the right to elect under which coverage to file his claim, could not, by refraining to file a claim in this state, defeat the limited immunity granted to his employer and fellow employees by this section, and could not maintain a tort action in this state against his fellow employee for the injury. Olson v. American Oil Co., 474 F. Supp. 560, 1978 U.S. Dist. LEXIS 13912 (D.N.D. 1978), aff'd, 604 F.2d 26, 1979 U.S. App. LEXIS 13462 (8th Cir. N.D. 1979).

Elective Coverage.

An injured farm laborer having no notice of his employer’s election to be bound by the workers’ compensation act can maintain, apart from the act, common-law action against employer for damages. Rosebear v. Anderson, 143 F. Supp. 721, 1956 U.S. Dist. LEXIS 3021 (D.N.D. 1956), aff'd, 245 F.2d 673, 1957 U.S. App. LEXIS 3269 (8th Cir. N.D. 1957).

Contributing Employer.
—Employment of Temporary Workers.

A company securing the services of a temporary worker from a service providing temporary workers is not an employer under this section and is not immune from suit by an injured temporary worker. Cervantes v. Drayton Foods, L.L.C., 1998 ND 138, 582 N.W.2d 2, 1998 N.D. LEXIS 148 (N.D. 1998).

Equitable Estoppel.

There is no good reason to refuse to apply the doctrine of estoppel against the workers’ compensation fund created by the payment of premiums by employers, which payments earn the employers immunity from claims for relief by injured employees. Linnertz v. North Dakota Workers' Compensation Bureau, 502 N.W.2d 528, 1993 N.D. LEXIS 134 (N.D. 1993).

Exclusive Remedy.

The remedy provided for in this section is exclusive, and any common-law action otherwise maintainable is barred; determination by New York workers’ compensation board that injury occurred in course of employment was given full faith and credit with result that suit against executrix of co-employee’s estate was properly dismissed. Stine v. Weiner, 238 N.W.2d 918, 1976 N.D. LEXIS 194 (N.D. 1976).

Under the exclusive remedy provisions, a plaintiff employee has no ability to elect whether or not to bring suit against his or her employer. Hoerr v. Northfield Foundry & Mach. Co., 376 N.W.2d 323, 1985 N.D. LEXIS 459 (N.D. 1985).

Generally, when an employer complies with the workers’ compensation statutes, the employee’s exclusive remedy against the employer is limited to recovery under the workers’ compensation statutes. Barsness v. General Diesel & Equip. Co., 422 N.W.2d 819, 1988 N.D. LEXIS 108 (N.D. 1988).

Once a claimant is allowed to participate in the fund, he or she may no longer elect to bring a lawsuit against the employer. Westman v. Dessellier, 459 N.W.2d 545, 1990 N.D. LEXIS 155 (N.D. 1990).

Third-party indemnity and contribution action for fraud and deceit against employer was barred by the exclusive remedy provisions of the Workers' Smith v. Vestal, 494 N.W.2d 370, 1992 N.D. LEXIS 270 (N.D. 1992).

Exclusive Remedy Doctrine Applicable.

Employee who along with his son was employed by same employer, and who was injured in the course of employment in a one-vehicle accident while riding as a passenger in his own vehicle, which was being driven by his son, could not recover under the general liability and under insurance provisions of his own automobile insurance policies where the policy language clearly and unambiguously provided that he was entitled to benefits only if he was “legally entitled to recover” or his son was “legally liable to pay,” since his son was statutorily immune under the exclusive remedy provisions of the Workers' Compensation Act. Stuhlmiller v. Nodak Mut. Ins. Co., 475 N.W.2d 136, 1991 N.D. LEXIS 169 (N.D. 1991).

Employer’s related company was immune from liability in wrongful death action because decedent’s surviving spouse had received Workforce Safety and Insurance (WSI) benefits and for WSI exclusive remedy purposes, the employer and related company were the same entity as determined by the WSI under its authority of N.D.C.C. § 65-01-02(22) and thus, the company was a contributing employer under N.D.C.C. § 65-01-08. Therefore, the decedent’s estate representative was not permitted to proceed against the company under N.D.C.C. § 65-01-09 for third party liability. Trinity Hosps. v. Mattson, 2006 ND 231, 723 N.W.2d 684, 2006 N.D. LEXIS 237 (N.D. 2006).

District court did not err in dismissing an employee’s negligence action because an employee and coworker were immune from suit under the Workforce Safety and Insurance Act’s exclusive remedy provisions; the determinations in California administrative proceedings were irrelevant for deciding statutory immunity because the employer paid Workforce Safety and Insurance premiums to secure coverage on the employee’s behalf, and the employee received benefits throughout the California proceedings. Brock v. Price, 2019 ND 240, 934 N.W.2d 5, 2019 N.D. LEXIS 251 (N.D. 2019).

Exclusive Remedy Doctrine Not Applicable.

An employer foregoes the protections of the exclusive remedy doctrine when he enters into an indemnity contract with someone other than the employee who is later injured. Sorensen v. Tenneco Oil Co., 609 F. Supp. 838, 1985 U.S. Dist. LEXIS 19479 (D.N.D. 1985).

Exclusivity Generally.

The exclusivity provisions of the Workers’ Compensation Act are embodied in N.D.C.C. § 65-01-01 and this section. Westman v. Dessellier, 459 N.W.2d 545, 1990 N.D. LEXIS 155 (N.D. 1990).

Failure to Comply.

Father of deceased employee was entitled to sue at law for employee’s death where employer had not complied with workers’ compensation act. Olson v. Hemsley, 48 N.D. 779, 187 N.W. 147, 1922 N.D. LEXIS 101 (N.D. 1922).

In case the employer has failed to comply with the workers’ compensation act, he is liable to such injured employee for the damages so sustained, without regard to fault. Fahler v. Minot, 49 N.D. 960, 194 N.W. 695, 1923 N.D. LEXIS 46 (N.D. 1923); State ex rel. Dushek v. Watland, 51 N.D. 710, 201 N.W. 680, 1924 N.D. LEXIS 94 (N.D. 1924).

Horseplay.

As a matter of law, employee’s act of horseplay in intentionally pushing the knees out from under co-employee was not a sufficiently substantial deviation from his course of employment so as to transform him from a co-employee to a third-person tortfeasor. Mitchell v. Sanborn, 536 N.W.2d 678, 1995 N.D. LEXIS 150 (N.D. 1995).

Indemnity or Contribution by Employer.

This section bars any cause of action for contribution or indemnity that a third party may have against the employer, arising out of the third party’s common-law liability to an injured employee. White v. McKenzie Electric Cooperative, Inc., 225 F. Supp. 940, 1964 U.S. Dist. LEXIS 6497 (D.N.D. 1964).

Where employer had complied with the workers’ compensation statutes and injured employee had received workers’ compensation benefits for his injuries, employee was barred from recovery in tort action against employer for his injuries, and employer was properly dismissed, as a third party defendant in an action for the injuries brought by the employee against a third party who had joined the employer to the action in an attempt to seek contribution or indemnity. Gernand v. Ost Servs., 298 N.W.2d 500, 1980 N.D. LEXIS 300 (N.D. 1980).

In situations where an employer and a third-party tortfeasor both negligently cause an employee’s injuries, liability is imposed on the third-party tortfeasor for the negligence of the third party and the employer without permitting the third-party tortfeasor to get contribution from the employer. Barsness v. General Diesel & Equip. Co., 422 N.W.2d 819, 1988 N.D. LEXIS 108 (N.D. 1988).

The exclusive remedy rule prohibiting a third-party tortfeasor from getting contribution from the employer does not prohibit enforcement of an employer’s contractual agreement to indemnify a third-party tortfeasor. Barsness v. General Diesel & Equip. Co., 422 N.W.2d 819, 1988 N.D. LEXIS 108 (N.D. 1988).

Injury Caused by Fellow Employee.

This section bars an action by a plaintiff who was unloading office equipment from a station wagon parked parallel to the curb in front of his place of employment when he was struck by an auto driven by a fellow employee whose duties were to have ended the day prior to the accident but who was coming back to the office in a company car with defective brakes to attend a required sales meeting and to bill out the sales made on his trip. Lacy v. Grinsteinner, 190 N.W.2d 11, 1971 N.D. LEXIS 140 (N.D. 1971).

Intentional Injuries.

While leaving open issue of whether or not an employee may institute civil action against his employer for an intentionally caused injury, an employee covered by workers’ compensation may not institute civil action against his employer for an accidental injury resulting from an intentional tort. Schreder v. Cities Serv. Co., 336 N.W.2d 641, 1983 N.D. LEXIS 388 (N.D. 1983).

Liability of General Contractor and Subcontractor.

Under former subdivision 9 c of N.D.C.C. § 65-01-02 (see present paragraph 16.c. for similar provisions) and this section, the employee of one contractor injured by the negligence of an employee of another contractor on the same project is not foreclosed from suing the employee of the other contractor and the other contractor for negligence. Boettner v. Twin City Constr. Co., 214 N.W.2d 635, 1974 N.D. LEXIS 249 (N.D. 1974).

Out-of-State Employer.

Where out-of-state employer provided coverage under North Dakota workers’ compensation law and also had workers’ compensation with a private insurance carrier under Minnesota law, which permitted coverage for accidents occurring outside Minnesota, and employee who was injured on a job in North Dakota applied for and received benefits under Minnesota law and then filed a lawsuit in North Dakota against two North Dakota corporations as a result of the injury, full faith and credit clause of United States Constitution did not require North Dakota to apply Minnesota workers’ compensation law, which permits tortfeasors to seek contribution from an employer for its percentage of negligence contributing to injury causing accident, and this section was applicable to bar North Dakota corporations from seeking contribution from out-of-state employer. Barry v. Baker Elec. Coop., 354 N.W.2d 666, 1984 N.D. LEXIS 361 (N.D. 1984).

Statute of Limitations.

Statute of limitations for commencement of an action based upon death of an employee of an uninsured employer is six years. State ex rel. Woods v. Hughes Oil Co., 58 N.D. 581, 226 N.W. 586, 1929 N.D. LEXIS 252 (N.D. 1929).

True Intentional Injury.

The North Dakota Workers Compensation Act does not preclude recovery for true intentional injuries, and an employee can pursue a civil cause of action against his employer for a true intentional injury. Zimmerman v. Valdak Corp., 1997 ND 203, 570 N.W.2d 204, 1997 N.D. LEXIS 261 (N.D. 1997).

An employer is deemed to have intended to injure if the employer had knowledge an injury was certain to occur and willfully disregarded that knowledge. Zimmerman v. Valdak Corp., 1997 ND 203, 570 N.W.2d 204, 1997 N.D. LEXIS 261 (N.D. 1997).

Collateral References.

Workers’ compensation law as precluding employee’s suit against employer for third person’s criminal attack, 49 A.L.R.4th 926.

Workers’ compensation act as precluding tort action for injury to or death of employee’s unborn child, 55 A.L.R.4th 792.

Law Reviews.

The Third Party’s Right to Contribution from an Employer Covered by Workmen’s Compensation, 56 N.D. L. Rev. 373 (1980).

Workers’ Compensation: The Assault on the Shield of Immunity — Coming to Blows with the Exclusive-Remedy Provisions of the North Dakota Workers’ Compensation Act, 70 N.D. L. Rev. 905 (1994).

Constitutional Law — Workers Compensation: Equal Protection Challenge to the Agriculture Exemption and Use of Rational Basis Scrutiny in Haney v. North Dakota Workers Compensation Bureau, 518 N.W.2d 195 (N.D. 1994), 71 N.D. L. Rev. 781 (1995).

65-01-09. Injury through negligence of third person — Option of employee — Organization subrogated when claim filed — Lien created.

When an injury or death for which compensation is payable under provisions of this title has been sustained under circumstances creating in some person other than the organization a legal liability to pay damages in respect thereto, the injured employee, or the injured employee’s dependents may claim compensation under this title and proceed at law to recover damages against such other person.

  1. The organization is subrogated to the rights of the injured employee or the injured employee’s dependents to the extent of fifty percent of the damages recovered up to a maximum of the total amount the organization has paid or would otherwise pay in the future in compensation and benefits for the injured employee. The organization also has a lien to the extent of fifty percent of the damages recovered up to a maximum of the total amount the organization has paid in compensation and benefits. The organization’s subrogation interest or lien may not be reduced by settlement, compromise, or judgment. The action against such other person may be brought by the injured employee, or the injured employee’s dependents in the event of the injured employee’s death. Such action shall be brought in the injured employee’s or in the injured employee’s dependents’ own right and name and as trustee for the organization for the subrogation interest of the organization. However, if the director chooses not to participate in an action, and the decision is in writing, the organization has no subrogation interest and no obligation to pay fees or costs under this section and no lien.
  2. If the injured employee or the injured employee’s dependents do not institute suit within sixty days after date of injury, the organization may bring the action in its own name and as trustee for the injured employee or the injured employee’s dependents and retain as its subrogation interest the full amount it has paid or would otherwise pay in the future in compensation and benefits to the injured employee or the injured employee’s dependents and retain as its lien the full amount the organization has paid in compensation and benefits. In the alternative, the organization may bring an action against a third party to recover its lien for benefits paid to the injured employee. Within sixty days after both the injured employee and the organization have declined to commence an action against a third person as provided above, the employer may bring the action in the employer’s own name or in the name of the injured employee, or both, and in trust for the organization and for the injured employee. The party bringing the action may determine if the trial jury should be informed of the trust relationship.
  3. If the action is brought by the injured employee or the injured employee’s dependents, or the employer as provided in subsection 2, the organization shall pay fifty percent of the costs of the action, exclusive of attorney’s fees, when such costs are incurred as the action progresses before recovery of damages. If there is no recovery of damages in the action, this shall be a cost of the organization to be paid from the organization’s general fund. After recovery of damages in the action, the costs of the action, exclusive of attorney’s fees, must be prorated and adjusted on the percentage of the total subrogation interest of the organization recovered to the total recovery in the action. The organization shall pay attorney’s fees to the injured employee’s attorney from the organization’s general fund as follows:
    1. Twenty-five percent of the subrogation interest recovered for the organization before judgment; and
    2. Thirty-three and one-third percent of the subrogation interest recovered for the organization when recovered through judgment entered as a result of a trial on the merits or recovered through binding alternative dispute resolution.
  4. The above provisions as to costs of the action and attorney’s fees are effective only when the injured employee advises the organization in writing the name and address of the injured employee’s attorney, and the injured employee has employed such attorney for the purpose of collecting damages or of bringing legal action for recovery of damages. If an injured employee fails to pay the organization’s subrogation interest and lien within thirty days of receipt of a recovery in a third-party action, the organization’s subrogation interest is the full amount of the damages recovered, up to a maximum of the total amount it has paid or would otherwise pay in the future in compensation and benefits to the injured employee or the injured employee’s dependents, no costs or attorney’s fees will be paid from the organization’s subrogation interest and the organization’s lien is the full amount of the damages recovered up to a maximum of the total amount it has paid.
  5. The organization’s lien is created upon first payment of benefits. The lien attaches to all claims, demands, settlement proceeds, judgment awards, or insurance payable by reason of a legal liability of a third person. If the organization does not receive payment of its lien amount within thirty days of the payment of any recovery and if the organization has served, by regular mail, written notice of its lien upon the injured employee or the injured employee’s dependents and upon the third person, the insurer of the third person, the injured employee or injured employee’s dependents, and the attorney of the injured employee or injured employee’s dependents are liable to the organization for the lien amount. A release or satisfaction of any judgment, claim, or demand given by the injured employee or the injured employee’s dependents is not valid or effective against the lien. An action to collect the organization’s lien amount must be commenced within one year of the organization first possessing actual knowledge of a recovery.
  6. Upon receipt of its subrogation interest, the organization shall credit the medical expense assessment paid by the employer under section 65-04-04.4 to the employer’s account.
  7. If the organization’s lien is not recognized by another jurisdiction, the organization may issue a decision, including a decision demanding repayment from the injured employee, of all benefits and compensation the organization has made on behalf of the injured employee, including costs and administrative fees.

Source:

S.L. 1919, ch. 162, § 20; 1925 Supp., § 396a20; R.C. 1943, § 65-0109; S.L. 1949, ch. 355, § 1; 1951, ch. 343, § 1; 1955, ch. 354, § 7; 1957 Supp., § 65-0109; S.L. 1965, ch. 452, § 1; 1981, ch. 641, § 1; 1991, ch. 714, § 24; 1997, ch. 531, § 1; 2003, ch. 561, § 3; 2003, ch. 564, § 1; 2005, ch. 602, § 1; 2017, ch. 435, § 1, eff August 1, 2017.

Notes to Decisions

Action Against Employer or Fellow Employee.

Injured employee is not entitled to receive benefits under the workers’ compensation act and also maintain an action against his employer or fellow employee at common law for intentional or willful injuries. Schlenk v. Aerial Contractors, 268 N.W.2d 466, 1978 N.D. LEXIS 258 (N.D. 1978).

Lien created.

District court properly dismissed a claimant’s appeal for lack of jurisdiction because he did not meet the statutory requirements to file the appeal in the county in which the injury occurred or the county in which he resided, the Workforce Safety and Insurance had a statutory lien on the claimant’s third party recovery, and he did not pay any of the sums secured by the lien as statutorily required. Decker v. Workforce Safety & Ins., 2021 ND 117, 2021 N.D. LEXIS 117 (N.D. 2021).

Action at Law.

Dependent father of deceased employee could sue at law for latter’s death. Olson v. Hemsley, 48 N.D. 779, 187 N.W. 147, 1922 N.D. LEXIS 101 (N.D. 1922).

The workers compensation bureau must pay fifty percent of the costs incurred by an employee prosecuting a third-party claim. 409 N.W.2d 344.

Any Ambiguity.

While this section may create an ambiguity in reference to the bureau’s obligation for costs through the insertion of language regarding proration and adjustment, any ambiguity must be interpreted in favor of the worker, and in pursuit of the legislative intent, providing a greater incentive to the injured worker to prosecute third-party claims. 409 N.W.2d 344.

Attorney's Fees.

This section does not regulate attorney fees payable by injured claimants on funds they recover due to the efforts of their private attorneys, or impose a legal obligation on private attorneys to follow the same procedure in calculating their attorney fees as the worker’s compensation bureau. Jones v. Pringle & Herigstad, P.C., 546 N.W.2d 837, 1996 N.D. LEXIS 119 (N.D. 1996).

Where worker’s compensation claimant entered agreement for attorneys to represent her in action against third party tortfeasor, and the method of determining the attorneys’ fee was clearly set out in the agreement, the fact attorneys later entered a written agreement to represent the worker’s compensation bureau for its statutory subrogated interest for benefits when a claimant seeks recovery for injuries from third persons did not render the agreement between claimant and her attorneys ambiguous, and claimant was bound to pay the fee according to the terms of the agreement. Jones v. Pringle & Herigstad, P.C., 546 N.W.2d 837, 1996 N.D. LEXIS 119 (N.D. 1996).

Where the attorney fully disclosed to the claimant that his fee would be one-third of the gross amount of the recovery from the third party, and the record showed there were difficult issues in the case, the case was time-consuming, and special expertise was required to perform the necessary legal services, the fee arrangement was not unreasonable. Disciplinary Bd. of the Supreme Court v. Dooley (In re Disciplinary Action Against Dooley), 1999 ND 184, 599 N.W.2d 619, 1999 N.D. LEXIS 204 (N.D. 1999).

Burden of Proof.

North Dakota Workforce Safety and Insurance (WSI) could apply the subrogation statute, N.D.C.C. § 65-01-09, to the employee’s settlement award where the employee did not prove that the settlement damages caused by the alleged third party negligence did not arise out of his initial work injury. Toso v. Workforce Safety & Ins., 2006 ND 70, 712 N.W.2d 312, 2006 N.D. LEXIS 75 (N.D. 2006).

Co-Employees.

Co-employees retain their status as co-employees and their immunity from tort liability so long as they are acting in the course of their employment; the most satisfactory test to determine course of employment for purposes of co-employee immunity is the same course-of-employment test used to determine basic compensation coverage. Under that standard, in determining co-employee immunity, the test is whether the negligent co-employee would have been entitled to receive workers’ compensation benefits if that co-employee had been injured in the same incident. Mitchell v. Sanborn, 536 N.W.2d 678, 1995 N.D. LEXIS 150 (N.D. 1995).

Contribution by Employer.

In situations where an employer and a third-party tortfeasor both negligently cause an employee’s injuries, liability is imposed on the third-party tortfeasor for the negligence of the third party and the employer without permitting the third-party tortfeasor to get contribution from the employer. Barsness v. General Diesel & Equip. Co., 422 N.W.2d 819, 1988 N.D. LEXIS 108 (N.D. 1988).

Contributory Negligence.

While the damages recovered by plaintiff reflect a twenty percent reduction from the damages he sustained because of negligence attributed to him, the North Dakota supreme court is unable to construe the language employed in this section to permit or require further reduction of the fund’s interest in the damages recovered by the percentage of negligence attributed to plaintiff. Kelsh v. North Dakota Workmen's Compensation Bureau, 388 N.W.2d 870, 1986 N.D. LEXIS 347 (N.D. 1986).

Election of Remedies.

Appointment of guardian for dependent minor is not essential to making of binding election to accept benefit of workers’ compensation act rather than to proceed against third-party tort-feasor. Nelson v. Westland Oil Co., 96 F. Supp. 656, 1949 U.S. Dist. LEXIS 1788 (D.N.D. 1949).

Exclusive Remedy Rule.

The exclusive remedy rule prohibiting a third-party tortfeasor from getting contribution from the employer does not prohibit enforcement of an employer’s contractual agreement to indemnify a third-party tortfeasor. Barsness v. General Diesel & Equip. Co., 422 N.W.2d 819, 1988 N.D. LEXIS 108 (N.D. 1988).

Employer’s related company was immune from liability in wrongful death action because decedent’s surviving spouse had received Workforce Safety and Insurance (WSI) benefits and for WSI exclusive remedy purposes, the employer and related company were the same entity as determined by the WSI under its authority of N.D.C.C. § 65-01-02(22) and thus, the company was a contributing employer under N.D.C.C. § 65-01-08. Therefore, the decedent’s estate representative was not permitted to proceed against the company under N.D.C.C. § 65-01-09 for third party liability. Trinity Hosps. v. Mattson, 2006 ND 231, 723 N.W.2d 684, 2006 N.D. LEXIS 237 (N.D. 2006).

Horseplay.

As a matter of law, employee’s act of horseplay in intentionally pushing the knees out from under co-employee was not a sufficiently substantial deviation from his course of employment so as to transform him from a co-employee to a third-person tortfeasor. Mitchell v. Sanborn, 536 N.W.2d 678, 1995 N.D. LEXIS 150 (N.D. 1995).

Interest Recovered in Suit.

The term damages within this section includes the interest recovered by the injured worker in suing. Therefore, the bureau properly included interest recovered by the worker in calculating its subrogation claim. Kavadas v. North Dakota Workers Compensation Bureau, 466 N.W.2d 839, 1991 N.D. App. LEXIS 4 (N.D. Ct. App. 1991).

Joint and Several Liability of Third Party.

Where employee was injured in work-related accident resulting from negligence of his employer, who was 75% negligent, and third party, who was 25% negligent, and employee received workers’ compensation benefits for his injuries and filed an action against third party in accordance with this section, trial court erred in reducing employee’s damage recovery against third party by percentage of negligence attributable to employer, who was immune from suit because of the workers’ compensation exclusive remedy provision; such reduction of damage recovery was contrary to express language of former N.D.C.C. § 9-10-07, which retains doctrine of joint and several liability, permitting employee to recover his damages in full from third party. Layman v. Braunschweigische Maschinenbauanstalt, Inc., 343 N.W.2d 334, 1983 N.D. LEXIS 434 (N.D. 1983).

Legislative Intent.

The legislature intended this statutory provision as an incentive for the worker to pursue and litigate legal claims against culpable third parties. 409 N.W.2d 344.

Release by Employee.

An injured employee’s release of cause of action against third person negligently causing injury does not bar action against employer for failing to comply with compensation act. State ex rel. Woods v. Hughes Oil Co., 58 N.D. 581, 226 N.W. 586, 1929 N.D. LEXIS 252 (N.D. 1929).

State As Party.

Actions wherein bureau is authorized to cause suit to be brought must be brought by state and not by bureau. Henderson v. Scott, 72 N.D. 616, 10 N.W.2d 490, 1943 N.D. LEXIS 100 (N.D. 1943); State ex rel. Workmen's Compensation Fund v. Thompson, 73 N.D. 56, 11 N.W.2d 113, 1943 N.D. LEXIS 61 (N.D. 1943).

Subrogation Rights of Bureau.
—In General.

The 1949 amendment changing the bureau’s right of subrogation did not operate retrospectively and an employee who had elected under the prior law to receive workmen’s compensation had no right to bring action against third-party wrongdoer. Gimble v. Montana-Dakota Utils. Co., 77 N.D. 581, 44 N.W.2d 198, 1950 N.D. LEXIS 153 (N.D. 1950) (1950) Contra Nelson v. Westland Oil Co., 181 F.2d 371, 1950 U.S. App. LEXIS 2617 (8th Cir. N.D. 1950).

Subrogation of compensation fund applies even though no compensation payments have been made and bureau may enforce subrogation by withholding payments that would otherwise be due. Breitwieser v. State, 62 N.W.2d 900, 1954 N.D. LEXIS 65 (N.D. 1954).

Where settlement is made under wrongful death law of another state and persons other than dependents are entitled to share in proceeds of settlement, compensation fund is subrogated only to extent to which beneficiaries of workers’ compensation act are entitled to share in proceeds as dependents. Breitwieser v. State, 62 N.W.2d 900, 1954 N.D. LEXIS 65 (N.D. 1954).

Workers’ compensation bureau was not entitled to subrogation as to sums paid or payable to surviving widow of deceased employee where the statute of limitations had expired as to widow’s claim against third parties for death of her husband before the widow or the bureau brought an action against the third parties. Ness v. St. Aloisius Hosp., 313 N.W.2d 781, 1981 N.D. LEXIS 364 (N.D. 1981).

The purpose of the bureau’s subrogation rights is to reimburse the fund, to the extent possible, at the expense of the persons at fault. Blaskowski v. North Dakota Workmen's Compensation Bureau, 380 N.W.2d 333, 1986 N.D. LEXIS 240 (N.D. 1986).

In 1965 the legislature reduced the bureau’s right to subrogation of third-party recoveries from one-hundred percent to fifty percent. This change apparently was made to induce employees to bring actions against third parties who were at fault. An obvious result of this change was that the bureau received less subrogation from third-party recoveries. The bureau responded to this decreased subrogation by adopting policies that more thoroughly protected the remainder of its subrogation interest. Blaskowski v. North Dakota Workmen's Compensation Bureau, 380 N.W.2d 333, 1986 N.D. LEXIS 240 (N.D. 1986).

The bureau does not automatically receive one-half of every recovery. It only receives one-half of a recovery if it pays benefits which add up to one-half of the recovery. Blaskowski v. North Dakota Workmen's Compensation Bureau, 380 N.W.2d 333, 1986 N.D. LEXIS 240 (N.D. 1986).

Fact that the bureau failed to indicate its intention to suspend future benefits in its claimed subrogation interest prepared by the bureau for employee in preparation of trial against third party would not result in the bureau losing any right to suspend future benefits. The statute does not require the bureau to make predictions regarding possible future costs resulting from possible future claims which may or may not arise. Blaskowski v. North Dakota Workmen's Compensation Bureau, 380 N.W.2d 333, 1986 N.D. LEXIS 240 (N.D. 1986).

The purpose of changing the language of the statute in 1981 from “paid or to be paid” to “it has paid or would otherwise pay in the future” was to clarify the language, and no substantive change was intended. An additional change made in 1981 was the addition of the clause: “The bureau’s subrogation interest may not be reduced by settlement, compromise, or judgment”. These two changes made statutory the bureau’s policies that were designed to ensure the bureau received its fifty percent subrogation interest. Blaskowski v. North Dakota Workmen's Compensation Bureau, 380 N.W.2d 333, 1986 N.D. LEXIS 240 (N.D. 1986).

The subrogation rights of the bureau are statutory, and equitable concepts are, therefore, not controlling. State by Workmen's Compensation Bureau v. Clary, 389 N.W.2d 347, 1986 N.D. LEXIS 327 (N.D. 1986).

While equity may support plaintiff ’s contention that the subrogation interest of the bureau should be reduced by the percentage of negligence assigned to the employee by a jury in a trial against a third-party tort-feasor, the statute does not provide for such a reduction. State by Workmen's Compensation Bureau v. Clary, 389 N.W.2d 347, 1986 N.D. LEXIS 327 (N.D. 1986).

To construe this section so as to prevent the bureau from suspending future benefits would hinder the bureau’s efforts to enforce its subrogation rights and would be contrary to the intent of the legislature. Blaskowski v. North Dakota Workmen's Compensation Bureau, 380 N.W.2d 333, 1986 N.D. LEXIS 240 (N.D. 1986).

This section unambiguously provides that the workers compensation bureau’s subrogation rights apply to the extent of fifty percent of the damages recovered, and neither permits nor requires the bureau’s subrogation interest to be further reduced when the recipient’s recovery from the third-party tortfeasor does not constitute a total recovery of the damages sustained by the recipient; the reason that a recipient secures only a partial recovery against the third-party tortfeasor is immaterial to the application of the bureau’s subrogation rights. Waith v. North Dakota's Workmen's Compensation Bureau, 409 N.W.2d 94, 1987 N.D. LEXIS 340 (N.D. 1987).

The workers compensation bureau should not receive a prorated subrogation interest when a benefit recipient recovers against a third-party tortfeasor less than the total damages sustained by the recipient because the tortfeasor, a political subdivision, is protected by N.D.C.C. § 32-12.1-03 maximum liability limit. Waith v. North Dakota's Workmen's Compensation Bureau, 409 N.W.2d 94, 1987 N.D. LEXIS 340 (N.D. 1987).

Neither N.D.C.C. § 32-03.2-02, nor this section, permits a reduction of the bureau’s subrogation rights because the claimant is unable to recover his full damages from all tortfeasors. Kavadas v. North Dakota Workers Compensation Bureau, 466 N.W.2d 839, 1991 N.D. App. LEXIS 4 (N.D. Ct. App. 1991).

This section provides the bureau with a statutory subrogation interest against “damages recovered” by an injured employee. In its calculation of damages recoverable under this section, the bureau included the interest a third party in a tort claim recovered on the damages, even though the section does not specifically include the word “interest.” Kavadas v. North Dakota Workers Compensation Bureau, 466 N.W.2d 839, 1991 N.D. App. LEXIS 4 (N.D. Ct. App. 1991).

The bureau’s right of subrogation does not extend to amounts paid to a wife for loss of consortium. Meyer v. North Dakota Workers Compensation Bureau, 512 N.W.2d 680, 1994 N.D. LEXIS 46 (N.D. 1994).

1999 version of N.D.C.C. § 65-01-09 did not grant to North Dakota’s Workforce Safety and Insurance agency a subrogation interest in an injured worker’s legal malpractice claim against the lawyers who failed to prosecute a medical malpractice action against a physician, who failed to provide proper treatment for the claimant’s work-related injuries, because the claimant recovered for the loss of a legal right, not a physical injury as contemplated by the statute. Haugenoe v. Workforce Safety & Ins., 2008 ND 78, 748 N.W.2d 378, 2008 N.D. LEXIS 79 (N.D. 2008).

—Attorney's Fees.

The attorney fee language in this section is unambiguous: the worker’s compensation bureau must pay attorney fees on funds recovered for the bureau based on given percentages. How the bureau internally accounts for attorney fees on suspended benefits does not impose a legal obligation on private attorneys to follow the same procedure in calculating their attorney fees. Jones v. Pringle & Herigstad, P.C., 546 N.W.2d 837, 1996 N.D. LEXIS 119 (N.D. 1996).

DECISIONS UNDER PRIOR LAW

Section 9-10-07.

No conflict exists between this section and former N.D.C.C. § 9-10-07. State by Workmen's Compensation Bureau v. Clary, 389 N.W.2d 347, 1986 N.D. LEXIS 327 (N.D. 1986).

The comparative negligence statute, former N.D.C.C. § 9-10-07, has not impliedly amended this section. State by Workmen's Compensation Bureau v. Clary, 389 N.W.2d 347, 1986 N.D. LEXIS 327 (N.D. 1986).

Subrogation.

Workman awarded compensation could not, under prior law, sue third party for damages, as his right was subrogated to compensation fund and bureau could sue. Tandsetter v. Oscarson, 56 N.D. 392, 217 N.W. 660, 1928 N.D. LEXIS 225 (N.D. 1928).

An employee who had been compensated from workers’ compensation fund for injury, including aggravation thereof caused by physician’s malpractice, had no cause of action against physician under prior law since cause of action passed to fund by operation of law. Polucha v. Landes, 60 N.D. 159, 233 N.W. 264, 1930 N.D. LEXIS 221 (N.D. 1930).

Collateral References.

Right to maintain action against fellow employee for injury or death covered by workmen’s compensation, 21 A.L.R.3d 845.

Right to maintain malpractice suit against injured employee’s attending physician notwithstanding receipt of workmen’s compensation award, 28 A.L.R.3d 1066.

Attorney’s fee or other expenses of litigation incurred by employee in action against third-party tort-feasor as charge against employer’s distributive share, 74 A.L.R.3d 854.

When does statute of limitations begin to run upon an action by subrogated insurer against third-party tort-feasor, 91 A.L.R.3d 844.

Modern status of effect of state workmen’s compensation act on right of third-person tortfeasor to contribution or indemnity from employer of injured or killed workman, 100 A.L.R.3d 350.

Workers’ compensation act as precluding tort action for injury to or death of employee’s unborn child, 55 A.L.R.4th 792.

Willful, wanton, or reckless conduct of coemployee as ground of liability despite bar of workers’ compensation law, 57 A.L.R.4th 888.

Right of employer or workers’ compensation carrier to lien against, or reimbursement out of, uninsured or underinsured motorist proceeds payable to employee injured by third party, 33 A.L.R.5th 587.

Law Reviews.

Workers’ Compensation: The Assault on the Shield of Immunity — Coming to Blows with the Exclusive-Remedy Provisions of the North Dakota Workers’ Compensation Act, 70 N.D. L. Rev. 905 (1994).

North Dakota Supreme Court Review (Sandberg v. American Family Ins. Co.), 83 N.D. L. Rev. 1085 (2007).

Note.

Section 4 of chapter 435, S.L. 2017 provides, “ APPLICATION. Section 1 of this Act applies to all claims regardless of date of injury.”

65-01-10. Waiver of rights to compensation void — Deduction of premium from employee prohibited — Penalty.

No agreement by an employee to waive rights to compensation under this title is valid except as provided in section 65-05-25. No agreement by any employee to pay any portion of the premium paid or payable by the employer into the fund is valid, and any employer who deducts any portion of the premium from the wages or salary of any employee eligible for benefits under this title is guilty of a class A misdemeanor and is subject to a penalty of up to five thousand dollars. The organization may reduce the penalties provided under this section. An employer may not appeal an organization decision not to reduce a penalty under this section.

Source:

S.L. 1919, ch. 162, § 21; 1925 Supp., § 396a21; R.C. 1943, § 65-0110; S.L. 1975, ch. 106, § 669; 1977, ch. 579, § 4; 1991, ch. 714, § 25; 2019, ch. 524, § 3, eff August 1, 2019.

Notes to Decisions

Constitutionality.

This statute does not impair the obligation of contracts. State ex rel. Amerland v. Hagan, 44 N.D. 306, 175 N.W. 372, 1919 N.D. LEXIS 213 (N.D. 1919), overruled, Benson v. North Dakota Workmen's Compensation Bureau, 283 N.W.2d 96, 1979 N.D. LEXIS 285 (N.D. 1979).

65-01-11. Burden of proof in compensation matters — Death certificate.

If the organization or an employer claims an employee is not entitled to the benefits of the North Dakota workforce safety and insurance law because the employee’s injury was caused by the employee’s willful intention to cause self-injury, or to injure another, or by reason of the voluntary impairment caused by use of alcohol, recreational marijuana use, or illegal use of a controlled substance by the employee, the burden of proving the exemption or forfeiture is on the organization or on the person alleging the same; however, an alcohol concentration level at or above the limit set by the United States secretary of transportation in the Code of Federal Regulations in effect on August 1, 2011, or a level of an illegally used controlled substance or recreational marijuana sufficient to cause impairment found by a test conducted by a physician, qualified technician, chemist, or registered nurse at or above the cutoff level in the Code of Federal Regulations in effect on August 1, 2011, creates a rebuttable presumption the injury was due to impairment caused by the use of alcohol, recreational marijuana use, or the illegal use of a controlled substance. An employer who has a mandatory drug alcohol testing policy for work accidents, or an employer or a health care provider who has reasonable grounds to suspect an employee’s alleged work injury was caused by the employee’s voluntary impairment caused by use of alcohol, recreational marijuana use, or illegal use of a controlled substance may request the employee undergo testing to determine if the employee had alcohol, marijuana, or the controlled substance in the employee’s system at levels greater than the limit set by the United States department of transportation at the time of the injury. If an employee refuses to submit to a reasonable request to undergo a test to determine if the employee was impaired or if an employee refuses to submit to a test for drugs or alcohol after a work accident as mandated by company policy, the employee forfeits all entitlement to workforce safety and insurance benefits arising out of that injury. Any claimant against the fund, however, has the burden of proving by a preponderance of the evidence that the claimant is entitled to benefits. If a claim for death benefits is filed, the official death certificate must be considered as evidence of death and may not be used to establish the cause of death.

Source:

S.L. 1919, ch. 162, § 2; 1921, ch. 142, § 1; 1925, ch. 222, § 1; 1925 Supp., § 396a2; S.L. 1935, ch. 286, § 1; 1941, ch. 305, § 1; 1943, ch. 274, § 1; R.C. 1943, § 65-0111; S.L. 1975, ch. 581, § 1; 1981, ch. 642, § 1; 1989, ch. 69, § 76; 1993, ch. 387, § 8; 1993, ch. 614, § 4; 1995, ch. 611, § 1; 1997, ch. 527, § 3; 2003, ch. 561, § 3; 2011, ch. 506, § 1; 2019, ch. 523, § 3, eff August 1, 2019; 2021, ch. 500, § 2, eff August 1, 2021.

Note.

Section 13 of chapter 500, S.L. 2021, provides, " APPLICATION. This Act applies to all claims regardless of date of injury."

Notes to Decisions

Burden of Proof.
—In General.

One seeking an award from workers’ compensation bureau has burden of establishing by preponderance of evidence that injury for which he claims compensation was received in course of his employment. Oberg v. North Dakota Workmen's Compensation Bureau, 57 N.D. 189, 220 N.W. 923, 1928 N.D. LEXIS 114 (N.D. 1928); Sandlie v. Workmen's Compensation Bureau, 70 N.D. 449, 295 N.W. 497, 1940 N.D. LEXIS 192 (N.D. 1940); Booke v. Workmen's Compensation Bureau, 70 N.D. 714, 297 N.W. 779, 1941 N.D. LEXIS 220 (N.D. 1941); Burkhardt v. State, 78 N.D. 818, 53 N.W.2d 394, 1952 N.D. LEXIS 80 (N.D. 1952).

Claimant against the North Dakota workers’ compensation fund has the burden of proving by a preponderance of the evidence the existence of an injury for which she is entitled to participate in the fund. Roberts v. North Dakota Workmen's Compensation Bureau, 326 N.W.2d 702, 1982 N.D. LEXIS 389 (N.D. 1982).

—Alcoholism.

This section provides that the burden of proof shifts to the bureau in cases in which the employee’s voluntary intoxication is the cause of the employee’s injury, and does not require the burden of proof to shift when the alleged injury is itself alcoholism. Darnell v. North Dakota Workers Compensation Bureau, 450 N.W.2d 721, 1990 N.D. LEXIS 6 (N.D. 1990).

—Of Bureau.

This section generally requires the claimant to prove a compensable injury by a preponderance of evidence in order to participate in the fund. However, the bureau has the burden of proof if it claims that an employee is not entitled to benefits because of the employee’s willful intent to injure himself or the employee’s voluntary intoxication. Darnell v. North Dakota Workers Compensation Bureau, 450 N.W.2d 721, 1990 N.D. LEXIS 6 (N.D. 1990).

Workers’ Compensation Bureau’s finding that claimant failed to prove that her current condition was related to a prior work injury was supported by a preponderance of the evidence; the bureau was responsible for weighing the credibility of medical evidence and in doing so explained why it gave more weight to their medical examiner’s opinion. Otto v. North Dakota Workers Compensation Bureau, 533 N.W.2d 703, 1995 N.D. LEXIS 111 (N.D. 1995).

Because the Bureau relied on parts of a independent medical examination report favorable to its decision and ignored parts of the report unfavorable to its decision, the Bureau’s decision was not supported by a preponderance of the evidence and the judgment was reversed and the case remanded to the Bureau for further proceedings to clarify the discrepancies in the independent medical examination report. Negaard-Cooley v. North Dakota Workers Compensation Bureau, 2000 ND 122, 611 N.W.2d 898, 2000 N.D. LEXIS 131 (N.D. 2000).

—Of Claimant.

Claimant has the burden of proving his right to participate in compensation benefits by showing that he was actually injured in the course of employment and that the ensuing disability is causally connected to the employment injury; compensation award cannot be made on surmise, conjecture or mere guess. Inglis v. North Dakota Workmen's Compensation Bureau, 312 N.W.2d 318, 1981 N.D. LEXIS 405 (N.D. 1981).

A claimant of compensation benefits has the burden to prove that he or she was actually injured in the course of employment and that the ensuing disability is causally connected to the employment injury. Robert v. North Dakota Workmen's Compensation Bureau, 321 N.W.2d 501, 1982 N.D. LEXIS 290 (N.D. 1982).

Claimant of compensation benefits has the burden of proving by a preponderance of the evidence that he or she is entitled to participate in the benefits available from the fund; such claimant must establish that the injury was incurred in the course of employment and that the disability is causally connected to the employment injury. Reynolds v. North Dakota Workmen's Compensation Bureau, 328 N.W.2d 247, 1982 N.D. LEXIS 402 (N.D. 1982).

Claimant had the burden of proving that his July 1985 head injury was related to his April 1986 headaches and hospitalization. Howes v. North Dakota Workers Compensation Bureau, 429 N.W.2d 730, 1988 N.D. LEXIS 259 (N.D. 1988), cert. denied, 489 U.S. 1014, 109 S. Ct. 1126, 103 L. Ed. 2d 189, 1989 U.S. LEXIS 904 (U.S. 1989).

If the bureau terminates benefits, after initially accepting a claim and paying benefits, the claimant has the burden of proving his or her right to continue receiving benefits. Howes v. North Dakota Workers Compensation Bureau, 429 N.W.2d 730, 1988 N.D. LEXIS 259 (N.D. 1988), cert. denied, 489 U.S. 1014, 109 S. Ct. 1126, 103 L. Ed. 2d 189, 1989 U.S. LEXIS 904 (U.S. 1989).

A claimant must show, by a simple preponderance of the evidence, a compensable injury in order to participate in the workers compensation fund. Moses v. North Dakota Workers Compensation Bureau, 429 N.W.2d 436, 1988 N.D. LEXIS 255 (N.D. 1988).

The claimant has the burden of proving by a preponderance of the evidence that she is entitled to receive benefits from the bureau. Risch v. North Dakota Workers Compensation Bureau, 447 N.W.2d 308, 1989 N.D. LEXIS 198 (N.D. 1989).

A claimant seeking benefits from the bureau has the burden of proving by a preponderance of the evidence that he is entitled to participate in the fund. Schmalz v. North Dakota Workers Compensation Bureau, 449 N.W.2d 817, 1989 N.D. LEXIS 241 (N.D. 1989).

To participate in the workers’ compensation fund, this section requires a claimant to prove a compensable injury by a preponderance of the evidence. Wherry v. North Dakota State Hosp., 498 N.W.2d 136, 1993 N.D. LEXIS 52 (N.D. 1993).

To receive workers’ compensation benefits, the claimant must prove by a preponderance of the evidence that his injury is causally related to his employment. Spangler v. North Dakota Workers Compensation Bureau, 519 N.W.2d 576, 1994 N.D. LEXIS 165 (N.D. 1994).

Where the worker’s treating physician, a second physician and a physical therapist concluded that the worker’s injury-related work restrictions did not preclude him from working altogether, but a third physician offered a conflicting medical opinion as to his ability to work, the worker did not meet his burden of establishing entitlement to disability benefits. Boger v. North Dakota Workers Compensation Bureau, 1999 ND 192, 600 N.W.2d 877, 1999 N.D. LEXIS 221 (N.D. 1999).

District court was correct in upholding the Workers Compensation Bureau’s order denying the claimant’s reapplication for temporary total disability benefits; the claimant was unable to prove actual wage loss, which was a prerequisite to reinstating discontinued disability benefits. Gronfur v. N.D. Workers Comp. Fund, 2003 ND 42, 658 N.W.2d 337, 2003 N.D. LEXIS 56 (N.D. 2003).

Causal Connection.

To be entitled to an award claimant must show direct causal connection between conditions under which his work was performed, and disease from which he is suffering. Wobbe v. Workmen's Compensation Bureau, 73 N.D. 256, 13 N.W.2d 712, 1944 N.D. LEXIS 57 (N.D. 1944).

Where competent evidence traces a causal connection between an affliction from which a workman was suffering and the accident, or shows that the accident either caused or accelerated the effect of such affliction, that is sufficient to establish a claim against the fund, but recovery cannot be allowed upon pure speculation. Kuntz v. North Dakota Workmen's Compensation Bureau, 139 N.W.2d 525, 1966 N.D. LEXIS 197 (N.D. 1966).

The claimant must show that an ensuing disability is causally connected to the employment injury. Howes v. North Dakota Workers Compensation Bureau, 429 N.W.2d 730, 1988 N.D. LEXIS 259 (N.D. 1988), cert. denied, 489 U.S. 1014, 109 S. Ct. 1126, 103 L. Ed. 2d 189, 1989 U.S. LEXIS 904 (U.S. 1989).

Employee’s workers compensation claim for a back condition was properly denied because there was no showing by a preponderance of the evidence that her job was a substantial contributing factor to her injury where the objective medical findings established that the employee had been suffering from a pre-existing back injury from a car accident since 1992. Myhre v. N.D. Workers Comp. Bureau, 2002 ND 186, 653 N.W.2d 705, 2002 N.D. LEXIS 239 (N.D. 2002).

Where Workforce Safety and Insurance denied a wife’s claim because she failed to show that asbestos exposure was a primary or direct cause of her husband’s lung cancer, WSI committed error because it did not analyze the evidence in light of the substantial contributing factor standard. It was possible that the husband’s smoking and the asbestos exposure were both substantial contributing factors in the husband’s lung cancer and testimony from the treating physician raised the question of whether the occupational exposure to asbestos was a substantial contributing factor in the development of his lung cancer. Manske v. Workforce Safety & Ins., 2008 ND 79, 748 N.W.2d 394, 2008 N.D. LEXIS 80 (N.D. 2008).

Because appellant was unable to show a causal connection between her unexplained fall at work and her employment, the administrative law judge properly denied her request for workers’ compensation. Appellant did not meet her burden of showing that she sustained a compensable injury under N.D.C.C. § 65-01-11. Fetzer v. N.D. Workforce Safety & Ins., 2012 ND 73, 815 N.W.2d 539, 2012 N.D. LEXIS 70 (N.D. 2012).

North Dakota Workforce Safety and Insurance properly denied the claimant medical benefits for his right vertebral artery occlusion because the preponderance of the evidence established that the condition was not causally related to his work injury. Brockel v. N.D. Workforce Safety & Ins., 2014 ND 26, 2014 N.D. LEXIS 24 (Feb. 13, 2014).

Cause of Death.

A heart attack was established with reasonable medical certainty as the cause of death where doctor testified that, although death could have been caused by a stroke or an aneurysm, it was his opinion that death was caused by a heart attack. Nelson v. North Dakota Workmen's Compensation Bureau, 316 N.W.2d 790, 1982 N.D. LEXIS 211 (N.D. 1982).

The standard of reasonable medical certainty is sufficient to establish the cause of death. Nelson v. North Dakota Workmen's Compensation Bureau, 316 N.W.2d 790, 1982 N.D. LEXIS 211 (N.D. 1982).

Co-Employees.

Co-employees retain their status as co-employees and their immunity from tort liability so long as they are acting in the course of their employment; the most satisfactory test to determine course of employment for purposes of co-employee immunity is the same course-of-employment test used to determine basic compensation coverage. Under that standard, in determining co-employee immunity, the test is whether the negligent co-employee would have been entitled to receive workers’ compensation benefits if that co-employee had been injured in the same incident. Mitchell v. Sanborn, 536 N.W.2d 678, 1995 N.D. LEXIS 150 (N.D. 1995).

Credibility.

The bureau may question the credibility of witnesses when such credibility is relevant. Ehli v. North Dakota Workers Compensation Bureau, 447 N.W.2d 313, 1989 N.D. LEXIS 195 (N.D. 1989).

The opinion of treating physician was held not to be entitled to greater weight than the opinion of an independent medical examiner; it is up to the worker’s compensation bureau to weigh the credibility of medical evidence. Symington v. North Dakota Workers Compensation Bureau, 545 N.W.2d 806, 1996 N.D. LEXIS 108 (N.D. 1996).

Employee’s workers compensation claim for chemical exposure was properly denied because the accepted medical evidence did not establish by a preponderance of the evidence that the employee’s sensitivity to smells and chemicals was the result of an exposure to spray glue that was used to make foam cushions; the workers compensation bureau was not required to accept medical evidence that was not considered medically or scientifically valid. Myhre v. N.D. Workers Comp. Bureau, 2002 ND 186, 653 N.W.2d 705, 2002 N.D. LEXIS 239 (N.D. 2002).

Denial of Benefits.
—In General.

Evidence held sufficient for the bureau to determine that further benefits should be denied to employee. Eull v. North Dakota Workers Compensation Bureau, 475 N.W.2d 129, 1991 N.D. LEXIS 172 (N.D. 1991).

—Explanation.

Where workers compensation bureau failed to adequately explain why it rejected claimant’s treating physician’s reports and administrative law judge’s recommendation to reinstate benefits, judgment affirming denial of benefits was reversed with instructions to remand claim to bureau to adequately explain its decision. Blanchard v. North Dakota Workers Compensation Bureau, 1997 ND 118, 565 N.W.2d 485, 1997 N.D. LEXIS 129 (N.D. 1997).

Trial court erred in reversing the N.D. Workforce Safety and Insurance Fund’s (WSI’s) denial of workers’ compensation benefits to an employee because WSI adequately explained its rationale and reasoning for accepting the opinion of its physician and rejecting the opinions of the employee’s physicians; WSI’s findings of fact were supported by a preponderance of the evidence. Bruder v. N.D. Workforce Safety & Ins. Fund, 2009 ND 23, 761 N.W.2d 588, 2009 N.D. LEXIS 29 (N.D. 2009).

Failure to Carry Burden.

Claimant had the burden of proving that her injury occurred during the course of her employment, and in view of inconsistencies in her claim and testimony which substantiated the bureau’s findings of a lack of credibility, as well as evidence of her prior medical history, a reasoning mind could have reasonably concluded that she failed to prove that her injuries arose out of and in the course of her employment. Ehli v. North Dakota Workers Compensation Bureau, 447 N.W.2d 313, 1989 N.D. LEXIS 195 (N.D. 1989).

The workers’ compensation bureau’s finding that claimant failed to prove a causal connection between his injury and his disability was supported by a preponderance of the evidence. Wherry v. North Dakota State Hosp., 498 N.W.2d 136, 1993 N.D. LEXIS 52 (N.D. 1993).

Court did not err in denying a claimant’s reapplication for worker’s compensation benefits where a doctor’s opinion that he was totally disabled from working in July 2002 did not prove that he was similarly disabled six months earlier when he quit his job in January 2002, or that a change in his medical condition caused him to leave his employment. Beckler v. Workforce Safety & Ins. (In re Beckler), 2005 ND 33, 692 N.W.2d 483, 2005 N.D. LEXIS 39 (N.D. 2005).

Employee did not prove that he suffered a compensable work related injury because the employee had symptoms consistent with a disc herniation before the claimed date of injury, and he was engaged in non-work activities that could have caused or contributed to the disc herniation. An expert testified the events and activities noted in the employee’s medical records, such as playing football or laying carpet, could have caused a disc condition to become more symptomatic. Schoch v. N.D. Workforce Safety & Ins., 2010 ND 25, 778 N.W.2d 542, 2010 N.D. LEXIS 26 (N.D. 2010).

Where claimant suffered off-the-job injuries to her lower back and had degenerative disc disease, picking up a band-aid at work triggered a preexisting condition within the meaning of N.D.C.C. § 65-01-02(10)(b) but did not substantially accelerate or worsen her condition. Claimant failed to prove by a preponderance of the evidence that she suffered a compensable injury; therefore, she was not entitled to benefits under N.D.C.C. § 65-01-11. Curran v. N.D. Workforce Safety & Ins., 2010 ND 227, 791 N.W.2d 622, 2010 N.D. LEXIS 230 (N.D. 2010).

Failure to Seek Immediate Medical Attention.

Failure to seek immediate medical attention after an alleged injury does not automatically preclude an award of compensation benefits. Robert v. North Dakota Workmen's Compensation Bureau, 321 N.W.2d 501, 1982 N.D. LEXIS 290 (N.D. 1982).

Horseplay.

As a matter of law, employee’s act of horseplay in intentionally pushing the knees out from under co-employee was not a sufficiently substantial deviation from his course of employment so as to transform him from a co-employee to a third-person tortfeasor. Mitchell v. Sanborn, 536 N.W.2d 678, 1995 N.D. LEXIS 150 (N.D. 1995).

Partial Disability.

Where claimant remained physically impaired by his sensitivity from his burns, but his physical impairment alone did not justify partial disability benefits, claimant had to show that his injury prevented him from continuing his employment as a truck driver, and nowhere in the record was there any medical evidence that he could not have returned to work with the proper thermal equipment. Absent such evidence, the bureau reasonably concluded that the greater weight of the evidence indicated that he had not suffered a loss of earning capacity, and the bureau’s denial of temporary partial disability benefits was affirmed. Rooks v. North Dakota Workers' Compensation Bureau, 506 N.W.2d 78, 1993 N.D. LEXIS 174 (N.D. 1993).

Preexisting Condition.

Where decedent employee died from rupture of aneurysm of aorta more than five weeks after injury to ankle while working in bowling alley, and where doctors testified at trial that it was reasonable to assume that a causal connection existed, but no positive medical testimony appeared in the record that the physicians knew the death was caused or accelerated by such injury, there could be no recovery. Kuntz v. North Dakota Workmen's Compensation Bureau, 139 N.W.2d 525, 1966 N.D. LEXIS 197 (N.D. 1966).

The testimony of one physician, to the effect that the injury to the claimant’s kidneys aggravated his preexisting blood pressure problem, was sufficient proof to establish a causal connection between his injury and his subsequent cerebral hemorrhage. O'Brien v. North Dakota Workmen's Compensation Bureau, 222 N.W.2d 379, 1974 N.D. LEXIS 160 (N.D. 1974).

Workforce safety and insurance benefits were denied because a claimant did not establish that his increased pain, increased need for medical care, and increased need for medication constituted a substantial worsening or acceleration of his preexisting back condition under N.D.C.C. § 65-01-02(10)(b)(7) [now N.D.C.C. § 65-01-02(11)(b)(7)]; the inconsistencies in the medical opinions were adequately addressed, and adequate reasons were given for disregarding evidence favorable to the claimant. Bergum v. N.D. Workforce Safety & Ins., 2009 ND 52, 764 N.W.2d 178, 2009 N.D. LEXIS 33 (N.D. 2009).

Reasoning mind could have found that the claimant failed to establish, by a preponderance of the evidence, that the claimant’s right shoulder pain was substantially accelerated or substantially worsened by the claimant’s work injury and vocational training, which meant that the claimant did not have a N.D.C.C. § 65-01-11 compensable injury. The injury was not compensable because N.D.C.C. § 65-01-02(10)(b)(7) [now N.D.C.C. § 65-01-02(11)(b)(7)] excluded preexisting injuries unless they substantially accelerated or substantially worsened a claimant’s prior injury, which the claimant was not able to show. Johnson v. N.D. Workforce Safety & Ins. Fund, 2012 ND 87, 816 N.W.2d 74, 2012 N.D. LEXIS 88 (N.D. 2012).

Presumption.

Presumption that one who performs services for another is an employee is not evidence of fact, and when evidence is introduced as to agreement under which employment is performed, evidence is controlling. Starkenberg v. North Dakota Workmen's Compensation Bureau, 73 N.D. 234, 13 N.W.2d 395, 1944 N.D. LEXIS 56 (N.D. 1944).

Rebutting Evidence of Causal Connection.

Bureau’s findings of fact were not supported by preponderance of evidence where, although one doctor concluded that based upon claimant’s history, work injury to feet did not cause claimant’s back problems, that doctor was not specifically asked whether claimant’s fall caused his back injury or whether back injury manifested itself when claimant returned to work; therefore, where another doctor explicitly opined that claimant’s fall caused his back pain, although the latter doctor’s opinion was necessarily reliant upon claimant’s history long after the fact of claimant’s initial injury, the testimony did not support the bureau’s determination that the fall in question did not cause claimant’s later back pain. In re Claim of Murray, 431 N.W.2d 651, 1988 N.D. LEXIS 223 (N.D. 1988).

Source of Injury.

The workers’ compensation bureau did not carry its burden of demonstrating that the claimant intentionally injured himself and faked a work-related fall for purposes of collecting benefits. Siewert v. North Dakota Workers Compensation Bureau, 554 N.W.2d 465, 1996 N.D. LEXIS 235 (N.D. 1996).

Temporary Benefits.

When claimant suffered an injury to his left leg and ankle that occurred while he was working as a heavy equipment operator, North Dakota Workforce Safety and Insurance accepted his claim under N.D.C.C. § 65-01-11; claimant was awarded medical benefits and received temporary total disability benefits because he did return to work. Johnson v. N.D. Workforce Safety & Ins., 2010 ND 198, 789 N.W.2d 565, 2010 N.D. LEXIS 195 (N.D. 2010).

Termination of Benefits.

Where employee was awarded a continuous, ongoing grant of benefits, he was entitled to benefits until workers compensation bureau sought to terminate further benefits based upon an updated medical report addressing the duration of worker’s disability. Frohlich v. North Dakota Workers Compensation Bureau, 556 N.W.2d 297, 1996 N.D. LEXIS 258 (N.D. 1996).

Widow of Employee.

The burden of proof is upon the alleged widow of the deceased employee to prove that an actual husband and wife relationship existed in a claim for widow’s benefits under this act. Fancher v. North Dakota Workmen's Compensation Bureau, 123 N.W.2d 105, 1963 N.D. LEXIS 105 (N.D. 1963).

DECISIONS UNDER PRIOR LAW

Claimant’s Burden of Proof.

A claimant seeking workers’ compensation benefits from the bureau has the burden of proving by a preponderance of the evidence that he is entitled to participate in the fund. However, former subsection (17)(d) of N.D.C.C. § 65-01-02 (now N.D.C.C. § 65-01-15.1), created a limited exception to this general rule which shifted the burden of proof from the claimant to the bureau in cases involving specified conditions or impairments of health suffered by a fireman or law enforcement officer. Flermoen v. North Dakota Workers Compensation Bureau, 470 N.W.2d 220, 1991 N.D. LEXIS 100 (N.D. 1991).

Collateral References.

Workers’ compensation: injuries incurred while traveling to or from work with employer’s receipts, 63 A.L.R.4th 253.

Workers’ compensation: compensability of injuries incurred traveling to or from medical treatment of earlier compensable injury, 83 A.L.R.4th 110.

Law Reviews.

Evidence in Workmen’s Compensation Cases, Daniel E. Buchanan, 54 N.D. L. Rev. 173 (1977).

65-01-12. Attorney general to represent organization.

Upon the request of the organization, the attorney general shall institute and prosecute the necessary actions or proceedings for the enforcement of this title or for the recovery of any money due the fund or of any penalty provided for in this title, and shall defend all suits, actions, or proceedings brought against the organization or any of its employees in the attorney general’s official capacity.

Source:

S.L. 1919, ch. 162, § 24; 1925 Supp., § 396a24; R.C. 1943, § 65-0112; S.L. 1965, ch. 453, § 1; 1989, ch. 295, § 5; 2003, ch. 561, § 3.

Notes to Decisions

Attorney-Client Relationship.

Relationship of attorney general and workers’ compensation bureau, in all matters where attorney general acts as attorney for bureau, is that of attorney and client and his powers in that capacity are to be determined according to law applicable to that relationship. Robinson v. State, 63 N.W.2d 521, 1954 N.D. LEXIS 73 (N.D. 1954).

65-01-13. Information fund — Continuing appropriation.

There is created a fund to be known as the information fund within the workforce safety and insurance fund, to which the organization shall deposit all moneys received from private citizens, businesses, associations, corporations, and limited liability companies for providing these entities with publications and statistical information concerning workforce safety and insurance matters. The information must be provided at cost. The moneys in the fund are appropriated, as a standing and continuing appropriation, to workforce safety and insurance to pay publication and statistical processing expenses incurred by the organization.

Source:

S.L. 1991, ch. 715, § 1; 1993, ch. 54, § 106; 2003, ch. 561, § 3; 2009, ch. 608, § 2.

65-01-14. Informal decision by organization. [Repealed]

Repealed by S.L. 1997, ch. 532, § 6.

65-01-15. Yearly documentation required for firefighter and law enforcement officer.

Except for benefits for an exposure to a bloodborne pathogen as defined by section 23-07.5-01 occurring in the course of employment, a full-time paid firefighter or law enforcement officer who uses tobacco is not eligible for the benefits provided under section 65-01-15.1, unless the full-time paid firefighter or law enforcement officer provides yearly documentation from a health care provider which indicates the full-time paid firefighter or law enforcement officer has not used tobacco for the preceding two years.

Source:

S.L. 1995, ch. 610, § 2; 1997, ch. 527, § 5; 2005, ch. 235, § 7; 2019, ch. 523, § 4, eff August 1, 2019.

Notes to Decisions

Applicability.

The drafters of this section did not prohibit application of the statute based on the date of injury or specify another basis for being “subject to” the statute; therefore, cases falling under this section will follow the precedent that unless otherwise provided, the statutes in effect on the date of an injury govern workers’ compensation benefits. Wanstrom v. North Dakota Workers Compensation Bureau, 2000 ND 17, 604 N.W.2d 860, 2000 N.D. LEXIS 17 (N.D. 2000).

Construction with Other Laws.

Where claimant was injured before becoming subject to the terms of this section, the date of injury was the governing date and the presumption under N.D.C.C. § 65-01-02(18)(d) (now N.D.C.C. § 65-01-15.1) applied. Wanstrom v. North Dakota Workers Compensation Bureau, 2000 ND 17, 604 N.W.2d 860, 2000 N.D. LEXIS 17 (N.D. 2000).

65-01-15.1. Presumption of compensability for certain conditions of full-time paid firefighters and law enforcement officers.

  1. Any condition or impairment of health of a full-time paid firefighter or law enforcement officer caused by lung or respiratory disease, hypertension, heart disease, or an exposure to a bloodborne pathogen as defined by section 23-07.5-01 occurring in the course of employment, or occupational cancer in a full-time paid firefighter, is presumed to have been suffered in the line of duty. The presumption may be rebutted by clear and convincing evidence the condition or impairment is not work-related.
  2. As used in this section, an occupational cancer is one which arises out of employment as a full-time paid firefighter and is due to injury due to exposure to smoke, fumes, or carcinogenic, poisonous, toxic, or chemical substances while in the performance of active duty as a full-time paid firefighter.
  3. A full-time paid firefighter or law enforcement officer is not eligible for the benefit provided under this section unless that full-time paid firefighter or law enforcement officer has completed five years of continuous service and has successfully passed a medical examination which fails to reveal any evidence of such a condition. An employer shall require a medical examination upon employment, for any employee subject to this section. After the initial medical examination, an employer shall require at least a periodic medical examination as follows: for one to ten years of service, every five years; for eleven to twenty years of service, every three years; and for twenty-one or more years of service, every year. The periodic medical examination, at a minimum, must consist of a general medical history of the individual and the individual’s family; an occupational history including contact with and an exposure to hazardous materials, toxic products, contagious and infectious diseases, and to physical hazards; a physical examination including measurement of height, weight, and blood pressure; and laboratory and diagnostic procedures including a nonfasting total blood cholesterol test. If the medical examination reveals that an employee falls into a recognized risk group, the employee must be referred to a qualified health professional for future medical examination. If a medical examination produces a false positive result for a condition covered under this section, the organization shall consider the condition to be a compensable injury. In the case of a false positive result, neither the coverage of the condition nor the period of disability may exceed fifty-six days. This section does not affect an employee’s responsibility to document that the employee has not used tobacco as required under section 65-01-15. Results of the examination must be used in rebuttal to a presumption afforded under this section.
  4. For purposes of this section, “law enforcement officer” means a person who is licensed to perform peace officer law enforcement duties under chapter 12-63 and is employed full time by the bureau of criminal investigation, the game and fish department, the state highway patrol, the parole and probation division, the North Dakota state university police department, the North Dakota state college of science police department, the university of North Dakota police department, a county sheriff’s department, a city police department, or the parks and recreation department pursuant to section 55-08-04.
  5. The presumption does not include a condition or impairment of health of a full-time paid firefighter or law enforcement officer, who has been employed for ten years or less, if the condition or impairment is diagnosed more than two years after the employment as a full-time paid firefighter or law enforcement officer ends. The presumption also does not include a condition or impairment of health of a full-time paid firefighter or law enforcement officer, who has been employed more than ten years, if the condition or impairment is diagnosed more than five years after the employment as a full-time paid firefighter or law enforcement officer ends.

Source:

S.L. 1997, ch. 527, § 4; 1997, ch. 529, § 2; 2005, ch. 235, § 8; 2007, ch. 566, § 1; 2009, ch. 610, § 1; 2013, ch. 500, § 1; 2015, ch. 480, § 2, eff August 1, 2015; 2019, ch. 525, § 2, eff July 1, 2019.

Notes to Decisions

Construction with Other Laws.

Where claimant was injured before becoming subject to the terms of N.D.C.C. § 65-01-15, the date of injury was the governing date and the presumption under N.D.C.C. § 65-01-15.1, applied. Wanstrom v. North Dakota Workers Compensation Bureau, 2000 ND 17, 604 N.W.2d 860, 2000 N.D. LEXIS 17 (N.D. 2000).

Failure to Rebut Presumption in Previous Enactment of this Section.

Medical expert’s opinion that regular smoke exposure was not a substantial causative factor for a firefighter’s lung disease was legally insufficient to rebut the presumption formerly contained in N.D.C.C. § 65-01-15.1 that a firefighter’s lung disease arose in the line of duty. Wanstrom v. North Dakota Workers Compensation Bureau, 2001 ND 21, 621 N.W.2d 864, 2001 N.D. LEXIS 22 (N.D. 2001).

65-01-16. Decisions by organization — Disputed decisions.

The following procedures must be followed in claims for benefits, notwithstanding any provisions to the contrary in chapter 28-32:

  1. The organization shall send a copy of each initial claim form filed with the organization to the claimant’s employer, by regular mail, along with a form for the employer’s response, if the employer’s response has not been filed at the time the claim is filed..
  2. The organization may conduct a hearing on any matter within its jurisdiction by informal internal review of the information of record.
  3. The organization may issue a notice of decision for any decision made by informal internal review and shall serve the notice of decision on the parties by regular mail. A notice of decision must include a statement of the decision, a short summary of the reason for the decision, and notice of the right to reconsideration.
  4. A party has forty-five days from the day the notice of decision was mailed by the organization in which to file a written request for reconsideration. The employer is not required to file the request through an attorney. The request must state the reason for disagreement with the organization’s decision and the desired outcome. The request may be accompanied by additional evidence not previously submitted to the organization. The organization shall reconsider the matter by informal internal review of the information of record. Absent a timely and sufficient request for reconsideration, the notice of decision is final and may not be reheard or appealed.
  5. After receiving a request for reconsideration, the organization shall serve on the parties by regular mail a notice of decision reversing the previous decision or, in accordance with the North Dakota Rules of Civil Procedure, an administrative order that includes its findings, conclusions, and order. The organization may serve an administrative order on any decision made by informal internal review without first issuing a notice of decision and receiving a request for reconsideration. If the organization does not issue an order within sixty days of receiving a request for reconsideration, any interested party may request, and the organization shall promptly issue, an appealable determination.
  6. An employee has forty-five days from the day the administrative order was mailed in which to file a request for assistance from the decision review office under section 65-02-27.
  7. A party has forty-five days, from the date of service of an administrative order or from the day the decision review office mails its notice that the office’s assistance is complete, in which to file a written request for rehearing. The request must specifically state each alleged error of fact and law to be reheard and the relief sought. Absent a timely and sufficient request for rehearing, the administrative order is final and may not be reheard or appealed.
  8. Rehearings must be conducted as hearings under chapter 28-32 to the extent the provisions of that chapter do not conflict with this section.
  9. A party may appeal a posthearing administrative order to district court in accordance with chapter 65-10. Chapter 65-10 does not preclude the organization from appealing to district court a final order issued by a hearing officer under this title.
  10. Any notice of decision, administrative order, or posthearing administrative order is subject to review and reopening under section 65-05-04.

Source:

S.L. 1997, ch. 532, § 1; 1999, ch. 553, §§ 1, 2; 2003, ch. 561, § 3; 2009, ch. 611, § 4; 2009, ch. 612, § 1; 2011, ch. 507, §§ 1, 2; 2017, ch. 435, § 2, eff August 1, 2017; 2021, ch. 502, § 1, eff August 1, 2021.

Note.

Section 13 of chapter 502, S.L. 2021 provides, “ APPLICATION. This Act applies to all claims, regardless of date of injury, which have a notice of decision issued after July 31, 2021.

Cross-References.

Administrative Agencies Practice Act, see N.D.C.C. ch. 28-32.

Notes to Decisions

Counsel.

Decision of Workforce Safety & Insurance denying an employee’s claim for benefits was void because the employer’s Ohio attorneys were not authorized to practice law in North Dakota, and the work they performed in filing a motion for reconsideration under N.D.C.C. § 65-01-16(4) and motion for extension of time was not preparatory work under the safe harbor provision of N.D.R. Prof. Conduct 5.5. Carlson v. Workforce Safety & Ins., 2009 ND 87, 765 N.W.2d 691, 2009 N.D. LEXIS 86 (N.D. 2009).

Due Process Violated.

Where an ALJ and workforce safety and insurance (WSI) found that a claimant had never received the mailed notice of intention to discontinue/reduce his benefits (NOID), WSI’s termination of his ongoing disability benefits violated due process as he had not received prior notice or an opportunity to respond and his benefits were reinstated as of the date of their termination. Rojas v. Workforce Safety & Ins., 2005 ND 147, 703 N.W.2d 299, 2005 N.D. LEXIS 182 (N.D. 2005).

Ex-Parte Communications.

The appellate court harmonized subsection (8) of this section with N.D.C.C. ch. 28-32 to allow the Bureau to consult with its outside litigation counsel when reviewing a pending ALJ recommendation, but to preclude those consultations from being ex parte. Lawrence v. North Dakota Workers Compensation Bureau, 2000 ND 60, 608 N.W.2d 254, 2000 N.D. LEXIS 64 (N.D. 2000).

Exhaustion Not Met.

District court did not err in dismissing a worker's complaint for lack of subject matter jurisdiction where he failed to meet the mandated statutory time frames for requesting reconsideration or appealing Workforce Safety and Insurance's (WSI's) final decision under N.D.C.C. § 65-01-16, and thus, he had statutory administrative remedies that he failed to exhaust before bringing an action for declaratory relief. Zerr v. N.D. Workforce Safety & Ins., 2017 ND 175, 898 N.W.2d 700, 2017 N.D. LEXIS 165 (N.D. 2017).

Trial court did not err by granting summary judgment to Workforce Safety and Insurance (WSI) in its collection action against the claimant because he did not administratively challenge the WSI notice of decision denying liability for his and requiring reimbursement for overpayment rendering it final. State v. Oden, 2020 ND 243, 951 N.W.2d 187, 2020 N.D. LEXIS 242 (N.D. 2020).

Rehearing.

On remand following an appeal in a worker’s compensation matter, an administrative law judge did not err in conducting a de novo evidentiary hearing. Miller v. Workforce Safety & Ins., 2009 ND 109, 767 N.W.2d 154, 2009 N.D. LEXIS 118 (N.D. 2009).

Remedies for Violation.

Appellate court reversed trial court’s judgment directing the North Dakota Workers Compensation Bureau to award benefits to claimant and instead directed that the case be remanded for reconsideration and rehearing where ex-parte communications took place between the Bureau’s outside counsel and the Bureau and its in-house counsel. Elshaug v. North Dakota Workers Compensation Bureau, 2000 ND 42, 607 N.W.2d 568, 2000 N.D. LEXIS 43 (N.D. 2000).

DECISIONS UNDER PRIOR LAW

Notice of Decision.

Former N.D.C.C. § 65-01-14 outlined the procedure when a claim for benefits or reapplication for benefits was made under this title, and contemplated a “notice of decision” when a final determination was made on a claim or on a reapplication; it would have been absurd to require the bureau to issue a “notice of decision” every time the bureau conducted any investigation or review of a claimant’s file. Tooley v. Alm, 515 N.W.2d 137, 1994 N.D. LEXIS 89 (N.D. 1994).

65-01-17. Agricultural employment exemption — Custom agricultural operations.

For purposes of the agricultural service exception to hazardous employment under section 65-01-02, an agricultural employer that engages in a custom agricultural operation, which is the planting, care, or harvesting of grain or field crops on a contract-for-hire basis, exclusive of hauling by special contractor, retains the exemption unless the employer’s custom agricultural operations are based outside this state or require more than thirty actual working days of operation during the calendar year.

Source:

S.L. 2001, ch. 577, § 1; 2003, ch. 561, § 2; 2005, ch. 610, § 2.

65-01-18. Alternative dispute resolution — Pilot program — Continuing appropriation.

Notwithstanding any other provision of law, the organization may develop and implement pilot programs to allow the organization to assess alternative forms of dispute resolution to resolve disputes with injured employees. The goal of the pilot program must be to develop timely, cost-effective, and amicable options to resolve disputes during any stage in the claim adjudication or appeal process. A pilot program may address a broad range of approaches, including collaborative efforts between the organization and other public or private entities. Participation of an injured employee in the pilot program is voluntary. No more than fifty thousand dollars per biennium from the workforce safety and insurance fund is appropriated to the organization on a continuing basis for payment of organization expenses associated with the pilot program.

Source:

S.L. 2019, ch. 525, § 3, eff July 1, 2019.

65-01-19. Pilot programs — Report to legislative management.

Annually the organization shall report to the legislative management on the status of any current pilot programs and pilot programs completed within the previous twelve months. The report must include a summary of findings and recommendations on each pilot program, together with any legislation required to implement the recommendations.

Source:

S.L. 2019, ch. 526, § 1, eff August 1, 2019.

CHAPTER 65-02 Workforce Safety and Insurance Organization

65-02-01. Workforce safety and insurance — Director — Division directors.

The organization must be maintained for the administration of this title. The director may appoint the director of any division established by the director. The appointment of a division director must be on a nonpartisan, merit basis.

Source:

S.L. 1919, ch. 162, § 4; 1919 Sp., ch. 73, § 1; 1921, ch. 145, § 1; 1925, ch. 220, § 1; 1925 Supp., § 396a4; S.L. 1927, ch. 285, § 1; 1931, ch. 314, § 1; 1935, ch. 286, § 3; R.C. 1943, § 65-0201; S.L. 1955, ch. 354, § 8; 1957 Supp., § 65-0201; S.L. 1989, ch. 69, § 77; 1989, ch. 295, § 6; 1997, ch. 461, § 11; 1997, ch. 528, § 2; 2003, ch. 561, § 3; 2009, ch. 611, § 5.

Notes to Decisions

Control of Litigation.

Entire executive control of administration of functions of bureau is vested in commissioners and this executive control is extended to any litigation that bureau may have, so that attorney general has no power to compromise claims without consent of bureau. Robinson v. State, 63 N.W.2d 521, 1954 N.D. LEXIS 73 (N.D. 1954).

Removal of Commissioner.

Governor may remove a commissioner of workers’ compensation bureau who carries on private law practice in addition to his duties at bureau. State ex rel. Wehe v. North Dakota Workmen's Compensation Bureau, 46 N.D. 147, 180 N.W. 49, 1920 N.D. LEXIS 59 (N.D. 1920).

It is essential in order to confer jurisdiction on governor for removal of a commissioner, that hearing be had where accused may know nature of charges against him, may cross-examine witnesses, and may produce testimony to disprove charges. State ex rel. Wehe v. Frazier, 47 N.D. 314, 182 N.W. 545, 1921 N.D. LEXIS 116 (N.D. 1921).

Governor, in exercising power of removal over a commissioner, acts in quasi-judicial capacity pursuant to legislative limitations, and must exercise legal discretion in addition to an executive discretion. State ex rel. Wehe v. Frazier, 47 N.D. 314, 182 N.W. 545, 1921 N.D. LEXIS 116 (N.D. 1921).

Where governor fails to accord to a commissioner a hearing on his removal and where commissioner refuses to be sworn as witness unless such hearing is accorded, there is no jurisdiction to order removal. State ex rel. Wehe v. Frazier, 47 N.D. 314, 182 N.W. 545, 1921 N.D. LEXIS 116 (N.D. 1921).

Suit Against Bureau.

Workers compensation bureau is not a legal entity subject to suit, but suit against bureau in legal effect is suit against state. Watland v. North Dakota Workmen’s Comp. Bureau, 58 N.D. 303, 225 N.W. 812 (1929), overruled on other grounds, Bulman v. Hulstrand Constr. Co., 521 N.W.2d 632 (N.D. 1994), explained, Henderson v. Scott, 72 N.D. 616, 10 N.W.2d 490, 1943 N.D. LEXIS 100 (N.D. 1943).

65-02-01.1. Workforce safety and insurance.

The legislative council may delete, where appropriate, “workers compensation bureau”, “North Dakota workers compensation bureau”, or any derivatives of those terms, which when used in context indicate an intention to refer to those terms, wherever they appear in the North Dakota Century Code or in the supplements thereto and to insert in lieu of each deletion “workforce safety and insurance”. Such changes are to be made when any volume or supplement of the North Dakota Century Code is being reprinted. It is the intent of the legislative assembly that workforce safety and insurance be substituted for, shall take any action previously to be taken by, and shall perform any duties previously to be performed by the workers compensation bureau. The legislative council may replace “bureau”, where appropriate, wherever the term appears in the North Dakota Century Code or in the supplements of the North Dakota Century Code, with the term “organization”. These changes are to be made when any volume or supplement is being reprinted.

Source:

S.L. 1987, ch. 751, § 1; 2003, ch. 561, § 3.

65-02-01.2. Organization to establish personnel system. [Repealed]

Repealed by S.L. 2009, ch. 611, § 13.

65-02-01.3. Workforce safety and insurance — Executive director — Governor to appoint — Personnel.

Notwithstanding any other provisions of law, the governor shall appoint a director of workforce safety and insurance who shall serve at the pleasure of the governor. The governor shall set the compensation and prescribe the duties of the director. Each employee of workforce safety and insurance must occupy a position in the classified service and must be subject to the provisions of the state personnel system provided in chapter 54-44.3.

Source:

I.M., approved November 4, 2008.

65-02-02. Oath of office.

Before commencing to perform the duties of director of the organization, the director shall file an oath of office in the usual form.

Source:

S.L. 1919, ch. 162, § 4; 1919 Sp., ch. 73, § 1; 1921, ch. 145, § 1; 1925, ch. 220, § 1; 1925 Supp., § 396a4; S.L. 1927, ch. 285, § 1; 1931, ch. 314, § 1; 1935, ch. 286, § 3; R.C. 1943, § 65-0202; S.L. 1945, ch. 264, § 20; 1949, ch. 314, § 18; 1949, ch. 354, § 2; 1957 Supp., § 65-0202; S.L. 1981, ch. 535, § 17; 1989, ch. 295, § 7; 1999, ch. 113, § 22; 2003, ch. 561, § 3.

65-02-03. Organization — Quorum — Effect of vacancy — Vacancies which must be filled within thirty days. [Repealed]

Repealed by S.L. 1989, ch. 295, § 21.

65-02-03.1. Workforce safety and insurance board of directors — Appointment.

  1. The board consists of eleven members. The appointment and replacement of the members must ensure that:
    1. Six board members represent employers in this state which maintain active accounts with the organization. Two of the employer members must be employers with annual premiums, which at the time of the member’s initial appointment were greater than twenty-five thousand dollars; one of the employer members must be an employer with an annual premium, which at the time of the member’s initial appointment was less than twenty-five thousand dollars; one of the employer members must be an employer with an annual premium, which at the time of the member’s initial appointment was less than ten thousand dollars; and two of the employer members must be employer at-large representatives. Except for the employer at-large representatives, each employer representative must be a principal owner, chief executive officer, or chief financial officer of the employer.
    2. Three members represent employees. Of the three employee members, one member must represent organized labor and one other member must have received workforce safety and insurance wage-loss benefits at some time during the ten years before the member’s initial appointment.
    3. One member is a member of the North Dakota medical association.
    4. One member is a member at large who must be a resident of this state and at least twenty-one years of age.
  2. Board members shall serve four-year terms. The governor shall make the necessary appointments to ensure the term of office of members begins on January first of each even-numbered year. A board member may not serve more than two consecutive terms.
    1. A departing member representing an employer must be replaced by a member representing an employer, most of whose employees are in a different rate classification than those of the employer represented by the departing member. The governor shall appoint the member for an employer representative from a list of three potential candidates submitted by a coordinating committee appointed by the governor, composed of representatives from the associated general contractors of North Dakota, the North Dakota petroleum council, the greater North Dakota chamber of commerce, the North Dakota motor carriers association, the North Dakota hospital association, the national federation of independent business, the lignite energy council, and other statewide business interests.
    2. The governor shall select the member for the organized labor employee representative from a list of three potential candidates submitted by an organization that is statewide in scope and which through the organization’s affiliates embraces a cross section and a majority of organized labor in this state.
    3. The governor shall select the two employee representatives who do not represent organized labor and the member at large.
    4. The governor shall select the member representing the North Dakota medical association from a list of three potential candidates submitted by the North Dakota medical association.
    5. Within the thirty days following receipt of a list of potential candidates representing employers, organized labor, or the North Dakota medical association, the governor may reject the list and request that the submitting entity submit a new list of potential candidates.
  3. Vacancies in the membership of the board must be filled for the unexpired term by appointment by the governor as provided in this section.

Source:

S.L. 1997, ch. 528, § 3; 2003, ch. 561, § 3; 2003, ch. 565, § 1; 2005, ch. 603, § 1; 2007, ch. 567, § 1; 2009, ch. 614, § 1; 2011, ch. 54, § 14; 2019, ch. 527, § 1, eff August 1, 2019.

Note.

Section 2 of chapter 527, S.L. 2019 provides, “ APPLICATION. This Act applies to board members appointed or reappointed afterJuly 31, 2019. The term of a board member whose term is scheduled to end on December 31, 2020, or December 31, 2022, must be extended for one year to transition all board terms to begin in even-numbered years”.

65-02-03.2. Compensation of board members.

A board member is entitled to receive compensation as determined by the board for days spent in attendance at board meetings or other business as approved by the board. A board member is entitled to reimbursement for mileage and expenses as provided for state officers.

Source:

S.L. 1997, ch. 432, § 37; 1997, ch. 528, § 4; 2001, ch. 23, § 7.

65-02-03.3. Board — Powers and duties.

The board shall:

  1. Assist the organization in developing and submitting a budget, responding to any audit recommendations, formulating policies, and discussing issues related to the administration of the organization, including the determination of employer premium rates, maintenance of the solvency of the workforce safety and insurance fund, and provision of rehabilitation services, while ensuring impartiality and freedom from political influence.
  2. Recommend principles of continuous improvement goalsetting, a procedure for implementing a team-oriented continuous improvement program throughout all operations of the organization. The program must include a number of challenging, measurable goals to ensure the organization maintains focus on improving those areas most important to its primary mission.
  3. Adopt internal management rules creating bylaws for the board and relating to the election of a board chairman, formation of committees, voting procedures, and other procedural matters.
  4. Provide annual, formal recommendations to the governor regarding setting premium levels and providing premium dividend distributions.
  5. Provide formal recommendations to the governor regarding legislation that affect the organization.
  6. Provide formal recommendations to the governor regarding the fund’s investment allocation.

Source:

S.L. 1997, ch. 528, § 5; 2003, ch. 561, § 3; 2009, ch. 611, § 6.

65-02-04. Chairman. [Repealed]

Repealed by S.L. 1989, ch. 295, § 21.

65-02-05. Office space for organization — Expenditures from fund for employees and supplies — Travel.

The organization must be provided with office space. The organization, at the expense of the fund, shall provide all necessary equipment, supplies, stationery, and furniture, and all clerical and other help necessary to carry out the provisions of this title. The employees of the organization are entitled to receive from the fund for each mile [1.61 kilometers] actually and necessarily traveled in the performance of official duty by motor vehicle the same rates in the same manner as other state officials. If travel is by a motor vehicle owned by the state, or by any department or political subdivision thereof, no allowance may be paid for the mileage. Vouchers for travel and other administrative expenses must bear the approval of the organization and the office of management and budget before payment is made therefor. Travel and other administrative expense payments must be made by warrant-check prepared by the office of management and budget drawn upon the state treasurer against the fund. Expenditures made under this section, however, must be within the limitations designated by the legislative assembly in appropriation measures adopted from time to time.

Source:

S.L. 1919, ch. 162, § 4; 1921, ch. 145, § 1; 1925, ch. 220, § 1; 1925 Supp., § 396a4; S.L. 1927, ch. 285, § 1; 1931, ch. 314, § 1; R.C. 1943, § 65-0205; S.L. 1955, ch. 354, § 1; 1957 Supp., § 65-0205; S.L. 1965, ch. 181, § 31; 1977, ch. 579, § 5; 1989, ch. 295, § 8; 2003, ch. 561, § 3.

Notes to Decisions

Audit of Expenses.

Bill for supplies and for auditing expenses of traveling auditor incurred by workers’ compensation bureau must be audited by state auditing board. State ex rel. Workmen's Compensation Bureau v. Steen, 48 N.D. 1172, 189 N.W. 247, 1922 N.D. LEXIS 158 (N.D. 1922).

65-02-05.1. Building maintenance account — Continuing appropriation.

There is a building maintenance account within the workforce safety and insurance fund, to which the organization shall deposit all building rental proceeds if the organization builds a building that includes rental space for other state entities. The moneys in the account are appropriated on a continuing basis to the organization to pay bond principal and interest payments, operating, maintenance, repair, and payments in lieu of taxes expenses of the building and grounds. This account may be used only for the purposes identified in this section. The organization may either hire or contract for building maintenance and repair services anticipated by this section.

Source:

S.L. 2001, ch. 23, § 6; 2003, ch. 561, § 3; 2007, ch. 63, § 6.

65-02-06. Expenditures by organization from fund — Employment of full-time special assistant attorneys general authorized.

The organization may make necessary expenditures to obtain statistical and other information required for the proper enforcement of this title. The salaries and compensation of the director of the organization and of all employees of the organization, and all other authorized expenses of the organization, including the premium on the bond required of the state treasurer under section 65-04-30, must be paid out of the fund. The organization may employ duly appointed special assistant attorneys general and pay from the fund the entire salary of each special assistant attorney general.

Source:

S.L. 1919, ch. 162, § 4; 1921, ch. 145, § 1; 1925, ch. 220, § 1; 1925 Supp., § 396a4; S.L. 1927, ch. 285, § 1; 1931, ch. 314, § 1; 1935, ch. 286, § 3; R.C. 1943, § 65-0206; S.L. 1989, ch. 295, § 9; 1989, ch. 766, § 1; 1995, ch. 504, § 2; 1995, ch. 613, § 1; 2003, ch. 561, § 3.

65-02-06.1. Allocated loss adjustment expenses — Continuing appropriation — Annual review.

Money in the workforce safety and insurance fund is appropriated on a continuing basis for the payment of all allocated loss adjustment expenses experienced by the organization in its administration of this title. In its annual audit, the organization shall include a breakdown of those allocated loss adjustment expenses that reflect the attorney’s fees and costs paid to attorneys who represent injured workers, the attorney’s fees and costs paid to attorneys with whom it contracts to represent the organization, the amount paid for administrative law judges for hearings, and the court reporter and other legal expenses paid.

Source:

S.L. 1997, ch. 26, § 4; 1999, ch. 553, § 3; 2003, ch. 561, § 3; 2013, ch. 499, § 2.

65-02-06.2. Litigation expenses — Continuing appropriation.

Money in the workforce safety and insurance fund is appropriated to the organization on a continuing basis for payment of organization expenses associated with litigating employer-related issues arising under this title and for payment of organization expenses associated with litigating medical provider-related issues identified under sections 65-02-23 and 65-02-20.

Source:

S.L. 2009, ch. 21, § 3.

Effective Date.

This section became effective August 1, 2009.

65-02-07. Organization to have seal. [Repealed]

Source:

S.L. 1919, ch. 162, § 4; 1921, ch. 145, § 1; 1925, ch. 220, § 1; 1925 Supp., § 396a4; R.C. 1943, § 65-0207; S.L. 1949, ch. 354, § 3; 1957 Supp., § 65-0207; 1993, ch. 613, § 2; 2003, ch. 561, § 3; Repealed by 2019, ch. 525, § 9, eff July 1, 2019.

65-02-08. Rulemaking power of the organization — Timeliness for issuance of decision — Fees prescribed by organization — Attorney’s fees and costs.

  1. The organization shall adopt rules necessary to carry out this title. All fees on claims for medical and hospital goods and services provided under this title to an injured employee must be in accordance with schedules of fees adopted by the organization. Before the effective date of any adoption of, or change to, a fee schedule, the organization shall hold a public hearing, which is not subject to chapter 28-32.
  2. The organization shall issue a decision within sixty days following the date all elements of initial filing or notice of reapplication of claim are satisfied or a claim for additional benefits over and above benefits previously awarded is made. The organization’s administrative rules must define satisfaction of elements of filing.
    1. By administrative rule, the organization shall establish costs payable, maximum costs, a reasonable maximum hourly rate, and a maximum fee to compensate an injured employee’s attorney for legal services following issuance of an administrative or judicial order reducing or denying benefits.
    2. Except for an initial determination of compensability, an attorney’s fee may not exceed twenty percent of the amount awarded, subject to a maximum fee set by administrative rule. The amount of the attorney’s fees must be determined in the same manner as prescribed by the organization for attorney’s fees. The total amount of attorney fees paid by the organization may not exceed the fee cap established for the highest appellate level at which the injured employee prevails.
    3. The organization shall pay an attorney’s fees and costs if the injured employee prevailed in binding dispute resolution under section 65-02-20, the injured employee prevailed after an administrative hearing under chapter 28-32, or the injured employee prevailed at the district or supreme court as provided for under section 65-10-03. The organization shall pay the attorney’s fees and costs at the time the injured employee prevails. The organization may not condition payment of attorney’s fees and costs upon the injured employee prevailing upon any future appeal.
    4. An injured employee does not prevail unless an additional benefit, previously denied, is paid. An injured employee does not prevail on a remand for further action or proceedings unless that injured employee ultimately receives an additional benefit as a result of the remand.
    5. Notwithstanding the requirement under subdivision d that an additional benefit be paid or received, an injured employee who prevails at the administrative or district court level is eligible for attorney’s fees and costs for prevailing at that level, regardless of whether the organization ultimately prevails upon the organization’s appeal of an administrative or district court order.
    6. This subsection does not prevent an injured employee or an employer from hiring or paying an attorney.
    7. All disputes relating to payment or denial of an attorney’s fees or costs must be submitted to the court, hearing officer, or arbitrator for decision, but a court, hearing officer, or arbitrator may not order the maximum fees be exceeded.
    8. The organization shall pay an injured employee’s attorney’s fees and costs from the organization’s general fund. The organization is liable for its costs on appeal if the decision of the organization is affirmed.

Source:

S.L. 1919, ch. 162, § 4; 1921, ch. 145, § 1; 1925, ch. 220, § 1; 1925 Supp., § 396a4; S.L. 1931, ch. 314, § 1; 1939, ch. 251, § 2; 1943, ch. 274, § 10; R.C. 1943, § 65-0208; S.L. 1965, ch. 455, § 1; 1969, ch. 559, § 1; 1975, ch. 581, § 2; 1977, ch. 579, § 6; 1987, ch. 752, § 1; 1989, ch. 767, § 1; 1991, ch. 714, § 29; 1993, ch. 619, § 1; 1995, ch. 614, § 1; 1997, ch. 533, § 2; 1999, ch. 554, § 1; 2017, ch. 436, § 1, eff August 1, 2017.

Cross-References.

Rulemaking by administrative agencies, see N.D.C.C. §§ 28-32-02 through 28-32-18.1.

Rules as to unemployment compensation division and state employment service, see N.D.C.C. § 52-02-04.

Notes to Decisions

In General.

This section, which authorizes the workers compensation bureau to promulgate and enforce rules, does not relieve the bureau of responsibility for compliance with the Administrative Agencies Practices Act in establishing those rules, including fee schedules. Johnson v. North Dakota Workers Compensation Bureau, 428 N.W.2d 514, 1988 N.D. LEXIS 182 (N.D. 1988), limited, Traynor Law Firm v. State, 2020 ND 108, 943 N.W.2d 320, 2020 N.D. LEXIS 107 (N.D. 2020).

Attorney’s Fee.

The phrase “attorney’s fee” as used in this section refers to expenses incurred for the services of an attorney. Howes v. North Dakota Workers Compensation Bureau, 429 N.W.2d 730, 1988 N.D. LEXIS 259 (N.D. 1988), cert. denied, 489 U.S. 1014, 109 S. Ct. 1126, 103 L. Ed. 2d 189, 1989 U.S. LEXIS 904 (U.S. 1989).

This section prevented the claimant’s attorney from seeking fees from the claimant and from otherwise seeking more than what was provided in the workers compensation bureau’s schedule of fees. Johnson v. North Dakota Workers Compensation Bureau, 428 N.W.2d 514, 1988 N.D. LEXIS 182 (N.D. 1988), limited, Traynor Law Firm v. State, 2020 ND 108, 943 N.W.2d 320, 2020 N.D. LEXIS 107 (N.D. 2020).

Record of workers compensation bureau’s rulemaking proceeding was adequate under the Administrative Agencies Practice Act, and its promulgation of maximum hourly compensation rates for claimant’s attorney’s fees and fee caps was not an arbitrary or capricious application of its statutory authority. Little v. Traynor, 1997 ND 128, 565 N.W.2d 766, 1997 N.D. LEXIS 131 (N.D. 1997).

Attorney who executed a notice of legal representation which provided that attorney’s sole remuneration for representing client before the Workers Compensation Bureau would be paid by the Bureau and who billed client after unilaterally terminating his representation committed a knowing violation of Prof. Conduct Rule 1.5(a), warranting a thirty day suspension from the practice of law and an assessment of all costs of the disciplinary proceeding. Disciplinary Bd. v. Moe, 1999 ND 110, 594 N.W.2d 317, 1999 N.D. LEXIS 98 (N.D. 1999).

The ambiguous language of this section must be construed to further its purpose of assisting injured workers in hiring and paying for competent representation, therefore, the statute only prohibits an attorney from receiving double fees from the client and the Bureau for legal services rendered to an injured employee; it does not prohibit an injured employee from entering a fee agreement with an attorney and then, upon prevailing in the case, seeking full or partial reimbursement from the Bureau, in the amount of the fees allowed under the statute. Ash v. Traynor, 2000 ND 75, 609 N.W.2d 96, 2000 N.D. LEXIS 83 (N.D. 2000).

N.D.C.C. §§ 65-02-08 and 65-10-03 and N.D.C.C. § 28-32-50 are not irreconcilable, and the goals and intent of the legislature can be harmonized. The Supreme Court of North Dakota concludes a prevailing injured employee is entitled to attorney’s fees in actions against Workforce Safety and Insurance (WSI) under N.D.C.C. §§ 65-02-08 and 65-10-03 up to the statutory limit, but when WSI denies or reduces the employee’s benefits without substantial justification, N.D.C.C. § 28-32-50 may be applied to award the employee reasonable attorney’s fees. Rojas v. Workforce Safety & Ins., 2006 ND 221, 723 N.W.2d 403, 2006 N.D. LEXIS 227 (N.D. 2006).

N.D.C.C. §§ 65-02-08 and 65-10-03 guarantee an automatic award of attorney’s fees to the prevailing party, but N.D.C.C. § 28-32-50 requires the party to not only prevail but also requires proof that the agency acted without substantial justification; the language of N.D.C.C. § 28-32-50 is expansive and inclusive, and does not exclude actions against WSI. The Supreme Court of North Dakota concludes these statutes are not irreconcilable and apply in different situations, and therefore can be harmonized. Rojas v. Workforce Safety & Ins., 2006 ND 221, 723 N.W.2d 403, 2006 N.D. LEXIS 227 (N.D. 2006).

Trial court erred in affirming the decision of Workforce Safety & Insurance (WSI) to pay a claimant only $9,876 for costs and attorney’s fees after he won his appeal to have his benefits reinstated, based upon the maximum amount WSI could pay under the fee cap in N.D.C.C. §§ 65-02-08 and 65-10-03, because the general attorney fee provision for administrative actions, N.D.C.C.§ 28-32-50, could apply to WSI cases where the claimant alleged that WSI acted without substantial justification in reducing or denying benefits. Therefore, the case was remanded for a determination as to whether the WSI acted without substantial justification warranting an additional award of attorney’s fees under N.D.C.C. § 28-32-50. Rojas v. Workforce Safety & Ins., 2006 ND 221, 723 N.W.2d 403, 2006 N.D. LEXIS 227 (N.D. 2006).

Improper Denial of Fees.

Bureau exceeded its statutory authority by denying a claimant attorney fees for representation before the bureau on his request for a lump sum settlement on the ground that his claim had not been “denied or reduced” under an administrative regulation adopted by the bureau. Moore v. North Dakota Workmen's Compensation Bureau, 374 N.W.2d 71, 1985 N.D. LEXIS 388 (N.D. 1985).

Section provides that the bureau shall pay a claimant’s attorney fees incurred “in proceedings before the bureau…”.The statute does not differentiate between types of proceedings in which attorney fees are authorized, nor can it be interpreted to limit the claimant’s right to attorney fees to situations in which the bureau has either “denied or reduced” a claim. Moore v. North Dakota Workmen's Compensation Bureau, 374 N.W.2d 71, 1985 N.D. LEXIS 388 (N.D. 1985).

Required Approval.

Workers compensation bureau did not act beyond its statutory authority in adopting a $100 limit for reimbursement of a claimant’s reasonable and necessary costs, unless approved by the bureau in advance of their accrual. Little v. Traynor, 1997 ND 128, 565 N.W.2d 766, 1997 N.D. LEXIS 131 (N.D. 1997).

Law Reviews.

North Dakota Supreme Court Review (Rojas v. Workforce Safety and Ins.), 83 N.D. L. Rev. 1085 (2007).

65-02-08.1. State advisory council — Composition — Compensation — Duties. [Repealed]

Repealed by S.L. 1997, ch. 528, § 7.

65-02-09. General information to public — Biennial report.

The organization, from time to time, may publish and distribute among employers and employees general information as to the business transacted by the organization as in its judgment may be useful. The director shall submit a biennial report to the governor and the secretary of state in accordance with section 54-06-04. The report must include:

  1. A statement of the number of awards made by it.
  2. A general statement of the causes of accidents leading to the injuries for which the awards were made.
  3. A detailed statement of the disbursements from the fund.
  4. A statement of the conditions of the various funds carried by the organization.
  5. A breakdown of those allocated loss adjustment expenses that reflect the attorney’s fees and costs paid to attorneys who represent injured workers, the attorney’s fees and costs paid to attorneys with whom the organization contracts to represent the organization, the amount paid for administrative law judges for hearings, and the amount paid for the court reporter and any other legal expenses.
  6. Any other matters which the organization wishes to call to the attention of the governor, including any recommendation for legislation or otherwise which it may have to make.

Source:

S.L. 1919, ch. 162, § 25; 1925 Supp., § 396a25; R.C. 1943, § 65-0209; S.L. 1963, ch. 346, § 72; 1973, ch. 403, § 56; 1975, ch. 466, § 58; 1983, ch. 699, § 2; 1989, ch. 295, § 10; 1995, ch. 350, § 55; 2003, ch. 561, § 3; 2013, ch. 499, § 3.

Cross-References.

Report on unemployment compensation division and state employment service, see N.D.C.C. § 52-02-03.

65-02-10. Organization to submit budget. [Repealed]

Repealed by S.L. 1959, ch. 372, § 117.

65-02-11. Process and procedure — Investigations — Examination of witnesses — Costs.

Except as otherwise provided by this title, process and procedure under this title is governed by chapter 28-32. The organization may make investigation as in its judgment is best calculated to ascertain the substantial rights of all the parties. Any member of the organization and any person specifically designated by the organization may examine witnesses and records, with or without subpoena, examine, investigate, copy, photograph, and take samples at any pertinent location or facility, administer oaths to witnesses, require the attendance of witnesses without fee whenever the testimony is taken at the home, office, or place of work of those witnesses, and generally to do anything necessary to facilitate or promote the efficient administration of this title. The organization may issue a subpoena to compel the attendance of witnesses and the production of books, papers, correspondence, memoranda, and any other records deemed necessary by the organization. Subpoenas may be enforced by applying to a judge of the district court for an order requiring the attendance of a witness, the production of all documents and objects described in the subpoena, or otherwise enforcing an order. Failure to comply with the order of the district court is contempt as provided in chapter 27-10. The organization shall pay the costs of any medical examination, scientific investigation, medical or expert witness appearance or report, requested or approved by the organization, relating to a claim for benefits, from the organization’s general fund.

Source:

S.L. 1919, ch. 162, § 4; 1921, ch. 145, § 1; 1925, ch. 220, § 1; 1925 Supp., § 396a4; S.L. 1927, ch. 285, § 1; 1931, ch. 314, § 1; 1939, ch. 251, § 2; R.C. 1943, § 65-0211; S.L. 1975, ch. 581, § 3; 1997, ch. 532, § 2; 2003, ch. 561, § 3; 2003, ch. 562, § 3.

Cross-References.

Administrative procedure, see N.D.C.C. §§ 28-32-32 through 28-32-39.

Notes to Decisions

Conflicting Medical Evidence.

The bureau has the authority to decide conflicting medical evidence. That decision will be upheld unless it is not supported by a preponderance of the evidence. Latraille v. North Dakota Workers Compensation Bureau, 481 N.W.2d 446, 1992 N.D. LEXIS 42 (N.D. 1992).

Construction.

N.D.C.C. § 65-02-11 is construed to require an element of reasonableness in determining the scope of the phrase “anything necessary” in order to avoid unreasonable or absurd consequences. State v. Altru Health Sys., 2007 ND 38, 729 N.W.2d 113, 2007 N.D. LEXIS 38 (N.D. 2007).

Hearings.

The provisions of the workers’ compensation act and N.D.C.C. ch. 28-32 require that whenever the bureau has made an initial determination disallowing a claim based on a record made at an informal hearing, the claimant, upon request, is entitled to an evidentiary hearing if there is a dispute on material facts. Steele v. North Dakota Workmen's Compensation Bureau, 273 N.W.2d 692, 1978 N.D. LEXIS 188 (N.D. 1978).

Restrictions Upheld.

District court did not abuse its discretion under N.D.C.C. § 65-02-11, in restricting the Workforce Safety and Insurance (WSI) from requiring the claimant’s treating physician and physician’s assistant to review the WSI’s videotaped surveillance of the claimant in preparation for or during their ex parte, investigatory depositions, because the WSI’s attempt to require the treating physician and physician’s assistant to view the videotaped surveillance and answer questions relating to the videotape at the investigatory stage sought to interfere with the existing physician-patient relationship and went beyond the scope of the consent granted by the claimant in N.D.C.C. § 65-05-30. State v. Altru Health Sys., 2007 ND 38, 729 N.W.2d 113, 2007 N.D. LEXIS 38 (N.D. 2007).

Law Reviews.

North Dakota Supreme Court Review (State v. Altru Health Sys.), 83 N.D. L. Rev. 1085 (2007).

65-02-12. Hearings by director.

Any investigation, inquiry, hearing, or decision, and every order by the director is deemed to be the order or decision of the organization.

Source:

S.L. 1921, ch. 145, § 1; 1925, ch. 220, § 1; 1925 Supp., § 396a4; S.L. 1927, ch. 285, § 1; 1931, ch. 314, § 1; R.C. 1943, § 65-0212; S.L. 1975, ch. 581, § 4; 1989, ch. 295, § 11; 2003, ch. 561, § 3.

Notes to Decisions

Approval of Agreement.

A quorum of the workers compensation bureau’s commissioners must approve an agreement before it is effective; where no such approval occurred, nor did the claimant offer evidence of such approval, the proposed stipulation for settlement did not establish a contract. Levey v. North Dakota Workers Compensation Bureau, 425 N.W.2d 376, 1988 N.D. LEXIS 137 (N.D. 1988).

Decision of Administrative Law Judge.

Administrative law judge’s (ALJ) decision that plaintiff was unable to return to his pre-injury employment would be deemed a recommendation, where record did not show workers compensation bureau’s request for ALJ to preside over proceeding asked ALJ to issue final order. Blanchard v. North Dakota Workers Compensation Bureau, 1997 ND 118, 565 N.W.2d 485, 1997 N.D. LEXIS 129 (N.D. 1997).

Finality.

Where the Workers Compensation Bureau requested a hearing officer to issue recommended findings of fact and conclusions of law with regard to whether the claimant was entitled to a higher permanent partial impairment award, the officer’s decision was a recommendation, not a final order. Feist v. North Dakota Workers Compensation Bureau (Northern Bottling Co.), 1997 ND 177, 569 N.W.2d 1, 1997 N.D. LEXIS 196 (N.D. 1997).

65-02-13. Organization may reinsure risks.

The organization may reinsure any risk or any part thereof and may enter into agreements of reinsurance.

Source:

S.L. 1919, ch. 162, § 14; 1925 Supp., § 396a14; R.C. 1943, § 65-0213; 2003, ch. 561, § 3.

65-02-13.1. Expenditures by organization for reinsurance and extraterritorial coverage and other states’ insurance — Report in annual financial audit.

There is appropriated out of the workforce safety and insurance fund, as a continuing appropriation, an amount necessary to allow the organization to establish a program of reinsurance and a program of extraterritorial coverage and other states’ insurance. The organization may execute a contract for reinsurance and a contract for extraterritorial coverage and other states’ insurance binding on the organization and the contracting party. The term identified in the contract may extend past the end of the biennium in which a contract under this section is executed. The independent annual financial audit report on the organization shall report on any contract executed pursuant to this section.

Source:

S.L. 1995, ch. 613, § 2; 1999, ch. 555, § 1; 2003, ch. 561, § 3.

65-02-14. Organization to aid in rehabilitating persons injured in employment. [Repealed]

Repealed by S.L. 1975, ch. 584, § 10.

65-02-15. Workforce safety and insurance binding arbitration. [Repealed]

Repealed by S.L. 2003, ch. 562, § 13.

65-02-16. Removal of a panel member. [Repealed]

Repealed by S.L. 1993, ch. 614, § 13.

65-02-17. Binding arbitration. [Repealed]

Repealed by S.L. 1995, ch. 614, § 6.

65-02-18. Administrative orders — Binding arbitration decisions — Appeals. [Repealed]

Repealed by S.L. 1995, ch. 614, § 6.

65-02-19. Organization to contract for administrative services. [Repealed]

Repealed by S.L. 1999, ch. 554, § 4.

65-02-20. Organization to establish managed care program.

The organization shall establish a managed care program, including utilization review and bill review, to effect the best medical solution for an injured employee in a cost-effective manner upon a finding by the organization that the employee suffered a compensable injury. The program shall operate according to guidelines adopted by the organization and shall provide for medical management of claims within the bounds of workforce safety and insurance law. Information compiled and analysis performed pursuant to a managed care program which relate to patterns of treatment, cost, or outcomes by health care providers and allied health care professionals are confidential and are not open to public inspection to the extent the information and analysis identify a specific health care provider or allied health care professional, except to the specific health care provider, allied health care professional, organization employees, or persons rendering assistance to the organization in the administration of this title. If an employee, employer, or allied health care professional disputes a managed care decision, the employee, employer, or allied health care professional shall request binding dispute resolution on the decision. The organization shall make rules providing for the procedures for dispute resolution. Dispute resolution under this section is not subject to chapter 28-32 or section 65-01-16. A dispute resolution decision under this section requested by an allied health care professional concerning payment for medical treatment already provided or a request for diagnostic tests or treatment is not reviewable by any court. A dispute resolution decision under this section requested by an employee is reviewable by a court only if medical treatment has been denied to the employee. A dispute resolution decision under this section requested by an employer is reviewable by a court only if medical treatment is awarded to the employee. The dispute resolution decision may be reversed only if the court finds an abuse of discretion in the dispute resolution process. Any person providing binding dispute resolution services under this section is exempt from civil liability relating to the binding dispute resolution process and decision.

Source:

S.L. 1991, ch. 714, § 31; 1993, ch. 621, § 1; 1995, ch. 614, § 3; 1997, ch. 532, § 3; 1999, ch. 554, § 2; 2003, ch. 561, § 3; 2003, ch. 562, § 4; 2019, ch. 523, § 5, eff August 1, 2019.

Notes to Decisions

Due Process.

Workers’ compensation claimant’s due process rights were not violated because the North Dakota Workforce Safety and Insurance Fund (WSI) was not required to provide a trial type proceeding for a dispute resolution regarding a prosthetic device. Whedbee v. N.D. Workforce Safety, 2014 ND 79, 845 N.W.2d 632, 2014 N.D. LEXIS 90 (N.D. 2014).

Workers’ compensation claimant’s due process rights were not violated by the denial of a requested prosthetic device because he had no protectable property interest in receiving one prosthetic device over another; there was no termination of benefits that occurred, and the North Dakota Workforce Safety and Insurance Fund (WSI), through binding dispute resolution, decided the best medical solution in a cost-effective manner. Whedbee v. N.D. Workforce Safety, 2014 ND 79, 845 N.W.2d 632, 2014 N.D. LEXIS 90 (N.D. 2014).

Effective Date of Dispute Resolution Procedures.

The resolution procedures for disputes of managed care recommendations became effective only for disputes that occurred after the adoption of administrative rules providing these procedures; these rules were adopted effective January 1, 1994, and did not apply to recommendations of the managed care administrator to deny payments occurring before that date. Vickery v. North Dakota Workers Compensation Bureau, 545 N.W.2d 781, 1996 N.D. LEXIS 106 (N.D. 1996).

Judicial Review.

Where the North Dakota Workforce Safety and Insurance (WSI) sent claimant a letter denying her request to increase the level of reimbursement for her home health care services, the letter was not an appealable decision under N.D.C.C. § 65-02-20 and claimant did not appeal the subsequent decision of WSI’s binding dispute resolution (BDR) program. Therefore, the district court did not have subject matter jurisdiction to review WSI’s decision, and the district court’s judgment affirming the BDR decision was void. Carroll v. N.D. Workforce Safety & Ins., 2008 ND 139, 752 N.W.2d 188, 2008 N.D. LEXIS 140 (N.D. 2008).

District court did not have subject matter jurisdiction to review the binding dispute resolution decision by North Dakota Workforce Safety and Insurance to deny payment for a myoelectric-powered prosthesis recommended for the injured worker because the request for binding dispute resolution was made by the injured worker’s medical provider and not the injured worker, and the medical provider could not have been acting on the injured worker’s behalf because the medical provider was not a licensed North Dakota lawyer. Jassek v. N.D. Workforce Safety & Ins., 2013 ND 69, 830 N.W.2d 582, 2013 N.D. LEXIS 79 (N.D. 2013).

Prosthetic Device.

In a workers’ compensation case, it was not an abuse of discretion for the North Dakota Workforce Safety and Insurance Fund (WSI) to deny a claimant’s request for a myoelectric prosthesis during binding dispute resolution because the WSI was not required to provide the claimant’s preferred device; it considered each device’s durability, cost, and impact on the amputation injuries suffered. Whedbee v. N.D. Workforce Safety, 2014 ND 79, 845 N.W.2d 632, 2014 N.D. LEXIS 90 (N.D. 2014).

Treating Physician.

In a workers’ compensation case, an opinion from a benefit claimant’s doctor was not entitled to controlling weight because the statute relating to treating doctor’s opinions did not apply to managed care programs. Whedbee v. N.D. Workforce Safety, 2014 ND 79, 845 N.W.2d 632, 2014 N.D. LEXIS 90 (N.D. 2014).

65-02-21. Contract for administration of managed care program.

The organization may contract for the services of a third-party administrator to implement a managed care program by soliciting bids for administrative services, including a description of the program and the services expected of the managed care administrator. The organization shall award an administrative services contract to the bidder who will best serve the interests of the organization and the employees under this title. The contract must be for the period of a biennium. The organization may renew, renegotiate, or rebid a contract based upon contract performance, cost, and the best interests of an employee who suffers a compensable injury.

Source:

S.L. 1991, ch. 714, § 31; 1993, ch. 620, § 2; 1999, ch. 554, § 3; 2003, ch. 561, § 3.

65-02-21.1. Licensure required for psychologists and physicians performing utilization review.

Psychologists making utilization review determinations under sections 65-02-20 and 65-02-21 shall have current licenses from the state board of psychologist examiners. Health care providers making utilization review determinations under sections 65-02-20 and 65-02-21 shall have current licenses from the appropriate North Dakota licensing board. This requirement does not apply to psychologists or health care providers conducting independent medical examinations or independent medical reviews under section 65-05-28.

Source:

S.L. 1999, ch. 264, § 3; 2009, ch. 615, § 1; 2015, ch. 297, § 40, eff August 1, 2015; 2019, ch. 523, § 6, eff August 1, 2019.

65-02-21.2. Ambulance services classifications.

For purposes of classifying ambulance services for benefits provided under this title, the classifications established under section 50-24.1-16 apply.

History. S.L. 2015, ch. 193, § 4, eff August 1, 2015.

65-02-22. Hearing officer — Qualifications — Location.

A hearing officer designated by the office of administrative hearings under chapter 28-32 must be an individual licensed to practice law in this state. A hearing officer may not maintain an office within the organization.

Source:

S.L. 1995, ch. 615, § 1; 1995, ch. 616, § 1; 2003, ch. 561, § 3; 2009, ch. 611, § 7.

Law Reviews.

Are Employees Obtaining “Sure and Certain Relief” Under the 1995 Legislative Enactments of the North Dakota Workers’ Compensation Act?, 72 N.D. L. Rev. 349 (1996).

65-02-22.1. Appointment of administrative law judges — Hearings.

Notwithstanding any other provisions of law, workforce safety and insurance shall contract with the office of administrative hearings for the designation of administrative law judges who shall conduct evidentiary hearings and issue final findings of fact, conclusions of law, and orders. Rehearings must be conducted as hearings under chapter 28-32.

Source:

I.M., approved November 4, 2008.

Notes to Decisions

Standard of Review.

Administrative law judge’s finding that the claimant was capable of performing the return-to-work options identified in her vocational rehabilitation plan was supported by a preponderance of the evidence, because the claimant’s treating neurologist was aware of her psychological impairments and treatments, and approved the identified return-to-work options. Bishop v. N.D. Workforce Safety & Ins., 2012 ND 217, 823 N.W.2d 257, 2012 N.D. LEXIS 229 (N.D. 2012).

65-02-23. Workforce safety and insurance fraud unit — Continuing appropriation.

The organization shall establish a workforce safety and insurance fraud unit. The organization may employ investigators and licensed attorneys, or contract with a private investigator whenever feasible or cost-effective, to investigate and review any alleged case of fraud against the fund by employers, injured workers, or providers of medical or other services, including activities described under section 65-04-33 or 65-05-33. The unit shall refer cases of fraud to the organization for the imposition of administrative penalties and may refer them to the appropriate authorities for prosecution. Money in the workforce safety and insurance fund is appropriated on a continuing basis for payment of costs associated with identifying, preventing, and investigating employer or provider fraud. The organization may establish a process to charge investigative costs against the rate class of an employer being investigated and to credit any recoveries to that rate class.

Source:

S.L. 1995, ch. 616, § 1; 1997, ch. 534, § 1; 1999, ch. 549, § 3; 1999, ch. 553, § 4; 2001, ch. 578, § 1; 2003, ch. 561, § 3; 2009, ch. 616, § 1.

65-02-24. Immunity from civil liability.

A person who notifies the organization or who assists the organization on any matter pertaining to the administration of this title of an alleged violation of section 65-04-33 or 65-05-33, or who provides information in the course of an investigation of an alleged violation of section 65-04-33 or 65-05-33, is not subject to civil liability for that action if the action was in good faith and without malice. At the request of the person who notifies or assists the organization or who provides information to the organization, the organization may not reveal the identity of that person or disclose any information that may reveal the identity of that person to any person other than a representative of or a person rendering assistance to the organization.

Source:

S.L. 1995, ch. 616, § 2; 2001, ch. 578, § 2; 2003, ch. 561, § 3.

Notes to Decisions

Testimony Not Compelled.

N.D.C.C. § 65-02-24 did not compel a claimant’s treating physician to become an expert for the Workforce Safety and Insurance’s investigations into alleged violations of N.D.C.C. § 65-05-33 outside of the treating physician’s (or physician’s assistant) examination or treatment of the claimant. State v. Altru Health Sys., 2007 ND 38, 729 N.W.2d 113, 2007 N.D. LEXIS 38 (N.D. 2007).

65-02-25. Amnesty for certain claims and accounts.

After the workforce safety and insurance fraud unit is established, the organization may offer, not more than once every twelve months, a period of amnesty to any person who has willfully made a false claim or false statement or who has willfully misrepresented payroll, to allow that person the opportunity to close and repay the false claim, to close and repay the claim for which a false statement has been made, or to pay the appropriate premium and penalty on an account for which payroll was misrepresented. The amnesty period may not exceed sixty days. A person who receives amnesty under this section is immune from criminal prosecution relating to those acts for which amnesty is received.

Source:

S.L. 1995, ch. 616, § 3; 1997, ch. 534, § 2; 2003, ch. 561, § 3.

Notes to Decisions

Compliance.

Although an employer may be entitled to amnesty from criminal prosecution in some circumstances wherein the employer was required to obtain workers' compensation coverage, an employer is statutorily obligated to correct inaccurate estimates of wages during a previous reporting period and an employer is not provided with immunity for complying with that statutory obligation after an employee is injured. An employer's ignorance of the reporting requirements is not a defense. Vail v. S/L Servs., 2017 ND 202, 900 N.W.2d 271, 2017 N.D. LEXIS 204 (N.D. 2017).

65-02-26. Nondisclosure of investigative information.

Any investigative information gathered pursuant to section 65-02-23 is criminal investigative information and may not be disclosed except as provided in section 44-04-18.7. Notwithstanding sections 65-04-15 and 65-05-32, the fraud unit may provide investigative and claim file information to other fraud investigative and law enforcement entities, and gather investigative and claim file information from them.

Source:

S.L. 1995, ch. 616, § 4; 1997, ch. 534, § 3.

65-02-27. Decision review office.

The organization’s decision review office is established. The decision review office is independent of the claims department of the organization and activities administered through the office must be administered in accordance with this title. The decision review office shall provide assistance to an injured employee who has filed a claim, which may include acting on behalf of an injured employee who is aggrieved by a decision of the organization, communicating with organization staff regarding claim dispute resolution, and informing an injured employee of the effect of decisions made by the organization, an injured employee, or an employer under this title. The organization shall employ a director of the decision review office and other personnel determined to be necessary for the administration of the office. An individual employed to administer the decision review office may not act as an attorney for an injured employee. The organization may not pay attorney’s fees to an attorney who represents an injured employee in a disputed claim before the organization unless the injured employee has first attempted to resolve the dispute through the decision review office. A written request for assistance by an injured employee who contacts the decision review office within the period for requesting a hearing on an administrative order tolls the time period for requesting a hearing on that order. The period begins upon notice to the injured employee, sent by regular mail, that the decision review office’s assistance to the injured employee is completed. The information contained in a file established by the decision review office on an injured employee’s disputed claim, including communications from an injured employee, is privileged and may not be released without the injured employee’s permission. Information in the file containing the notes or mental impressions of decision review office staff is confidential and may not be released by the decision review office.

Source:

S.L. 1995, ch. 612, § 1; 1997, ch. 532, § 4; 1999, ch. 553, §§ 5, 9; 2003, ch. 561, § 3; 2009, ch. 612, § 2; 2017, ch. 435, § 3, eff August 1, 2017.

65-02-28. Organization claim files — Destruction.

If the organization determines that a person who has a claim for injury on file has been deceased for at least ten years, the organization may destroy any claim files for that person. The organization may not destroy any claim file it specifically has been requested not to destroy. The organization shall establish a means for maintaining statistical and identifying information for any claim files destroyed under this section.

Source:

S.L. 1997, ch. 535, § 1; 2003, ch. 561, § 3.

65-02-29. Independent audit. [Repealed]

Repealed by S.L. 1999, ch. 553, § 8.

65-02-30. Independent performance evaluation — Organization development of performance measurements — Continuing appropriation.

Once every four years, the director shall request the state auditor to select a firm with extensive expertise in workers’ compensation practices and standards to complete a performance evaluation of the functions and operations of the organization during that evaluation period. This may not be construed to require the firm to be a certified public accounting firm. The firm’s report must contain recommendations for departmental improvement or an explanation of why no recommendations are being made. The director or the director’s designee, the chairman of the board or the chairman’s designee, and a representative of the firm shall present the evaluation report and any action taken to the legislative management’s workers’ compensation review committee and to the governor. The director shall provide a copy of the performance evaluation report to the state auditor. Except as otherwise provided in this section, the workers’ compensation review committee may select no more than four elements to be evaluated in the performance evaluation and shall inform the state auditor of the selected items to be evaluated. The state auditor shall include the elements selected by the committee in the performance evaluation, but the state auditor may select additional elements to be evaluated. The total number of elements, including those selected by the workers’ compensation review committee, may not exceed eight. In exceptional circumstances, the state auditor may include more than eight elements for evaluation. If more than eight elements are selected, the state auditor shall report to the workers’ compensation review committee the additional elements selected and the exceptional circumstances to support the inclusion of the additional elements. Money in the workforce safety and insurance fund is appropriated on a continuing basis for the payment of the expense of conducting the performance evaluation. The organization shall develop and maintain comprehensive, objective performance measurements. These measurements may be evaluated as part of the independent performance evaluation under this section.

Source:

S.L. 1997, ch. 528, § 6; 1999, ch. 553, § 6; 2003, ch. 561, § 3; 2003, ch. 565, § 2; 2009, ch. 616, § 2; 2009, ch. 482, § 95; 2011, ch. 508, § 1.

65-02-31. Payments in lieu of taxes by organization.

If a building and associated real property is purchased by the organization pursuant to a legislative grant of authority, the organization shall make payments in lieu of property taxes in the manner and according to the conditions and procedures that would apply if the building and property were privately owned.

Source:

S.L. 1999, ch. 37, § 46; 2003, ch. 561, § 3.

65-02-32. Assessment of property — Notice to organization.

All property subject to valuation must be assessed for the purpose of making the payments under section 65-02-31 in the same manner as other real property in this state is assessed for tax purposes. Before June thirtieth of each year, the county auditor of any county in which property subject to valuation is located shall give written notice to workforce safety and insurance and the tax commissioner of the value placed by the county board of equalization upon each parcel of property subject to valuation in that county.

Source:

S.L. 2003, ch. 84, § 5.

65-02-33. Occupational health and preventive medicine programs — Continuing appropriation.

The organization may establish and implement programs to advance occupational health and preventive medicine in this state and to protect the integrity of the fund. These programs may include the provision of education or training, consultation, grants, scholarships, or other incentives that promote superior care and treatment of the workforce in this state. Funds in the workforce and insurance fund are appropriated to the organization on a continuing basis for the purpose of funding the programs implemented under this section.

Source:

S.L. 2007, ch. 47, § 6; 2009, ch. 611, § 8.

65-02-34. Spending authority — Limited. [Repealed]

Repealed by S.L. 2009, ch. 611, § 13.

65-02-35. Attorney’s fees for legal review in preparation for rehearing of an administrative order.

  1. The organization shall pay an injured employee’s attorney for the fees and costs to consult with the injured employee regarding a request for rehearing of an administrative order issued by the organization under section 65-01-16 and chapter 28-32. The attorney’s fees and costs under this section are for the purpose of an initial consultation and review of the claimant’s case and are separate from and independent of the attorney’s fees and costs provided for under section 65-02-08. To be eligible for payment of attorney’s fees and costs under this section, before consulting the attorney the injured employee must first receive a certificate of completion from the decision review office, and the attorney consultation must take place after the certificate of completion is issued but before the rehearing is conducted.
  2. Payment of attorney’s fees and costs under this section is limited as follows:
    1. An injured employee may consult with one attorney per administrative order;
    2. The payment amount for attorney’s fees may not exceed a total of five hundred dollars per injured employee, per administrative order;
    3. The payment amount for costs may not exceed a total of one hundred fifty dollars per injured employee, per administrative order;
    4. The attorney must be licensed to practice law in North Dakota and must be in good standing; and
    5. The organization may deny fees and costs the organization determines to be excessive or frivolous.
  3. To obtain payment under this section, an attorney shall submit to the organization a fee statement. The fee statement must be signed by the attorney and must include:
    1. The name of the injured employee;
    2. The workforce safety and insurance claim number;
    3. The date of the billing statement;
    4. A summary of the basic legal issue;
    5. The date of each service or charge being billed;
    6. An itemization and a reasonable description of the legal work performed for each service or charge;
    7. The time and amount billed for each item; and
    8. The total time and amounts billed.
  4. Under this section, the organization shall reimburse the following costs:
    1. Actual postage, if postage exceeds three dollars per parcel;
    2. Actual toll charges for long-distance telephone calls;
    3. Copying charges at eight cents per page;
    4. Mileage and other expenses for reasonable and necessary travel, including per diem, all of which are to be paid in the amounts paid state officials as provided under sections 44-08-04 and 54-06-09; and
    5. Other reasonable and necessary costs, not to exceed one hundred fifty dollars.
  5. Under this section, the organization may not reimburse the following costs:
    1. Express mail;
    2. Additional copies of transcripts;
    3. Costs incurred to obtain medical records;
    4. Copy charges for documents provided by the organization; and
    5. Costs for typing and clerical or office services.

Source:

S.L. 2009, ch. 617, § 1; 2013, ch. 63, § 15.

65-02-36. Attorney’s fees for legal review of proposed settlement.

The organization shall pay up to five hundred dollars to an attorney for review of a proposed settlement offered to an injured employee, if the employee to whom the settlement is offered was not represented by an attorney at the time the offer was made. Subdivisions d and e of subsection 2 of section 65-02-35 apply to the payment of fees under this section. The organization may reimburse an attorney for costs under this section according to subsections 3, 4, and 5 of section 65-02-35. Fees and costs under this section are payable regardless of whether the injured employee accepts the settlement proposal.

Source:

S.L. 2009, ch. 617, § 2.

Effective Date.

This section became effective August 1, 2009.

65-02-37. Attorney’s fees reimbursement.

An employer that is insured and in good standing with the organization is eligible for reimbursement of reasonable legal costs and reasonable attorney’s fees if the employer is found to be uninsured or noncompliant by the workers’ compensation authorities of another state and hires an attorney to defend against the determination. A reimbursement may be made only if the organization determines the employer’s employees did not regularly work in the other state.

Source:

S.L. 2021, ch. 503, § 1, eff March 15, 2021.

65-02-38. Electronic transaction payment fees – Continuing appropriation.

Money in the workforce safety and insurance fund is appropriated on a continuing basis for payment of fees associated with credit or debit card payments made to the organization.

Source:

S.L. 2021, ch. 503, § 2, eff March 15, 2021.

65-02-39. Fees for outgoing file copies.

The organization may charge a fee not exceeding twenty dollars for the first twenty-five pages and seventy-five cents per page after twenty-five pages when providing an outgoing file copy. In an electronic, digital, or other computerized format, the organization may charge a fee of thirty dollars for the first twenty-five pages and twenty-five cents per page after twenty-five pages. The fees include any administration cost, retrieval fee, or postage expense.

Source:

S.L. 2021, ch. 500, § 3, eff July 1, 2021.

CHAPTER 65-03 Prevention of Injuries

65-03-01. Jurisdiction of organization — Safety regulations — Enforcement.

The organization shall have full power and jurisdiction over, and the supervision of, every employment and place of employment subject to the provisions of this title, and whenever necessary adequately to enforce and administer this title, shall issue and enforce all necessary and proper rules and safety regulations. The organization may designate some suitable person to make inspections to determine if safety rules and regulations are being followed or complied with.

Source:

S.L. 1919, ch. 162, § 4; 1921, ch. 145, § 1; 1925, ch. 220, § 1; 1925 Supp., § 396a4; S.L. 1927, ch. 285, § 1; 1931, ch. 314, § 1; 1935, ch. 286, § 3; 1939, ch. 251, § 3; R.C. 1943, § 65-0301; 2003, ch. 561, § 3.

65-03-02. Penalty for violation of safety rule or regulation — Fine — Penalty premium rating — Extension of time to comply.

Any employer who shall fail to comply with any reasonable safety rule or regulation made in accordance with the provisions of this chapter, within twenty days after notice from the organization or its authorized agent, shall be guilty of an infraction, and the organization may penalize the premium rating of the employer guilty of such violation in an amount not exceeding ten percent during the year or years in which such violation continues. Upon application and a proper and sufficient showing that the rule or regulation cannot be complied with within the twenty days herein specified, the organization may extend such time for such period as the facts in each case warrant, but not to exceed three months.

Source:

S.L. 1927, ch. 285, § 1; 1931, ch. 314, § 1; R.C. 1943, § 65-0302; S.L. 1975, ch. 106, § 670; 2003, ch. 561, § 3.

65-03-03. Mine foremen — Rules regarding. [Repealed]

Repealed by S.L. 2009, ch. 608, § 6.

65-03-04. Safety programs — Continuing appropriation.

The organization shall create and operate work safety and loss prevention programs to protect the health of covered employees and the financial integrity of the fund, including programs promoting safety practices by employers and employees through education, training, consultation, grants, or incentives. As a term of award of a grant under this section, a recipient authorizes the organization to disclose the name of the award recipient and the amount of the award received. Any funds deposited in the workforce safety insurance fund are appropriated to the organization on a continuing basis for the purpose of funding the programs implemented under this section.

Source:

S.L. 1999, ch. 555, § 2; 1999, ch. 553, § 7; 2003, ch. 561, § 3; 2003, ch. 565, § 3; 2005, ch. 604, § 1; 2009, ch. 608, § 3.

65-03-05. Safety grant programs — Reporting requirements.

The organization shall compile data relating to grants issued under this chapter. The organization shall report biennially to the legislative council.

Source:

S.L. 2009, ch. 608, § 4.

Effective Date.

This section became effective August 1, 2009.

CHAPTER 65-04 The Fund and Premium Payments Thereto

65-04-01. Classification of employments — Premium rates — Requirements.

  1. The organization shall classify employments with respect to their degrees of hazard, determine the risks of different classifications, and fix the rate of premium for each of the classifications sufficiently high to provide for:
    1. The payment of the expenses of administration of the organization;
    2. The payment of compensation according to the provisions and schedules contained in this title; and
    3. The maintenance by the fund of adequate reserves and surplus to the end that it may be kept at all times in an entirely solvent condition.
  2. In the exercise of the powers and discretion conferred upon it, the organization shall fix and maintain for each class of occupation, the lowest rate which still will enable it to comply with the other provisions of this section.
  3. The organization shall establish premium rates annually on an actuarial basis. The statewide average premium rate level may not deviate by more than five percentage points from the recommended actuarial indicated premium level for that year.
  4. Before the effective date of any premium rate change, including a change in the minimum premium, the organization shall hold a public hearing on the rate change. Chapter 28-32 does not apply to a hearing held by the organization under this subsection.

Source:

S.L. 1919, ch. 162, § 7; 1923, ch. 347, § 1; 1925, ch. 221, § 1; 1925 Supp., § 396a7; S.L. 1931, ch. 312, § 1; R.C. 1943, § 65-0401; S.L. 1995, ch. 617, § 1; 2003, ch. 561, § 3; 2005, ch. 604, § 2; 2009, ch. 618, § 1.

Notes to Decisions

Constitutionality.

It is not unconstitutional for legislature to delegate power to classify employments with respect to degree of hazards to workers’ compensation bureau. State ex rel. Amerland v. Hagan, 44 N.D. 306, 175 N.W. 372, 1919 N.D. LEXIS 213 (N.D. 1919), overruled, Benson v. North Dakota Workmen's Compensation Bureau, 283 N.W.2d 96, 1979 N.D. LEXIS 285 (N.D. 1979).

Classification Of Employees.

Workforce Safety and Insurance (WSI) did not err in refusing to create a new rate classification for an assisted living retirement facility or for resident service aides employed therein for the purpose of establishing their employer’s insurance premiums because N.D.C.C. § 65-04-01 did not require WSI to adjudicate individual contested claims at the lowest possible scheduled rate and any claim for the creation of new classifications or rates had to be made in the context of the actuarial process. Spectrum Care v. Workforce Safety & Ins., 2004 ND 229, 690 N.W.2d 233, 2004 N.D. LEXIS 372 (N.D. 2004).

Classification by Workforce Safety and Insurance (WSI) of resident service aides employed in an assisted living retirement facility as “9002 Domestics” with a designated rate of 3.31 for purposes of establishing the employer’s insurance premiums was affirmed because a reasoning mind could have reasonably concluded that resident service aides spent about 75 percent of their time on domestic type duties that fit within the description of “9002 Domestics” in WSI’s Classification Manual, WSI’s findings were supported by a preponderance of the evidence, and its findings supported its conclusions of law and decision. Spectrum Care v. Workforce Safety & Ins., 2004 ND 229, 690 N.W.2d 233, 2004 N.D. LEXIS 372 (N.D. 2004).

Equitable Estoppel.

There is no good reason to refuse to apply the doctrine of estoppel against the workers’ compensation fund created by the payment of premiums by employers, which payments earn the employers immunity from claims for relief by injured employees. Linnertz v. North Dakota Workers' Compensation Bureau, 502 N.W.2d 528, 1993 N.D. LEXIS 134 (N.D. 1993).

Premium Rates.

It is no objection to validity of rates that, as first determined, they may prove to be somewhat higher than required to cover risk. State ex rel. Johnson v. Hughes Elec. Co., 51 N.D. 45, 199 N.W. 128, 1924 N.D. LEXIS 143 (N.D. 1924).

Presumption of Validity.

There is a presumption that classification of industries and rates of premiums fixed by bureau are valid and fixed in conformity to statute; such presumption may be rebutted only by clear showing that they do not so conform, or that they are unreasonable or confiscatory. State ex rel. Johnson v. Hughes Elec. Co., 51 N.D. 45, 199 N.W. 128, 1924 N.D. LEXIS 143 (N.D. 1924).

Solvency of Fund.

Workers’ compensation bureau is required to maintain solvency of fund at all times. State ex rel. Stearns v. Olson, 43 N.D. 619, 175 N.W. 714, 1919 N.D. LEXIS 64 (N.D. 1919).

65-04-02. Reserves — Surplus.

  1. The organization shall maintain adequate financial reserves to ensure the solvency of the fund and the payment of future benefit obligations, based upon actuarially sound principles. The discount rate used in evaluating the financial reserves may not exceed six percent. The level of financial reserves plus available surplus determined as of June thirtieth of each year must be at least one hundred twenty percent but may not exceed one hundred forty percent of the actuarially established discounted reserve.
  2. If the level of financial reserves plus available surplus determined as of June thirtieth of any year is below one hundred twenty percent of the actuarially established discounted reserve, the organization may not issue premium dividends and, notwithstanding section 65-04-01, the organization shall modify recommended premium rate levels so that the organization is estimated to come into compliance within the following two years.
  3. If the level of financial reserves plus available surplus determined as of June thirtieth of any year is above one hundred forty percent of the actuarially established discounted reserve, the organization shall issue premium dividends in a fiscally prudent manner so that the organization is estimated to come into compliance with the requirements of subsection 1 within the following two years. However, premium dividends issued may not exceed fifty percent of the preceding year’s premium in any given year.
  4. If the level of financial reserves plus available surplus determined as of June thirtieth of any year is between one hundred twenty percent and one hundred thirty percent of the actuarially established discounted reserve, the organization may not issue premium dividends.
  5. If the level of financial reserves plus available surplus determined as of June thirtieth of any year is one hundred thirty percent to one hundred forty percent of the actuarially established discounted reserve, the organization may issue premium dividends. However, premium dividends issued may not exceed forty percent of the preceding year’s premium in any given year, and the level of financial reserves plus available surplus may not be reduced below one hundred thirty percent.
  6. For the purposes of this section, “available surplus” means net assets as stated on the statement of net assets of the organization, but does not include funds designated or obligated to specific programs or projects pursuant to a directive or specific approval by the legislative assembly.
  7. The independent annual financial audit of the organization must report the organization’s financial reserves.

Source:

S.L. 1919, ch. 162, § 7; 1923, ch. 347, § 1; 1925, ch. 221, § 1; 1925 Supp., § 396a7; S.L. 1931, ch. 312, § 1; 1943, ch. 274, § 11; R.C. 1943, § 65-0402; S.L. 1989, ch. 69, § 78; 1999, ch. 230, § 2; 2003, ch. 561, § 3; 2005, ch. 605, § 1; 2009, ch. 614, § 2.

65-04-03. Accounts to be kept for classifications and employers.

The organization shall keep an accurate account of the moneys paid in premiums by each of the several classes of occupations or industries and of the disbursements on account of injuries to and deaths of employees thereof, and it also shall keep an account of the moneys received from each individual employer and of the amount disbursed from the fund on account of injuries to and deaths of employees of each employer.

Source:

S.L. 1919, ch. 162, § 7; 1923, ch. 347, § 1; 1925, ch. 221, § 1; 1925 Supp., § 396a7; S.L. 1931, ch. 312, § 1; R.C. 1943, § 65-0403; 2003, ch. 561, § 3.

65-04-03.1. State entities account — Continuing appropriation.

  1. The organization shall establish a single workforce safety and insurance account for state entities covered by chapter 32-12.2. The organization shall use the combined payroll, premium, and loss history of selected agencies to determine future experience rates, dividends, assessments, and premiums. Classifications and premium rates must be based on the hazards and risks of the different occupations covered by this account. The payroll reporting period for this account is for a fiscal year of July first through June thirtieth. The office of management and budget shall furnish combined payroll information to the organization in a format prescribed by the organization.
  2. Workforce safety and insurance premiums from state entities covered by chapter 32-12.2 must be deposited in the risk management workers’ compensation fund. The state investment board shall invest this fund in accordance with chapter 21-10. Funds received as contributions from state entities, all other payments deposited in this fund, and interest and income received on investments are appropriated on a continuing basis for the purposes of this fund. The purposes of this fund are to pay workforce safety and insurance premiums for state agencies, workforce safety and insurance claims costs not covered by the deductible contract, and costs associated with workers’ compensation loss control programs. The risk management division of the office of management and budget shall administer this fund. Section 54-44.1-11 does not apply to this fund.
  3. A state entity covered by chapter 32-12.2 shall participate in the risk management workforce safety and insurance program unless exempted by the director of the office of management and budget.
  4. The risk management division of the office of management and budget shall administer the account’s internal workforce safety and insurance return-to-work program. Every state entity is required to participate in the return-to-work program. The program may include assigning employees to agencies other than the agency for which the employee worked on the date of the injury.
  5. The office of management and budget may adopt rules to administer the risk management workforce safety and insurance program.

Source:

S.L. 2001, ch. 15, § 29; 2003, ch. 561, § 3; 2003, ch. 564, § 2; 2007, ch. 568, § 1; 2009, ch. 482, § 98; 2013, ch. 501, § 1.

Effective Date.

The 2009 amendment of this section by section 98 of chapter 482, S.L. 2009 became effective August 1, 2009.

65-04-04. Employers obligated to pay premiums and assessments — Certificate provided.

  1. Each employer subject to this title shall pay into the fund the amount of premium and assessment determined by the organization. The amount must be determined by the classifications, rules, and rates made and published by the organization and must be based on a proportion of the annual expenditure of money by the employer for the service of persons subject to the provisions of this title.
  2. The organization shall provide to the employer a certificate specifying that the payment has been made. The certificate, is prima facie evidence of the payment of the premium.
  3. Notwithstanding the provisions of section 65-04-15, the certificate may reflect the employer has paid the minimum due and has no employees for the period indicated on the certificate. If an employer defaults on premium or assessment payments after a certificate has been issued, the organization may revoke that employer’s certificate.
  4. The organization shall provide that premiums or assessments payable by school districts, multidistrict special education units, area career and technology centers, and regional education associations, townships, and all public corporations or agencies, except municipal corporations, fall due at the end of the fiscal year of that entity, and that premiums or assessments payable by all municipal corporations fall due at the end of the calendar year, and may make provisions so that premiums or assessments of other employers fall due on different or specified dates.
  5. For the purpose of effectuating different or specified due dates, the organization may carry new or current risks for a period of less than one year and not to exceed eighteen months, either by request of the employer or action of the organization.
  6. An employer subject to this chapter shall display in a conspicuous manner at the workplace and in a sufficient number of places to reasonably inform employees of the fact, a certificate showing compliance with this chapter and the toll-free telephone number used to report unsafe working conditions and actual or suspected workforce safety and insurance fraud.
  7. Any employer subject to this chapter is liable to pay a civil penalty of two hundred fifty dollars for failure to display the notice of compliance and the toll-free telephone number as required by this section.

Source:

S.L. 1919, ch. 162, §§ 6, 7; 1923, ch. 347, § 1; 1925, ch. 221, § 1; 1925 Supp., §§ 396a6, 396a7; S.L. 1931, ch. 312, § 1; R.C. 1943, § 65-0404; S.L. 1945, ch. 338, § 1; 1951, ch. 344, § 2; 1953, ch. 352, § 1; 1957 Supp., § 65-0404; S.L. 1961, ch. 389, § 1; 1963, ch. 425, § 1; 1991, ch. 716, § 1; 1993, ch. 614, § 8; 2001, ch. 578, § 3; 2003, ch. 561, § 3; 2003, ch. 564, § 3; 2007, ch. 569, § 1; 2009, ch. 163, § 5; 2019, ch. 524, § 4, eff August 1, 2019.

Notes to Decisions

Equitable Estoppel.

There is no good reason to refuse to apply the doctrine of estoppel against the workers’ compensation fund created by the payment of premiums by employers, which payments earn the employers immunity from claims for relief by injured employees. Linnertz v. North Dakota Workers' Compensation Bureau, 502 N.W.2d 528, 1993 N.D. LEXIS 134 (N.D. 1993).

Individual Risk Basis.

Premiums are based upon risk involved by each employer and cover protection provided for his employees only; each employer pays in proportion to his payroll and his accident experience shown in each case. State ex rel. Workmen's Compensation Fund v. E. W. Wylie Co., 79 N.D. 471, 58 N.W.2d 76, 1953 N.D. LEXIS 55 (N.D. 1953).

Public Moneys.

Moneys collected from employers by the workers’ compensation bureau pursuant to its established premium rates are public moneys within the meaning of section 12, article X of the constitution to be deposited with the state treasurer. They can be disbursed only pursuant to an appropriation contained in that section or made by the legislature. North Dakota Workmens Comp. Bureau v. S.A. Healy Co., 109 N.W.2d 249 (N.D. 1960).

Refunds.

The workers’ compensation bureau has no power to grant refunds to employers who have paid premiums pursuant to rates established by the bureau nor may the bureau be compelled to hold a hearing on an application for such refund. North Dakota Workmens Comp. Bureau v. S.A. Healy Co., 109 N.W.2d 249 (N.D. 1960).

Unpaid Premiums.

Due to the mandatory nature of workers’ compensation premium payments, an employer’s unpaid premiums are nondischargeable priority excise taxes under 11 USCS § 523(a)(1)(A). North Dakota Workers Compensation Bureau v. Voightman (In re Voightman), 239 B.R. 380, 1999 Bankr. LEXIS 1185 (B.A.P. 8th Cir. 1999).

65-04-04.1. Determination of weekly wage for premium purposes to veteran-on-the-job trainee. [Repealed]

Repealed by S.L. 1997, ch. 538, § 1.

65-04-04.2. Basis of calculating premiums.

  1. For each year, the amount of an employee’s wages subject to premium calculations must be determined as an amount equal to seventy percent of the statewide average annual wage, hereafter referred to as limited payroll, rounded to the nearest one hundred dollars, determined by the organization on or before July first as calculated by job service North Dakota under subsection 3 of section 52-04-03.
  2. The rates for each classification must be determined by:
    1. Estimating the revenue needed by each employment classification;
    2. Estimating the total limited payroll to be reported by all employers in each employment classification for the year; and
    3. Dividing the estimated revenue needed by an employment classification by the estimated total limited payroll in that classification to determine the required average premium for that classification rate.

Source:

S.L. 1991, ch. 716, § 2; 1993, ch. 622, § 1; 2003, ch. 561, § 3.

65-04-04.3. Employer relief for third-party recovery.

The organization, upon recovery of its subrogation interest after a third-party lawsuit under section 65-01-09, shall give relief to the employer from the date of injury for the amount of the recovery up to the actual amount expended on a claim charged against the employer’s account. For purposes of this section, “relief” means the amount of money recovered by the organization in a third-party action will be deducted from the amount charged against the employer’s experience rating.

Source:

S.L. 1995, ch. 618, § 1; 2003, ch. 561, § 3.

65-04-04.4. Medical expense assessments.

The employer shall reimburse the organization for all medical expenses related to a compensable injury to an employee if the expenses do not exceed two hundred fifty dollars and shall reimburse the organization for the first two hundred fifty dollars of medical expenses when the expenses exceed two hundred fifty dollars. If a claim for benefits is filed with the organization by midnight central time on the first business day following the workplace injury, the organization shall pay the first two hundred fifty dollars of medical expenses. A claim is filed by submitting a form furnished by the organization or by another method designated by the organization. If a claim for benefits is filed with the organization more than fourteen days from the date the employer received notice of the workplace injury from the employee, the employer shall reimburse the organization for the first three hundred fifty dollars of medical expenses if the expenses exceed three hundred fifty dollars. If the organization determines the claim is compensable, the organization shall pay the medical expenses associated with the claim and notify the employer of payments to be made by the employer under this section. If the employer does not pay the organization within thirty days of notice by the organization, the organization may impose a penalty on that employer. The penalty may not exceed one hundred twenty-five percent of the payment owed by the employer. The organization shall collect the penalty in a civil action against the employer and deposit the money in the fund. An employer may not directly or indirectly charge an injured employee for any payment the employer makes on a claim. Except as otherwise provided, if the cost of an injured employee’s medical treatment exceeds two hundred fifty dollars, the organization shall pay all further medical expenses. This section is effective for all compensable injuries that occur after July 31, 1995. This section does not apply to compensable injuries paid under sections 65-06.2-04 and 65-06.2-08.

Source:

S.L. 2017, ch. 437, § 1, eff August 1, 2017.

65-04-04.5. Settlement in discretion of organization.

Notwithstanding the other provisions of this chapter, the organization may settle an amount owed by an employer to resolve a disputed issue at any time and on its own motion or by application of an employer.

Source:

S.L. 2021, ch. 503, § 7, eff March 15, 2021.

65-04-05. Employer to furnish payroll information to organization — Determination of status — Report of actual and estimated payrolls. [Repealed]

Repealed by S.L. 2001, ch. 578, § 17.

65-04-05.1. Sections 65-04-04 and 65-04-05 retroactive. [Repealed]

Repealed by S.L. 1951, ch. 344, § 11.

65-04-06. Employer obligated to file payroll reports — Organization to specify method of providing information — Verification may be required.

Each employer subject to this title shall provide at least annually a payroll report to the organization. The organization may require an employer to file a payroll report with the organization more frequently during the premium year.

Each employer required to file a payroll report must file the report by an electronic method approved by the organization. An employer that does not comply with the requirements to file the payroll report electronically is deemed to have failed to submit the payroll report. If an employer is unable to provide the information required, the employer shall submit to the organization in writing the reason. The organization and its representatives may require any employer to submit information under oath.

Source:

S.L. 1919, ch. 162, § 5; 1921, ch. 143, § 1; 1925 Supp., § 396a5; S.L. 1939, ch. 251, § 4; R.C. 1943, § 65-0406; S.L. 1983, ch. 696, § 2; 2003, ch. 561, § 3; 2019, ch. 524, § 5, eff August 1, 2019.

65-04-07. County superintendents of schools to report school district clerks to organization. [Repealed]

Repealed by S.L. 1995, ch. 176, § 2.

65-04-08. County auditors to report auditors and clerks to organization. [Repealed]

Repealed by S.L. 1997, ch. 538, § 1.

65-04-09. All public contracts involving labor to be reported to organization. [Repealed]

Repealed by S.L. 1997, ch. 538, § 1.

65-04-10. Provision relating to workforce safety and insurance required in contractor’s bonds.

There must be inserted in every bond given by a contractor doing work for the state of North Dakota or for any political subdivision thereof, in addition to the general provisions for the faithful and complete performance of all work required under the contract, this further provision: That the contractor has made, or will make, prior to the commencement of any work by the contractor or any subcontractor under the contract, full and true report to the organization of the payroll expenditures for the employees to be engaged in the work, and that the contractor has paid, or will pay, the premium thereon prior to the commencement of the work.

Source:

S.L. 1925, ch. 96, § 1; 1925 Supp., § 396a30; R.C. 1943, § 65-0410; S.L. 1993, ch. 613, § 3; 2003, ch. 561, § 3.

Notes to Decisions

Action on Bond.

Condition in contractor’s bond that contractor will comply with workers’ compensation law is for benefit of employees, not bureau, and bureau may not bring action against surety on bond for unpaid premiums. State v. Padgett, 54 N.D. 211, 209 N.W. 388, 1926 N.D. LEXIS 136 (N.D. 1926).

65-04-11. Organization may make examinations under oath to secure payroll information.

The director, the organization, or any person employed by the organization for that purpose may examine under oath any employer, or any officer, agent, or employee of any employer, for the purpose of ascertaining any information which the employer is required under this title to furnish to the organization.

Source:

S.L. 1919, ch. 162, § 5; 1921, ch. 143, § 1; 1925 Supp., § 396a5; S.L. 1939, ch. 251, § 4; R.C. 1943, § 65-0411; S.L. 1989, ch. 295, § 12; 2003, ch. 561, § 3.

65-04-12. Penalties for failure to obtain coverage or to make payroll reports — How collected — Disposition. [Repealed]

Repealed by S.L. 2001, ch. 578, § 17.

65-04-13. Books, records, and payrolls of employers subject to audit and inspection — Penalty for refusal to permit inspection.

All books, records, and payrolls of the employers of the state, showing or reflecting in any way upon the amount of wage expenditure of the employers, are open always for inspection by the organization or any of its traveling auditors, inspectors, or assistants for the purpose of ascertaining the correctness of the reports, wage expenditures, the number of employees, and any other information necessary for the organization to administer this title. An employer who refuses to submit the employer’s books, records, and payrolls for inspection by the organization, or its auditor, inspector, or assistant presenting written authority from the organization, is subject to a penalty of five hundred dollars for each offense. The organization shall collect the penalty by civil action in the name of the state and shall deposit a penalty collected under this section to the credit of the fund.

Source:

S.L. 1919, ch. 162, § 5; 1921, ch. 143, § 1; 1925 Supp., § 396a5; R.C. 1943, § 65-0413; S.L. 1989, ch. 295, § 13; 1991, ch. 714, § 34; 1995, ch. 619, § 2; 2003, ch. 561, § 3.

65-04-14. False payroll report — Liability of employer — Collection and disposition of penalty. [Repealed]

Repealed by S.L. 2001, ch. 578, § 17.

65-04-15. Information in employer’s files confidential — Exceptions — Penalty if employee of organization divulges information.

  1. The information contained in an employer’s file is confidential and not subject to disclosure under chapter 44-04 and section 6 of article XI of the Constitution of North Dakota, is for the exclusive use and information of the organization or its agents in the discharge of the organization’s official duties, and is not open to the public nor usable in any court in any court action or proceeding unless the organization is a party to that court action or proceeding. The information contained in the file, however, may be tabulated and published by the organization in statistical form for the use and information of the state departments and of the public.
  2. An employer file includes all documents and data pertaining to a person that pays premium to the organization, except for information relating to a grant award under section 65-03-04 which the organization is specifically authorized to disclose or under section 65-03-04 which does not disclose payroll or premium information as provided in subsection 3.
  3. Upon request, the organization shall disclose the rate classification of an employer to the requester; however, the organization may not disclose any information that would reveal the amount of payroll upon which that employer’s premium is being paid or the amount of premium the employer is paying. The organization may disclose whether an employer’s file is active, canceled, closed, pending, delinquent, or uninsured. The information in the employer’s file may not be released in aggregate form, except to those persons contracting with the organization for exchange of information pertaining to the administration of this title, except upon written authorization by the employer for a specified purpose, or at the discretion of the organization with regard to delinquent and uninsured employers. Disclosure by a public servant of information contained in an employer’s report, except as otherwise allowed by law, is a violation of section 12.1-13-01. Anyone who is convicted under section 12.1-13-01 is disqualified from holding any office or employment with the organization.
  4. The organization may, upon request of the state tax commissioner or the secretary of state, furnish to them a list of employers showing only the names, addresses, and organization file identification numbers of such employers as those files relate to this chapter; provided, that any such list so furnished must be used by the tax commissioner or the secretary of state only for the purpose of administering their duties. The organization may provide any state or federal agency information obtained pursuant to the administration of this title. Any information so provided must be used only for the purpose of administering the duties of that state or federal agency.
  5. Whenever the organization obtains information on activities of a contractor doing business in this state of which officials of the secretary of state, job service North Dakota, or tax commissioner may be unaware and that may be relevant to the duties of those officials, the organization shall provide any relevant information to those officials for the purpose of administering their duties.
  6. The organization may provide any state agency or a private entity with a list of names and addresses of employers for the purpose of jointly publishing or distributing publications or other information pursuant to section 54-06-04.3. Any information so provided may only be used for the purpose of jointly publishing or distributing publications or other information as provided in section 54-06-04.3.

Source:

S.L. 1919, ch. 162, § 5; 1921, ch. 143, § 1; 1925 Supp., § 396a5; R.C. 1943, § 65-0415; S.L. 1969, ch. 516, § 4; 1973, ch. 503, § 1; 1975, ch. 580, § 1; 1983, ch. 696, § 4; 1985, ch. 686, § 1; 1989, ch. 509, § 4; 1991, ch. 568, § 6; 1991, ch. 714, § 36; 2003, ch. 508, § 2; 2003, ch. 561, § 3; 2003, ch. 564, § 4; 2005, ch. 606, § 1; 2007, ch. 569, § 2; 2009, ch. 608, § 5.

65-04-16. Adjustment of premium paid on estimated payroll.

In the event that the amount of premium collected from any employer at the beginning of any premium period is ascertained and calculated by using as a basis the estimated expenditures for wages for the period of time covered by such premium payments, an adjustment of the amount of such premiums shall be made at the end of said period, and the actual amount of such premium shall be determined from the actual expenditure of wages for said period.

Source:

S.L. 1919, ch. 162, § 7; 1923, ch. 347, § 1; 1925, ch. 221, § 1; 1925 Supp., § 396a7; S.L. 1931, ch. 312, § 1; R.C. 1943, § 65-0416.

65-04-17. Experience rating of employers.

The organization may establish a system for the experience rating of risks of employers contributing to the fund, and such system shall provide for the credit rating and the penalty rating of individual risks within such limitations as the organization may establish from time to time.

In calculating the experience rating, the organization shall determine the minimum rate for each employment classification by multiplying the required average premium rate by twenty-five hundredths to get the minimum rate assigned to an employer with a positive experience rating.

The organization may not amend its experience rating system by emergency rulemaking.

Source:

S.L. 1923, ch. 347, § 1; 1925, ch. 221, § 1; 1925 Supp., § 396a7; S.L. 1931, ch. 312, § 1; R.C. 1943, § 65-0417; S.L. 1977, ch. 579, § 7; 1993, ch. 622, § 2; 1995, ch. 617, § 2; 2003, ch. 561, § 3; 2007, ch. 569, § 3.

Notes to Decisions

Individual Risk Basis.

This statute implies that premiums are based upon risk involved by each employer and cover protection provided for his employees only. State ex rel. Workmen's Compensation Fund v. E. W. Wylie Co., 79 N.D. 471, 58 N.W.2d 76, 1953 N.D. LEXIS 55 (N.D. 1953).

65-04-17.1. Retrospective rating program.

The organization may establish a program to provide retrospective rating. The organization may not require an employer to participate in the program, but it may refuse to allow an employer to participate when it determines that refusal is appropriate. The organization shall establish formulas, based on sound actuarial principles, for premium calculation under the program. Sections 65-04-01, 65-04-04, and 65-04-04.2 do not apply to retrospective premiums allowed under this section. Any moneys held by the organization for future claim payments must accrue interest at a reasonable rate as determined by the organization. The organization may execute a contract with an employer to establish a retrospective rating plan for that employer. The contract is binding on the employer and the organization for the term identified in the contract. The term identified in the contract may extend past the end of the biennium in which the contract is executed but the term may not exceed ten years. The organization shall determine the amount of the deposit premium to be paid by an employer participating in the program. The amount of the deposit premium must be based on current rates, payroll, and experience rate factors. The organization shall establish the maximum premium liability of a participating employer. The maximum premium is not subject to the limitations of section 65-04-17. The organization may provide refunds from the workforce safety and insurance fund when it is determined appropriate under the retrospective rating formula established. The organization shall provide any refund due within thirty days after the date of the retrospective premium valuation. The organization may impose a penalty if an employer fails to pay additional premium due within thirty days after the retrospective premium valuation. The organization may require an employer to provide a bond, letter of credit, or other security approved by the organization to guarantee payment of future employer obligations incurred by a retrospective rating plan. The organization may charge an employer participating in the program a nonrefundable surcharge for the purpose of assisting retirement of any unfunded liability of the fund.

Source:

S.L. 1995, ch. 620, § 1; 1999, ch. 555, § 4; 2003, ch. 561, § 3.

65-04-18. Subsequent injury or aggravation of previous injury or condition of employee — Charge to employer’s risk — Charge of part of claim to subsequent injury fund.

Whenever a subsequent injury or aggravation of a previous injury or pre-existing condition occurs to an employee, the risk of the employer for whom such person was working at the time of such subsequent injury or aggravation shall be charged only with the amount of the awards resulting from such subsequent injury or aggravation. Whenever such subsequent injury or aggravation results in further disability or an aggravation of a pre-existing injury or condition, the compensation which is in excess of the amount to which the injured employee would have been entitled solely by reason of the subsequent injury or aggravation shall be charged to the subsequent injury fund and not to the classification or the risk to which the subsequent injury or aggravation is charged.

Source:

S.L. 1919, ch. 162, § 7; 1923, ch. 347, § 1; 1925, ch. 221, § 1; 1925 Supp., § 396a7; S.L. 1931, ch. 312, § 1; R.C. 1943, § 65-0418; S.L. 1947, ch. 375, § 3; 1957 Supp., § 65-0418; S.L. 1969, ch. 561, § 1.

Notes to Decisions

Charge to Employer’s Experience Rating Proper.

Workers Compensation Bureau properly found worker’s acute septicemia infection originated in laceration sustained during the course of his employment and concluded, even if he had not been affected by a preexisting diabetic condition, he would have been disabled by the infected laceration for at least six months, and properly charged employer’s experience rating for claim expenses incurred within six months of the laceration. Berg Transp. v. North Dakota Workers Compensation Bureau, 542 N.W.2d 729, 1996 N.D. LEXIS 24 (N.D. 1996).

Construction and Interpretation.

This section applies to determine what part of claim is chargeable to particular employer’s classification or risk and what part shall be chargeable to subsequent injury fund; it does not apply to determine whether claimant is entitled to benefits. Johnson v. North Dakota Workmen's Compensation Bureau, 344 N.W.2d 480, 1984 N.D. LEXIS 248 (N.D. 1984).

Purpose.

A second or subsequent injury fund protects employees because it provides full compensation to a previously impaired worker who suffers a subsequent work injury by apportioning claim expenses between the current employer’s experience rating and the fund, and it encourages employers to hire previously impaired employees because the apportionment scheme charges an employer’s experience rating only for injuries attributable to the employer’s work environment. Berg Transp. v. North Dakota Workers Compensation Bureau, 542 N.W.2d 729, 1996 N.D. LEXIS 24 (N.D. 1996).

Collateral References.

Workers’ compensation: compensability of injuries incurred traveling to or from medical treatment of earlier compensable injury, 83 A.L.R.4th 110.

65-04-19. Organization to assign rate classifications, calculate premium, and determine premium due from employer — Audit — Notification of billing statement as notice of amount due.

  1. The organization shall assign rate classifications based on information provided to the organization by the employer or information gathered through the organization’s investigative process.
  2. The organization shall determine the amount of premium due from every employer subject to this title for the twelve months next succeeding the date of expiration of a previous period of insurance or next succeeding the date at which the organization received information an employer is subject to the title.
  3. If the organization does not receive the payroll report or, in the case of a noncompliant employer, the organization does not receive reliable and accurate payroll information, the organization may calculate premium using the wage cap in effect per employee reported in the previous payroll report, using information obtained through the organization’s investigative process, or using data obtained from job service North Dakota.
  4. The organization may audit an employer conducting business in this state. Audit findings are applicable to the audited period and the subsequent payroll period only, unless the audit referral is made for a potential violation of section 65-04-33.
  5. The organization shall send a copy of the billing statement to the employer. Sending the billing statement, by mail or electronically, constitutes notice to the employer of the amount due.

Source:

S.L. 1919, ch. 162, § 8; 1921, ch. 144, § 1; 1923, ch. 349, § 1; 1925, ch. 226, § 1; 1925 Supp., § 396a8; S.L. 1931, ch. 315, § 1; R.C. 1943, § 65-0419; S.L. 1983, ch. 696, § 5; 1995, ch. 619, § 4; 2001, ch. 578, § 4; 2003, ch. 561, § 3; 2017, ch. 438, § 2, eff August 1, 2017; 2019, ch. 524, § 6, eff August 1, 2019; 2021, ch. 503, § 3, eff March 15, 2021.

Notes to Decisions

Clerical Error.

Clerical error by bureau in its premium notice and pay-in-order, whereby an employer was charged at higher rate on employees than bureau’s published or manual rate does not invalidate such notice and order, nor does it relieve employer from paying manual or fixed rate for that industry. State ex rel. Johnson v. Hughes Elec. Co., 51 N.D. 45, 199 N.W. 128, 1924 N.D. LEXIS 143 (N.D. 1924).

Failure to Pay Premiums.

Failure of an employer to pay premium due on or before date fixed by pay-in-order issued by bureau automatically suspends right of employees to share in fund under control bureau. LIGHT v. NORTH DAKOTA WORKMEN'S COMPENSATION BUR., 57 N.D. 487, 222 N.W. 952, 1929 N.D. LEXIS 342 (N.D. 1929).

Partial Payment.

Where partial payments are made on judgment against an employer for recovery of premium due, employees are entitled to participate in fund from date fixed by pay-in-order and for such portion of year thereafter as amount paid bears proportionately to annual premium. LIGHT v. NORTH DAKOTA WORKMEN'S COMPENSATION BUR., 57 N.D. 487, 222 N.W. 952, 1929 N.D. LEXIS 342 (N.D. 1929).

65-04-19.1. Premium discount for implementation of risk management programs.

Any employer who achieves the benchmarks outlined by the organization’s risk management programs is eligible for a discount in the annual premium for the year following the year in which the risk management program’s benchmarks are achieved.

Source:

S.L. 1993, ch. 624, § 1; 2003, ch. 561, § 3; 2005, ch. 604, § 3; 2007, ch. 569, § 4.

65-04-19.2. State agency participation in risk management program. [Repealed]

Repealed by S.L. 2003, ch. 564, § 14.

65-04-19.3. Premium calculation programs — Authority.

The organization may create and implement actuarially sound employer premium calculation programs, including dividends, group insurance, premium deductibles, and reimbursement for medical expense assessments. Programs created or modified under this section are not subject to title 28-32 and may include requirements or incentives for the early reporting of injuries. An employer with a deductible policy under this section, who chooses to pursue a third-party action under section 65-01-09 after an injured worker and the organization have chosen not to pursue the third-party action, may keep one hundred percent of the recovery obtained, regardless of the expense incurred in covering the injury and regardless of any contrary provision in section 65-01-09. If the employer pursues the third-party action pursuant to this section, neither the organization nor the injured worker has any liability for sharing in the expense of bringing that action.

Source:

S.L. 1999, ch. 555, § 3; 2001, ch. 579, § 1; 2003, ch. 561, § 3; 2005, ch. 604, § 4; 2009, ch. 611, § 9.

65-04-20. Installment payment of premiums — Interest required.

An employer, subject to section 65-04-22, may pay the annual premium in installments.

Interest must be charged at the prevailing base rate posted by the Bank of North Dakota plus two and one-half percent. The interest charged must be at least six percent per annum. Interest must be charged on all premiums deferred under this section. Upon default in payment of any installment, the penalties apply which are provided in sections 65-04-22 and 65-04-33.

Source:

S.L. 1921, ch. 144, § 1; 1923, ch. 349, § 1; 1925, ch. 226, § 1; 1925 Supp., § 396a8; S.L. 1931, ch. 315, § 1; R.C. 1943, § 65-0420; S.L. 1983, ch. 697, § 1; 1991, ch. 714, § 37; 1995, ch. 621, § 1; 2001, ch. 578, § 5; 2005, ch. 607, § 1; 2013, ch. 502, § 1.

65-04-21. Utilization of public funds for payment of premiums due the fund.

The state of North Dakota or any municipality thereof, whenever necessary, may use any funds of the state or municipality, as the case may be, except such funds as are raised by special levies, for the payment of premiums due the fund for insurance upon employees of such state or municipality. If there are no funds on hand with which the premium payments may be made, the state or a municipality thereof may issue special warrants against its general fund for the payment of such premiums, and such warrants shall be paid in their order the same as any other warrants of the state or municipality.

Source:

S.L. 1935, ch. 288, § 2; R.C. 1943, § 65-0421.

65-04-22. Organization may make premium due immediately — When premium is in default — Penalty.

The organization may require a security deposit, or other instrument that is acceptable to the organization, within any time which, in the judgment of the organization, is reasonable and necessary. The organization may require advance payment of the premium, either in full or in installments. Any payment shall be in default one month from the payment due date specified in the billing statement.

Default of any installment payment will, at the option of the organization, make the entire remaining balance of the premium due and payable. The organization may declare an employer uninsured at any time after forty-five days have passed from the due date specified in the billing statement and the employer has failed to make a payment to the organization. The organization may decline coverage to any employer that has been determined to be uninsured under this section or where a premium delinquency remains unresolved.

When an employer defaults in the payment of a premium, an installment of the premium, penalty or interest, or in the filing of any bond required under this chapter, the employer at the time of default is subject to a penalty not to exceed two hundred fifty dollars plus two percent of the amount of premiums, penalties, and interest in default, and beginning one month after default, a penalty of two percent of the amount of premiums, penalties, and interest in default for each month or fraction of a month the premium, penalty, or interest remains unpaid.

Source:

S.L. 1919, ch. 162, § 8; 1921, ch. 144, § 1; 1923, ch. 349, § 1; 1925, ch. 226, § 1; 1925 Supp., § 396a8; S.L. 1931, ch. 315, § 1; 1939, ch. 251, § 6; R.C. 1943, § 65-0422; S.L. 1975, ch. 581, § 5; 1983, ch. 697, § 2; 2001, ch. 578, § 6; 2003, ch. 561, § 3; 2005, ch. 607, § 2; 2013, ch. 502, § 2; 2015, ch. 484, § 1, eff August 1, 2015; 2017, ch. 437, § 2, eff August 1, 2017; 2019, ch. 524, § 7, eff August 1, 2019.

65-04-22.1. Retroactive payment not required.

When the organization reviews a potential employment relationship involving an independent contractor who has a valid identification number issued under section 34-05-01.4 and determines that the party described as an independent contractor is an employee for purposes of workforce safety and insurance premiums, rather than an independent contractor, the organization may not require the party determined to be the employer to pay premiums for that employee, or any interest, penalty, or delinquency fee with respect to those premiums, retroactive to the date the relationship with the employee began, unless, however, the organization determines that the employer willfully and intentionally entered the relationship with the purpose of avoiding workforce safety and insurance premium payments. The organization may require the payment of premiums for that employee as of the date the order declaring an employment relationship becomes final.

Source:

S.L. 1993, ch. 347, § 5; 2003, ch. 561, § 3.

65-04-23. Penalties for default in payment of premiums, penalties, and interest. [Repealed]

Repealed by S.L. 2001, ch. 578, § 17.

65-04-24. Notice of premium or assessment owing — Organization to bring suit for premiums in default.

The organization shall notify an employer of the amount of premium, assessment, penalty, and interest due the organization from the employer. If the employer fails to pay that amount within thirty days, the organization may collect the premium, assessment, penalties, and interest due by civil action. In any action for the collection of amounts due the organization under this title, the court may not review or consider the action of the organization regarding the acceptance or payment of any claim. The organization may adjust or compromise the account. The organization may retain counsel on a contingent or hourly fee basis to represent the organization in any proceeding relating to the collection of amounts due under this title. The organization shall charge attorney’s fees and costs to the organization’s general fund.

Source:

S.L. 1919, ch. 162, § 8; 1921, ch. 144, § 1; 1923, ch. 349, § 1; 1925, ch. 226, § 1; 1925 Supp., § 396a8; S.L. 1931, ch. 315, § 1; 1943, ch. 274, § 12; R.C. 1943, § 65-0424; S.L. 1975, ch. 581, § 7; 1995, ch. 619, § 6; 2001, ch. 578, § 7; 2003, ch. 561, § 3; 2019, ch. 524, § 8, eff August 1, 2019; 2021, ch. 503, § 4, eff March 15, 2021.

Notes to Decisions

Action by State.

This statute discloses legislative intent that actions must be brought by state and not by bureau. Henderson v. Scott, 72 N.D. 616, 10 N.W.2d 490, 1943 N.D. LEXIS 100 (N.D. 1943).

DECISIONS UNDER PRIOR LAW

Time Limit.

Former provision that suit be brought within twenty days after default of employer placed upon bureau duty to bring suit within time specified, but was not a statute of limitations and did not create a condition precedent to maintenance of an action. State v. Halverson, 69 N.D. 225, 285 N.W. 292, 1939 N.D. LEXIS 145 (N.D. 1939).

Venue.

Chapter 315, S.L. 1931, providing for action to be brought in Burleigh County or county where employer engaged in business, did not abrogate employer’s right to change of venue to county of his residence in accordance with general statute relating thereto. State v. Osen, 67 N.D. 436, 272 N.W. 783, 1937 N.D. LEXIS 97 (N.D. 1937).

65-04-25. Service of nonresident employer in suit for premium or in suit against an uninsured employer.

If the employer in an action to collect delinquent premiums or for injuries sustained in the employer’s employment for which the employer did not carry the required insurance is a nonresident of this state, or a foreign corporation or limited liability company doing business in this state, service of the summons may be made upon any agent, representative, or foreman of the employer in this state, or in the case of a foreign corporation, its director, and if there is no agent, representative, or foreman, or in the case of a foreign corporation, director, upon whom service can be made in this state, service upon the secretary of state constitutes personal service upon that nonresident employer or corporation’s director who has either failed to secure the necessary coverage or who is delinquent in the employer’s premiums, or service may be made in any other manner designated by law. The organization may retain counsel who is licensed in another state to represent the organization on a contingent or hourly fee basis in any proceeding relating to the collection of amounts due the organization under this title. All attorney’s fees and costs incurred under this section are a charge to the general fund.

Source:

S.L. 1919, ch. 162, § 8; 1921, ch. 144, § 1; 1923, ch. 349, § 1; 1925, ch. 226, § 1; 1925 Supp., § 396a8; S.L. 1931, ch. 315, § 1; R.C. 1943, § 65-0425; S.L. 1955, ch. 354, § 9; 1957 Supp., § 65-0425; S.L. 1975, ch. 581, § 8; 1993, ch. 54, § 106; 2001, ch. 578, § 8; 2003, ch. 561, § 3; 2021, ch. 503, § 5, eff March 15, 2021.

Cross-References.

Service by publication, see N.D.R.Civ.P. 4(e).

65-04-26. Lien priority and filing — Remedies available in action for delinquent premiums — Exemptions restricted.

The claim of the organization in bankruptcy, probate, insolvency, and receivership proceedings for premiums in default and penalties is a lien with the same priority as prior income tax liens, except that this lien is not enforceable against a purchaser, including a lien creditor, of real estate or personal property for valuable consideration without notice. Notice of this lien must be filed in the place and manner provided for in section 57-38-49. A certificate of the organization that premiums and penalties are due for the period stated in the certificate is prima facie evidence of this fact. In any action brought for the recovery of premiums in default and penalties, the remedies of garnishment or attachment, or both, are available. No exemptions except absolute exemptions under section 28-22-02 may be allowed against any levy under execution pursuant to judgment recovered in the action.

Source:

S.L. 1919, ch. 162, § 8; 1921, ch. 144, § 1; 1923, ch. 349, § 1; 1925, ch. 226, § 1; 1925 Supp., § 396a8; S.L. 1931, ch. 315, § 1; R.C. 1943, § 65-0426; S.L. 1959, ch. 419, § 1; 1985, ch. 687, § 1; 1993, ch. 625, § 1; 2003, ch. 561, § 3.

Cross-References.

Absolute exemptions, see N.D.C.C. § 28-22-02.

Attachment, see N.D.C.C. ch. 32-08.1.

Garnishment, see N.D.C.C. ch. 32-09.1.

DECISIONS UNDER PRIOR LAW

Unconstitutionality.

Provision in prior statute which subordinated lien of mortgagee to lien of state’s judgment, without notice to mortgagee at time he accepted his mortgage that it might be so subordinated, deprived mortgagee of his property without due process of law in violation of both state and federal constitutions. Federal Farm Mortgage Corp. v. Berzel, 69 N.D. 760, 291 N.W. 550, 1940 N.D. LEXIS 205 (N.D. 1940).

65-04-26.1. Corporate officer personal liability.

  1. An officer or director of a corporation, or manager or governor of a limited liability company, or partner of a limited liability partnership, or employee of a corporation or limited liability company having twenty percent stock ownership who has control of or supervision over the filing of and responsibility for filing payroll reports or making payment of premiums or reimbursements under this title and who fails to file the reports or to make payments as required, is personally liable for premiums under this chapter and reimbursement under section 65-04-04.4, including interest, penalties, and costs if the corporation or limited liability company does not pay to the organization those amounts for which the corporation or limited liability company is liable.
  2. The personal liability of any person as provided in this section survives dissolution, reorganization, bankruptcy, receivership, or assignment for the benefit of creditors. For the purposes of this section, all wages paid by the corporation or limited liability company must be considered earned from any person determined to be personally liable.
  3. After review of the evidence in the employer’s file, the organization shall determine personal liability under this section. The organization shall issue a decision under this section pursuant to section 65-04-32.

Source:

S.L. 1991, ch. 714, § 38; 1993, ch. 54, § 106; 1995, ch. 619, § 7; 2001, ch. 578, § 9; 2003, ch. 561, § 3; 2003, ch. 564, § 5; 2017, ch. 437, § 3, eff August 1, 2017; 2021, ch. 503, § 6, eff March 15, 2021.

Notes to Decisions

Applicability.

Under this section, an officer or director of a corporation can be held personally liable for unpaid workers compensation insurance premiums, regardless of whether that individual has an ownership interest in the corporation. Grand Forks Prof'l Baseball, Inc. v. N.D. Workers Comp. Bureau, 2002 ND 204, 654 N.W.2d 426, 2002 N.D. LEXIS 275 (N.D. 2002), cert. denied, 538 U.S. 1057, 123 S. Ct. 2221, 155 L. Ed. 2d 1107, 2003 U.S. LEXIS 4093 (U.S. 2003).

This section unambiguously imposes liability upon directors for unpaid premiums regardless of whether they owned corporate stock. Grand Forks Prof'l Baseball, Inc. v. N.D. Workers Comp. Bureau, 2002 ND 204, 654 N.W.2d 426, 2002 N.D. LEXIS 275 (N.D. 2002), cert. denied, 538 U.S. 1057, 123 S. Ct. 2221, 155 L. Ed. 2d 1107, 2003 U.S. LEXIS 4093 (U.S. 2003).

Plain language of N.D.C.C. § 65-04-26.1(1) requires a corporation or limited liability company to be liable in the first instance in order for that liability to extend to a manager or governor of the limited liability company; the liability of the Cherokee entities’ general manager was dependent on whether the Cherokee entities were liable for the amounts. If the Cherokee entities were arms of the tribe and immune from claims, they could not be held liable for premiums or reimbursements. Remand was required. State v. Cherokee Servs. Grp., LLC, 2021 ND 36, 955 N.W.2d 67, 2021 N.D. LEXIS 33 (N.D. 2021).

Current Officer.

The corporate liability statute, by placing responsibility only on an “officer ... who fails ... to make payments as required,” strongly suggests the potentially liable officer must in fact be an officer at the time the default occurs. Raboin v. North Dakota Workers Compensation Bureau, 1997 ND 221, 571 N.W.2d 833, 1997 N.D. LEXIS 283 (N.D. 1997).

Remedies.

Initiation of an action by the bureau against a corporation for unpaid workers’ compensation insurance premiums does not constitute an election of remedies precluding the bureau from seeking payment of the unpaid premiums from the individual corporate officers and directors. Grand Forks Prof'l Baseball, Inc. v. N.D. Workers Comp. Bureau, 2002 ND 204, 654 N.W.2d 426, 2002 N.D. LEXIS 275 (N.D. 2002), cert. denied, 538 U.S. 1057, 123 S. Ct. 2221, 155 L. Ed. 2d 1107, 2003 U.S. LEXIS 4093 (U.S. 2003).

Because under this section, the personal liability of corporate officers and directors survives dissolution, reorganization, or bankruptcy of the corporation, where the bureau believes that a corporate entity is now defunct and attempts to collect workers compensation insurance premiums would be futile, the bureau has no statutory requirement to first attempt to settle its claim with the corporation. Grand Forks Prof'l Baseball, Inc. v. N.D. Workers Comp. Bureau, 2002 ND 204, 654 N.W.2d 426, 2002 N.D. LEXIS 275 (N.D. 2002), cert. denied, 538 U.S. 1057, 123 S. Ct. 2221, 155 L. Ed. 2d 1107, 2003 U.S. LEXIS 4093 (U.S. 2003).

In a case in which an individual appealed a district court’s affirmation of an administrative law judge’s (ALJ) finding, the ALJ correctly determined that the individual was an employer under N.D.C.C. § 65-01-02(17) and that the individual was aware workers’ compensation coverage was required for all employees and that he intentionally tried to avoid the responsibility to provide coverage. The Individual was personally liable for past premiums and penalties owed to Workforce Safety and Insurance. Muldoon v. N.D. Workforce Safety & Ins. Fund, 2012 ND 244, 823 N.W.2d 761, 2012 N.D. LEXIS 251 (N.D. 2012).

65-04-26.2. General contractor liability for subcontractors and independent contractors.

  1. An individual employed by a subcontractor or by an independent contractor operating under an agreement with a general contractor is deemed to be an employee of the general contractor and any subcontractor that supplied work to the subcontractor or independent contractor. A general contractor and a subcontractor are liable for payment of premium and any applicable penalty for an employee of a subcontractor or independent contractor that does not secure required coverage or pay the premium owing. The general contractor and a subcontractor are liable for payment of this premium and penalty until the subcontractor or independent contractor pays this premium and penalty. The liability imposed on a general contractor and a subcontractor under this section for the payment of premium and penalties under this title which are not paid by a subcontractor or independent contractor is limited to work performed under that general contractor.
  2. Upon request of the organization, a person the organization determines may have information that may assist the organization in determining the amount of wages expended by the subcontractor or independent contractor shall provide this information to the organization.
  3. If the organization is unable to obtain complete and reliable payroll information for a subcontractor or independent contractor, the organization may calculate premium using the available payroll information of the subcontractor or independent contractor for work performed under the liable general contractor or a subcontractor as permitted in section 65-04-19. If a subcontractor’s or independent contractor’s liability for failure to secure coverage or pay the premium owing arises from a single project with a general contractor, the liability of the general contractor and subcontractor is one hundred percent of the amount of premium and penalty owed by the subcontractor or independent contractor. If there is evidence showing the subcontractor or independent contractor was working on multiple projects during the period the subcontractor or independent contractor failed to secure coverage, the organization shall set the amount of the general contractor and subcontractor’s liability which may not exceed seventy percent of the total premium and penalty owed by the subcontractor or independent contractor.
  4. The definition of the term “contractor” under section 43-07-01 applies to this section.

Source:

S.L. 2017, ch. 438, § 3, eff August 1, 2017; 2019, ch. 524, § 9, eff August 1, 2019.

Notes to Decisions

Unpaid Premiums and Penalties.

While the district court erred in dismissing a cross-appeal by Workforce Safety & Insurance (WSI) cross-appeal as untimely, it properly affirmed a determination by an administrative law judge holding a contractor liable for unpaid workers compensation premiums and penalties attributed to a subcontractor’s account and that the contractor’s principal was personally liable for unpaid workers compensation premiums because the imposition of derivative liability was statutorily allowed against a general contractor without proof the underling assessment of liability against a subcontractor was final, and, in the absence of adequate payroll records, WSI appropriately calculated the amount of the late premiums. Brendel Constr., Inc. v. N.D. Workforce Safety & Ins., 2021 ND 3, 953 N.W.2d 612, 2021 N.D. LEXIS 10 (N.D. 2021).

65-04-27. Payment of claims — Employers in default.

The payment of a judgment rendered in an action brought against an employer for the collection of defaulted premiums or the voluntary payment of the amount of premium, penalties, and costs prior to judgment entitles the employer and that employer’s employees to the benefits provided in this title from the date of the payment. The organization shall pay an employee who sustains an injury while working for an employer whose premium is in default the same as the employee would receive if the employee were working for an employer whose premium is not in default.

Source:

S.L. 1919, ch. 162, § 8; 1921, ch. 144, § 1; 1923, ch. 349, § 1; 1925, ch. 226, § 1; 1925 Supp., § 396a8; S.L. 1931, ch. 315, § 1; R.C. 1943, § 65-0427; S.L. 1955, ch. 354, § 2; 1957 Supp., § 65-0427; S.L. 1995, ch. 619, § 8; 2003, ch. 561, § 3.

65-04-27.1. Injunctive relief — Procedure.

    1. To protect the lives, safety, and well-being of wageworkers, to ensure fair and equitable contributions to the workforce safety and insurance fund among all employers, and to protect the workforce safety and insurance fund, the organization may institute injunction proceedings in the name of the state of North Dakota against certain employers to prohibit them from employing others in those employments defined as hazardous by this title:
      1. When it has been brought to the attention of the organization that the employer has unlawfully employed uninsured workers in violation of section 65-04-33;
      2. When the employer defaults in the payment of insurance premiums, reimbursements, penalties, or interest into the fund; or
      3. When the organization, in exercise of the authority granted it by section 65-03-01, finds that it is necessary to enjoin and restrain certain employers and employments to protect the lives and safety of the employees because of the employer’s failure or refusal to comply with necessary and proper safety rules.
    2. The courts of this state have jurisdiction to grant preventive relief under the circumstances described in subdivision a.
  1. Chapter 32-06 as it relates to injunction applies to proceedings instituted under this section to the extent that chapter is applicable.
  2. In addition to chapter 32-06, when the court has granted an immediate temporary injunction at the time of the commencement of the action, the defendant employer may have a hearing by the court on the merits of the case without delay. Upon three days’ written notice to the organization, the court shall proceed to hearing on the merits and render its decision.
  3. In addition to chapter 32-06, when the court has not granted an immediate temporary injunction at the time of the commencement of the action and the time for answer has expired, either party may have a hearing by the court on the merits of the case. Upon ten days’ notice by either party to the other, the court shall proceed to hearing on the merits and render its decision.
  4. Any court of competent jurisdiction in this state shall impose a fine of at least one thousand dollars against an employer who has violated an injunction granted under this section. The court shall impose a fine for each violation, in addition to any other penalty provided by law.

Source:

S.L. 1959, ch. 418, § 2; 1989, ch. 69, § 80; 1991, ch. 714, § 39; 1995, ch. 619, § 9; 2001, ch. 578, § 11; 2003, ch. 561, § 3.

Notes to Decisions

Funds Not Insurance.

The statutory references to insurance in the workers’ compensation laws do not make the protections provided by a workers compensation board into insurance as contemplated in N.D.C.C. ch. 26.1-42, governing the guaranty association. The funds provided by the workers compensation board are not insurance; they are workers’ compensation, and are derived from a statutorily created scheme designed to protect workers injured in the course of their employment. Beyer's Cement v. North Dakota Ins. Guar. Ass'n, 417 N.W.2d 370, 1987 N.D. LEXIS 454 (N.D. 1987).

65-04-27.2. Cease and desist order — Civil penalty.

  1. If it appears to the organization an employer is without workers compensation coverage or is in an uninsured status in violation of this title, by registered mail the director may issue to the employer an order to cease and desist and a notice of opportunity for hearing. Within thirty days of receipt of the order, a party to the order may make a written request for a hearing. If a hearing is not requested, the order is final and may not be appealed. If a hearing is requested, the hearing must be conducted in accordance with chapter 28-32 to the extent that chapter does not conflict with this section and the order remains in effect until the hearing officer renders a decision. If an employer fails to appear at a hearing requested under this section, that employer defaults and the allegations contained in the cease and desist order are deemed true.
  2. In addition to the penalties in section 65-04-33, a person that employs an individual in violation of a cease and desist order issued under this section is subject to a penalty of ten thousand dollars and to a penalty of one hundred dollars per day for each day the violation continues. The organization may reduce the penalties under this section.
  3. A general contractor or a subcontractor that willfully uses the services of a subcontractor precluded from operating under a cease and desist order is subject to a penalty of five thousand dollars and one hundred dollars per day for each day the violation occurs. The organization shall provide notice to the general contractor or subcontractor by regular mail before assessing penalties under this section. The organization may reduce the penalties under this section.

Source:

S.L. 2017, ch. 438, § 4, eff August 1, 2017; 2019, ch. 524, § 10, eff August 1, 2019.

Notes to Decisions

Construction.

N.D.C.C. § 65-04-27.2(1) does not allow Workforce Safety and Insurance (WSI) to issue cease and desist orders to insurance companies because they provided coverage to an employer; thus, WSI’s order to the insurance company to cease and desist from writing workers compensation coverage in the state of North Dakota exceeded the scope of authority granted to WSI by statute. State v. Cherokee Servs. Grp., LLC, 2021 ND 36, 955 N.W.2d 67, 2021 N.D. LEXIS 33 (N.D. 2021).

65-04-28. Complying employers not liable for injuries to or deaths of employees — Common-law actions barred.

Employers who comply with the provisions of this chapter shall not be liable to respond in damages at common law or by statute for injury to or death of any employee, wherever occurring, during the period covered by the premiums paid into the fund.

Source:

S.L. 1919, ch. 162, § 9; 1925 Supp., § 396a9; R.C. 1943, § 65-0428; S.L. 1949, ch. 354, § 4; 1957 Supp., § 65-0428.

Notes to Decisions

Constitutionality.

This section does not, by exonerating employers from common-law liability while leaving third persons subject thereto, violate equal privileges and immunities clause of state constitution or Equal Protection Clause of federal constitution. State ex rel. Workmen's Compensation Fund v. E. W. Wylie Co., 79 N.D. 471, 58 N.W.2d 76, 1953 N.D. LEXIS 55 (N.D. 1953).

Common Law and Statutory Tort Law.

The workers’ compensation act is a distinct body of law separate from common law and other statutory tort-law provisions. State by Workmen's Compensation Bureau v. Clary, 389 N.W.2d 347, 1986 N.D. LEXIS 327 (N.D. 1986).

Exclusive Remedy.

Generally, when an employer complies with the workers’ compensation statutes, the employee’s exclusive remedy against the employer is limited to recovery under the workers’ compensation statutes. Barsness v. General Diesel & Equip. Co., 422 N.W.2d 819, 1988 N.D. LEXIS 108 (N.D. 1988).

Third-party indemnity and contribution action for fraud and deceit against employer was barred by the exclusive remedy provisions of the Workers' Compensation Act. Smith v. Vestal, 494 N.W.2d 370, 1992 N.D. LEXIS 270 (N.D. 1992).

Injured employee had a right to bring a tort action against an employer for personal injuries which the employee suffered while working for the employer, which incorrectly classified the employee as an independent contractor, because the exclusive remedy provisions of the North Dakota workers' compensation laws did not preclude the action under provisions authorizing the action for the employer willfully misrepresenting to an insurer the amount of payroll upon which a premium was based, or for willfully failing to secure coverage for employees. Vail v. S/L Servs., 2017 ND 202, 900 N.W.2d 271, 2017 N.D. LEXIS 204 (N.D. 2017).

District court did not err in dismissing an employee’s negligence action because an employee and coworker were immune from suit under the Workforce Safety and Insurance Act’s exclusive remedy provisions; the determinations in California administrative proceedings were irrelevant for deciding statutory immunity because the employer paid Workforce Safety and Insurance premiums to secure coverage on the employee’s behalf, and the employee received benefits throughout the California proceedings. Brock v. Price, 2019 ND 240, 934 N.W.2d 5, 2019 N.D. LEXIS 251 (N.D. 2019).

Employer was entitled to supervisory writs directing a district court to grant the employer summary judgment barring civil liability for deceased and injured workers’ injuries because Workforce and Safety Insurance’s unappealed decision that the workers were employees was res judicata. Plains Trucking, LLC v. Hagar, 2019 ND 226, 932 N.W.2d 541, 2019 N.D. LEXIS 227 (N.D. 2019).

“Dual Capacity Theory” of Employer’s Liability.

The “dual capacity theory” of employer’s liability is not applicable under North Dakota’s workers’ compensation act, therefore when employee receives an injury covered by the act he may not maintain an action against his employer on theory that employer’s liability stems from breach of warranty or products liability. Schlenk v. Aerial Contractors, 268 N.W.2d 466, 1978 N.D. LEXIS 258 (N.D. 1978).

Equitable Estoppel.

There is no good reason to refuse to apply the doctrine of estoppel against the workers’ compensation fund created by the payment of premiums by employers, which payments earn the employers immunity from claims for relief by injured employees. Linnertz v. North Dakota Workers' Compensation Bureau, 502 N.W.2d 528, 1993 N.D. LEXIS 134 (N.D. 1993).

Indemnity or Contribution by Employer.

This section bars any cause of action for contribution or indemnity that a third party may have against the employer, arising out of the third party’s common-law liability to an injured employee. White v. McKenzie Electric Cooperative, Inc., 225 F. Supp. 940, 1964 U.S. Dist. LEXIS 6497 (D.N.D. 1964).

In situations where an employer and a third-party tortfeasor both negligently cause an employee’s injuries, liability is imposed on the third-party tortfeasor for the negligence of the third party and the employer without permitting the third-party tortfeasor to get contribution from the employer. Barsness v. General Diesel & Equip. Co., 422 N.W.2d 819, 1988 N.D. LEXIS 108 (N.D. 1988).

Third-Party Liability.

This section does not relieve an employer of common-law liability to an injured employee of another employer, even though injury was incurred in course of employment and both employers had complied with statute. State ex rel. Workmen's Compensation Fund v. E. W. Wylie Co., 79 N.D. 471, 58 N.W.2d 76, 1953 N.D. LEXIS 55 (N.D. 1953).

The operation of the joint and several liability provision of former N.D.C.C. § 9-10-07 and the immunity provision of this section rendered the joint tortfeasor liable for the negligence of the immune employers, as well as its own negligence. Beaudoin v. Texaco, Inc., 653 F. Supp. 512, 1987 U.S. Dist. LEXIS 1310 (D.N.D. 1987).

The “person against whom recovery is sought” under former N.D.C.C. § 9-10-07 includes statutorily immune employers who were not made parties to the action. Beaudoin v. Texaco, Inc., 653 F. Supp. 512, 1987 U.S. Dist. LEXIS 1310 (D.N.D. 1987).

The exclusive remedy rule prohibiting a third-party tortfeasor from getting contribution from the employer does not prohibit enforcement of an employer’s contractual agreement to indemnify a third-party tortfeasor. Barsness v. General Diesel & Equip. Co., 422 N.W.2d 819, 1988 N.D. LEXIS 108 (N.D. 1988).

True Intentional Injury.

The North Dakota Workers Compensation Act does not preclude recovery for true intentional injuries, and an employee can pursue a civil cause of action against his employer for a true intentional injury. Zimmerman v. Valdak Corp., 1997 ND 203, 570 N.W.2d 204, 1997 N.D. LEXIS 261 (N.D. 1997).

An employer is deemed to have intended to injure if the employer had knowledge an injury was certain to occur and willfully disregarded that knowledge. Zimmerman v. Valdak Corp., 1997 ND 203, 570 N.W.2d 204, 1997 N.D. LEXIS 261 (N.D. 1997).

DECISIONS UNDER PRIOR LAW

Common Law Remedy.

Injured employee seeking common-law recovery from complying employer had burden of proof as to age so as to bring him within former provision permitting common-law remedy in case of minors employed in violation of law. Schnoor v. Meinecke, 77 N.D. 96, 40 N.W.2d 803, 1950 N.D. LEXIS 109 (N.D. 1950).

Election of Remedies.

Minor under sixteen years of age, who commenced an action for personal injuries against employer made an election of remedies, and no express allegation of such election in complaint was necessary. Schnoor v. Meinecke, 75 N.D. 768, 33 N.W.2d 66, 1948 N.D. LEXIS 104 (N.D. 1948).

Collateral References.

Workers’ compensation law as precluding employee’s suit against employer for third person’s criminal attack, 49 A.L.R.4th 926.

Law Reviews.

Workers’ Compensation: The Assault on the Shield of Immunity — Coming to Blows with the Exclusive-Remedy Provisions of the North Dakota Workers’ Compensation Act, 70 N.D. L. Rev. 905 (1994).

65-04-29. Employers carrying on nonhazardous employment may come under law — Employee’s option.

Any employer carrying on any employment not defined as hazardous under section 65-01-02 who complies with this title and who pays into the fund the premiums provided for under this chapter is covered under the fund and is not liable to respond in damages at common law or by statute for injuries to or the death of any employee, wherever occurring, during the period covered by such premiums. Any employee who elects before injury not to come under workforce safety and insurance may do so by notifying the organization and the employer of such election in writing.

Source:

S.L. 1919, ch. 162, § 12; 1925 Supp., § 396a12; R.C. 1943, § 65-0429; S.L. 1959, ch. 420, § 1; 1989, ch. 69, § 81; 1991, ch. 714, § 40; 2003, ch. 561, § 3.

DECISIONS UNDER PRIOR LAW

Failure to Post Notice.

Absent actual notice, failure of farmer to post notice required by statute at place where he conducted his farming business prohibited him from substituting workers’ compensation liability for common-law liability. Rosebear v. Anderson, 143 F. Supp. 721, 1956 U.S. Dist. LEXIS 3021 (D.N.D. 1956), aff'd, 245 F.2d 673, 1957 U.S. App. LEXIS 3269 (8th Cir. N.D. 1957).

Failure to post necessary notice, despite otherwise complete compliance with workers’ compensation act, would disqualify farm employer from taking advantage of act. Rosebear v. Anderson, 143 F. Supp. 721, 1956 U.S. Dist. LEXIS 3021 (D.N.D. 1956), aff'd, 245 F.2d 673, 1957 U.S. App. LEXIS 3269 (8th Cir. N.D. 1957).

Location of Notice.

Posting of notice approximately three and one-half miles from defendant employer’s farm did not constitute constructive notice to agricultural laborers of employer’s election to cover them with workmen’s compensation. Rosebear v. Anderson, 143 F. Supp. 721, 1956 U.S. Dist. LEXIS 3021 (D.N.D. 1956), aff'd, 245 F.2d 673, 1957 U.S. App. LEXIS 3269 (8th Cir. N.D. 1957).

Law Reviews.

Constitutional Law — Workers Compensation: Equal Protection Challenge to the Agriculture Exemption and Use of Rational Basis Scrutiny in Haney v. North Dakota Workers Compensation Bureau, 518 N.W.2d 195 (N.D. 1994), 71 N.D. L. Rev. 781 (1995).

65-04-30. State treasurer is custodian of fund — Deposit — Disbursement on vouchers.

The state treasurer is the custodian of the fund and all payments of awards of the organization for disbursements other than travel and administrative expenses must be paid by the state treasurer upon warrant-checks authorized and prepared by the organization. Warrants drawn upon the fund and paid by the state treasurer must be returned to the organization and must be kept in the files of the organization. The organization shall submit to the office of management and budget once each month a monthly financial statement showing the receipts, disbursements, investments, and status of the fund. The treasurer may deposit any portion of the fund not needed for immediate use in the manner and subject to the requirements prescribed by law for the deposit by the treasurer of state funds. Any interest earned by any portion of the fund which is deposited by the state treasurer under this section must be collected by the state treasurer and placed to the credit of the fund.

Source:

S.L. 1919, ch. 162, § 13; 1925 Supp., § 396a13; S.L. 1935, ch. 286, § 5; R.C. 1943, § 65-0430; S.L. 1965, ch. 181, § 32; 1999, ch. 113, § 23; 2003, ch. 561, § 3.

Cross-References.

Deposit of state funds, see N.D.C.C. § 21-04-02.

Unemployment compensation fund, see N.D.C.C. ch. 52-03.

Notes to Decisions

Disbursement from Fund.

Fund of which state treasurer is custodian is special fund, and thus can be disbursed without warrant from state auditor. State ex rel. Stearns v. Olson, 43 N.D. 619, 175 N.W. 714, 1919 N.D. LEXIS 64 (N.D. 1919).

65-04-31. Investment of fund.

Investment of the fund must be under the supervision of the state investment board in accordance with chapter 21-10. For purposes of this section, the director is the official signatory for the organization on any check, document, or other legal instrument relating to or resulting from the investment of organization funds.

Source:

S.L. 1927, ch. 284, §§ 1, 2; 1937, ch. 189, §§ 1, 2; 1939, ch. 186, §§ 1, 3, 4; R.C. 1943, § 65-0431; S.L. 1947, ch. 376, § 1; 1957, ch. 181, § 6; 1957 Supp., § 65-0431; S.L. 1963, ch. 205, § 6; 1963, ch. 426, § 1; 1975, ch. 581, § 9; 1989, ch. 295, § 14; 2003, ch. 561, § 3.

Cross-References.

Permission of industrial commission necessary for investment of public funds, see N.D.C.C. § 54-27-16.

65-04-32. Decisions by organization — Disputed decisions.

Notwithstanding any provisions to the contrary in chapter 28-32, the following procedures apply when the organization issues a decision under this chapter or section 65-04-04.4:

  1. The organization may issue a notice of decision based on an informal internal review of the record and shall serve notice of the decision on the parties by regular mail. The organization shall include with the decision a notice of the employer’s right to reconsideration.
  2. An employer has forty-five days from the day the notice of decision was mailed to file a written petition for reconsideration. The employer is not required to file the request through an attorney. The request must state the reason for disagreement with the organization’s decision and the desired outcome. The request may be accompanied by additional evidence not previously submitted to the organization. The organization shall reconsider the matter by informal internal review of the information of record. Absent a timely and sufficient request for reconsideration, the notice of decision is final and may not be reheard or appealed.
  3. After receiving a petition for reconsideration, unless settlement negotiations are ongoing, the organization shall serve on the parties by regular mail an administrative order including its findings of fact, conclusions of law, and order, in response to the petition for reconsideration. The organization may serve an administrative order on any decision made by informal internal review without first issuing a notice of decision and receiving a request for reconsideration. If the organization does not issue an order within sixty days of receiving a request for reconsideration, a party may request, and the organization shall promptly issue, an appealable determination.
  4. A party has forty-five days from the date of service of an administrative order to file a written request for rehearing. The request must state specifically each alleged error of fact and law to be reheard and the relief sought. Absent a timely and sufficient request for rehearing, the administrative order is final and may not be reheard or appealed.
  5. Rehearings must be conducted as hearings under chapter 28-32 to the extent that chapter does not conflict with this section.
  6. An employer may appeal a posthearing administrative order to district court in accordance with chapter 65-10. Chapter 65-10 does not preclude the organization from appealing to district court a final order issued by a hearing officer under this title.

Source:

S.L. 2001, ch. 578, § 10; 2003, ch. 561, § 3; 2003, ch. 564, § 6; 2009, ch. 611, § 10; 2011, ch. 507, § 3; 2011, ch. 512, § 2; 2017, ch. 437, § 4, eff August 1, 2017; 2019, ch. 524, § 11, eff August 1, 2019; 2021, ch. 502, § 2, eff August 1, 2021.

Note.

Section 13 of chapter 502, S.L. 2021 provides, “ APPLICATION. This Act applies to all claims, regardless of date of injury, which have a notice of decision issued after July 31, 2021.

Cross-References.

Administrative rehearing, see N.D.C.C. § 28-32-40.

Notes to Decisions

Service of process.

Order of the Department of Workforce Safety and Insurance finding an employer personally liable for unpaid premiums, penalties, interest, and costs was reversed because an administrative law judge, in addressing the employer’s argument that the employer was not properly served with a notice of decision by regular mail sent to the employer’s attorney, did not address the factual issue of whether the attorney represented the employer at the time the order was issued or was authorized to accept service on the employer’s behalf. Robinson v. N.D. Workforce Safety & Ins., 2019 ND 201, 931 N.W.2d 692, 2019 N.D. LEXIS 209 (N.D. 2019).

65-04-33. Intentional acts — Failure to secure coverage — Uninsured — Noncompliance — Failure to submit necessary reports — Penalty.

  1. An employer may not employ any person, or receive the fruits of the labor of any person, in a hazardous employment as defined in this title, without first applying for workforce safety and insurance coverage for the protection of employees by notifying the organization of the intended employment, the nature of the intended employment, and the estimated payroll expenditure for the coming twelve-month period.
    1. An employer that willfully misrepresents to the organization or its representative, by statement or omission, the amount of payroll upon which a premium under this title is based, or that willfully fails to secure coverage for employees, is liable to the state in the amount of five thousand dollars plus three times the difference between the premium paid and the amount of premium the employer should have paid.
    2. The organization shall collect a penalty imposed under this subsection in a civil action in the name of the state, and the organization shall deposit a penalty collected under this subsection to the credit of the workforce safety and insurance fund.
    3. An employer that willfully misrepresents to the organization or its representative, by statement or omission, the amount of payroll upon which a premium under this title is based, or that willfully fails to secure coverage for employees, is guilty of a class A misdemeanor. If the premium due exceeds one thousand dollars, the penalty for willful failure to secure coverage or willful misrepresentation to the organization or its representative is a class C felony. If the employer is a corporation or a limited liability company, the president, secretary, treasurer, or person with primary responsibility is liable for the failure to secure workforce safety and insurance coverage under this subsection.
    4. In addition to the penalties prescribed by this subsection, the organization may initiate injunction proceedings as provided for in this title to enjoin an employer from unlawfully employing uninsured workers.
    5. The cost of an investigation under this subsection which results in a criminal conviction may be charged to the employer’s account and collected by civil action.
  2. An employer that willfully makes a false statement or fails to make a statement in an attempt to preclude an injured worker from securing benefits or payment for services, or that willfully discharges or threatens to discharge an employee for seeking or making known the intention to seek workforce safety and insurance benefits is liable to the state in the amount of five thousand dollars. The organization shall collect a civil penalty imposed under this section in a civil action in the name of the state, and the organization shall deposit a penalty collected under this section to the credit of the workforce safety and insurance fund. A willful violation of this section is a class A misdemeanor. The cost of an investigation under this subsection which results in a criminal conviction may be charged to the employer’s account and collected by civil action.
    1. An employer that is uninsured for failure to secure coverage is liable for any premiums, assessments plus penalties and interest due on those premiums, plus a penalty of twenty-five percent of all premiums due during the most recent year of failure to secure coverage.
    2. An additional five percent penalty is due for each year of failure to secure coverage before the most recent year beginning on the date the organization became aware of the employer’s failure to secure coverage, resulting in the penalty for the second most recent year being thirty percent, for the third most recent year being thirty-five percent, for the fourth most recent year being forty percent, for the fifth most recent year being forty-five percent, and for the sixth most recent year being fifty percent.
    3. In addition, the organization may assess a penalty of up to five thousand dollars for each premium period the employer failed to secure coverage. The organization may not assess a penalty for more than six years of failure to secure coverage.
    4. The organization may assess an employer the actual cost and reserves of any claim attributable to the employer during the time the employer failed to secure coverage.
    5. The penalties for employers are in addition to any other penalties by law. The organization may reduce the penalties provided for under this section. An employer may not appeal an organization decision not to reduce a penalty under this subsection.
    1. An employer in noncompliance is subject to a penalty of up to five thousand dollars for each premium period the employer was in noncompliance.
    2. The organization may not assess a penalty for more than six years of past noncompliance.
    3. The organization may reduce the penalties provided for under this section. An employer may not appeal an organization decision not to reduce a penalty under this subsection.
    1. An employer that fails or refuses to furnish to the organization the payroll report or estimate, or that fails or refuses to furnish other information required by the organization under this chapter is subject to a penalty established by the organization of up to five thousand dollars.
    2. Upon the request of the organization, the employer shall furnish the organization any of that employer’s payroll records, payroll reports, and other information required by the organization under this chapter and an estimate of payroll for the advance premium year.
    3. If the employer fails or refuses to provide the records within thirty days of a written request from the organization, the employer is subject to a penalty of five thousand dollars and a penalty not to exceed one hundred dollars for each day until the organization receives the records.
    4. The organization may not assess a penalty that exceeds one hundred fifty dollars under this subsection against an organized township.
    5. The organization may reduce penalties for employers under this subsection. However, an employer may not appeal an organization decision not to reduce a penalty.

Source:

S.L. 2001, ch. 578, § 12; 2003, ch. 508, § 3; 2003, ch. 561, § 3; 2003, ch. 564, § 7; 2003, ch. 566, § 1; 2005, ch. 606, § 2; 2005, ch. 607, § 3; 2013, ch. 502, § 3; 2015, ch. 484, § 2, eff August 1, 2015; 2017, ch. 437, § 5, eff August 1, 2017; 2019, ch. 524, § 12, eff August 1, 2019; 2021, ch. 500, § 4, eff August 1, 2021.

Note.

Section 13 of chapter 500, S.L. 2021 provides, “ APPLICATION. Sections 1, 2, 5, 6, 7, 8, 9, 10, 11, and 12 of this Act apply to all claims regardless of date of injury. Section 4 of this Act applies to all payroll periods of employer accounts regardless of the date of the statement or omission and applies to all claims regardless of the date of injury.”

Cross-References.

Absolute exemptions, see N.D.C.C. § 28-22-02.

Notes to Decisions

Civil Action Against Employer.

Where employee is injured in the course of his employment and at the time of the injury the employer is uninsured for workers’ compensation coverage, and where the injured employee has not been awarded workers’ compensation benefits under former N.D.C.C. § 65-09-03, such employee’s option under N.D.C.C. § 65-09-02 to pursue a civil action against the employer is not negated by fact that employer, subsequent to the injury, has paid the premiums, penalties and interest required by this section. Shaughnessy v. Bohnet, 303 N.W.2d 337, 1981 N.D. LEXIS 244 (N.D. 1981).

Injured employee had a right to bring a tort action against an employer for personal injuries which the employee suffered while working for the employer, which incorrectly classified the employee as an independent contractor, because the exclusive remedy provisions of the North Dakota workers' compensation laws did not preclude the action under provisions authorizing the action for the employer willfully misrepresenting to an insurer the amount of payroll upon which a premium was based, or for willfully failing to secure coverage for employees. Vail v. S/L Servs., 2017 ND 202, 900 N.W.2d 271, 2017 N.D. LEXIS 204 (N.D. 2017).

Compensation Not Insurance.

The statutory references to insurance in the workers’ compensation laws do not make the protections provided by a workers’ compensation board into insurance as contemplated in N.D.C.C. ch. 26.1-42, governing the guaranty association. The funds provided by the workers’ compensation board are not insurance; they are workers’ compensation, and are derived from a statutorily created scheme designed to protect workers injured in the course of their employment. Beyer's Cement v. North Dakota Ins. Guar. Ass'n, 417 N.W.2d 370, 1987 N.D. LEXIS 454 (N.D. 1987).

Failure to Notify.

Failure to notify the workers compensation bureau of intention to hire employees, as required by this section, did not constitute a failure of the employer to be insured as provided by former N.D.C.C. § 65-04-12, and create a civil remedy under N.D.C.C. § 65-09-01 for injured employees, where the employer had paid his premium. Courchene v. Delaney Distribs., 421 N.W.2d 811, 1988 N.D. LEXIS 80 (N.D. 1988).

N.D.C.C. § 65-04-33(1) does not impose an ongoing obligation on employers to report every day-to-day fluctuation in their number of employees during a premium period, because premium adjustments are made on an annual basis. Carlson v. GMR Transp., Inc., 2015 ND 121, 863 N.W.2d 514, 2015 N.D. LEXIS 126 (N.D. 2015).

Employer was entitled to supervisory writs directing a district court to grant the employer summary judgment barring civil liability for deceased and injured workers’ injuries because no fact question existed as to whether an exception to the employer’s immunity due to the employer reporting an inaccurate payroll to Workforce Safety and Insurance (WSI) applied, as WSI (1) found no such violation, (2) did not try to collect additional premiums, and (3) gave no notice that WSI processed the workers’ claims under N.D.C.C. ch. 65-09. Plains Trucking, LLC v. Hagar, 2019 ND 226, 932 N.W.2d 541, 2019 N.D. LEXIS 227 (N.D. 2019).

Failure to Notify of Hiring Employees.

Failure to notify the workers compensation bureau of intention to hire employees, as required by former N.D.C.C. § 65-01-05 (now this section), did not constitute a failure of the employer to be insured as provided by this section and create a civil remedy under N.D.C.C. § 65-09-01 for injured employees, where the employer had paid his premium. Courchene v. Delaney Distribs., 421 N.W.2d 811, 1988 N.D. LEXIS 80 (N.D. 1988).

Willfulness.

In a case in which an individual appealed a district court’s affirmation of an administrative law judge’s (ALJ) finding, the ALJ correctly determined that the individual was an employer under N.D.C.C. § 65-01-02(17) and that the individual was aware workers’ compensation coverage was required for all employees and that he intentionally tried to avoid the responsibility to provide coverage. The Individual was personally liable for past premiums and penalties owed to Workforce Safety and Insurance. Muldoon v. N.D. Workforce Safety & Ins. Fund, 2012 ND 244, 823 N.W.2d 761, 2012 N.D. LEXIS 251 (N.D. 2012).

District court did not err in holding that the company had not lost its employer immunity under the workers' compensation laws where the ultimate determination that the driver was an independent contractor had not been overruled in subsequent decisions, and reasonable persons could have only concluded that the company had not willfully misrepresented the amount of its payroll for purposes of N.D.C.C. § 65-04-33(2). Carlson v. GMR Transp., Inc., 2015 ND 121, 863 N.W.2d 514, 2015 N.D. LEXIS 126 (N.D. 2015).

Law Reviews.

Constitutional Law — Workers Compensation: Equal Protection Challenge to the Agriculture Exemption and Use of Rational Basis Scrutiny in Haney v. North Dakota Workers Compensation Bureau, 518 N.W.2d 195 (N.D. 1994), 71 N.D. L. Rev. 781 (1995).

CHAPTER 65-05 Claims and Compensation

65-05-01. Claims for benefits — When and where filed.

All original claims for benefits must be filed by the injured employee, or someone on the injured employee’s behalf, within one year after the injury or within two years after the death. The date of injury for purposes of this section is the first date that a reasonable person knew or should have known that the employee suffered a work-related injury and has either lost wages because of a resulting disability or received medical treatment. Notwithstanding a statute of limitations assertion, the claimant bears the burden of proving any entitlement to benefits. If the organization is estopped from applying the statute of limitations in this section because an employer’s willful conduct prevented an injured employee from filing a claim in a timely manner, that employer shall reimburse the organization for the full amount of all benefits paid during the first five years of that claim. Benefits may not be allowed under this title to any person, except as provided in section 65-05-04, unless that person, or someone on that person’s behalf, files a written claim for benefits within the time specified in this section. A claim must be filed by:

  1. Delivering it at the office of the organization or to any person the organization designates by rule; or
  2. Depositing it in the mail properly stamped and addressed to the organization or to any person the organization designates by rule.

Source:

S.L. 1919, ch. 162, § 15; 1925 Supp., § 396a15; S.L. 1941, ch. 305, § 4; R.C. 1943, § 65-0501; S.L. 1967, ch. 484, § 1; 1977, ch. 579, § 8; 1979, ch. 652, § 1; 1989, ch. 766, § 2; 1993, ch. 620, § 3; 1997, ch. 539, § 1; 2003, ch. 561, § 3.

Notes to Decisions

Applicability of Amendments.

Where the legislature did not direct retroactive application of 1993 amendments to N.D.C.C. § 65-05-01, and the workers compensation bureau’s findings were based on pre-1993 evidence and it contended claimant’s claim arose before the 1993 amendment, the 1993 amendment was inapplicable. Anderson v. North Dakota Workers Compensation Bureau, 553 N.W.2d 496, 1996 N.D. LEXIS 210 (N.D. 1996).

Burden of Proof.

A defense based on the statute of limitations in a civil proceeding is an affirmative defense, and the workers compensation bureau has the burden of proving the statute of limitations has run when relying on this section to deny a claim. Anderson v. North Dakota Workers Compensation Bureau, 553 N.W.2d 496, 1996 N.D. LEXIS 210 (N.D. 1996).

Commencement of Time to File.

Workers’ compensation claimant’s time to file began when he was first informed that he had a herniated disc which was linked to a fall suffered at work, rather than from the date he actually fell, where the claimant was initially informed by a physician that his back pain was the result of arthritis. White v. North Dakota Workers Compensation Bureau, 441 N.W.2d 908, 1989 N.D. LEXIS 103 (N.D. 1989).

Where defendant had received medical treatment for his lung condition, had missed numerous work days because of that condition, and had been informed by his doctor that the condition was work-related, he reasonably knew that he had a compensable injury which began the period for filing a claim. Grotte v. North Dakota Workers' Compensation Bureau, 489 N.W.2d 875, 1992 N.D. LEXIS 178 (N.D. 1992).

Construction of Claims.

Rules of construction applicable to insurance contracts apply to claims against workers’ compensation fund. Bordson v. North Dakota Workmen's Compensation Bureau, 49 N.D. 534, 191 N.W. 839, 1922 N.D. LEXIS 84 (N.D. 1922).

Employer Misrepresentation.
—Access to Claim Forms.

Evidence of free employee access to insurance forms, but limited access to injury report forms necessary for filing workers’ compensation claims, was indicative of employer discouragement of workers’ compensation claims and of the employer’s contribution to a general pattern of employee confusion about when to file workers’ compensation claims and when to file insurance claims. Linnertz v. North Dakota Workers' Compensation Bureau, 502 N.W.2d 528, 1993 N.D. LEXIS 134 (N.D. 1993).

—Statute Tolled.

An employer’s provision of private insurance payments covering eighty percent of its injured employee’s chiropractic expenses, coupled with evidence of employer misrepresentation and a general pattern of employee confusion facilitated by the employer, warranted tolling the statute of limitations until the last insurance payment. Linnertz v. North Dakota Workers' Compensation Bureau, 502 N.W.2d 528, 1993 N.D. LEXIS 134 (N.D. 1993).

Where an employer was alleged to have facilitated a general pattern of employee confusion about when to file a workers’ compensation claim and when to file an insurance claim, the employer had the burden of showing that it made reasonable efforts to inform employees about when an insurance claim was appropriate, when a workers’ compensation claim was appropriate, and of the necessity of timely filing of workers’ compensation claims. Where the employer failed to meet that burden, the one-year period within which to file a workers’ compensation claim under this section is equitably tolled until the injured worker receives the last private insurance carrier payment. Linnertz v. North Dakota Workers' Compensation Bureau, 502 N.W.2d 528, 1993 N.D. LEXIS 134 (N.D. 1993).

Workers’ compensation benefits for allege workplace injuries in 1999 or 2000 were properly denied as time-barred, notwithstanding that the employer had allegedly misled the worker to believe that the injuries were not covered, because the worker did not file a timely claim after discovering in 2002 that the claims were covered, at which time the tolling of the statute of limitations for those claims ended. Nagel v. Workforce Safety & Ins., 2007 ND 202, 743 N.W.2d 112, 2007 N.D. LEXIS 205 (N.D. 2007).

Equitable Estoppel.

Equitable estoppel may be applied to bar an assertion that a claim was untimely under this section. Linnertz v. North Dakota Workers' Compensation Bureau, 502 N.W.2d 528, 1993 N.D. LEXIS 134 (N.D. 1993).

There is no good reason to refuse to apply the doctrine of estoppel against the workers’ compensation fund created by the payment of premiums by employers, which payments earn the employers immunity from claims for relief by injured employees. Linnertz v. North Dakota Workers' Compensation Bureau, 502 N.W.2d 528, 1993 N.D. LEXIS 134 (N.D. 1993).

Failure to Seek Immediate Medical Attention.

Failure to seek immediate medical attention after an alleged injury does not automatically preclude an award of compensation benefits. Robert v. North Dakota Workmen's Compensation Bureau, 321 N.W.2d 501, 1982 N.D. LEXIS 290 (N.D. 1982).

Knowledge of Compensable Injury.

A reasoning mind could conclude that petitioner had knowledge of a compensable injury once he knew that his emphysema was a result of his employment and was informed that he should quit working. Rogers v. North Dakota Workers Compensation Bureau, 482 N.W.2d 607, 1992 N.D. LEXIS 58 (N.D. 1992).

Without loss of work time, significant medical expense, or specific medical advice, a reasonable person would not reasonably know of a compensable work injury. Anderson v. North Dakota Workers Compensation Bureau, 553 N.W.2d 496, 1996 N.D. LEXIS 210 (N.D. 1996).

Late Filing of Claim.

Where claim was filed with bureau more than sixty days after injury and death of employee, but within one year after his death and denied as not being incurred within course of employment, objections as to prompt filing of claim within statutory period were not material. Gotchy v. North Dakota Workmen's Compensation Bureau, 49 N.D. 915, 194 N.W. 663, 1923 N.D. LEXIS 42 (N.D. 1923).

Where the claimant testified that he was aware of the connection between stress on the job and his headaches in August and September of 1984, the claimant’s claim was filed more than one year after the date of injury and/or the date that he knew or should have known that the condition was related to his employment, and was properly dismissed, as untimely. Evjen v. North Dakota Workers Compensation Bureau, 429 N.W.2d 418, 1988 N.D. LEXIS 251 (N.D. 1988).

Workplace Safety and Insurance Fund’s finding that a claimant failed to file a timely claim for workers compensation benefits within one year of his work injury, as required by N.D.C.C. § 65-05-01, was supported by a preponderance of the evidence; although the claimant knew or should have known that he had suffered a work-related injury, he did not file a claim for benefits until some three years later. Ringsaker v. Workforce Safety & Ins. Fund, 2005 ND 44, 693 N.W.2d 14, 2005 N.D. LEXIS 47 (N.D. 2005).

Claimant failed to timely file a claim for workers’ compensation benefits because the claimant had at all times indicated that his psychological problems began when he was trapped at work on December 5, 2013; he sought medical treatment shortly after the incident and he was encouraged to apply for worker’s compensation benefits by a medical professional; and, if he received a physical injury from repeatedly hitting his head against the wall during the work incident, the evidence supported a finding that a reasonable lay person, not learned in medicine, knew or should have known that he suffered a compensable work-related injury on December 5, 2013; however, the claimant did not file a claim for workers’ compensation benefits until May 2016. Lechner v. N.D. Workforce Safety & Ins., 2018 ND 270, 920 N.W.2d 288, 2018 N.D. LEXIS 270 (N.D. 2018).

Liberal Construction.

The purpose of the Workers’ Compensation Act is remedial and should be construed liberally in favor of the injured worker. Liberal construction resolves reasonable doubt in favor of the injured worker because it was for the workers’ benefit that the Act was passed. Kallhoff v. North Dakota Workers' Compensation Bureau, 484 N.W.2d 510, 1992 N.D. LEXIS 97 (N.D. 1992).

“Reasonable Person”.

As used in this section, the term “reasonable person” refers to a wage worker, an ordinary reasonable lay person, and not a person learned in medicine; the term “reasonable” varies and takes on full meaning from the setting of the employment and the degree of skill or type of skill and knowledge needed to satisfactorily perform the job. Teegarden v. North Dakota Workmen's Compensation Bureau, 313 N.W.2d 716, 1981 N.D. LEXIS 369 (N.D. 1981).

Reasonable Person Standard.

The legislature intended that any doubt about whether a claimant can determine the actual date of a compensable injury with certainty must be resolved by testing the claimant’s knowledge under the reasonable person standard. White v. North Dakota Workers Compensation Bureau, 441 N.W.2d 908, 1989 N.D. LEXIS 103 (N.D. 1989).

Any doubt about whether or not a claimant can determine the actual date of a compensable injury, should “be resolved by testing the claimant’s knowledge under the reasonable person standard.” Rogers v. North Dakota Workers Compensation Bureau, 482 N.W.2d 607, 1992 N.D. LEXIS 58 (N.D. 1992).

Scope of Statute.

Period of limitation contained in this statute is applicable only to claims for compensation out of workers’ compensation fund and does not apply to claims presented for an award against an employer who has failed to comply with act. Nyland v. Northern Packing Co., 56 N.D. 624, 218 N.W. 869, 1928 N.D. LEXIS 180 (N.D. 1928); State ex rel. Woods v. Hughes Oil Co., 58 N.D. 581, 226 N.W. 586, 1929 N.D. LEXIS 252 (N.D. 1929).

DECISIONS UNDER PRIOR LAW

Late Filing of Claim.

Where claimant froze his toe, and it appeared that no serious consequence resulted until approximately ten months thereafter, claim which was filed more than year after original freezing was barred by time limitation provided in this statute. Bjorseth v. North Dakota Workmen’s Comp. Bureau, 62 N.D. 623, 244 N.W. 515 (1932), decided prior to the amendment to this section by Session Laws 1941, ch. 35; Session Laws 1967, ch. 484; Session Laws 1977, ch. 579; and Session Laws 1979, ch. 652.

Failure to file compensation claim within sixty days does not of itself destroy right to compensation under compensation act, but places on claimant burden of showing to bureau reasonable grounds for waiver. Pearce v. North Dakota Workmen's Compensation Bureau, 67 N.D. 512, 274 N.W. 587, 1937 N.D. LEXIS 107 (N.D. 1937).

Where claim is not filed until after expiration of sixty days, but within one year thereof, claimant must show to bureau reasonable grounds for permitting him to file his claim, and exercise of such discretion by bureau may be reviewed on appeal. Pearce v. North Dakota Workmen's Compensation Bureau, 67 N.D. 512, 274 N.W. 587, 1937 N.D. LEXIS 107 (N.D. 1937).

Workmen’s compensation bureau has no jurisdiction to pass on an original application for compensation made more than two years after an accident. Schmidt v. North Dakota Workmen’s Comp. Bureau, 73 N.D. 245, 13 N.W.2d 610 (1943), decided prior to the enactment of N.D.C.C. § 65-05-03.

Power of Bureau Limited.

This statute acts as a limitation upon power of bureau to allow claims for disability payable out of fund. Bjorseth v. North Dakota Workmen’s Comp. Bureau, 62 N.D. 623, 244 N.W. 515 (1932); Schmidt v. North Dakota Workmen’s Comp. Bureau, 73 N.D. 245, 13 N.W.2d 610 (1943), decided prior to the enactment of N.D.C.C. § 65-05-03.

Silicosis.

Silicosis did not become an injury for the purposes of the act until it became disabling, and a claim filed within sixty days of that time was filed within the required time even though almost three years after termination of the exposure that caused the disease. Beauchamp v. North Dakota Workmen’s Comp. Bureau, 126 N.W.2d 417 (N.D. 1964), decided prior to the amendment of N.D.C.C. § 65-05-01.

Collateral References.

When limitation period begins to run against cause of action or claim for contracting of disease, 11 A.L.R.2d 277.

Statute permitting new action after failure of original action commenced within period of limitations, as applicable in cases where original action failed for lack of jurisdiction, 6 A.L.R.3d 1043.

Effect of injured employee’s proceeding for workmen’s compensation benefits on running of statute of limitations governing action for personal injury arising from same incident, 71 A.L.R.3d 849.

Workers’ compensation: vocational rehabilitation statutes, 67 A.L.R.4th 612.

Workers’ compensation: recovery for home service provided by spouse, 67 A.L.R.4th 765.

Prejudicial effect of bringing to jury’s attention fact that plaintiff in personal injury or death action is entitled to workers’ compensation benefits, 69 A.L.R.4th 131.

When limitations period begins to run as to claim for disability benefits for contracting of disease under Workers’ Compensation or Occupational Diseases Act, 86 A.L.R.5th 295.

When time period commences as to claim under workers’ compensation or occupational diseases act for death of worker due to contraction of disease, 100 A.L.R.5th 567.

Right to Workers’ Compensation for Injury Suffered by Employee While Driving Employer’s Vehicle, 28 A.L.R.6th 1.

65-05-01.1. Pneumoconiosis claims — Rules — Agreements.

The organization shall provide such additional coverage, allow such additional time for claims to be filed, and pay such additional compensation and other benefits in excess of the coverage, filing time, and benefits otherwise provided in this title, as may be required by the Federal Coal Mine Health and Safety Act of 1969 and amendments thereto, for any coal miner, coal miner’s surviving spouse, or dependents who, due to the disability or death of such coal miner as the result of pneumoconiosis, would be entitled to claim benefits under such federal Act; provided, however, that such claim is first filed with the federal agency designated in the federal Act and adjudicated and found compensable by them; and provided that such pneumoconiosis was contracted or aggravated as the result of employment as a coal miner in the state of North Dakota. The organization shall adopt such reasonable rules and enter into such agreements necessary to comply with section 421 of said federal Act.

Source:

S.L. 1983, ch. 699, § 1; 2003, ch. 561, § 3.

65-05-01.2. Notice to employer.

When an employee is involved in an accident while on the job, the employee shall take steps immediately to notify the employer that the accident occurred and what is the general nature of the injury to the employee, if apparent. Notice may be either oral or written. The notice must be given to the employee’s immediate supervisor or another supervisor authorized to receive notice. Absent good cause, notice may not be given later than seven days after the accident occurred or the general nature of the employee’s injury became apparent.

Source:

S.L. 1995, ch. 622, § 1.

Notes to Decisions

Construction.

Obvious purpose of N.D.C.C. §§ 65-05-01.2 and 65-05-01.3 is to provide notice to an employer to allow the employer to alleviate dangerous conditions to prevent injuries. The plain language of those statutes allows the Workforce Safety and Insurance to “consider” a claimant’s failure to notify an employer of an accident and the nature of the employee’s injuries. Mickelson v. N.D. Workforce Safety & Ins., 2012 ND 164, 820 N.W.2d 333, 2012 N.D. LEXIS 172 (N.D. 2012).

Collateral References.

When limitations period begins to run as to claim for disability benefits for contracting of disease under Workers’ Compensation or Occupational Diseases Act, 86 A.L.R.5th 295.

Law Reviews.

Are Employees Obtaining “Sure and Certain Relief” Under the 1995 Legislative Enactments of the North Dakota Workers’ Compensation Act?, 72 N.D. L. Rev. 349 (1996).

65-05-01.3. Failure to comply with notice and filing provisions.

If an employee fails to notify the employer of an accident and the general nature of the employee’s injury, the organization may consider that failure to notify in determining whether the employee’s injury is compensable.

Source:

S.L. 1995, ch. 622, § 2; 2003, ch. 561, § 3.

Notes to Decisions

Construction.

Obvious purpose of N.D.C.C. §§ 65-05-01.2 and 65-05-01.3 is to provide notice to an employer to allow the employer to alleviate dangerous conditions to prevent injuries. The plain language of those statutes allows the Workforce Safety and Insurance to “consider” a claimant’s failure to notify an employer of an accident and the nature of the employee’s injuries. Mickelson v. N.D. Workforce Safety & Ins., 2012 ND 164, 820 N.W.2d 333, 2012 N.D. LEXIS 172 (N.D. 2012).

65-05-01.4. Employer to file first report of notice of injury.

The employer shall file a first report of notice of injury with the organization within seven days from the date the employer receives the notice of injury from the employee. Failure of the employer to file a first report of notice of injury is an admission by the employer that the alleged injury may be compensable. The organization may make or reopen a determination made without an employer’s first report of notice of injury on its own motion pursuant to section 65-05-04 on the grounds determined by the organization to be sufficient.

Source:

S.L. 1995, ch. 622, § 3; 2003, ch. 561, § 3.

Notes to Decisions

Exclusivity of Remedy.

Because the employer’s failure to file a first report of notice of injury does not result in a loss of that employer’s right to assert the exclusive remedy of worker’s compensation, the claimant’s former employer was not responsible for his damages for failing to file a first report under this statute. Frith v. N.D. Workforce Safety & Ins., 2014 ND 93, 845 N.W.2d 892, 2014 N.D. LEXIS 95 (N.D.), cert. denied, 574 U.S. 1027, 135 S. Ct. 719, 190 L. Ed. 2d 442, 2014 U.S. LEXIS 7974 (U.S. 2014).

65-05-01.5. Organization to notify employee of receipt of employer’s first report of notice of injury.

If a claim for compensation has not been received by the organization but the organization has received an employer’s first report of notice of injury, the organization shall notify the employee that the employer’s first report has been received and shall advise the employee of the claim filing requirements of section 65-05-01.

Source:

S.L. 1995, ch. 622, § 4; 2003, ch. 561, § 3.

65-05-02. Form in which claim must be filed.

Every claim must be made on forms to be furnished by the organization and must contain all the information required by it. Each claim must be signed by the person entitled to compensation or by the person acting on that person’s behalf and, except in case of death, must be accompanied by a certificate of the employee’s doctor stating that the employee was physically examined, stating the nature of the injury and the nature and probable extent of the disability. For any reasonable cause shown, the organization may waive the provisions of this section.

Source:

S.L. 1919, ch. 162, § 15; 1925 Supp., § 396a15; S.L. 1941, ch. 305, § 4; R.C. 1943, § 65-0502; S.L. 1947, ch. 375, § 4; 1957 Supp., § 65-0502; S.L. 1977, ch. 579, § 9; 1989, ch. 765, § 2; 1989, ch. 766, § 3; 2003, ch. 561, § 3.

65-05-03. Jurisdiction of organization to hear questions within its jurisdiction — Finality of determination.

The organization shall have full power and authority to hear and determine all questions within its jurisdiction, and its decisions, except as provided in chapter 65-10, are final and are entitled to the same faith and credit as a judgment of a court of record.

Source:

S.L. 1919, ch. 162, § 17; 1925 Supp., § 396a17; S.L. 1935, ch. 286, § 6; R.C. 1943, § 65-0503; S.L. 1947, ch. 377, § 1; 1949, ch. 354, § 5; 1951, ch. 342, § 2; 1957 Supp., § 65-0503; S.L. 1981, ch. 643, § 2; 1989, ch. 765, § 3; 2003, ch. 561, § 3.

Notes to Decisions

In General.

Bureau has full power and authority to hear and determine all questions within its jurisdiction, and its decision is final. Gotchy v. North Dakota Workmen's Compensation Bureau, 49 N.D. 915, 194 N.W. 663, 1923 N.D. LEXIS 42 (N.D. 1923).

Workers’ compensation bureau is charged with duty and vested with authority to hear and determine all claims by an injured employee for compensation from fund, and in exercise of such power it has full authority to hear and determine all questions within its jurisdiction. State ex rel. North Dakota Workmen's Compensation Bureau v. Broadway Inv. Co., 85 N.W.2d 251, 1957 N.D. LEXIS 148 (N.D. 1957).

Employees of Another State.

Courts of North Dakota will, on principles of comity, decline jurisdiction to hear suit for injuries suffered by an employee of coal mine operated within this state by state of South Dakota, such employee also being resident of North Dakota. Paulus v. State, 52 N.D. 84, 201 N.W. 867, 1924 N.D. LEXIS 113 (N.D. 1924).

Evidentiary Hearing.

A claimant’s right to an evidentiary hearing by the workers’ compensation bureau is not limited to only those instances where the claimant can make a further showing in addition to his original claim. A claimant is entitled to an evidentiary hearing whenever a dispute of material fact exists, including instances where the factual dispute arises from the original claim. Weber v. North Dakota Workmen's Compensation Bureau, 377 N.W.2d 571, 1985 N.D. LEXIS 436 (N.D. 1985).

Final Action.

Action of compensation bureau declining to reopen claim constitutes “final action”, and is appealable where determination evidences final decision refusing compensation. Hanson v. North Dakota Workmen's Compensation Bureau, 60 N.D. 220, 233 N.W. 900, 1930 N.D. LEXIS 223 (N.D. 1930).

Decision of workers’ compensation bureau on matters of fact is final, except on ground going to basis of claimant’s right, but bureau may not take arbitrary action. Wallace v. North Dakota Workmen's Compensation Bureau, 69 N.D. 165, 284 N.W. 420, 1939 N.D. LEXIS 138 (N.D. 1939).

When workers’ compensation bureau determined an applicant was entitled to share in compensation fund, any decision which it made as to amount of compensation, if any, to be allowed for any of different factors in injury, was declared to be final. Schmidt v. North Dakota Workmen’s Comp. Bureau, 74 N.D. 520, 23 N.W.2d 26 (1946), decided prior to the amendment to N.D.C.C. § 65-05-04.

The decision of the bureau is final and entitled to the same faith and credit as a judgment of the court of record, except that a claimant may appeal therefrom to the district court. Knutson v. North Dakota Workmen's Compensation Bureau, 120 N.W.2d 880, 1963 N.D. LEXIS 79 (N.D. 1963).

Question of whether an injury occurred “in course of employment” is within jurisdiction of workers’ compensation bureau, and its decision is res judicata unless timely appealed from, or unless it is shown in a subsequent proceeding that extenuating circumstances deprived claimant of opportunity to make an informed decision whether to file for benefits. Stine v. Weiner, 238 N.W.2d 918, 1976 N.D. LEXIS 194 (N.D. 1976).

Trial court did not err by granting summary judgment to Workforce Safety and Insurance (WSI) in its collection action against the claimant because he did not administratively challenge the WSI notice of decision denying liability for his and requiring reimbursement for overpayment rendering it final. State v. Oden, 2020 ND 243, 951 N.W.2d 187, 2020 N.D. LEXIS 242 (N.D. 2020).

Full Faith and Credit.

This section means only that when decisions of the bureau are final, and not merely interlocutory, they are entitled to full faith and credit. The statute does not render unappealable a final, noninterlocutory bureau decision. It does not speak to appealability; it addresses only the effect of finality, which is full faith and credit. Thus, an unappealed workers’ compensation decision is a final decision entitled to full faith and credit. Westman v. North Dakota Workers Compensation Bureau, 459 N.W.2d 540, 1990 N.D. LEXIS 167 (N.D. 1990).

Historical Review.

For a case discussing history of statutes concerning appealability and review of decisions of the workers compensation bureau, see Westman v. North Dakota Workers Compensation Bureau, 459 N.W.2d 540, 1990 N.D. LEXIS 167 (N.D. 1990).

Injury Outside State.

Employee of North Dakota firm who was injured in the course of his employment in Montana should have been given a choice of seeking workers’ compensation benefits in North Dakota or in Montana. Bekkedahl v. North Dakota Workmen's Compensation Bureau, 222 N.W.2d 841, 1974 N.D. LEXIS 167 (N.D. 1974), limited, United States Fidelity & Guar. Co. v. North Dakota Workmen's Compensation Bureau, 275 N.W.2d 618, 1979 N.D. LEXIS 216 (N.D. 1979).

Liberal Construction Rule.

Rule that workers’ compensation act should be given liberal construction to accomplish purpose intended applies not only to bureau’s duty to determine whether an injury is compensable, but also to its duty to determine who was employer at time of injury. State ex rel. North Dakota Workmen's Compensation Bureau v. Broadway Inv. Co., 85 N.W.2d 251, 1957 N.D. LEXIS 148 (N.D. 1957).

Position of Bureau to Claimant.

Although the claimant has the burden of establishing his right to receive benefits, the bureau should not place itself in a true or full adversary position to the claimant. Weber v. North Dakota Workmen's Compensation Bureau, 377 N.W.2d 571, 1985 N.D. LEXIS 436 (N.D. 1985).

Remand by District Court.

Where additional evidence has become available after a case has been appealed to the district court, the court should remand to the bureau to take the additional evidence and reconsider its decision since the court has no power to take the evidence itself. Knutson v. North Dakota Workmen's Compensation Bureau, 120 N.W.2d 880, 1963 N.D. LEXIS 79 (N.D. 1963) (decided before 1965 amendment of N.D.C.C. § 65-10-01).

Res Judicata.

An unappealed workers compensation bureau decision is res judicata unless the Bureau reopens a claim. Lass v. North Dakota Workmen's Compensation Bureau, 415 N.W.2d 796, 1987 N.D. LEXIS 426 (N.D. 1987).

The res judicata effect of a workers compensation bureau decision extends only to matters adjudicable at the time of that decision; thus, absent a reopening, an unappealed decision on an employee’s present medical condition is final and res judicata of his medical condition at that time; such a decision, however, is not res judicata of his future medical condition, which was not adjudicable at the time of that decision. Lass v. North Dakota Workmen's Compensation Bureau, 415 N.W.2d 796, 1987 N.D. LEXIS 426 (N.D. 1987).

Claimant could not retry the issue of whether his initial non-work injury was a preexisting condition sufficient to invoke the aggravation statute. Rieniets v. North Dakota Workers' Compensation Bureau, 512 N.W.2d 708, 1994 N.D. LEXIS 56 (N.D. 1994).

In the absence of new evidence or a change in medical condition, the bureau’s order awarding a claimant benefits for her work injury, entered with knowledge of a noncompensable injury and after a formal adjudicative hearing, precludes the bureau from relitigating the effect of the noncompensable injury on her work injury. Cridland v. North Dakota Workers Compensation Bureau, 1997 ND 223, 571 N.W.2d 351, 1997 N.D. LEXIS 281 (N.D. 1997).

In a collection action seeking to recover unpaid worker’s compensation insurance premiums, whether or not a company hired independent contractors was an issue that could not have been raised due to administrative res judicata. It was the precise issue decided in a prior administrative action determining liability. State ex rel. Workforce Safety & Ins. v. JFK Raingutters, LLC, 2007 ND 80, 733 N.W.2d 248, 2007 N.D. LEXIS 83 (N.D. 2007).

Law Reviews.

Administrative Law, Judicial Review of Administrative Decisions in North Dakota, 24 Bar Briefs, State Bar Ass’n of N.D. 211 (1948).

Judicial Review of Decisions of the Workmen’s Compensation Bureau of North Dakota, 3 Dak. L. Rev. 16 (1930).

65-05-04. Organization has continuing jurisdiction over claims properly filed.

If the original claim for compensation has been made within the time specified in section 65-05-01, the organization at any time, on its own motion or on application, may review the award, and in accordance with the facts found on such review, may end, diminish, or increase the compensation previously awarded, or, if compensation has been refused or discontinued, may award compensation. There is no appeal from an organization decision not to reopen a claim after the organization’s order on the claim has become final.

Source:

S.L. 1919, ch. 162, § 18; 1925 Supp., § 396a18; R.C. 1943, § 65-0504; S.L. 1981, ch. 643, § 3; 2003, ch. 561, § 3.

Notes to Decisions

In General.

Workers’ compensation bureau, upon determining that claimant is entitled to participate in compensation fund, has continuing jurisdiction over application and injury stated therein, whether injury is held temporary or permanent. Lillefjeld v. North Dakota Workmen's Compensation Bureau, 62 N.D. 388, 244 N.W. 36, 1932 N.D. LEXIS 192 (N.D. 1932).

Workers’ compensation bureau has continuing jurisdiction and may end, diminish, or increase compensation previously awarded, or may award where it previously has been refused or discontinued. Dahl v. Workmen's Compensation Bureau, 63 N.D. 327, 248 N.W. 273, 1933 N.D. LEXIS 187 (N.D. 1933).

Additional Proof of Claim.

It is duty of bureau to consider and pass upon any additional proof that may be made in support of properly filed claim. Hanson v. North Dakota Workmen's Compensation Bureau, 56 N.D. 525, 218 N.W. 215, 1928 N.D. LEXIS 167 (N.D. 1928).

Appeal.

Absent an appeal from an order denying benefits, a workers compensation bureau decision not to reopen a claim for consideration of new or additional evidence of medical condition at the time of a denial which is sought to be reopened is not appealable, but a bureau decision not to reopen a claim upon a request based upon a change in the claimant’s medical condition since the original decision is appealable. Lass v. North Dakota Workmen's Compensation Bureau, 415 N.W.2d 796, 1987 N.D. LEXIS 426 (N.D. 1987).

Burden of Proof.

If bureau terminates benefits after initially accepting claim and paying benefits, claimant has burden of proving his or her right to continue receiving benefits. Froysland v. North Dakota Workers Compensation Bureau, 432 N.W.2d 883, 1988 N.D. LEXIS 233 (N.D. 1988).

Decision Not to Reopen Claim.

After bureau’s order on claim has become final, bureau’s decision regarding whether or not to reopen original claim is discretionary and claimant has no right to appeal from that decision. Jones v. North Dakota Workmen's Compensation Bureau, 334 N.W.2d 188, 1983 N.D. LEXIS 292 (N.D. 1983).

Claimant had no right to appeal bureau’s decision not to reopen his claim. Manikowske v. North Dakota Workmen's Compensation Bureau, 338 N.W.2d 823, 1983 N.D. LEXIS 354 (N.D. 1983).

Although when a claimant seeks to reopen a claim based upon evidence of a change in medical condition, the bureau must exercise its jurisdiction and consider the request on its merits, and the bureau’s decision thereon is appealable, the bureau’s decision whether to reopen an original claim and relitigate the claimant’s earlier medical condition is discretionary, and the claimant has no right to appeal that decision. Olson v. North Dakota Workers Compensation Bureau, 453 N.W.2d 606, 1990 N.D. LEXIS 78 (N.D. 1990).

Denial of Review, Appeal.

Where compensation claim is allowed and application for review thereafter made, claimant is without right of appeal from action of bureau in denying review. Ethen v. North Dakota Workmen's Compensation Bureau, 62 N.D. 394, 244 N.W. 32, 1932 N.D. LEXIS 193 (N.D. 1932).

Determination As to Injury.

Where an application is made within time required by statute, fact that bureau may have allowed compensation based upon mere partial knowledge of extent of injury does not prevent applicant from having application reopened long after time for filing original claims has passed. Schmidt v. North Dakota Workmen’s Comp. Bureau, 73 N.D. 245, 13 N.W.2d 610 (1943), decided prior to the enactment of N.D.C.C. § 65-05-03.

Workplace Safety and Insurance (WSI) appropriately exercised its continuing jurisdiction on its own motion, under N.D.C.C. § 65-05-04, to assess a claimant’s vocational rehabilitation and that the claimant was properly found in noncompliance with vocational rehabilitation; N.D.C.C. §§ 65-05.1-01(8)(a) also provided that WSI could initiate vocational rehabilitation services on its own motion. Drayton v. Workforce Safety & Ins., 2008 ND 178, 756 N.W.2d 320, 2008 N.D. LEXIS 180 (N.D. 2008).

Discovery Rights.

Where bureau terminates previous award, claimant whose application to combat termination is accepted, has right to examine all of files and records in case upon which bureau based its decision to terminate award. Wallace v. North Dakota Workmen's Compensation Bureau, 69 N.D. 165, 284 N.W. 420, 1939 N.D. LEXIS 138 (N.D. 1939).

Jurisdiction of Board After Judgment.

After judgment on an appeal, bureau may not deny or refuse right of claimant established upon an appeal, but it may increase or decrease award, or may award lump sum comformably to judgment rendered. Gotchy v. North Dakota Workmen's Compensation Bureau, 49 N.D. 915, 194 N.W. 663, 1923 N.D. LEXIS 42 (N.D. 1923).

Judgment awarding compensation to an injured workman when acted upon by bureau becomes award of bureau and subject to its continuing jurisdiction the same as any other award. Dahl v. Workmen's Compensation Bureau, 63 N.D. 327, 248 N.W. 273, 1933 N.D. LEXIS 187 (N.D. 1933).

Continuing jurisdiction is jurisdiction to modify awards with respect to payments falling due in future in accordance with facts later found to exist, and, where an award has been made by court and incorporated in judgment, continuing jurisdiction of bureau must be exercised pursuant to and consistent with judgment rendered. Hanson v. North Dakota Workmen's Compensation Bureau, 63 N.D. 479, 248 N.W. 680, 1933 N.D. LEXIS 201 (N.D. 1933).

The bureau at any time, on its own motion or on application, may review award and in accordance with facts found on such review, may end, diminish, or increase compensation previously awarded, or, if compensation has been refused or discontinued, may award compensation; and this authority to review is not limited to consideration of change in claimant’s condition. Geo. E. Haggart, Inc. v. North Dakota Workmen's Compensation Bureau, 171 N.W.2d 104, 1969 N.D. LEXIS 81 (N.D. 1969).

Workforce Safety and Insurance’s exercise of continuing jurisdiction was beyond the scope of the supreme court’s remand in the first appeal; WSI was bound by the supreme court’s judgment in the first appeal and, under the law of the case doctrine, was precluded from using its continuing jurisdiction to readjudicate whether the worker was the employer’s employee. Carlson v. Workforce Safety & Ins., 2012 ND 203, 821 N.W.2d 760, 2012 N.D. LEXIS 211 (N.D. 2012).

Noninsured Employer.

This section does not apply to claims against noninsured employer. State ex rel. Woods v. Hughes Oil Co., 58 N.D. 581, 226 N.W. 586, 1929 N.D. LEXIS 252 (N.D. 1929).

Reapplication for Benefits.

Workers Compensation Bureau’s notice of its intention to discontinue benefits after discovering worker had previously accepted a lump sum settlement in lieu of future benefits established that Bureau had not accepted the worker’s reapplication for benefits. Kerzman v. North Dakota Workers Compensation Bureau, 1999 ND 44, 590 N.W.2d 888, 1999 N.D. LEXIS 48 (N.D. 1999).

Res Judicata.

An unappealed workers compensation bureau decision is res judicata unless the bureau reopens a claim. Lass v. North Dakota Workmen's Compensation Bureau, 415 N.W.2d 796, 1987 N.D. LEXIS 426 (N.D. 1987).

The res judicata effect of a workers compensation bureau decision extends only to matters adjudicable at the time of that decision; thus, absent a reopening, an unappealed decision on an employee’s present medical condition is final and res judicata of his medical condition at that time; such a decision, however, is not res judicata of his future medical condition, which was not adjudicable at the time of that decision. Lass v. North Dakota Workmen's Compensation Bureau, 415 N.W.2d 796, 1987 N.D. LEXIS 426 (N.D. 1987).

The language of this section which authorizes the Bureau to review an award “at any time” does not preclude application of the doctrine of administrative res judicata to bureau decisions entered after a formal adjudicative hearing. Cridland v. North Dakota Workers Compensation Bureau, 1997 ND 223, 571 N.W.2d 351, 1997 N.D. LEXIS 281 (N.D. 1997).

Appellate court concluded administrative res judicata prevented the Bureau from relying on claimant’s termination from employment to deny wage loss benefits where this issue was not litigated at the hearing. Baier v. North Dakota Workers Compensation Bureau, 2000 ND 78, 609 N.W.2d 722, 2000 N.D. LEXIS 89 (N.D. 2000).

Workers Compensation Bureau correctly interpreted N.D.C.C. § 65-05-08(1) in determining the decedent failed to show an actual wage loss caused by a significant change in his compensable medical condition; when the decedent withdrew his appeal of a Bureau order denying further disability benefits, that order became res judicata of the decedent’s medical condition at that time, subject only to reopening under this section. Bachmeier v. N.D. Workers Comp. Bureau, 2003 ND 63, 660 N.W.2d 217, 2003 N.D. LEXIS 76 (N.D. 2003).

When appellant suffered a workplace injury to his nose, he began having headaches and was treated for a sexual dysfunction. Administrative res judicata under N.D.C.C. § 65-05-04 did not bar the Workforce Safety and Insurance Fund’s denial of benefits for appellant’s headaches and vision problems, because an award of duplicate benefits for Viagra was the dispositive issue before the administrative law judge in the prior case; rather than the compensability of appellant’s headaches and vision problems. Landrum v. Workforce Safety & Ins. Fund, 2011 ND 108, 798 N.W.2d 669, 2011 N.D. LEXIS 114 (N.D. 2011).

Review and Modification.

The authority provided in this section to review and modify awards is not limited to a consideration of a change in the claimant’s condition. Lass v. North Dakota Workmen's Compensation Bureau, 415 N.W.2d 796, 1987 N.D. LEXIS 426 (N.D. 1987).

Termination of Benefits.

In a workers’ compensation case, where the workers compensation bureau decides to terminate benefits after initially granting compensation, the burden is on the claimant to establish that he or she has a continuing right to receive the benefits. Kopp v. North Dakota Workers Compensation Bureau, 462 N.W.2d 132, 1990 N.D. LEXIS 224 (N.D. 1990).

DECISIONS UNDER PRIOR LAW

Appeal.

Former N.D.C.C. § 65-01-14 provided an informal decision of the workers compensation bureau was final, absent a request for reconsideration, subject only to reopening under this section. McArthur v. North Dakota Workers Compensation Bureau, 1997 ND 105, 564 N.W.2d 655, 1997 N.D. LEXIS 104 (N.D. 1997).

65-05-05. Payments made to insured employees injured in course of employment and to their dependents.

  1. The organization shall disburse the fund for the payment of compensation and other benefits as provided in this chapter to employees, or to their dependents in case death has ensued, who:
    1. Are subject to the provisions of this title;
    2. Are employed by employers who are subject to this title; and
    3. Have been injured in the course of their employment.
  2. If an employee, or any person seeking benefits because of the death of an employee, applies for benefits from another state for the same injury, the organization will suspend all future benefits pending resolution of the application. If an employee, or any person seeking benefits because of the death of an employee, is determined to be eligible for benefits through some other state act or enters an agreement to resolve a claim through some other state act, no further compensation may be allowed under this title and the employee, or any person seeking benefits because of the death of an employee, must reimburse the organization for the entire amount of benefits paid.

Source:

S.L. 1919, ch. 162, §§ 3, 10; 1921, ch. 141, § 1; 1923, ch. 350, § 1; 1925, ch. 223, § 1; 1925 Supp., §§ 396a3, 396a10; S.L. 1927, ch. 286, § 1; 1929, ch. 260, § 1; 1931, ch. 313, §§ 1, 2; 1935, ch. 286, § 4; 1941, ch. 303, § 2; R.C. 1943, § 65-0505; S.L. 1955, ch. 354, § 10; 1957 Supp., § 65-0505; S.L. 1973, ch. 504, § 1; 1981, ch. 643, § 4; 1983, ch. 699, § 3; 1993, ch. 626, § 1; 2003, ch. 561, § 3; 2005, ch. 602, § 2; 2013, ch. 499, § 4.

Note.

Section 18 of chapter 499, S.L. 2013 provides: “APPLICATION. Sections 4, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, and 17 apply to all claims regardless of date of injury. Section 6 applies to permanent impairment evaluations performed on or after August 1, 2011.”

Notes to Decisions

Bureau’s Waiver of Issues.

When the workers’ compensation bureau dismissed, its appeal from an award of disability benefits and stipulated that the only remaining issue was whether the court had erred in stopping benefits after a claimant had accepted Montana benefits, the bureau waived all other issues, including the issue of whether the claimant had factually established a right to receive disability benefits. Jones v. North Dakota Workers' Compensation Bureau, 502 N.W.2d 509, 1993 N.D. LEXIS 137 (N.D. 1993).

Claims by Dependents.

Under workers’ compensation act, rights of claimant to participate in compensation fund because of dependency on deceased insured employee are individual rights, and claimants asserting such rights have separate claims. Weisgerber v. Workmen's Compensation Bureau, 70 N.D. 165, 292 N.W. 627, 1940 N.D. LEXIS 157 (N.D. 1940).

Exclusivity.

District court did not err in dismissing an employee’s negligence action because an employee and coworker were immune from suit under the Workforce Safety and Insurance Act’s exclusive remedy provisions; the determinations in California administrative proceedings were irrelevant for deciding statutory immunity because the employer paid Workforce Safety and Insurance premiums to secure coverage on the employee’s behalf, and the employee received benefits throughout the California proceedings. Brock v. Price, 2019 ND 240, 934 N.W.2d 5, 2019 N.D. LEXIS 251 (N.D. 2019).

Filing in Each State.

While an employee may choose to file for benefits in the state which provides the benefits the employee finds most desirable, he may not pick and choose which benefits he will file for in each state. Each state has adopted a compensation plan as a whole. To allow an employee to file for the highest benefits of one type in one state and the highest benefit of another type in another state would allow the employee to receive greater compensation than either state contemplated. Plante v. North Dakota Workers Compensation Bureau, 455 N.W.2d 195, 1990 N.D. LEXIS 100 (N.D. 1990).

As amended, the statute strengthened North Dakota's policy by discouraging claimants from seeking duplicate or supplemental benefits in a second State after obtaining North Dakota benefits; even if that indirect effect conflicted with the policies of other States like Colorado, it was consistent with North Dakota's valid policy and thus survived rational basis review. DeCrow v. N.D. Workforce Safety & Ins. Fund, 864 F.3d 989, 2017 U.S. App. LEXIS 13877 (8th Cir. N.D. 2017).

In Course of Employment.

An injury is received “in the course of employment” under the workers compensation act when it occurs while workman is performing duties of his employment. O'Leary v. North Dakota Workmen's Compensation Bureau, 62 N.D. 457, 243 N.W. 805, 1932 N.D. LEXIS 204 (N.D. 1932).

Protection afforded to an employee by workers’ compensation act covers such duties as an employee would reasonably and ordinarily be called upon to perform in employment listed and returned to compensation bureau by employer in his application for classification. O'Leary v. North Dakota Workmen's Compensation Bureau, 62 N.D. 457, 243 N.W. 805, 1932 N.D. LEXIS 204 (N.D. 1932).

Generally, an injury received by an employee in going to and from work is not an injury received “in the course of his employment” within workers’ compensation act. Fink v. Workmen's Compensation Bureau, 68 N.D. 531, 282 N.W. 505, 1938 N.D. LEXIS 143 (N.D. 1938).

An injury is received “in due course of employment”, within meaning of the workers’ compensation act, when it comes while workman is doing duty which he is employed to perform. Moug v. Workmen's Compensation Bureau, 70 N.D. 656, 297 N.W. 129, 1941 N.D. LEXIS 212 (N.D. 1941).

Workers’ compensation fund is created to protect workmen, but is limited to injuries by accident occurring in course of employment, and is not health or accident insurance fund. Booke v. Workmen's Compensation Bureau, 70 N.D. 714, 297 N.W. 779, 1941 N.D. LEXIS 220 (N.D. 1941).

Compensable injury is not limited to one arising out of employment so long as it is sustained in course of employment. State ex rel. Kusie v. Weber, 72 N.D. 705, 10 N.W.2d 741, 1943 N.D. LEXIS 108 (N.D. 1943).

If an employee is injured while performing duty required by his employment, fact that he is at same time going home from his work will not preclude him from recovering compensation. Johnson v. North Dakota Workmen's Compensation Bureau, 75 N.D. 604, 31 N.W.2d 447, 1948 N.D. LEXIS 86 (N.D. 1948).

If injury occurs within period of employment at place where employee may reasonably be and while he is engaged in performing duties of his contract of employment or is engaged in something incident thereto and contemplated thereby, injury arises in course of his employment and is compensable. Welch v. North Dakota Workmen's Compensation Bureau, 75 N.D. 608, 31 N.W.2d 498, 1948 N.D. LEXIS 87 (N.D. 1948).

An injury arising in course of employment, which is not caused by employee’s willful intention to injure himself or to injure another or by voluntary intoxication of employee, is compensable injury. Lippmann v. North Dakota Workmen's Compensation Bureau, 79 N.D. 248, 55 N.W.2d 453, 1952 N.D. LEXIS 117 (N.D. 1952).

Workers compensation bureau’s decision that injury had not occurred in the course of employment was not supported by a preponderance of the evidence where there were discrepancies in a medical report relied upon by the bureau, which discrepancies were not clarified, and the bureau relied only upon the part of the report favorable to its decision and rejected or disregarded the part of the report and evidence unfavorable to its decision; under such circumstances, the bureau had a duty to clarify the discrepancies as part of its preliminary investigation. In re Claim of Bromley, 304 N.W.2d 412, 1981 N.D. LEXIS 214 (N.D. 1981).

Injury Outside State.

Compensation fund is not liable for injuries sustained in course of an employment situs of which is outside state. Altman v. North Dakota Workmen's Compensation Bureau, 50 N.D. 215, 195 N.W. 287, 1923 N.D. LEXIS 86 (N.D. 1923).

Where there is no express contract providing for extraterritorial coverage, an appointive peace officer of county receiving injuries outside state in course of his employment is not entitled to compensation on account of his injuries. MacArthur v. North Dakota Workmen's Compensation Bureau, 62 N.D. 572, 244 N.W. 259, 1932 N.D. LEXIS 216 (N.D. 1932).

This statute was intended to prevent duplication of benefits, and was held not to apply where claimant, who was not informed of his rights, had drawn partial benefits in Montana, and wanted to apply for the remainder of his benefits under the North Dakota law. Bekkedahl v. North Dakota Workmen's Compensation Bureau, 222 N.W.2d 841, 1974 N.D. LEXIS 167 (N.D. 1974), limited, United States Fidelity & Guar. Co. v. North Dakota Workmen's Compensation Bureau, 275 N.W.2d 618, 1979 N.D. LEXIS 216 (N.D. 1979).

Claimant who made an informed choice in applying for and receiving benefits under another state’s compensation program for death of her husband that occurred in that state irrevocably waived any rights to obtain benefits under North Dakota compensation program by such application and receipt. United States Fidelity & Guar. Co. v. North Dakota Workmen's Compensation Bureau, 275 N.W.2d 618, 1979 N.D. LEXIS 216 (N.D. 1979).

Legislative Intent.

The legislative intent of this provision was to compel the claimant to seek workers’ compensation benefits in just one jurisdiction in order to avoid duplication of benefits. 466 N.W.2d 148.

Payments to Insurance Companies.

Workers’ compensation statutes contain no provisions authorizing the bureau to pay contribution or indemnification to an insurance company that provides coverage for an out-of-state workers’ compensation program; insurance company which provided benefits to claimant under the Minnesota compensation program did not have standing to sue the North Dakota bureau for contribution or indemnification on grounds that North Dakota was the primary situs of employment and primarily liable. United States Fidelity & Guar. Co. v. North Dakota Workmen's Compensation Bureau, 275 N.W.2d 618, 1979 N.D. LEXIS 216 (N.D. 1979).

Person Entitled to Payment.

This section authorizes the bureau to pay compensation only to employees or their dependents and does not authorize contribution or indemnification payments to an insurance company. United States Fidelity & Guar. Co. v. North Dakota Workmen's Compensation Bureau, 275 N.W.2d 618, 1979 N.D. LEXIS 216 (N.D. 1979).

Private Insurance Policy.

This section was inapplicable where workers’ compensation policy was a private insurance policy which employer required employee to purchase and pay for himself; employee did not receive workers’ compensation benefits from the state of Indiana; the benefits paid under the policy were equal to the level of workers’ compensation benefits payable under Indiana law since that is where employee was injured. 466 N.W.2d 148.

Purpose.

The purpose of this section is to avoid a duplication of benefits and to compel the claimant to seek his remedy in one jurisdiction. United States Fidelity & Guar. Co. v. North Dakota Workmen's Compensation Bureau, 275 N.W.2d 618, 1979 N.D. LEXIS 216 (N.D. 1979).

Rebutting Evidence of Causal Connection.

Bureau’s findings of fact were not supported by preponderance of evidence where, although one doctor concluded that based upon claimant’s history, work injury to feet did not cause claimant’s back problems, that doctor was not specifically asked whether claimant’s fall caused his back injury or whether back injury manifested itself when claimant returned to work; therefore, where another doctor explicitly opined that claimant’s fall caused his back pain, although the latter doctor’s opinion was necessarily reliant upon claimant’s history long after the fact of claimant’s initial injury, the testimony did not support the bureau’s determination that the fall in question did not cause claimant’s later back pain. In re Claim of Murray, 431 N.W.2d 651, 1988 N.D. LEXIS 223 (N.D. 1988).

Because an administrative law judge (ALJ) did not apply the correct standard when evaluating conflicting medical opinions on causation where the ALJ’s rationale for discounting the opinion favorable to the claimant relied upon the importance of supporting a medical opinion with another scientific authority, such as a treatise or a published report of a study and neither the statutes nor case law imposed such a requirement, and because the court was unpersuaded by the ALJ’s speculation as to factual errors in the opinions, the court reversed an order affirming a decision of the Workforce Safety & Insurance Fund denying benefits for treatment of a worker’s back injury. The court also noted that it did not understand the ALJ’s reference to a “particularly heavy burden” and stated that the claimant need only prove it was more likely than not that his injuries were caused by his employment. Swenson v. Workforce Safety & Ins. Fund, 2007 ND 149, 738 N.W.2d 892, 2007 N.D. LEXIS 151 (N.D. 2007).

Separate Out-of-State Award.

Claimant’s Minnesota award was a distinct and separate award from his North Dakota award rather than being an addition to the North Dakota award where the Minnesota award entailed different periods of time and different benefits than the North Dakota award; thus, the Minnesota award was not a “supplement” within the meaning of this section. Plante v. North Dakota Workers Compensation Bureau, 455 N.W.2d 195, 1990 N.D. LEXIS 100 (N.D. 1990).

N.D.C.C. § 65-05-05 barred the payment of the same benefits by the North Dakota Workforce Safety and Insurance Fund to treat appellant injured worker’s sexual dysfunction, because Virginia’s Workers’ Compensation Commission already awarded benefits for the Viagra. Landrum v. Workforce Safety & Ins. Fund, 2011 ND 108, 798 N.W.2d 669, 2011 N.D. LEXIS 114 (N.D. 2011).

Settlement agreements.

Worker’s compensation claimant failed to raise a genuine issue of material fact establishing that Workforce Safety and Insurance (WSI) was a party to the settlement agreement and that the attorney executing the settlement on behalf of the “insurer” had authority, ostensible or otherwise, to bind WSI to the agreement and to waive its claims for reimbursement, and therefore the trial court did not err in denying the claimant’s cross-motion for summary judgment and granting summary judgment to WSI. State v. Oden, 2020 ND 243, 951 N.W.2d 187, 2020 N.D. LEXIS 242 (N.D. 2020).

“Supplement” Construed.

The word “supplement,” for purposes of this section, entails benefits awarded in a second state which are in addition to benefits awarded in the first state for either the identical period of time or the same type of benefit. Plante v. North Dakota Workers Compensation Bureau, 455 N.W.2d 195, 1990 N.D. LEXIS 100 (N.D. 1990).

Total Disability.

The fact that a claimant may be one hundred percent disabled does not of itself warrant an award under this chapter. To be compensable, the disability must be traceable to an injury suffered in the course of the claimant’s employment, and where a very serious disability existed in claimant prior to the accident upon which his claims were based, claimant was entitled to compensation only for aggravation of the previous disability. Bender v. North Dakota Workmen's Compensation Bureau, 139 N.W.2d 150, 1965 N.D. LEXIS 91 (N.D. 1965).

DECISIONS UNDER PRIOR LAW

Payment of Judgment Against Employer.

Partial payment of judgment against an employer for premium entitled employees to participate in compensation fund for portion of year covered by payment. LIGHT v. NORTH DAKOTA WORKMEN'S COMPENSATION BUR., 57 N.D. 487, 222 N.W. 952, 1929 N.D. LEXIS 342 (N.D. 1929).

Collateral References.

Workers’ compensation: sexual assaults as compensable, 52 A.L.R.4th 731.

Workers’ compensation act as precluding tort action for injury to or death of employee’s unborn child, 55 A.L.R.4th 792.

Workers’ compensation as precluding employee’s suit against employer for sexual harassment in the workplace, 51 A.L.R.5th 163.

Right to workers’ compensation for injury suffered at worker’s home where home is claimed as “work situs,” 4 A.L.R.6th 57.

Right to Compensation under State Workers’ Compensation Statute for Injuries Sustained During or as Result of Horseplay, Joking, Fooling, or the Like. 41 A.L.R.6th 207.

Injury to Employee as Arising out of or in Course of Employment for Purposes of State Workers’ Compensation Statute — Effect of Employer-Provided Living Quarters, Room and Board, or the Like. 42 A.L.R.6th 61.

Law Reviews.

Survey of decisions regarding workers’ compensation, 67 N.D. L. Rev. 350 (1991).

65-05-06. Payment of compensation in lieu of claim for relief against employer.

The payment of compensation or other benefits by the organization to an injured employee, or to the injured employee’s dependents in case death has ensued, are in lieu of any and all claims for relief whatsoever against the employer of the injured or deceased employee.

Source:

S.L. 1919, ch. 162, § 10; 1923, ch. 350, § 1; 1925 Supp., § 396a10; S.L. 1931, ch. 313, § 1; 1935, ch. 286, § 4; 1941, ch. 303, § 2; R.C. 1943, § 65-0506; S.L. 1985, ch. 82, § 161; 2003, ch. 561, § 3.

Notes to Decisions

Action Against Employer for Noncompensable Injuries.

Where decedent sustained injuries which were compensable under the act and for which his beneficiaries did in fact receive compensation, estate of decedent was barred from bringing tort suit against decedent’s employer for the noncompensable injuries of pain and suffering. Hulne v. International Harvester Co., 496 F. Supp. 849, 1980 U.S. Dist. LEXIS 13518 (D.N.D. 1980).

Co-Employees.

Co-employees retain their status as co-employees and their immunity from tort liability so long as they are acting in the course of their employment; the most satisfactory test to determine course of employment for purposes of co-employee immunity is the same course-of-employment test used to determine basic compensation coverage. Under that standard, in determining co-employee immunity, the test is whether the negligent co-employee would have been entitled to receive workers’ compensation benefits if that co-employee had been injured in the same incident. Mitchell v. Sanborn, 536 N.W.2d 678, 1995 N.D. LEXIS 150 (N.D. 1995).

Dual Capacity Doctrine.

Employee who applied for and received workers’ compensation for an injury caused by the shattering of a steel pin manufactured by his employer for use in the employer’s business was barred by this section from bringing an action against the contributing employer for the injury, and by failing to prove that the steel pin was manufactured for sale to the public rather than for the employer’s own use, the employee failed to establish any exception to this section that would entitle him to maintain an action against his employer under the dual capacity doctrine that the employer was also liable as a manufacturer of a defective product. Latendresse v. Preskey, 290 N.W.2d 267, 1980 N.D. LEXIS 203 (N.D. 1980).

Exclusive Remedy.

Truck driver who had received workers’ compensation for injuries was precluded from raising question of employment status in subsequent tort action against employer and fellow employee and thus had no right of action against either of them for same injuries and his wife had no right of action for loss of consortium. Lovelette v. Braun, 293 F. Supp. 41, 1968 U.S. Dist. LEXIS 11855 (D.N.D. 1968).

Generally, when an employer complies with the workers’ compensation statutes, the employee’s exclusive remedy against the employer is limited to recovery under the workers’ compensation statutes. Barsness v. General Diesel & Equip. Co., 422 N.W.2d 819, 1988 N.D. LEXIS 108 (N.D. 1988).

Third-party indemnity and contribution action for fraud and deceit against employer was barred by the exclusive remedy provisions of the Workers' Compensation Act. Smith v. Vestal, 494 N.W.2d 370, 1992 N.D. LEXIS 270 (N.D. 1992).

District court did not err in dismissing an employee’s negligence action because an employee and coworker were immune from suit under the Workforce Safety and Insurance Act’s exclusive remedy provisions; the determinations in California administrative proceedings were irrelevant for deciding statutory immunity because the employer paid Workforce Safety and Insurance premiums to secure coverage on the employee’s behalf, and the employee received benefits throughout the California proceedings. Brock v. Price, 2019 ND 240, 934 N.W.2d 5, 2019 N.D. LEXIS 251 (N.D. 2019).

Employer was entitled to supervisory writs directing a district court to grant the employer summary judgment barring civil liability for deceased and injured workers’ injuries because Workforce and Safety Insurance’s unappealed decision that the workers were employees was res judicata. Plains Trucking, LLC v. Hagar, 2019 ND 226, 932 N.W.2d 541, 2019 N.D. LEXIS 227 (N.D. 2019).

Horseplay.

As a matter of law, employee’s act of horseplay, in intentionally pushing the knees out from under co-employee, was not a sufficiently substantial deviation from his course of employment so as to transform him from a co-employee to a third-person tortfeasor. Mitchell v. Sanborn, 536 N.W.2d 678, 1995 N.D. LEXIS 150 (N.D. 1995).

Indemnity or Contribution by Employer.

Where employer had complied with the workers’ compensation statutes and injured employee had received workmen’s compensation benefits for his injuries, employee was barred from recovery in tort action against employer for his injuries, and employer was properly dismissed, as a third-party defendant in an action for the injuries brought by the employee against a third party who had joined the employer to the action in an attempt to seek contribution or indemnity. Gernand v. Ost Servs., 298 N.W.2d 500, 1980 N.D. LEXIS 300 (N.D. 1980).

This section bars any cause of action for contribution or indemnity that a third party may have against the employer, arising out of the third party’s common-law liability to an injured employee. White v. McKenzie Electric Cooperative, Inc., 225 F. Supp. 940, 1964 U.S. Dist. LEXIS 6497 (D.N.D. 1964).

In situations where an employer and a third-party tortfeasor both negligently cause an employee’s injuries, liability is imposed on the third-party tortfeasor for the negligence of the third party and the employer without permitting the third-party tortfeasor to get contribution from the employer. Barsness v. General Diesel & Equip. Co., 422 N.W.2d 819, 1988 N.D. LEXIS 108 (N.D. 1988).

The exclusive remedy rule prohibiting a third-party tortfeasor from getting contribution from the employer does not prohibit enforcement of an employer’s contractual agreement to indemnify a third-party tortfeasor. Barsness v. General Diesel & Equip. Co., 422 N.W.2d 819, 1988 N.D. LEXIS 108 (N.D. 1988).

Intentionally Inflicted Injuries.

Once the employee or his beneficiaries have received workers’ compensation benefits, they are precluded from pursuing a common-law action against employer, even for intentionally inflicted injuries. Hulne v. International Harvester Co., 496 F. Supp. 849, 1980 U.S. Dist. LEXIS 13518 (D.N.D. 1980).

Loss of Consortium.

Where widow received compensation benefits from workers’ compensation bureau for death of her husband who was killed in an industrial accident, she was barred from bringing suit in her individual capacity against her deceased husband’s employer and coemployee for loss of consortium. Schreder v. Cities Serv. Co., 336 N.W.2d 641, 1983 N.D. LEXIS 388 (N.D. 1983).

N.D.C.C. § 65-01-01 and this section bar the recovery of damages for loss of consortium by the spouse of an injured worker in an action against the injured worker’s employer. Wald v. Grafton, 442 N.W.2d 910, 1989 N.D. LEXIS 144 (N.D. 1989).

True Intentional Injury.

The North Dakota Workers Compensation Act does not preclude recovery for true intentional injuries, and an employee can pursue a civil cause of action against his employer for a true intentional injury. Zimmerman v. Valdak Corp., 1997 ND 203, 570 N.W.2d 204, 1997 N.D. LEXIS 261 (N.D. 1997).

An employer is deemed to have intended to injure if the employer had knowledge an injury was certain to occur and willfully disregarded that knowledge. Zimmerman v. Valdak Corp., 1997 ND 203, 570 N.W.2d 204, 1997 N.D. LEXIS 261 (N.D. 1997).

Collateral References.

Workmen’s compensation act as furnishing exclusive remedy for master’s failure to inform servant of disease or physical condition disclosed by medical examination, 69 A.L.R.2d 1213.

Law Reviews.

Workers’ Compensation: The Assault on the Shield of Immunity — Coming to Blows with the Exclusive-Remedy Provisions of the North Dakota Workers’ Compensation Act, 70 N.D. L. Rev. 905 (1994).

65-05-07. Injured employee given medical and hospital service required — Furnished artificial limbs and appliances for rehabilitation — Fee approval.

The fund shall furnish to an injured employee reasonable and appropriate medical, surgical, and hospital service and supplies necessary to treat a compensable injury. The fund may furnish artificial members and replacements the organization determines necessary to rehabilitate an injured employee.

  1. The allied health care professional must be acting within the scope of the allied health care professional’s license or fees will be denied.
  2. Fees may not be approved for more than one allied health care professional in a case in which treatment is provided over the same period of time except for the services of a consulting doctor, assistant surgeon, or anesthetist or in an emergency.
  3. The organization, in cooperation with professional organizations of allied health care professionals, shall establish a system of peer review to determine reasonableness of fees and payment denials for unjustified treatments, hospitalization, or visits. The allied health care professional may appeal adverse decisions of the organization in accordance with the medical aid rules adopted by the organization.
  4. An allied health care professional may not bill an injured employee for a service rendered as a result of the compensable work injury.
  5. Under this section, the organization may modify real estate and may provide for adaptations and modifications to motor vehicles as follows:
    1. In the case of an injured employee who sustained a catastrophic injury, as defined in chapter 65-05.1, the organization may pay an amount not to exceed seventy-five thousand dollars to provide permanent additions, remodeling, or adaptations to real estate it determines necessary. The dollar limit is for the life of the injured employee, regardless of any subsequent claim. This subdivision does not allow the organization to purchase any real estate.
    2. In the case of an injured employee who sustained a catastrophic injury, as defined in chapter 65-05.1, the organization may pay an amount not to exceed one hundred fifty thousand dollars to provide the most cost-effective, specially equipped motor vehicle or vehicle adaptations the organization determines medically necessary. The organization may establish factors to be used in determining whether a specially equipped motor vehicle or adaptation is necessary. Under this subdivision, the organization may not pay for insurance of or maintenance of the motor vehicle. Within the dollar limit and under this subdivision, the organization may pay for vehicle or adaptation replacement purchases. The dollar limit is for the life of the injured employee, regardless of any subsequent claim.
    3. In the case of an injured employee who has not sustained a catastrophic injury, as defined in chapter 65-05.1, the organization may provide the benefits under subdivisions a and b if the organization determines the benefits would be cost-effective and appropriate because of exceptional circumstances as determined by the organization.
  6. If an allied health care professional who has treated or provided services to an injured employee fails or refuses without just cause to file with the organization a report required by section 65-05-02, 65-05-08, or 65-05-08.1, within thirty days of examination, treatment, or provision of other services rendered in connection with a compensable work injury, or within thirty days of a request for the report made by the claimant, the claimant’s representative, or the organization, the organization shall assess as a penalty a sum of one hundred dollars. Health care providers and allied health care professionals may not bill an injured worker for a penalty assessed by the organization under this subsection.
  7. The filing of an accident report or the rendering of treatment to an injured worker who comes under the organization’s jurisdiction constitutes acceptance of the organization’s medical aid rules and compliance with the organization’s rules and fees.
  8. The organization may not pay for:
    1. Personal items for the injured employee’s personal use or hygiene, including toothbrushes, slippers, shampoo, and soap.
    2. A product or item including clothing or footwear unless the items are considered orthopedic devices and are prescribed by the treating allied health care professional.
    3. Furniture except hospital beds, shower stools, wheelchairs, or whirlpools if prescribed by the treating allied health care professional.
    4. Vitamins and food supplements except in those cases in which the injury causes severe dietary problems, the injury results in the employee’s paraplegia or quadriplegia, or the employee becomes wheelchair-bound due to the injury.
    5. Eye examinations unless there is a reasonable potential for injury to the employee’s eyes as a result of the injury.
    6. Private hospital or nursing home rooms except in cases of extreme medical necessity and only when directed by the attending doctor. If the employee desires better accommodations than those ordered by the attending doctor, the employee will pay the difference in cost.
    7. Serological tests, including VDRL and RPR, or other tests for venereal disease or pregnancy, or any other routine tests unless clearly necessitated by the injury.
    8. Aids or programs primarily intended to help the employee lose weight or stop smoking unless ordered by the organization.
    9. Home gymnasium or exercise equipment unless ordered by the organization.
    10. Memberships or monthly dues to health clubs, unless ordered by the organization.
    11. Massage, unless ordered by the organization.
    12. Medical marijuana.

Source:

S.L. 1919, ch. 162, § 3, subs. A; 1921, ch. 141, § 1, subs. A; 1925, ch. 223, § 1, subs. A; 1925 Supp., § 396a3, subs. A; S.L. 1927, ch. 286, § 1, subs. A; 1929, ch. 260, § 1, subs. A; 1939, ch. 251, § 1, subs. A; 1943, ch. 274, § 2; R.C. 1943, § 65-0507; S.L. 1967, ch. 484, § 2; 1975, ch. 584, § 8; 1981, ch. 640, § 2; 1989, ch. 769, § 1; 1991, ch. 714, § 42; 1997, ch. 540, § 1; 2003, ch. 561, § 3; 2003, ch. 562, § 5; 2007, ch. 570, § 1; 2007, ch. 571, § 1; 2011, ch. 509, § 1; 2011, ch. 512, § 3; 2013, ch. 503, § 1; 2017, ch. 434, § 2, eff August 1, 2017; 2019, ch. 523, § 7, eff August 1, 2019.

Notes to Decisions

Accessible Van.

Injured worker was entitled to reimbursement for the difference between the cost of a handicap accessible van and the cost of a vehicle he would have otherwise owned. Meyer v. North Dakota Workers Compensation Bureau, 512 N.W.2d 680, 1994 N.D. LEXIS 46 (N.D. 1994).

Appeal.
—Failure to Preserve Issue.

The issue of whether the Workers’ Compensation Bureau denied worker a fair hearing because it failed to establish a system of peer review as required under subsection (3) of this section was not preserved for appeal where worker did not raise this issue in the administrative proceedings nor in her appeal before the district court; an issue which has not been properly raised before the trial court cannot be raised for the first time on appeal to the supreme court. Vail v. North Dakota Workers Compensation Bureau (In re Vail), 522 N.W.2d 480, 1994 N.D. LEXIS 212 (N.D. 1994).

Chiropractic Treatment.

Worker who underwent chiropractic treatment for a work-related knee injury without a physician’s referral was not entitled to payment of worker’s compensation benefits for the cost of the treatment. Vraa v. North Dakota Workers Compensation Bureau, 1999 ND 6, 588 N.W.2d 857, 1999 N.D. LEXIS 10 (N.D. 1999).

Fee Approval.
—Standing.

Claimant did not have standing to challenge the workers compensation bureau’s claimed lack of a peer review system. This section does not allow claimants to appeal adverse bureau decisions on matters of “reasonableness of fees and payment denials for unjustified treatments”. Swanson v. North Dakota Workers Compensation Bureau, 553 N.W.2d 209, 1996 N.D. LEXIS 212 (N.D. 1996).

Trial court erred in remanding matter to the Bureau with an order that the Bureau adopt a peer review process; a claimant does not have standing to challenge the Bureau’s lack of a peer review system. Sherman v. North Dakota Workers Compensation Bureau, 1998 ND 97, 578 N.W.2d 517, 1998 N.D. LEXIS 84 (N.D. 1998).

Prosthetic Device.

In a workers' compensation case, it was not an abuse of discretion for the North Dakota Workforce Safety and Insurance Fund (WSI) to deny a claimant's request for a myoelectric prosthesis during binding dispute resolution because the WSI was not required to provide the claimant's preferred device; it considered each device's durability, cost, and impact on the amputation injuries suffered. Whedbee v. N.D. Workforce Safety, 2014 ND 79, 845 N.W.2d 632, 2014 N.D. LEXIS 90 (N.D. 2014).

Standing to Challenge Denial of Payment.

Worker lacked standing to challenge worker’s compensation bureau denial of payment for medical tests worker had received, since worker did not show that he was personally billed for those services, nor that he was denied medical services as a result of the bureau’s refusal to pay. Vickery v. North Dakota Workers Compensation Bureau, 545 N.W.2d 781, 1996 N.D. LEXIS 106 (N.D. 1996).

Collateral References.

Insured’s receipt of or right to workmen’s compensation benefits as affecting recovery under accident, hospital, or medical expense policy, 40 A.L.R.3d 1012.

Workers’ compensation: value of home services provided by victim’s relative, 65 A.L.R.4th 142.

Workers’ compensation: vocational rehabilitation statutes, 67 A.L.R.4th 612.

Workers’ compensation: reasonableness of employee’s refusal of medical services tendered by employer, 72 A.L.R.4th 905.

Compensability of specially equipped van or vehicle under workers’ compensation statutes, 63 A.L.R.5th 163.

65-05-07.1. Organization to adopt fee schedule. [Repealed]

Repealed by S.L. 1999, ch. 554, § 4.

65-05-07.2. Payment to organization for certain claims. [Repealed]

Source:

S.L. 1991, ch. 714, § 41; 1995, ch. 618, § 2; 1997, ch. 541, § 1; 2001, ch. 583, § 1; 2003, ch. 561, § 3; 2003, ch. 564, § 8; 2005, ch. 604, § 5; Repealed by 2017, ch. 437, § 6, eff August 1, 2017.

65-05-07.3. Medical bills — Electronic acceptance.

The organization shall establish guidelines, systems, and procedures for the acceptance of medical bills and supporting documentation by electronic methods. Health care providers shall submit medical bills and supporting documentation to the organization by this electronic method no later than July 1, 2021.

Source:

S.L. 2019, ch. 525, § 5, eff July 1, 2019.

65-05-08. Disability benefits — Not paid unless period of disability is of five days’ duration or more — Application required — Suspended during confinement — Duty to report wages.

Benefits may not be paid for disability, the duration of which is less than five consecutive calendar days. An employer may not require an employee to use sick leave or annual leave, or other employer-paid time off work, before applying for benefits under this section, in lieu of receiving benefits under this section, or in conjunction with benefits provided under this section, but may allow an employee to use sick leave or annual leave to make up the difference between the employee’s wage-loss benefits and the employee’s regular pay. If the period of disability is five consecutive calendar days’ duration or longer, benefits must be paid for the period of disability provided that:

  1. When disability benefits are discontinued, the organization may not begin payment again unless the injured employee files a reapplication for disability benefits on a form supplied by the organization. In case of reapplication, the award may commence no more than thirty days before the date of reapplication. Disability benefits must be reinstated upon proof by the injured employee that:
    1. The employee has sustained a significant change in the compensable medical condition;
    2. The employee has sustained an actual wage loss caused by the significant change in the compensable medical condition; and
    3. The employee has not retired or voluntarily withdrawn from the job market as defined in section 65-05-09.3.
  2. Payments of disability and rehabilitation benefits of an employee who is eligible for, or receiving, benefits under this title must be suspended when the employee is confined in a penitentiary, jail, youth correctional facility, or any other penal institution for a period of between seventy-two consecutive hours and one hundred eighty consecutive days. Payments of disability and rehabilitation benefits of an employee who is eligible for, or receiving, benefits under this title must be discontinued when the employee is confined in a penitentiary, jail, youth correctional facility, or any other penal institution for a period in excess of one hundred eighty consecutive days.
  3. An employee who is eligible for, or receiving disability or rehabilitation benefits under this title shall report any wages earned, from part-time or full-time work from any source. If an employee fails to report wages earned, the employee shall refund to the organization all disability or vocational rehabilitation benefits overpaid by the organization for that time period. To facilitate recovery of those benefits, the organization may offset future benefits payable, under section 65-05-29. If the employee willfully fails to report wages earned, the employee is subject to the penalties in section 65-05-33. An employee shall report whether the employee has performed work or received wages. The organization periodically shall provide a form to all injured employees receiving disability or rehabilitation benefits which the injured employee must complete to retain eligibility for further disability or rehabilitation benefits, regardless of the date of injury or claim filing. The form will advise the injured employee of the possible penalties for failure to report any work or activities as required by this section. An injured employee who is receiving disability or vocational rehabilitation benefits must report any work activities to the organization whether or not the injured employee receives any wages. An injured employee who is receiving disability or vocational rehabilitation benefits must also report any other activity if the injured employee receives any money, including prize winnings, from undertaking that activity, regardless of expenses or whether there is a net profit. For purposes of this subsection, “work” does not include routine daily activities of self-care or family care, or routine maintenance of the home and yard, and “activities” does not include recreational gaming or passive investment endeavors.
  4. An employee shall request disability benefits on a claim form furnished by the organization. Disability benefits may not commence more than one year prior to the date of filing of the initial claim for disability benefits.
  5. The provisions of this section apply to any disability claim asserted against the fund on or after July 1, 1991, irrespective of injury date.
  6. It is the burden of the employee to show that the inability to obtain employment or to earn as much as the employee earned at the time of injury is due to physical limitation related to the injury, and that any wage loss claimed is the result of the compensable injury.
  7. If the employee voluntarily limits income or refuses to accept employment suitable to the employee’s capacity, offered to or procured for the employee, the employee is not entitled to disability or vocational rehabilitation benefits during the limitation of income or refusal to accept employment unless the organization determines the limitation or refusal is justified. To receive additional disability or vocational rehabilitation benefits following an unjustified limitation or refusal, the employee shall meet the requirements of a reapplication for benefits as outlined in this section.
  8. The organization may not pay disability benefits unless the loss of earning capacity exceeds ten percent. The injured employee may earn up to ten percent of the employee’s preinjury average gross weekly earnings with no reduction in total disability benefits. The employee must report any earnings to the organization for a determination of whether the employee is within the limit set in this subsection.
  9. Upon securing suitable employment, the injured employee shall notify the organization of the name and address of the employer, the date the employment began, and the amount of wages being received. If the injured employee is receiving disability benefits, the injured employee shall notify the organization whenever there is a change in work status or wages received.
  10. The organization shall pay to an employee receiving disability benefits a dependency allowance for each child of the employee at the rate of fifteen dollars per week per child.
  11. Dependency allowance for the children may be made directly to either parent or guardian at the discretion of the organization.
  12. The organization may not pay wage loss benefits if the wage loss is related to the use or presence of medical marijuana.

Source:

S.L. 1919, ch. 162, § 3, subs. B; 1921, ch. 141, § 1, subs. B; 1925, ch. 223, § 1, subs. B; 1925 Supp., § 396a3, subs. B; S.L. 1927, ch. 286, § 1, subs. B; 1929, ch. 260, § 1, subs. B; R.C. 1943, § 65-0508; S.L. 1947, ch. 375, § 5; 1957 Supp., § 65-0508; S.L. 1967, ch. 484, § 3; 1989, ch. 770, § 1; 1991, ch. 714, § 43; 1997, ch. 542, § 1; 1999, ch. 556, § 1; 2001, ch. 575, § 2; 2003, ch. 561, § 3; 2009, ch. 619, § 1; 2013, ch. 499, § 5; 2017, ch. 434, § 3, eff August 1, 2017; 2021, ch. 500, § 5, eff August 1, 2021.

Note.

Section 13 of chapter 500, S.L. 2021, provides, “ APPLICATION. This Act applies to all claims regardless of date of injury.”

Notes to Decisions

Activities Considered Work.

Claimant’s activities of opening a restaurant at 5:00 a.m. and staying until 7:00 a.m., baking rolls, making coffee, signing receipts for deliveries, and cooking for customers, picking up supplies and performing maintenance work were considered work within the common understanding of work and were not for his benefit as therapy or self-care. Snyder v. North Dakota Workers Compensation Bureau, 2001 ND 38, 622 N.W.2d 712, 2001 N.D. LEXIS 38 (N.D. 2001).

While performing yard work and participating in a rummage sale did not constitute work, videotapes of the employee engaged in such activities were evidence of the employee’s physical abilities and were material to the evidence of fraud. Sjostrand v. N.D. Workers Comp. Bureau, 2002 ND 125, 649 N.W.2d 537, 2002 N.D. LEXIS 168 (N.D. 2002), cert. denied, 538 U.S. 928, 123 S. Ct. 1578, 155 L. Ed. 2d 321, 2003 U.S. LEXIS 2274 (U.S. 2003).

Activities Not Considered Work.

Order terminating an employee’s workers compensation benefits was reversed and remanded because the workers compensation bureau did not prove that the employee willfully made a material false statement justifying forfeiture of future benefits under N.D.C.C. § 65-05-33. The employee’s failure to report the receipt of money from the sale of vegetables was not material because the amount of money did not equal 10 percent of his income under this section, the bureau did not provide the notice of penalties required by this section, and the employee’s failure to report his gardening and harvest activities were not willful because casual activities not engaged in for remuneration or for an employer are not reasonably understood to be work. Wanner v. N.D. Workers Comp. Bureau, 2002 ND 201, 654 N.W.2d 760, 2002 N.D. LEXIS 272 (N.D. 2002).

Applicability of Amendments.

Amendment of this section which abrogated claimant’s vested right to receive disability benefits did not apply to his claim; his entitlement to benefits was governed by the statutes in effect at the time of his injury. Jensen v. North Dakota Workers Compensation Bureau, 1997 ND 107, 563 N.W.2d 112, 1997 N.D. LEXIS 112 (N.D. 1997).

Claimant's Knowledge and Intent.

Benefits could not be denied under this section where evidence in the record was insufficient to establish that claimant had knowledge of specific restrictions and intentionally exceeded those restrictions. Tangen v. North Dakota Workers Compensation Bureau, 2000 ND 135, 613 N.W.2d 490, 2000 N.D. LEXIS 140 (N.D. 2000).

Determination of Eligibility.

Where workers compensation bureau failed to adequately explain why it rejected claimant’s treating physician’s reports and administrative law judge’s recommendation to reinstate benefits, judgment affirming denial of benefits was reversed with instructions to remand claim to bureau to adequately explain its decision. Blanchard v. North Dakota Workers Compensation Bureau, 1997 ND 118, 565 N.W.2d 485, 1997 N.D. LEXIS 129 (N.D. 1997).

Where an ALJ and workforce safety and insurance (WSI) found that a claimant had never received the mailed notice of intention to discontinue/reduce his benefits (NOID), WSI’s termination of his ongoing disability benefits violated due process and WSI erred when it applied the reapplication statute, N.D.C.C. § 65-05-08(1), which was only applicable if the claimant’s prior disability benefits had been validly terminated, in deciding when benefits should have been resumed. Rojas v. Workforce Safety & Ins., 2005 ND 147, 703 N.W.2d 299, 2005 N.D. LEXIS 182 (N.D. 2005).

Due Process Rights Under Subsection (3).

RTW cards sent to worker under subsection (3) did not violate his procedural due process rights given that this section applied to him despite its enactment after his date of injury. Furthermore, the fact that the cards fail to define work or put claimants on notice as to what the Bureau considers work also does not violate claimants’ due process rights given that while the Bureau may not agree with the claimants’ view of work, the Bureau takes the risk that the courts will not agree with its application of the term to particular facts. Snyder v. North Dakota Workers Compensation Bureau, 2001 ND 38, 622 N.W.2d 712, 2001 N.D. LEXIS 38 (N.D. 2001).

Expert Medical Testimony.

In cases where expert medical testimony is desirable if not essential to a determination of causation, the bureau may not simply ignore competent medical testimony without expressly setting forth in its findings of fact adequate reasons, which are supported by the record, for doing so. Lang v. North Dakota Workers Compensation Bureau, 1997 ND 133, 566 N.W.2d 801, 1997 N.D. LEXIS 133 (N.D. 1997).

Injury and Accident Distinguished.

There is distinction between an injury and an accident as used in workers’ compensation act, injury meaning result of an accident and including all effects of accident, so that in allowing compensation workers’ compensation bureau considers all features of injuries resulting from an accident and awards compensation for all as one injury, but, if workman is injured in two or more separate accidents he may apply for compensation for each injury. Schmidt v. North Dakota Workmen’s Comp. Bureau, 73 N.D. 245, 13 N.W.2d 610 (1943), decided prior to the enactment of N.D.C.C. § 65-05-03.

Justification for Refusing Job Offer.

In determining whether a worker is justified in refusing a job offer, a court looks to see if a reasonably prudent person would refuse the offer under the same or similar circumstances, and also at the following nonexclusive factors found in Pulver v. Dundee Cement Co., 445 Mich. 68, 515 N.W.2d 728 (Mich. 1994): the timing of the offer, if the employee has moved, the reasons for moving, the diligence of the employee in trying to return to work, whether the employee has actually returned to work with some other employer and, whether the effort, risk, sacrifice or expense is such that a reasonable person would not accept the offer. Lawrence v. North Dakota Workers Compensation Bureau, 2000 ND 60, 608 N.W.2d 254, 2000 N.D. LEXIS 64 (N.D. 2000).

Periodic Reporting of Work Status.

Claimant’s argument that subsection (3) of this section did not apply to him because it was not in effect at the time of his work injury in 1988 was without merit given that N.D.C.C. § 65-05-04, providing that the Bureau may review any award and determine whether a worker remains disabled, has been in effect since 1919 and this section provides the Bureau with an appropriate way to investigate such claims by requiring claimants to complete reporting forms on a periodic basis regarding any work they might be performing. Snyder v. North Dakota Workers Compensation Bureau, 2001 ND 38, 622 N.W.2d 712, 2001 N.D. LEXIS 38 (N.D. 2001).

Reapplication for Benefits.

Whether worker sustained a significant change in his medical condition attributable to his work injury, and not the “good faith work trial” standard, applies to cases in which worker has reapplied for benefits. Johnson v. North Dakota Workers' Compensation Bureau, 539 N.W.2d 295, 1995 N.D. LEXIS 187 (N.D. 1995).

Subsection (1) did not govern claimant’s request for resumption of disability benefits, precluding award of benefits commencing more than thirty days before his reapplication, where 1989 amendment adding subsections (1) and (5) did not apply to his vested right to receive disability benefits upon again becoming disabled under statute in effect on the date of his injury. Jensen v. North Dakota Workers Compensation Bureau, 1997 ND 107, 563 N.W.2d 112, 1997 N.D. LEXIS 112 (N.D. 1997).

Workers Compensation Bureau’s notice of its intention to discontinue benefits after discovering worker had previously accepted a lump sum settlement in lieu of future benefits established that Bureau had not accepted the worker’s reapplication for benefits. Kerzman v. North Dakota Workers Compensation Bureau, 1999 ND 44, 590 N.W.2d 888, 1999 N.D. LEXIS 48 (N.D. 1999).

Where Bureau refuses to pay benefits despite an order to do so, the appropriate remedy for claimant was to seek a writ of mandamus in district court directing the Bureau to pay benefits in accordance with its order instead of reapplying for benefits under this section. Baier v. North Dakota Workers Compensation Bureau, 2000 ND 78, 609 N.W.2d 722, 2000 N.D. LEXIS 89 (N.D. 2000).

District court was correct in upholding the Workers Compensation Bureau’s order denying the claimant’s reapplication for temporary total disability benefits; the claimant was unable to prove actual wage loss, which was a prerequisite to reinstating discontinued disability benefits under subsection (1) of this section. Gronfur v. N.D. Workers Comp. Fund, 2003 ND 42, 658 N.W.2d 337, 2003 N.D. LEXIS 56 (N.D. 2003).

Former employee’s reapplication for benefits for a 1983 lower back injury was properly denied because the employee was unable to show that there was an actual wage loss as a result of the worsening of the prior injury; the employee was able to work until terminated for misconduct, and the employee was not eligible for further benefits until all of the requirements of subsection (1) of this section were satisfied. Lesmeister v. N.D. Workers Comp. Bureau, 2003 ND 60, 659 N.W.2d 350, 2003 N.D. LEXIS 74 (N.D. 2003).

Court did not err in denying a claimant’s reapplication for worker’s compensation benefits where a doctor’s opinion that he was totally disabled from working in July 2002 did not prove that he was similarly disabled six months earlier when he quit his job in January 2002, or that a change in his medical condition caused him to leave his employment. Beckler v. Workforce Safety & Ins. (In re Beckler), 2005 ND 33, 692 N.W.2d 483, 2005 N.D. LEXIS 39 (N.D. 2005).

Using the definition of “wage” found in N.D.C.C. § 65-01-02(37) in the context of “actual wage loss” under N.D.C.C. § 65-05-08(1)(b), the claimant must prove that he has sustained an actual loss of remuneration from employment which would be reportable to the internal revenue service as earned income for federal income tax purposes. To demonstrate an actual loss of wages or remuneration as a result of a change in the claimant’s compensable medical condition, the claimant must necessarily first demonstrate that he was earning wages from employment when the change in his medical condition occurred and must then show that the change caused at least a partial loss of those wages. Beckler v. Workforce Safety & Ins. (In re Beckler), 2005 ND 33, 692 N.W.2d 483, 2005 N.D. LEXIS 39 (N.D. 2005).

Workforce Safety and Insurance erred in applying N.D.C.C. § 65-05-08(1) and denying the claimant’s second application for workers’ compensation disability benefits because N.D.C.C. § 65-05-08(1) applied to a reapplication only when disability benefits had been discontinued, yet the claimant had never received benefits for his work-related injury. Therefore the claimant’s “reapplication” did not fit within the clear language of N.D.C.C. § 65-05-08(1). Houn v. Workforce Safety & Ins., 2005 ND 115, 698 N.W.2d 271, 2005 N.D. LEXIS 130 (N.D. 2005).

Denial of the employee’s reapplication for disability benefits was proper pursuant to N.D.C.C. § 65-05-08(1) because, while he was entitled to subpoena his doctors or to present telephonic testimony from his doctors, he nevertheless relied on written opinions from his doctors without any further elaboration and he did not present testimony from any other employees to support his claim. The employee therefore failed to make a record to establish his claim that he sustained a significant change in his compensable medical condition. Aga v. Workforce Safety & Ins., 2006 ND 254, 725 N.W.2d 204, 2006 N.D. LEXIS 261 (N.D. 2006).

District court erred in affirming an administrative agency order denying a claimant’s reapplication for workers’ compensation disability benefits under N.D.C.C. § 65-05-08, because the agency’s factual findings did not sufficiently address medical evidence in the record which showed that the claimant had suffered a significant change in his compensable medical condition and a resulting actual wage loss. Additional findings on these issues were required on remand, pursuant to N.D.C.C. § 28-32-46(7). Huwe v. Workforce Safety & Ins., 2008 ND 47, 746 N.W.2d 158, 2008 N.D. LEXIS 49 (N.D. 2008).

When claimant was injured at work and received temporary total disability benefits, he filed a claim for additional benefits three years later; North Dakota Workforce Safety and Insurance properly denied his claim. Claimant failed to meet the standard for a reapplication for benefits under N.D.C.C. § 65-05-08(1), because he had not shown an actual wage loss caused by a significant change in his compensable medical condition. Johnson v. N.D. Workforce Safety & Ins., 2010 ND 198, 789 N.W.2d 565, 2010 N.D. LEXIS 195 (N.D. 2010).

Voluntary Limitation of Income.

Evidence supported the North Dakota Workforce Safety and Insurance’s finding that by accepting and remaining in a lower position, the claimant voluntarily limited her income and lost her entitlement to partial disability benefits under N.D.C.C. § 65-05-08. Vogel v. Workforce Safety & Ins., 2005 ND 43, 693 N.W.2d 8, 2005 N.D. LEXIS 46 (N.D. 2005).

Wage Loss.

Under subdivision (1)(b) of this section, the claimant must prove that he has sustained an actual loss of remuneration from employment which would be reportable to the Internal Revenue Service as earned income; to demonstrate an actual loss of wages or remuneration as a result of a change in the claimant’s compensable medical condition, the claimant must necessarily first demonstrate that he was earning wages from employment when the change occurred and must then show that the change caused at least a partial loss of those wages. Gronfur v. N.D. Workers Comp. Fund, 2003 ND 42, 658 N.W.2d 337, 2003 N.D. LEXIS 56 (N.D. 2003).

Law Reviews.

North Dakota Supreme Court Review (Wanner v. North Dakota Workers’ Compensation Bureau, 2002 ND 201, 654 N.W.2d 760), see 79 N.D. L. Rev. 589 (2003).

65-05-08.1. Verification of disability.

  1. An injured employee’s health care provider shall certify the period of disability and the extent of the injured worker’s abilities and restrictions.
  2. A health care provider certifying disability shall include in the report filed with the organization:
    1. The medical basis established by medical evidence supported by objective medical findings for the certification of disability;
    2. Whether the employee is totally disabled, or, if the employee is not totally disabled, whether the employee is able to return to any employment, and a statement of the employee’s restrictions and physical limitations; and
    3. A professional opinion as to the expected length of, and reason for, the disability.
  3. A health care provider may not certify or verify past disability commencing more than sixty days before the health care provider’s examination of the employee.
  4. The report must be filed on a form furnished by the organization, or on any other form acceptable to the organization.
  5. The injured employee shall ensure the required reports for any period of disability are filed.
  6. Prior to the expiration of a period of disability certified by a health care provider, if a report certifying an additional period of disability has not been filed, or upon receipt of a report or other evidence indicating an injured employee who is receiving disability benefits has been or will be released to return to work, the organization shall send a notice to that employee of the organization’s intention to discontinue benefits, including an explanation of the reason for discontinuing benefits, an explanation of the injured employee’s right to respond, and the procedure for filing the required report or challenging the proposed action. Thereafter, if the required certification is not filed, the organization shall discontinue disability benefits, effective twenty-one days after the date the notice of intention to discontinue benefits is mailed or the date on which the injured employee actually returned to work, whichever occurs first.

Source:

S.L. 1991, ch. 714, § 44; 1993, ch. 614, § 9; 1993, ch. 627, § 1; 1997, ch. 542, § 2; 2003, ch. 561, § 3; 2017, ch. 439, § 1, eff August 1, 2017; 2019, ch. 523, § 8, eff August 1, 2019.

Notes to Decisions

Bureau’s Obligation to Request Certification.

The onus is on the workers compensation bureau to request medical certification of the duration of a claimant’s disability, and thereafter the claimant must ensure that the requested reports are filed. Frohlich v. North Dakota Workers Compensation Bureau, 556 N.W.2d 297, 1996 N.D. LEXIS 258 (N.D. 1996).

Content of Doctor’s Report.

The doctor’s report must include information relating to the extent of employee’s disability, whether the employee is able to return to some employment, including light or sedentary work and, if the employee is not totally disabled, a statement of the employee’s restrictions and physical limitations. Lindell v. N.D. Workers Comp. Bureau, 1998 ND 174, 584 N.W.2d 520, 1998 N.D. LEXIS 185 (N.D. 1998).

Degree of Disability.

Letter from worker’s physician failed to meet the disability verification requirements of this section where the letter did not address the degree of disability experienced by the worker and expressed no medical opinion regarding the expected length of the disability. Lindell v. N.D. Workers Comp. Bureau, 1998 ND 174, 584 N.W.2d 520, 1998 N.D. LEXIS 185 (N.D. 1998).

Disability Not Shown.

The Bureau did not err in denying claimant disability benefits after October 27, 1997, because a reasoning mind reasonably could have determined from the evidence that claimant failed to establish the statutory requirements for verifying disability after October 27, 1997, where she relied on a chiropractor’s report which verified disability for only 17 days; a medical report which did not include a disability rating; and a chiropractor’s report issued just one week prior to the hearing and found to be untimely and therefore inadmissible. Mikkelson v. North Dakota Workers Compensation Bureau, 2000 ND 67, 609 N.W.2d 74, 2000 N.D. LEXIS 82 (N.D. 2000).

Failure to Request Certification.

Workers compensation bureau’s failure to request doctor certification of the period of claimant’s temporary total disability benefits violated this section, and bureau was directed to award claimant benefits through date at which he was certified as at maximum medical improvement; bureau was not absolved from its responsibility to request updated medical certification under this section by protracted administrative and judicial proceedings. Frohlich v. North Dakota Workers Compensation Bureau, 556 N.W.2d 297, 1996 N.D. LEXIS 258 (N.D. 1996).

Legislative Intent.

The clear intent of this section is to protect a claimant’s right to rely upon regular ongoing benefits, not to provide a windfall to applicants on initial claims. Nemec v. North Dakota Workers Compensation Bureau, 543 N.W.2d 233, 1996 N.D. LEXIS 28 (N.D. 1996).

Termination of Benefits.

Due process requires the bureau to give a claimant prior notice of termination of disability benefits, a summary of the medical evidence supporting termination, and an opportunity to respond. Flink v. North Dakota Workers Compensation Bureau (Fargo Trailer Ctr.), 1998 ND 11, 574 N.W.2d 784, 1998 N.D. LEXIS 22 (N.D. 1998).

Pre-termination notice informing worker his disability benefits were going to be terminated based on information that the worker had been working during the time he had been claiming to be totally disabled was not inadequate. Unser v. North Dakota Workers Compensation Bur., 1999 ND 129, 598 N.W.2d 89, 1999 N.D. LEXIS 149 (N.D. 1999).

An allegation that a worker had made “false statements” concerning his physical disability status did not satisfy the fundamental requirements of notice and procedural due process. Vernon v. North Dakota Workers Compensation Bur., 1999 ND 153, 598 N.W.2d 139, 1999 N.D. LEXIS 168 (N.D. 1999).

The fact that the worker was given a transcript of his interview in which he disclosed to an investigator that he had done some snow removal work while receiving disability benefits did not cure the inadequate statement of evidentiary grounds for discontinuing benefits in the notice of intention to discontinue benefits given by the Workers Compensation Bureau. Stewart v. North Dakota Workers Compensation Bureau, 1999 ND 174, 599 N.W.2d 280, 1999 N.D. LEXIS 194 (N.D. 1999).

When worker’s work-related carpal tunnel syndrome resolved and she was subsequently permanently disabled as a result of a non-work-related back injury, she was no longer eligible for temporary disability benefits. Bjerke v. North Dakota Workers Compensation Bureau, 1999 ND 180, 599 N.W.2d 329, 1999 N.D. LEXIS 202 (N.D. 1999).

North Dakota Workforce Safety and Insurance erred in terminating the claimant?s disability benefits because the claimant was denied a fair hearing as he was not adequately advised that WSI contemplated terminating his disability benefits on the ground of lack of verification. Brockel v. N.D. Workforce Safety & Ins., 2014 ND 26, 2014 N.D. LEXIS 24 (Feb. 13, 2014).

Worker's rehabilitation and disability benefits were properly terminated because a reasoning mind could reasonably conclude the worker could return to work when (1) three medical providers, including one aware of the worker's employment duties, released the worker to return to work, and (2) no medical doctor certified the worker's disability status. Welch v. Workforce Safety & Ins., 2017 ND 210, 900 N.W.2d 822, 2017 N.D. LEXIS 212 (N.D. 2017).

65-05-08.2. Preacceptance disability benefits.

If, after receiving a claim for benefits, the organization determines that more information is needed to process the claim, but that the information in the file indicates the injured employee is more likely than not entitled to disability benefits, the organization may pay preacceptance disability benefits equal to the weekly disability benefit allowed under section 65-05-09. The organization may continue to pay preacceptance disability benefits to the employee during the period the claim is pending, unless the injured employee is not cooperating with requests from the organization for additional information needed to process the claim. The organization may not pay more than sixty days of preacceptance benefits. The organization may only recover a payment made to an injured employee under this section if that recovery is allowed under section 65-05-33. There is no appeal from an organization decision not to pay preacceptance disability benefits.

Source:

S.L. 1997, ch. 542, § 4; 2003, ch. 561, § 3; 2009, ch. 482, § 98; 2009, ch. 619, § 2.

65-05-08.3. Treating health care provider’s opinion.

  1. A presumption may not be established in favor of any health care provider’s opinion. The organization shall resolve conflicting medical opinions and in doing so the organization shall consider the following factors:
    1. The length of the treatment relationship and the frequency of examinations;
    2. The nature and extent of the treatment relationship;
    3. The amount of relevant evidence in support of the opinion;
    4. How consistent the opinion is with the record as a whole;
    5. Appearance of bias;
    6. Whether the health care provider specializes in the medical issues related to the opinion; and
    7. Other relevant factors.
  2. This section does not apply to managed care programs under section 65-02-20. For purposes of this section, the organization shall determine whether a health care provider is an injured employee’s treating health care provider.

Source:

S.L. 2009, ch. 620, § 1; 2013, ch. 504, § 1; 2019, ch. 523, § 9, eff August 1, 2019.

Notes to Decisions

Application.

In a workers’ compensation case, an opinion from a benefit claimant’s doctor was not entitled to controlling weight because the statute relating to treating doctor’s opinions did not apply to managed care programs. Whedbee v. N.D. Workforce Safety, 2014 ND 79, 845 N.W.2d 632, 2014 N.D. LEXIS 90 (N.D. 2014).

Requirements.

Administrative law judge (ALJ) properly found that an employee had sustained a compensable injury and was entitled to benefits because the ALJ made specific findings regarding the ALJ’s consideration of the evidence presented at the hearing, weighed the doctors’ competing opinions; because the ALJ had the opportunity to observe witnesses and the responsibility to assess the credibility of witnesses and resolve the conflicts in the evidence, the supreme court would not reweigh the evidence. State v. Sandberg, 2021 ND 39, 956 N.W.2d 342, 2021 N.D. LEXIS 39 (N.D. 2021).

Requirements.

District court erred in overturning the denial of workers’ compensation benefits by North Dakota Workforce Safety & Insurance (WSI) because WSI satisfied the statute by establishing that the claimant’s treating doctors’ opinions were inconsistent with other substantial record evidence and adequately explained its reasons for disregarding medical evidence favorable to her. Albright v. N.D. Workforce Safety & Ins., 2013 ND 97, 833 N.W.2d 1, 2013 N.D. LEXIS 92 (N.D. 2013).

65-05-09. Temporary total or permanent total disability — Weekly and aggregate benefit.

  1. If an injury causes temporary total or permanent total disability, the fund shall pay to the injured employee during that disability a weekly benefit equal to sixty-six and two-thirds percent of the gross average weekly wage of the injured employee, subject to a minimum of sixty percent and a maximum of one hundred twenty-five percent of the average weekly wage in the state. If an injured employee is disabled due to an injury, that injured employee’s benefits will be based upon the injured employee’s wage and the organization benefit rates in effect on the date of first disability.
  2. Unless otherwise provided in this subsection, if an injured employee suffers disability but is able to return to employment for a period of three consecutive calendar months or more, that injured employee’s benefits will be based upon the wage received at the time of the recurrence of the disability. If the wage received at the time of the recurrence of the disability is lower than the injured employee’s average weekly wage and the lower wage is due to the physical limitations of the compensable injury, the injured employee’s benefits must be based upon the injured employee’s average weekly wage. It is the burden of the injured employee to show the inability to earn as much as the injured employee’s average weekly wage is due to the physical limitation related to the injury. The organization benefit rates are those in effect at the time of that recurrence.
  3. The disability benefit or the combined disability benefit and dependency award may not exceed the weekly wage of the injured employee after deductions for social security and federal income tax.
  4. When an injured employee is permanently and totally disabled, must be maintained in a nursing home or similar facility, and has no dependent parent, spouse, or children, as much of that injured employee’s weekly benefit as is necessary may be used by the organization to help defray the cost of the nursing home care.

Source:

S.L. 1919, ch. 162, § 3, subs. C; 1921, ch. 141, § 1, subs. C; 1925, ch. 223, § 1, subs. C; 1925 Supp., § 396a3, subs. C; S.L. 1927, ch. 286, § 1, subs. C; 1929, ch. 260, § 1, subs. C; 1935, ch. 286, § 2, subs. C; 1941, ch. 305, § 2, subs. C; 1943, ch. 274, § 3; R.C. 1943, § 65-0509; S.L. 1945, ch. 337, § 2; 1947, ch. 375, § 6; 1949, ch. 354, § 6; 1951, ch. 344, § 5; 1953, ch. 353, § 2; 1957 Supp., § 65-0509; S.L. 1959, ch. 421, § 1; 1961, ch. 390, § 1; 1963, ch. 427, § 1; 1965, ch. 456, § 1; 1967, ch. 485, § 1; 1969, ch. 558, § 3; 1973, ch. 505, § 1; 1975, ch. 579, § 3; 1977, ch. 579, § 10; 1979, ch. 187, § 102; 1985, ch. 685, § 3; 1987, ch. 753, § 1; 1989, ch. 770, § 2; 1991, ch. 714, § 45; 1997, ch. 542, § 3; 1999, ch. 556, § 2; 2003, ch. 561, § 3; 2009, ch. 619, § 3, 2009, ch. 621, § 1; 2019, ch. 525, § 6, eff July 1, 2019; 2021, ch. 500, § 6, eff August 1, 2021.

Note.

Section 13 of chapter 500, S.L. 2021, provides, “ APPLICATION. This Act applies to all claims regardless of date of injury.”

Notes to Decisions

Benefit Rates.

Permanent impairment awards are to be based on the rate in effect at the time the impairment is determined, rather than the rate in effect on the date of injury. Gregory v. North Dakota Workmen's Compensation Bureau, 369 N.W.2d 119, 1985 N.D. LEXIS 334 (N.D. 1985).

Benefits Not Exclusive.

Since disability awards under this section were based on loss of earning capacity, such awards did not exclude an additional award for permanent partial disability under former N.D.C.C. § 65-05-12. Buechler v. North Dakota Workmen's Compensation Bureau, 222 N.W.2d 858, 1974 N.D. LEXIS 162 (N.D. 1974).

Neurosis.

Employee who suffered from hysteria and compensation neurosis causally connected with an injury sustained in the course of his employment and a resulting operation was entitled to recover under this act. Lyson v. North Dakota Workmen's Compensation Bureau, 129 N.W.2d 351, 1964 N.D. LEXIS 110 (N.D. 1964).

Nursing Home Costs.

Where claimant fractured her hip in the course of her employment in 1961, subsequently fell and broke her arm in hospital, was taken to nursing home in 1962, was declared permanently and totally disabled in 1964, received costs of nursing home care in addition to compensation from 1962 until 1965, and board’s 1965 application of compensation award to nursing home bill had been reversed, by district court, board could not, by 1969 resolution, reduce payments to claimant by applying large amount of her compensation award to the nursing home care either under theory that 1969 amendment allowing such a reduction of benefits was retroactive or theory that the section is merely remedial. Heddon v. North Dakota Workmen's Compensation Bureau, 189 N.W.2d 634, 1971 N.D. LEXIS 133 (N.D. 1971).

Retroactivity of 1969 Amendment.

N.D.C.C. § 1-02-10, which states that the code is not retroactively applicable unless expressly so declared, precludes the retroactive application of the 1969 amendment of this section concerning the right of the bureau to defray costs of nursing home care. Heddon v. North Dakota Workmen's Compensation Bureau, 189 N.W.2d 634, 1971 N.D. LEXIS 133 (N.D. 1971).

Social Security Offset.

The commissioner may take an offset against claimant’s lump sum temporary total disability award to the extent that the sum of the periodic workers’ compensation benefit and social security benefit exceeds 80% of claimant’s pre-disability income. Frost v. Chater, 952 F. Supp. 659, 1996 U.S. Dist. LEXIS 13442 (D.N.D. 1996).

Total Disability.

Generally speaking, total disability results when a workman is so disqualified from performing the usual tasks of a workman that he is unable to procure and retain employment, and in determining the extent of disability consideration must be given to the type of work being done at the time of the accident, the nature and extent of the injury, and the age, experience, training, and capabilities of the employee. Lyson v. North Dakota Workmen's Compensation Bureau, 129 N.W.2d 351, 1964 N.D. LEXIS 110 (N.D. 1964).

DECISIONS UNDER PRIOR LAW

Benefit Rates.

Under N.D.C.C. § 65-05-09(1), an employee’s benefits would be recalculated upon the recurrence of the disability, but a recalculation of average weekly wage occurred only if the employee was able to return to employment for a period of 12 consecutive calendar months or more before the recurrence of the disability that was the subject of the recalculation, and because the claimant had not returned to work for a period of 12 consecutive months or more at the time of the latest recurrence of his disability, the North Dakota Workforce Safety and Insurance was not authorized by N.D.C.C. § 65-05-09(1) to recalculate his average weekly wage. Stein v. Workforce Safety & Ins., 2006 ND 34, 710 N.W.2d 364, 2006 N.D. LEXIS 38 (N.D. 2006).

Collateral References.

Admissibility of evidence that injured plaintiff received benefits from a collateral source, on issue of malingering or motivation to extend period of disability, 47 A.L.R.3d 234.

Admissibility of opinion evidence as to employability on issue of disability in health and accident insurance and workers’ compensation cases, 89 A.L.R.3d 783.

Workers’ Compensation: Tips or gratuities as factor in determining amount of compensation. 16 A.L.R.5th 191.

Construction and application of state workers’ compensation laws to claim for hearing loss — Resulting from single traumatic accident or event, 90 A.L.R.6th 425.

65-05-09.1. Social security offset.

When an injured employee, or spouse or dependent of an injured employee, is eligible for and is receiving permanent total or temporary total disability benefits under section 65-05-09, and is also eligible for, is receiving, or will receive, benefits under title II of the Social Security Act [42 U.S.C. 423], the aggregate benefits payable under section 65-05-09 must be reduced, but not below zero, by an amount equal as nearly as practicable to one-half of such federal benefit. The federal benefit, or primary insurance amount, must be determined by the social security administration. The amount to be offset must equal the primary insurance amount rounded to the next lowest dollar less credit for either the entire amount of attorney’s fees and costs, or the fees and costs paid to an authorized representative of the employee as allowed by the social security administration, withheld from past-due social security benefits or paid directly by the claimant for representation before the social security administration. The amount of the offset computed by the organization initially must remain the same throughout the period of eligibility and may not be affected by any increase or decrease in federal benefits.

Any injured employee, or dependent of an injured employee, receiving permanent total or temporary total disability benefits under section 65-05-09 and whose benefits are offset as provided herein, is not eligible for any escalation of benefits which would adversely affect the organization’s right to offset workforce safety and insurance benefits against social security benefits, as provided for in this chapter. This offset will become effective on January 1, 1980, provided that it meets the criteria necessary to allow states to offset federal benefits under title II of the Social Security Act [42 U.S.C. 424a]. Providing further that:

  1. If the receipt of social security benefits results in an overpayment of temporary or permanent total disability benefits by the organization, a refund of any overpayment must be made by the injured employee or that overpayment must be taken from future disability benefits, permanent partial impairment awards, or personal reimbursements on the current claim or any future claim filed, at a recovery rate to be determined by the organization.
  2. If a claim has been accepted on an aggravation basis and the injured worker is eligible for social security benefits, the organization’s offset must be proportionally calculated.
  3. If any person described in this section refuses to authorize the release of information concerning the amount of benefits payable under the Social Security Act, the organization’s estimate of the amount is deemed to be correct until the actual amount is established and no adjustment may be made for any period of time covered by the refusal.

Source:

S.L. 1979, ch. 654, § 1; 1985, ch. 688, § 1; 1989, ch. 69, § 82; 1989, ch. 766, § 4; 1993, ch. 628, § 1; 2003, ch. 561, § 3; 2017, ch. 439, § 2, eff August 1, 2017.

Notes to Decisions

Applicability.

The social security offset does not apply if the state plan provides for a reduction in its benefits by reason of social security benefits. Frost v. Chater, 952 F. Supp. 659, 1996 U.S. Dist. LEXIS 13442 (D.N.D. 1996).

Amount of Offset.

Workers Compensation Bureau properly construed and applied the social security offset provisions of this section by computing the offset based solely on the claimant’s monthly SSA payment; this section neither requires nor allows the Bureau to adjust the social security offset because the Social Security Administration offset the claimant’s impairment award from her social security payments. Lee v. North Dakota Workers Compensation Bureau, 1998 ND 218, 587 N.W.2d 423, 1998 N.D. LEXIS 233 (N.D. 1998).

Federal Law.

Whether a payment received under a state workers compensation scheme constitutes a disability benefit which can be offset from social security benefits by the Social Security Administration is a question of federal law. Lee v. North Dakota Workers Compensation Bureau, 1998 ND 218, 587 N.W.2d 423, 1998 N.D. LEXIS 233 (N.D. 1998).

65-05-09.2. Retirement offset.

If an employee is entitled to permanent total disability benefits and social security retirement benefits under 42 U.S.C. sections 402 and 405, the aggregate wage-loss benefits payable under this title must be determined in accordance with this section. The employee’s social security retirement offset must equal forty percent of the calculated ratio of the employee’s average weekly wages, as calculated on the commencement of the first, or recurrent, disability under section 65-05-09, to the current state’s average weekly wage. Any offset calculated cannot exceed forty percent of the employee’s weekly social security retirement benefit. If a claim has been accepted on an aggravation basis and the employee is eligible for social security benefits, the organization’s offset must be proportionally calculated. An overpayment must be recouped in the same manner as set forth in section 65-05-09.1. This section applies to an employee who becomes entitled to and receives social security retirement benefits after June 30, 1989, or who receives social security retirement benefits that have been converted from social security disability benefits by the social security administration after June 30, 1989. A conversion by the organization from offsetting an employee’s social security disability benefits to offsetting an employee’s social security retirement benefits under this section may not result in a decrease in the aggregate amount of benefits the employee receives from both sources.

Source:

S.L. 1989, ch. 770, § 4; 1993, ch. 614, § 10; 2003, ch. 561, § 3.

Notes to Decisions

Application.

Because a benefit claimant’s total disability was determined prior to the 1989 and 1993 effective dates of N.D.C.C. § 65-05-09.2, the North Dakota Workforce Safety and Insurance (WSI) was unable to offset the claimant’s retirement benefits against his workers compensation disability benefits due to the claimant’s reliance interest in benefits and the obligation to pay by WSI. However, attorney fees and costs were not awarded since WSI did not act without substantial justification under the standard utilized in the Equal Access to Justice Act, 28 U.S.C.S. § 2412 because at least one judge agreed with the position advanced by WSI and it was a close question regarding unsettled law. Tedford v. Workforce Safety & Ins., 2007 ND 142, 738 N.W.2d 29, 2007 N.D. LEXIS 144 (N.D. 2007).

Law Reviews.

North Dakota Supreme Court Review (Tedford v. Workforce Safety & Ins., 2007 ND 142, 738 N.W.2d 29 (2007)), see 84 N.D. L. Rev. 567 (2008).

65-05-09.3. Retirement presumption — Termination of benefits upon retirement.

  1. An employee who has retired or voluntarily withdrawn from the labor force and who, at that time, was not eligible to receive temporary total disability, temporary partial disability, or permanent total disability benefits or to receive a rehabilitation allowance from the organization is presumed retired from the labor market. The presumption may be rebutted by a preponderance of the evidence; however, the subjective statement of an employee that the employee is not retired is not sufficient in itself to rebut objective evidence of retirement.
  2. An injured employee who begins receiving social security retirement benefits or other retirement benefits in lieu of social security retirement benefits or who attains retirement age for social security retirement benefits, unless the employee proves the employee is not eligible to receive social security retirement benefits or other benefits in lieu of social security retirement benefits, is considered retired. The organization may not pay any disability benefits, rehabilitation benefits, or supplementary benefits to an employee who is considered retired; however, the employee remains eligible for medical benefits, permanent partial impairment benefits, and the additional benefit payable under section 65-05-09.4.
  3. The organization retains liability for disability benefits, rehabilitation benefits, permanent partial impairment benefits, and medical benefits for an injured employee who is receiving social security retirement benefits or other retirement benefits in lieu of social security retirement benefits or who attains retirement age for social security retirement benefits, unless the employee is not eligible to receive social security retirement benefits or other benefits in lieu of social security retirement benefits, and who is gainfully employed and who suffers an injury arising out of and in the course of that employment. The organization may not pay disability or rehabilitation benefits under this subsection for more than three years, subject to section 65-05-09.2, for injuries occurring after August 1, 1997.
  4. If an employee is injured within the two years preceding the employee’s presumed retirement date, the organization shall pay disability benefits, rehabilitation benefits, or a combination of both benefits for no more than two years. If the duration of disability benefits, rehabilitation benefits, or a combination of both benefits extends beyond the presumed retirement date, the organization shall convert the benefit to an additional benefit payable at the date the disability ends or when two years of benefits have been paid, whichever occurs first.
  5. This section applies to an individual who begins receiving social security retirement benefits or other retirement benefits in lieu of social security retirement benefits or who attains retirement age for social security retirement benefits unless the employee proves the employee is not eligible to receive social security retirement benefits or other benefits in lieu of social security retirement benefits, after July 31, 1995.
  6. An injured employee who has received disability benefits that have been discontinued before retirement in accordance with this section is eligible to receive disability benefits after retirement if the injured employee meets the reapplication criteria under subsection 1 of section 65-05-08. Disability and rehabilitation benefits received under this subsection may not exceed three years.

Source:

S.L. 1991, ch. 714, § 46; 1995, ch. 623, § 1; 1997, ch. 543, § 2; 2003, ch. 561, § 3; 2011, ch. 510, § 1; 2019, ch. 528, § 1, eff August 1, 2019.

Notes to Decisions

Permanently Disabled Employee.

There is no statutory presumption of retirement for any employee who is permanently and totally disabled as defined in this title. Kallhoff v. North Dakota Workers' Compensation Bureau, 484 N.W.2d 510, 1992 N.D. LEXIS 97 (N.D. 1992).

An employee who planned to retire and submitted his letter of intent to retire, but then became permanently and totally disabled before his intended retirement date, was entitled to collect workers’ compensation benefits after the date of his retirement. Shiek v. N.D. Workers Comp. Bureau, 2001 ND 166, 634 N.W.2d 493, 2001 N.D. LEXIS 186 (N.D. 2001).

As a matter of law, an employee who becomes permanently and totally disabled on or before the employee’s intended retirement date has not retired or voluntarily withdrawn from the labor force. Shiek v. N.D. Workers Comp. Bureau, 2001 ND 166, 634 N.W.2d 493, 2001 N.D. LEXIS 186 (N.D. 2001).

Receipt of Benefits Prior to 1995.

This section does not terminate the disability benefits of workers who were already receiving permanent total disability benefits before 1995 amendment to this section took effect. Gregory v. North Dakota Workers Compensation Bureau, 1998 ND 94, 578 N.W.2d 101, 1998 N.D. LEXIS 87 (N.D. 1998).

This section does not apply to terminate the disability benefits of a claimant or other worker already receiving total disability benefits before the 1995 statute took effect, even as amended by 1997 amendment. Ash v. Traynor, 1998 ND 112, 579 N.W.2d 180, 1998 N.D. LEXIS 131 (N.D. 1998).

Retirement Presumption.

Bureau erred in ruling claimant’s permanent and total disability was irrelevant to application of retirement presumption under this section; clear language of section excludes permanently and totally disabled employees from operation of the presumption. Shiek v. North Dakota Workers Compensation Bureau, 1998 ND 139, 582 N.W.2d 639, 1998 N.D. LEXIS 154 (N.D. 1998).

Claimant must establish by a preponderance of the evidence that the claimant is totally and permanently disabled for retirement presumption not to apply. Shiek v. North Dakota Workers Compensation Bureau, 1998 ND 139, 582 N.W.2d 639, 1998 N.D. LEXIS 154 (N.D. 1998).

Workforce Safety and Insurance did not err in holding that the retirement presumption provisions of N.D.C.C. § 65-05-09.3(2) applied to an employee’s workers’ compensation claim because when the employee’s total disability benefits were terminated for a period beginning in August 1995, the employee lost the reliance interest in continued benefits and the provisions of the retirement presumption statute became applicable to the claim. Eslinger v. N.D. Workforce Safety & Ins., 2009 ND 90, 765 N.W.2d 731, 2009 N.D. LEXIS 95 (N.D. 2009).

Voluntary Withdrawal.

For purposes of eligibility for disability benefits, this section creates a presumption that an employee has “retired” when the employee has “voluntarily withdrawn from the labor force.” So, retirement is linked with the ordinary and commonly understood meaning that retirement is voluntary. Kallhoff v. North Dakota Workers' Compensation Bureau, 484 N.W.2d 510, 1992 N.D. LEXIS 97 (N.D. 1992).

Law Reviews.

Are Employees Obtaining “Sure and Certain Relief” Under the 1995 Legislative Enactments of the North Dakota Workers’ Compensation Act?, 72 N.D. L. Rev. 349 (1996).

North Dakota Supreme Court Review (Tedford v. Workforce Safety & Ins., 2007 ND 142, 738 N.W.2d 29 (2007)), see 84 N.D. L. Rev. 567 (2008).

65-05-09.4. Additional benefit payable.

If an injured employee’s benefits cease under subsection 2 of section 65-05-09.3, the organization shall pay to that employee every twenty-eight days a benefit based on the length of time the injured employee received disability benefits during the term of that claim. The organization shall pay the injured employee’s additional benefits until the employee’s death or for a period of time not to exceed the total length of time the employee received disability benefits under sections 65-05-08, 65-05-08.1, 65-05-09, and 65-05-10, and a vocational rehabilitation allowance under chapter 65-05.1, for that claim, whichever occurs first. The benefit is based on the injured employee’s compensation rate before any applicable social security offset. The percentage of that final payment payable as the additional benefit is:

At least 1 year and less than 3 years of disability 5 percent of weekly benefit. At least 3 years and less than 5 years of disability 10 percent of weekly benefit. At least 5 years and less than 7 years of disability 15 percent of weekly benefit. At least 7 years and less than 9 years of disability 20 percent of weekly benefit. At least 9 years and less than 11 years of disability 25 percent of weekly benefit. At least 11 years and less than 13 years of disability 30 percent of weekly benefit. At least 13 years and less than 15 years of disability 35 percent of weekly benefit. At least 15 years and less than 17 years of disability 40 percent of weekly benefit. At least 17 years and less than 20 years of disability 45 percent of weekly benefit. Twenty or more years of disability 50 percent of weekly benefit.

Click to view

However, the organization shall pay to an injured employee who has been determined to be catastrophically injured as defined by subdivision c of subsection 2 of section 65-05.1-06.1 an additional benefit, until the death of the employee, equal to one hundred percent of the final payment of the disability benefit that was discontinued under subsection 2 or 3 of section 65-05-09.3.

Source:

S.L. 1997, ch. 543, § 1; 2003, ch. 561, § 3; 2005, ch. 608, § 1.

65-05-09.5. Additional benefit payable — Alternative calculation.

  1. This section applies to an injured employee who has a claim for which:
    1. A compensable injury was incurred before August 1, 1995;
    2. The date of first disability or the date of successful reapplication under subsection 1 of section 65-05-08 was after July 31, 1995; and
    3. The injured employee received a determination of permanent and total disability before August 1, 2007.
  2. An injured employee who meets the requirements of subsection 1 is entitled to an alternative calculation of additional benefits payable instead of the calculation provided for under section 65-05-09.4. For the limited purpose of this alternative calculation, the organization shall use the calculation established under section 65-05-09.4 and shall consider that the injured employee’s pre-August 1, 1995, date of injury is also the injured employee’s date of first disability.

Source:

S.L. 2007, ch. 570, § 2.

65-05-10. Partial disability — Weekly benefit.

  1. If the injury causes temporary partial disability resulting in decrease of earning capacity, the disability benefit is sixty-six and two-thirds percent of the difference between the injured employee’s average weekly wage and the injured employee’s wage-earning capacity after the injury in the same or another employment. Partial disability benefits are subject to a maximum of one hundred twenty-five percent of the average weekly wage in the state. The combined partial disability benefits, dependency allowance, and postinjury wage-earning capacity may not exceed ninety percent of the average weekly wage of the injured employee.
  2. The benefits provided by this section are available to any otherwise eligible worker, providing the loss of earning capacity occurs after July 1, 1989. Partial loss of earning capacity occurring prior to July 1, 1989, must be paid at a rate to be fixed by the organization.
  3. Benefits must be paid during the continuance of partial disability, not to exceed a period of five years. The organization may waive the five-year limit on the duration of partial disability benefits in cases of catastrophic injury as defined in section 65-05.1-06.1 or when the injured worker is working and has long-term restrictions verified by clear and convincing objective medical and vocational evidence that limits the injured worker to working less than twenty-eight hours per week because of the compensable work injury. This subsection is effective for partial loss of earnings capacity occurring after June 30, 1991.
  4. The employee’s earnings capacity may be established by expert vocational evidence of a capacity to earn in the statewide job pool where the worker lives. Actual postinjury earnings are presumptive evidence of earnings capacity if the job employs the employee to full work capacity in terms of hours worked per week, and if the job is in a field related to the employee’s transferable skills. The presumption may be rebutted by competent evidence from a vocational expert that the employee’s actual earnings do not fairly reflect the employee’s earnings capacity in the statewide job pool, considering the employee’s capabilities, education, experience, and skills.

Source:

S.L. 1919, ch. 162, § 3, subs. D; 1921, ch. 141, § 1, subs. D; 1925, ch. 223, § 1, subs. D; 1925 Supp., § 396a3, subs. D; S.L. 1927, ch. 286, § 1, subs. D; 1929, ch. 260, § 1, subs. D; R.C. 1943, § 65-0510; S.L. 1945, ch. 337, § 3; 1957 Supp., § 65-0510; S.L. 1967, ch. 484, § 4; 1989, ch. 770, § 3; 1991, ch. 714, § 47; 1993, ch. 45, § 23; 1997, ch. 542, § 5; 1999, ch. 556, § 3; 2003, ch. 561, § 3; 2003, ch. 562, § 6; 2009, ch. 619, § 4; 2015, ch. 480, § 3, eff August 1, 2015; 2019, ch. 525, § 7, eff July 1, 2019; 2021, ch. 500, § 7, eff August 1, 2021.

Note.

Section 13 of chapter 500, S.L. 2021, provides, “ APPLICATION. This Act applies to all claims regardless of date of injury.”

Section 10 of chapter 525, S.L. 2019 provides, “ APPLICATION. Sections 1, 2, 4, 6, 7, and 8 of this Act apply to all claims regardless of date of injury.”

Notes to Decisions

Earning Capacity.

One of the rehabilitative goals of North Dakota’s workforce safety and insurance law was to return a disabled employee to substantial gainful employee with a minimum of retraining, as soon as possible after an injury has occurred, according to N.D.C.C. § 65-05.1-01(3). Since the evidence presented in the claimant’s case showed that the claimant could go to work as a store greeter despite wrist and shoulder pain the claimant had experienced in the claimant’s prior job, the evidence showed that the claimant had a residual earning capacity of $ 290 per week and was consistent with the establishment of earning capacity pursuant to N.D.C.C. § 65-05-10(3). Johnson v. N.D. Workforce Safety & Ins. Fund, 2012 ND 87, 816 N.W.2d 74, 2012 N.D. LEXIS 88 (N.D. 2012).

Effect of Discharge for Just Cause.

A discharge for just cause does not automatically bar an employee from receiving disability benefits. Wendt v. North Dakota Workers Compensation Bureau, 467 N.W.2d 720, 1991 N.D. LEXIS 56 (N.D. 1991).

Eligibility for Partial Disability Benefits.

There are three factors for determining whether an individual is entitled to partial disability benefits: First, there should be a physical disability; second, the disability should be partial, or in other words, the employee should be able to work subject to the disability; and third, there should be an actual loss of earning capacity that is causally related to the disability. Wendt v. North Dakota Workers Compensation Bureau, 467 N.W.2d 720, 1991 N.D. LEXIS 56 (N.D. 1991).

Trial court erred in upholding an order terminating an employee’s total disability benefits and awarding the employee partial disability benefits where the employee could not be returned to substantial gainful employment, as defined in N.D.C.C.§ 65-05.1-01(3), and did not have a retained earnings capacity to meet the income test of N.D.C.C. § 65-05.1-01(3). Rodenbiker v. Workforce Safety & Ins., 2007 ND 169, 740 N.W.2d 831, 2007 N.D. LEXIS 171 (N.D. 2007).

Termination of Award.

Evidence supported finding that an injured claimant refused to participate in rehabilitation options that were available to him; as such, the district court properly affirmed the Workforce Safety and Insurance order that terminated the award of rehabilitation benefits and partial disability benefits, pursuant to N.D.C.C. § 65-05.1-01. Tverberg v. Workforce Safety & Ins., 2006 ND 229, 723 N.W.2d 676, 2006 N.D. LEXIS 234 (N.D. 2006).

Trial court properly overturned a decision from the North Dakota Workforce Safety and Insurance to discontinue an employee’s partial disability benefits on the ground that it had paid the employee benefits for longer than the five-year limit provided by a 1991 amendment to N.D.C.C. § 65-05-10 where there was no evidence that after the employee’s June 1990 work injury, the employee ever regained the employee’s earning capacity. The plain language of N.D.C.C. § 65-05-10 required application of the five-year limit on disability benefits when an injured worker’s partial loss of capacity to earn wages happened after June 30, 1991. Reopelle v. Workforce Safety & Ins., 2008 ND 98, 748 N.W.2d 722, 2008 N.D. LEXIS 98 (N.D. 2008).

When the language of N.D.C.C. § 65-05-10(2) is considered in conjunction with the sparse legislative history for the specific provisions of that subsection and the general purpose of the legislation as a “cost saving bill,” the North Dakota Supreme Court concludes that the intention of the legislation is to limit partial disability benefits to a cumulative time period of five years; the North Dakota Supreme Court declines to amend or add language to N.D.C.C. § 65-05-10(2) to authorize payment of partial disability benefits for five continuous years before those benefits may be terminated. Therefore, benefits were properly terminated in a case where a claimant had been paid for 5 cumulative years, but not for five continuous years. Zimmerman v. N.D. Workforce Safety & Ins. Fund, 2010 ND 42, 779 N.W.2d 372, 2010 N.D. LEXIS 38 (N.D. 2010).

Total Disability.

Total disability exists when workman is unable, solely because of his job-related injury, to perform or obtain any substantial amount of labor in his particular line of work, or in any other for which he would be fitted. Jimison v. North Dakota Workmen's Compensation Bureau, 331 N.W.2d 822, 1983 N.D. LEXIS 252 (N.D. 1983).

Waiver.

Under N.D.C.C. § 65-05-10, the Workforce Safety and Insurance Fund (WSI) waived the five-year time limit for partial disability benefits; WSI accepted the employee’s doctor’s decision to limit amount of hours she was released to work, and the employee was informed she would receive benefits as long as WSI had verification of her continued disability. Von Ruden v. N.D. Workforce Safety & Ins. Fund, 2008 ND 166, 755 N.W.2d 885, 2008 N.D. LEXIS 169 (N.D. 2008).

Where employer reduced employee’s benefits to partial disability benefits upon her return to work and later discontinued those benefits after five years, employer properly applied N.D.C.C. 65-05-10(2) to deny waiver of five-year limitation although employee met the statutory requirements in that she had long-term restrictions and worked less than 28 hours per week; the plain language of the statute gave the employer the discretion as to whether to waive the five-year limitation when an employee meets one of the exceptions of the statute. Midthun v. N.D. Workforce Safety & Ins., 2009 ND 22, 761 N.W.2d 572, 2009 N.D. LEXIS 22 (N.D. 2009).

Excercise of the waiver provision in N.D.C.C. § 65-05-10(2) was interpreted as discretionary rather than mandatory because there was no indication that a mandatory requirement was intended by the legislature. Midthun v. N.D. Workforce Safety & Ins., 2009 ND 22, 761 N.W.2d 572, 2009 N.D. LEXIS 22 (N.D. 2009).

Collateral References.

Workers’ Compensation: Tips or gratuities as factor in determining amount of compensation, 16 A.L.R.5th 191.

Construction and application of state workers’ compensation laws to claim for hearing loss — Resulting from single traumatic accident or event, 90 A.L.R.6th 425.

65-05-10.1. Long-term temporary partial disability inflation adjustment.

This benefit only applies to claims with a date of first disability or date of successful reapplication occurring after June 30, 1991. For these claims, beginning on the first day of July immediately following the fifth full year of partial disability and every year thereafter, an injured employee who has received a waiver of the five-year cap on partial disability benefits under section 65-05-10 is eligible for a lump sum inflation adjustment. The organization shall calculate the lump sum inflation adjustment under this section on July first of each year by multiplying the previous year’s percent increase in the state’s average weekly wage, if any, by the total amount of partial disability payments paid to the injured employee in the preceding twelve months, including the preceding year’s inflationary adjustment award.

Source:

S.L. 2007, ch. 572, § 1.

65-05-11. Maximum and minimum compensation allowances — Total and partial disability. [Repealed]

Repealed by S.L. 1969, ch. 558, § 6.

65-05-12. Permanent impairment — Compensation — Time paid. [Repealed]

Repealed by S.L. 1995, ch. 624, § 2.

65-05-12.1. Permanent impairment. [Repealed]

Repealed by S.L. 1995, ch. 624, § 2.

65-05-12.2. Permanent impairment — Compensation — Time paid.

A permanent impairment is not intended to be a periodic payment and is not intended to reimburse the employee for specific expenses related to the injury or wage loss. If a compensable injury causes permanent impairment, the organization shall determine a permanent impairment award on the following terms:

  1. The organization shall calculate the amount of the award by multiplying thirty-five percent of the average weekly wage in this state on the date of the impairment evaluation, rounded to the next highest dollar, by the permanent impairment multiplier specified in subsection 10.
  2. The organization shall notify the employee by certified mail, to the last-known address of the employee, when that employee becomes potentially eligible for a permanent impairment award. After the organization has notified the employee, the employee shall file, within one hundred eighty days from the date the employee was notified, a written request for an evaluation for permanent impairment. Failure to file the written request within the one hundred eighty-day period precludes an award under this section.
  3. An injured employee is entitled to compensation for permanent impairment under this section only for those findings of impairment that are permanent and which were caused by the compensable injury. The organization may not issue an impairment award for impairment findings due to unrelated, noncompensable, or pre-existing conditions, even if these conditions were made symptomatic by the compensable work injury, and regardless of whether section 65-05-15 applies to the claim.
  4. An injured employee is eligible for an evaluation of permanent impairment only when all conditions caused by the compensable injury have reached maximum medical improvement. The injured employee’s doctor shall report to the organization the date an employee has reached maximum medical improvement and any evidence of impairment of function the injured employee has after that date. If the report states that the employee is potentially eligible for a permanent impairment award, the organization shall conduct a review and provide notice to the employee as provided by subsection 2. If the injured employee files a timely written request under subsection 2, the organization shall schedule an impairment evaluation by a doctor qualified to evaluate the impairment.
  5. A health care provider evaluating permanent impairment shall include a clinical report in sufficient detail to support the percentage ratings assigned. The organization shall adopt administrative rules governing the evaluation of permanent impairment. These rules must incorporate principles and practices of the sixth edition of the American medical association’s “Guides to the Evaluation of Permanent Impairment” modified to be consistent with North Dakota law, to resolve issues of practice and interpretation, and to address areas not sufficiently covered by the guides. Subject to rules adopted under this subsection, impairments must be evaluated under the sixth edition of the guides.
  6. The organization shall deduct, on a permanent impairment multiplier basis, from an award for impairment under this section, any previous impairment award under the workers’ compensation laws of any jurisdiction.
  7. An injured employee is not entitled to a permanent impairment award due solely to pain.
  8. Other than an award identified in subsection 11, an award may not be issued unless specifically identified and quantified within the sixth edition of the American medical association’s “Guides to the Evaluation of Permanent Impairment”.
  9. If an employee dies, the right to any compensation payable pursuant to an impairment evaluation previously requested by the employee under subsection 2, which remains unpaid on the date of the employee’s death, survives and passes to the employee’s dependent spouse, minor children, parents, or estate, in that order. If the employee dies, only those findings of impairment which are objectively verifiable such as values for surgical procedures and amputations may be considered in a rating for impairment. Impairment findings not supported by objectively verifiable evidence may not be included in a rating for impairment. The deceased employee’s dependents or representatives shall request an impairment award under this subsection within one year from the date of death of the employee.
  10. If the injury causes permanent impairment, the award must be determined based on the percentage of whole body impairment in accordance with the following schedule:
  11. An amputation of a finger or toe at the level of the distal interphalangeal joint or proximal to that joint, or the thumb or the great toe at the interphalangeal joint or proximal to that joint, which is determined to result in a whole body impairment of less than fourteen percent and which is not identified in the following schedule, is payable as a fourteen percent impairment. If an evaluation for the loss of an eye or for an amputation results in an award that is less than the permanent impairment multiplier identified in the following schedule, the organization shall pay an award equal to the permanent impairment multiplier set out in the following schedule:
  12. If there is a medical dispute regarding the percentage of an injured employee’s permanent impairment, all relevant medical evidence must be submitted to an independent health care provider who has not treated the employee and who has not been consulted by the organization in relation to the injury upon which the impairment is based. The organization shall establish a list of health care providers who have the training and experience necessary to conduct an evaluation of permanent impairment and to apply the sixth edition of the American medical association’s “Guides to the Evaluation of Permanent Impairment”. The organization shall define, by rule, the process by which the organization shall choose an independent health care provider or health care providers to review a disputed permanent impairment evaluation or rating. The decision of the independent health care provider or health care providers chosen under this process is presumptive evidence of the degree of permanent impairment of the employee which can only be rebutted by clear and convincing evidence. This subsection does not impose liability on the organization for an impairment award for a rating of impairment for a body part or condition the organization has not determined to be compensable as a result of the injury. The employee bears the expense of witness fees of the independent health care provider or health care providers if the employee disputes the findings of the independent health care provider or health care providers.
  13. An attorney’s fees are not payable unless there is a bona fide dispute as to the percentage of the employee’s permanent impairment or unless there is a dispute as to the employee’s eligibility for an award for permanent partial impairment. An attorney’s fees payable in connection with a permanent impairment dispute may not exceed twenty percent of the additional amount awarded upon final resolution of the dispute, subject to the maximum fees established pursuant to section 65-02-08.
  14. An attorney may not seek or obtain from an employee through a contingent fee arrangement, or on a percentage basis, costs or fees payable in connection with the award or denial of compensation for permanent impairment. A permanent impairment award is exempt from the claims of creditors, including an employee’s attorney, except as provided by section 65-05-29.
  15. If an injured employee qualifies for an additional award and the prior award was based upon the number of weeks, the impairment multiplier must be used to compare against the prior award of weeks in determining any additional award.

Impairment: Permanent impairment multiplier of: 1 to 13 percent 0 14 percent 10 15 percent 10 16 percent 15 17 percent 15 18 percent 20 19 percent 20 20 percent 25 21 percent 25 22 percent 30 23 percent 30 24 percent 30 25 percent 35 26 percent 35 27 percent 35 28 percent 40 29 percent 45 30 percent 50 31 percent 60 32 percent 70 33 percent 80 34 percent 90 35 percent 100 36 percent 110 37 percent 120 38 percent 130 39 percent 140 40 percent 150 41 percent 160 42 percent 170 43 percent 180 44 percent 190 45 percent 200 46 percent 210 47 percent 220 48 percent 230 49 percent 240 50 percent 260 51 percent 280 52 percent 300 53 percent 320 54 percent 340 55 percent 360 56 percent 380 57 percent 400 58 percent 420 59 percent 440 60 percent 465 61 percent 490 62 percent 515 63 percent 540 64 percent 565 65 percent 590 66 percent 615 67 percent 640 68 percent 665 69 percent 690 70 percent 715 71 percent 740 72 percent 765 73 percent 790 74 percent 815 75 percent 840 76 percent 865 77 percent 890 78 percent 915 79 percent 940 80 percent 965 81 percent 990 82 percent 1015 83 percent 1040 84 percent 1065 85 percent 1090 86 percent 1115 87 percent 1140 88 percent 1165 89 percent 1190 90 percent 1215 91 percent 1240 92 percent 1265 93 percent 1290 94 percent 1320 95 percent 1350 96 percent 1380 97 percent 1410 98 percent 1440 99 percent 1470 100 percent 1500

Click to view

For amputation of: Permanent impairment multiplier of: A thumb 65 The second or distal phalanx of the thumb 28 The first finger 40 The middle or second phalanx of the first finger 28 The third or distal phalanx of the first finger 22 The second finger 30 The middle or second phalanx of the second finger 22 The third or distal phalanx of the second finger 14 The third finger 20 The middle or second phalanx of the third finger 16 The fourth finger 16 The middle or second phalanx of the fourth finger 12 The leg at the hip 234 The leg at or above the knee 195 The leg at or above the ankle 150 A great toe 30 The second or distal phalanx of the great toe 18 Any other toe 12 For loss of: Permanent impairment multiplier of: An eye 150 Vision of an eye which equals or exceeds 20/200 corrected 100

Click to view

The award for the amputation of more than one finger of one hand may not exceed an award for the amputation of a hand. The award for the amputation of more than one toe of one foot may not exceed an award for the amputation of a foot. If any of the amputations or losses set out in this subsection combine with other impairments for the same work-related injury or condition, the organization shall issue an impairment award based on the greater of the permanent impairment multiplier allowed for the combined rating established under the sixth edition of the American medical association’s “Guides to the Evaluation of Permanent Impairment” or the permanent impairment multiplier set forth in this subsection.

Source:

S.L. 1995, ch. 624, § 1; 1999, ch. 551, § 2; 2001, ch. 580, § 1; 2003, ch. 561, § 3; 2007, ch. 573, § 1; 2009, ch. 622, § 1; 2011, ch. 511, § 1; 2013, ch. 499, § 6; 2019, ch. 523, §§ 10, 11, eff August 1, 2019.

Notes to Decisions

Constitutionality.

A worker’s right to receive partial permanent impairment benefits is not contractual in nature, and thus the application of this section to a worker injured before its effective date did not violate the constitutional prohibition against impairment of contract rights. Saari v. North Dakota Workers Compensation Bur., 1999 ND 144, 598 N.W.2d 174, 1999 N.D. LEXIS 173 (N.D. 1999).

Benefit Rates.

Permanent impairment awards are to be based on the rate in effect at the time the impairment is determined, rather than the rate in effect on the date of injury. Gregory v. North Dakota Workmen's Compensation Bureau, 369 N.W.2d 119, 1985 N.D. LEXIS 334 (N.D. 1985).

The right to receive permanent partial impairment benefits vests on the date eligibility is determined, not on the date of injury or the date of maximum medical improvement. Saari v. North Dakota Workers Compensation Bur., 1999 ND 144, 598 N.W.2d 174, 1999 N.D. LEXIS 173 (N.D. 1999).

Benefits Not Exclusive.

Since disability awards under former N.D.C.C. § 65-05-12 were based on the medical condition of the claimant, such awards did not exclude an additional award of permanent total disability under N.D.C.C. § 65-05-09. Buechler v. North Dakota Workmen's Compensation Bureau, 222 N.W.2d 858, 1974 N.D. LEXIS 162 (N.D. 1974).

Chronic Pain.

Where the claimant did not present medical evidence establishing that he was suffering from chronic pain nor that he was diagnosed with chronic pain syndrome, he was not entitled to a chronic pain syndrome evaluation under Chapter 15 of the AMA Guides Fourth Edition in order to assess an additional impairment based on chronic pain. Feist v. North Dakota Workers Compensation Bureau (Northern Bottling Co.), 1997 ND 177, 569 N.W.2d 1, 1997 N.D. LEXIS 196 (N.D. 1997).

Combination of Ratings.

The AMA Guides do not preclude the Workers Compensation Bureau from combining the ratings and awards for two separate claims pertaining to two separate anatomical impairments. Feist v. North Dakota Workers Compensation Bureau (Northern Bottling Co.), 1997 ND 177, 569 N.W.2d 1, 1997 N.D. LEXIS 196 (N.D. 1997).

This section as amended in 2001 requires that the total permanent impairment award given to workers with both prior and subsequent impairments must correspond to the combined value of all the prior and subsequent impairments on a whole-body impairment basis. Shiek v. N.D. Workers Comp. Bureau, 2002 ND 85, 643 N.W.2d 721, 2002 N.D. LEXIS 93 (N.D. 2002).

District court erred in affirming an administrative law judge’s order concluding that an injured employee was entitled to both the scheduled impairment award for vision loss and the whole body impairment award for his additional injuries because Workforce Safety and Insurance correctly determined that he was entitled to the greater of the combined rating for all accepted impairments under the AMA Guides or the injury schedule and the subject statute provided the greater permanent impairment multiplier. State v. Avila, 2020 ND 90, 942 N.W.2d 811, 2020 N.D. LEXIS 90 (N.D. 2020).

Construction of Award.

The term “weeks” in claimant’s permanent partial impairment award meant nothing more than dollars as compensation for loss of bodily function, did not substitute for periodic payments, and was not subject to social security offset. Frost v. Chater, 952 F. Supp. 659, 1996 U.S. Dist. LEXIS 13442 (D.N.D. 1996).

Factors Affecting Recovery.

Claimant who suffered five percent permanent partial disability due to partial loss of use of ankle was limited to recovery under schedule contained in former N.D.C.C. § 65-05-13 and was not entitled to have her earning capacity, age, or training considered in determining the amount of the award. Ambroson v. North Dakota Workmen's Compensation Bureau, 210 N.W.2d 85, 1973 N.D. LEXIS 112 (N.D. 1973).

Loss of Vision.

Bureau correctly applied former N.D.C.C. § 65-05-13, rather than former N.D.C.C. § 65-05-12, in determining and issuing a permanent partial impairment award to accident victim for injury to left eye resulting in partial loss of vision in such eye where the victim had an amblyopic defect in his right eye, which defect existed prior to the compensable injury to the left eye and which was not involved in the accident. Kavonius v. North Dakota Workmen's Compensation Bureau, 306 N.W.2d 209, 1981 N.D. LEXIS 292 (N.D. 1981).

Medical Opinion.

Where there was undisputed medical opinion of permanent partial impairment, and the workers compensation bureau failed to adequately explain its reasons for disregarding that evidence, the bureau erred in not finding that the claimant was entitled to benefits for permanent partial impairment. Hayes v. North Dakota Workers Compensation Bureau, 425 N.W.2d 356, 1988 N.D. LEXIS 151 (N.D. 1988).

Where the only medical evidence in the record showed that the claimant had a permanent partial impairment, both physicians discerned pain and its effect, and they identified objective evidence indicative of impairment, the workers compensation bureau erred in denying compensation solely because the claimant’s impairment was not substantiated by objective medical evidence under the American medical association’s guides to the evaluation of permanent impairment. Accordingly, the action was remanded for further proceedings by the bureau to determine the extent of impairment. Kroeplin v. North Dakota Workmen's Compensation Bureau, 415 N.W.2d 807, 1987 N.D. LEXIS 440 (N.D. 1987).

While injured employee’s doctor is required to report when employee reaches maximum medical improvement under subsection (5) of this section, such a report is not binding on the Workers Compensation Bureau. Sprunk v. North Dakota Workers Compensation Bureau, 1998 ND 93, 576 N.W.2d 861, 1998 N.D. LEXIS 88 (N.D. 1998).

District court properly held an administrative law judge erred in finding an employee had a 50% permanent partial impairment rating because the evidence was insufficient to establish a medical report relied on was based on the sixth edition of the American Medical Association’s Guides to the Evaluation of Permanent Impairment (AMA Guides), as the report, while using similar language, did not state the report’s evaluation was conducted under the AMA Guides, and no finding or evidence showed which edition of the AMA Guides the report’s author might “likely” have used. State v. Beaulieu, 2018 ND 213, 917 N.W.2d 211, 2018 N.D. LEXIS 217 (N.D. 2018).

Notification of Benefit Availability.

Claimants do not have a clear legal right to require the workers’ compensation bureau to notify them of the availability of impairment benefits. Tooley v. Alm, 515 N.W.2d 137, 1994 N.D. LEXIS 89 (N.D. 1994).

Law Reviews.

Are Employees Obtaining “Sure and Certain Relief” Under the 1995 Legislative Enactments of the North Dakota Workers’ Compensation Act?, 72 N.D. L. Rev. 349 (1996).

65-05-13. Scheduled injuries — Permanent loss of member — Compensation — Time compensation payable. [Repealed]

Repealed by S.L. 1995, ch. 624, § 2.

65-05-14. Scheduled injuries — Partial loss of use of member — Weekly compensation time — Compensation payable. [Repealed]

Repealed by S.L. 1995, ch. 624, § 2.

65-05-15. Aggravation awards.

When a compensable injury combines with a noncompensable injury, disease, or other condition, the organization shall award benefits on an aggravation basis, on the following terms:

  1. In cases of a prior injury, disease, or other condition, known in advance of the work injury, which has caused previous work restriction or interference with physical function the progression of which is substantially accelerated by, or the severity of which is substantially worsened by, a compensable injury, the organization shall pay benefits during the period of acute care in full. The period of acute care is presumed to be sixty days immediately following the compensable injury, absent clear and convincing evidence to the contrary. Following the period of acute care, the organization shall pay benefits on an aggravation basis.
  2. If the progression of a prior compensable injury is substantially accelerated by, or the severity of the compensable injury is substantially worsened by a noncompensable injury, disease, or other condition, the organization shall pay benefits on an aggravation basis.
  3. The organization shall pay benefits on an aggravation basis as a percentage of the benefits to which the injured worker would otherwise be entitled, equal to the percentage of cause of the resulting condition that is attributable to the compensable injury. Benefits payable on an aggravation basis are presumed to be payable on a fifty percent basis. The party asserting a percentage other than the presumed fifty percent may rebut the presumption with clear and convincing evidence to the contrary.
  4. When an injured worker is entitled to benefits on an aggravation basis, the organization shall still pay costs of vocational rehabilitation, burial expenses under section 65-05-26, travel, other personal reimbursement for seeking and obtaining medical care under section 65-05-28, and dependency allowance on a one hundred percent basis.

Source:

S.L. 1931, ch. 312, § 1; 1939, ch. 251, § 5; 1943, ch. 274, § 11; R.C. 1943, § 65-0515; S.L. 1953, ch. 353, § 6; 1957 Supp., § 65-0515; S.L. 1977, ch. 579, § 14; 1981, ch. 643, § 5; 1989, ch. 766, § 5; 1997, ch. 544, § 1; 2003, ch. 561, § 3; 2009, ch. 619, § 5.

Notes to Decisions

Applicability.

Because the administrative law judge determined that an employee sustained a compensable injury, and his compensable injury could combine with a noncompensable injury, disease, or other condition, as contemplated under the statute, the case was remanded to determine whether the statute applied and, if so, the proper calculation for an award of benefits to the employee. State v. Sandberg, 2021 ND 39, 956 N.W.2d 342, 2021 N.D. LEXIS 39 (N.D. 2021).

Aggravation of Preexisting Condition.

Where claimant was mentally defective prior to accident upon which claim was based, and mental deterioration followed, but because of claimant’s low original mentality, any further aggravation was said by experts to be immeasurable, claimant was allowed to recover an award of ten percent disability, or the minimum award for aggravation, even though claimant was totally disabled. Bender v. North Dakota Workmen's Compensation Bureau, 139 N.W.2d 150, 1965 N.D. LEXIS 91 (N.D. 1965).

Interpreting the 1997 version of this section, North Dakota Bureau of Workers Compensation properly applied the aggravation statute where a reasoning mind reasonably could have found from the evidence that claimant had preexisting fibromyalgia which caused substantial interference with her functioning, and that the work injury substantially aggravated claimant’s underlying preexisting fibromyalgia. Mikkelson v. North Dakota Workers Compensation Bureau, 2000 ND 67, 609 N.W.2d 74, 2000 N.D. LEXIS 82 (N.D. 2000).

Employee did not suffer a compensable injury to the back under N.D.C.C. § 65-01-02(10)(b)(7) [now subsec. (11)(b)(7)] because the injury was attributable to a pre-existing injury suffered in a car accident; moreover, the employee was unable to establish that the condition was substantially accelerated or worsened by the conditions of employment, which included standing, lifting, and walking. Myhre v. N.D. Workers Comp. Bureau, 2002 ND 186, 653 N.W.2d 705, 2002 N.D. LEXIS 239 (N.D. 2002).

Applicability.

This section applies when a “new” work injury “combines with” and aggravates a preexisting condition. Bruns v. North Dakota Workers Compensation Bureau, 1999 ND 116, 595 N.W.2d 298, 1999 N.D. LEXIS 92 (N.D. 1999).

Where a claimant did not introduce any evidence that his back condition constituted an aggravation of a compensable injury by a nonemployment injury as distinguished, from a new injury to the same area of his back, compensation was not granted for a non-work-related injury. Nohr v. North Dakota Workers Compensation Bureau, 419 N.W.2d 545, 1988 N.D. App. LEXIS 6 (N.D. Ct. App. 1988).

Computation of Compensation.

Aggravation of a preexisting condition by a compensable injury is compensable on a proportionate basis. Darnell v. North Dakota Workers Compensation Bureau, 450 N.W.2d 721, 1990 N.D. LEXIS 6 (N.D. 1990).

Computation of Degree of Aggravation.

Question of the degree to which an industrial accident aggravated a preexisting coronary disease and combined with it to bring about the death of claimant’s decedent was one of fact to be determined after the taking of evidence by the workmen’s compensation board, and the excuse that medical testimony was difficult to obtain for apportionment purposes was not sufficient to justify the board’s practice of awarding 50% of full benefits in all heart attack cases; therefore, where it was settled that claimant was entitled to some compensation, and in the absence of an evidentiary hearing to determine the proper percentage apportionment, she was entitled to receive full benefits. Stout v. North Dakota Workmen's Compensation Bureau, 253 N.W.2d 429, 1977 N.D. LEXIS 278 (N.D. 1977).

Where the workers compensation bureau ignored the testimony of three doctors indicating aggravation of the claimant’s chondromalacia by stair climbing, but it was obvious that the claimant suffered considerable impact to her knees from the repetitive climbing of stairs during her work, the findings of fact made by the agency were not supported by a preponderance of the evidence, and by ignoring the effect of the distinctive conditions of her job, the bureau did not make a just determination of her claim. Moses v. North Dakota Workers Compensation Bureau, 429 N.W.2d 436, 1988 N.D. LEXIS 255 (N.D. 1988).

“Condition”.

To activate the aggravation statute, a preexisting condition must be accompanied by an actual impairment or disability known in advance of the work-related injury. Darnell v. North Dakota Workers Compensation Bureau, 450 N.W.2d 721, 1990 N.D. LEXIS 6 (N.D. 1990).

Construction with Other Laws.

Under this section, read together with N.D.C.C. § 26.1-41-13(1), and in light of their respective purposes, defendant insurer could not offset workers’ compensation benefits after the Workers Compensation Bureau had applied subsection (4) (see now (3)) of this section and had reduced plaintiff ’s benefits by fifty percent as a result of an injury sustained in a later motor vehicle accident not related to his employment. Kroh v. American Family Ins., 487 N.W.2d 306, 1992 N.D. LEXIS 112 (N.D. 1992).

Death Benefit Claim.

This section is applicable to a death benefit claim. Balliet v. North Dakota Workmen's Compensation Bureau, 297 N.W.2d 791, 1980 N.D. LEXIS 294 (N.D. 1980).

Distinction Between Injuries.

This section expressly differentiates between “injuries” when it says “[i]n case of aggravation of a prior compensable injury by a nonemployment injury, the aggravation statute may be invoked where the nonemployment injury acts upon the prior compensable injury.” Kroh v. American Family Ins., 487 N.W.2d 306, 1992 N.D. LEXIS 112 (N.D. 1992).

Everyday Activity.

Under subdivision (3) (see now (2)) of this section, “[t]he aggravation statute may not be invoked if the result is but a natural progression of the compensable injury.” Thus, in some sense, an everyday activity or event can never substantially contribute to the severity, acceleration, or progression of a condition. Roggenbuck v. North Dakota Workers Compensation Bureau, 481 N.W.2d 599, 1992 N.D. LEXIS 47 (N.D. 1992).

Incident Precipitating Need for Treatment.

The fact that an incident precipitated the need for treatment, or precipitated an injury’s becoming disabling does not necessarily mean that such an event substantially contributed to the severity, acceleration, or progression of the condition or that it was a substantial factor in it. Roggenbuck v. North Dakota Workers Compensation Bureau, 481 N.W.2d 599, 1992 N.D. LEXIS 47 (N.D. 1992).

The fact that a person would not have immediately required surgery had the precipitating event not occurred does not necessarily mean the event was in any way a substantial factor. Roggenbuck v. North Dakota Workers Compensation Bureau, 481 N.W.2d 599, 1992 N.D. LEXIS 47 (N.D. 1992).

Legislative Intent.

The legislature’s failure to express its intention to offset workers’ compensation benefits reduced by application of the aggravation statute, shows its intent that there be no such offset. Kroh v. American Family Ins., 487 N.W.2d 306, 1992 N.D. LEXIS 112 (N.D. 1992).

Out-of-State Injury.

An injury which occurs in another state and which does not fall within provisions of N.D.C.C. § 65-08-01 is not compensable injury for purposes of this section, and if an out-of-state injury is aggravated by compensable injury occurring in North Dakota, benefits are to be apportioned in accordance with this section. Johnson v. North Dakota Workmen's Compensation Bureau, 344 N.W.2d 480, 1984 N.D. LEXIS 248 (N.D. 1984).

Prior Physical Condition.
—In General.

If injury is proximate cause of death or disability for which compensation is sought, physical condition of employee at and prior to time of injury is important only if injury for which compensation is sought was occasioned by disease that existed prior to injury. TWETEN v. NORTH DAKOTA WORKMEN'S COMPENSATION BUR., 69 N.D. 369, 287 N.W. 304, 1939 N.D. LEXIS 163 (N.D. 1939).

Purpose.

The obvious purpose of the 1981 amendment to this section is to bar payment of workers’ compensation benefits for whatever aggravation that a nonemployment injury causes to a prior compensable injury. Providing benefits only for work-related injury and not for aggravation to work-related injury by nonemployment injury is in accord with the purpose of the Workers’ Compensation Act, to provide sure and certain relief for workers injured in their employment. Kroh v. American Family Ins., 487 N.W.2d 306, 1992 N.D. LEXIS 112 (N.D. 1992).

Structural Weakness of Claimant.

This statute applies only to aggravation of an existing disease and does not require or permit a structural weakness to be considered in allowance of compensation. TWETEN v. NORTH DAKOTA WORKMEN'S COMPENSATION BUR., 69 N.D. 369, 287 N.W. 304, 1939 N.D. LEXIS 163 (N.D. 1939).

DECISIONS UNDER PRIOR LAW

“Active impairment”.

Active impairment under subsection (1) does not require proof of permanent impairment. Bruns v. North Dakota Workers Compensation Bureau, 1999 ND 116, 595 N.W.2d 298, 1999 N.D. LEXIS 92 (N.D. 1999) (applying 1989 version of statute).

Aggravation of Preexisting Condition.

Determination that worker’s prior knee injury was a preexisting condition at the time of his work-related knee injury was supported by the evidence. Bruns v. North Dakota Workers Compensation Bureau, 1999 ND 116, 595 N.W.2d 298, 1999 N.D. LEXIS 92 (N.D. 1999) (applying 1989 version of statute).

Law Reviews.

Evidence in Workmen’s Compensation Cases, Daniel E. Buchanan, 54 N.D. L. Rev. 173 (1977).

65-05-16. Death benefits payable.

  1. The organization may pay benefits under this chapter in the case of the death of an injured employee as the direct result of an injury sustained in the course of the injured employee’s employment when:
    1. If there has been no disability preceding death, the death occurs within one year after the date of the injury;
    2. If there has been disability preceding death, the death occurs within one year after the cessation of disability resulting from the injury;
    3. If there has been disability that has continued to the time of death, the death occurs within six years after the date of injury; or
    4. If there has been disability that has continued to the time of death, the death occurs more than six years after the date of injury, and the injured employee has been designated catastrophically injured as defined under section 65-05.1-06.1.
  2. The organization may not pay death benefits unless a claim is submitted within two years of the death and:
    1. The death is a direct result of an accepted compensable injury; or
    2. If a claim was not submitted by the deceased, the claim for death benefits is submitted within two years of the injury.

Source:

S.L. 1919, ch. 162, § 3, subs. G; 1921, ch. 141, § 1, subs. G; 1925, ch. 223, § 1, subs. G; 1925 Supp., § 396a3, subs. G; S.L. 1927, ch. 286, § 1, subs. G; 1929, ch. 260, § 1, subs. G; 1935, ch. 286, § 2, subs. G; 1939, ch. 251, § 1, subs. G; 1943, ch. 274, § 6; R.C. 1943, § 65-0516; S.L. 1977, ch. 579, § 15; 1979, ch. 652, § 2; 1997, ch. 545, § 1; 2003, ch. 561, § 3; 2007, ch. 570, § 3.

65-05-17. Weekly compensation allowances for death claims.

If death results from an injury under the conditions specified in section 65-05-16, the fund shall pay to the following persons, for the periods specified:

  1. To the decedent’s spouse or to the guardian of the children of the decedent, an amount equal to the benefit rate for total disability under section 65-05-09. All recipients of benefits under this subsection are eligible for benefits at the rate provided in this section, regardless of the date of death of the deceased employee. These benefits continue until the death of the decedent’s spouse; or, if the surviving children of the decedent are under the care of a guardian, until those children no longer meet the definition of child in this title. If there is more than one guardian for the children who survive the decedent, the organization shall divide the death benefits equally among the children and shall pay benefits to the children’s guardians. Total death benefits, including supplementary benefits, paid on any one claim may not exceed three hundred thousand dollars.
  2. To each child of the deceased employee, the amount of fifteen dollars per week. This rate must be paid to each eligible child regardless of the date of death. The organization may pay the benefit directly to the child of the deceased employee or to the surviving parent or guardian of the child. Dependency allowance may not be reduced by the percentage of aggravation.
  3. In addition to the payments provided under subsections 1 and 2, a payment in the sum of two thousand five hundred dollars to the decedent’s spouse or the guardian of the children of the decedent and eight hundred dollars for each dependent child. If there is more than one guardian of the decedent’s surviving children, the two thousand five hundred dollars must be divided equally among the children and paid to the children’s guardians.

Source:

S.L. 1919, ch. 162, § 3, subs. G, subds. a to g, k; 1921, ch. 141, § 1, subs. G, subds. a to g, k; 1925, ch. 223, § 1, subs. G, subds. a to g, k; 1925 Supp., § 396a3, subs. G, subds. a to g, k; S.L. 1927, ch. 286, § 1, subs. G, subds. a to g, k; 1929, ch. 260, § 1, subs. G, subds. a to g, k; 1935, ch. 286, § 2, subs. G; 1939, ch. 251, § 1, subs. G, subds. a to g, k; 1943, ch. 274, §§ 7, 8; R.C. 1943, § 65-0517; S.L. 1945, ch. 337, § 6; 1949, ch. 354, § 9; 1953, ch. 353, § 7; 1955, ch. 354, § 14; 1957 Supp., § 65-0517; S.L. 1959, ch. 421, § 3; 1965, ch. 457, § 1; 1967, ch. 484, § 7; 1973, ch. 507, § 1; 1975, ch. 582, § 1; 1977, ch. 579, § 16; 1979, ch. 652, § 3; 1979, ch. 653, § 1; 1981, ch. 643, § 6; 1983, ch. 700, § 3; 1985, ch. 685, § 4; 1985, ch. 688, § 2; 1987, ch. 754, § 1; 1989, ch. 295, § 15; 1989, ch. 766, § 6; 1997, ch. 545, § 2; 1999, ch. 557, § 1; 2003, ch. 561, § 3; 2003, ch. 562, § 7; 2009, ch. 619, § 6.

Notes to Decisions

Marriage of Child, Annulment.

Where incompetent child of deceased employee has her marriage annulled because of such incompetency, thus avoiding marriage ab initio, incompetent is entitled to receive compensation from bureau as though no marriage ceremony ever took place. First Nat'l Bank v. North Dakota Workmen's Compensation Bureau, 68 N.W.2d 661, 1955 N.D. LEXIS 90 (N.D. 1955).

Separate Dependency Rights.

Claims of parents against workers’ compensation fund, based upon dependency, are separate claims upon which each parent may have separate right of appeal to district court. Weisgerber v. Workmen's Compensation Bureau, 70 N.D. 165, 292 N.W. 627, 1940 N.D. LEXIS 157 (N.D. 1940).

Rights of claimants to participate in fund because of dependency upon deceased insured employee are individual rights, and claims asserting such rights are separate claims. Weisgerber v. Workmen's Compensation Bureau, 70 N.D. 165, 292 N.W. 627, 1940 N.D. LEXIS 157 (N.D. 1940).

Collateral References.

Statute permitting new action after failure of original action commenced within period of limitations, as applicable in cases where original action failed for lack of jurisdiction, 6 A.L.R.3d 1043.

65-05-18. Provisions of section 65-05-17 retroactive. [Repealed]

Repealed by omission from this code.

65-05-19. Providing nondependency payments in certain cases.

If the death of an employee with no surviving spouse or dependent children results from an injury within the time specified in section 65-05-16, the organization shall pay a lump sum equal to five percent of the maximum total death benefits specified in subsection 1 of section 65-05-17 to the surviving nondependent child, or in equal shares to the surviving nondependent children. In the event that no nondependent child is living, the sum provided under this section must be paid in equal shares to the surviving parents of the deceased, and if there are none, then to the deceased employee’s living brothers and sisters. If there are no living brothers or sisters, the sum under this section must be paid in equal shares to the surviving grandparents, if any, of the deceased employee.

Source:

S.L. 1941, ch. 306, § 1; R.C. 1943, § 65-0519; S.L. 1969, ch. 565, § 1; 1973, ch. 508, § 1; 1975, ch. 583, § 1; 1977, ch. 579, § 17; 1983, ch. 699, § 4; 2003, ch. 561, § 3; 2005, ch. 609, § 1.

65-05-20. Dependents have option of accepting amount of nondependency payments in lieu of dependency compensation. [Repealed]

Repealed by S.L. 1969, ch. 565, § 2.

65-05-20.1. Scholarship fund — Rules.

  1. The organization may establish a scholarship fund. Scholarships may be awarded to:
    1. The spouse and child of a worker who dies as a result of a compensable work-related injury, if the spouse and child have received benefits under section 65-05-17;
    2. The spouse and child of a worker who is deemed to be catastrophically injured as defined in subdivision c of subsection 2 of section 65-05.1-06.1; and
    3. Injured workers for whom the organization determines a scholarship would be beneficial and appropriate because of exceptional circumstances, or upon successful completion of a rehabilitation program contemplated under subdivision g of subsection 4 of section 65-05.1-01, as determined by the organization.
  2. For purposes of this section, child includes a legitimate child, a step child, adopted child, posthumous child, foster child, and acknowledged illegitimate child between twenty-three and twenty-six years of age who is enrolled as a full-time student in any accredited educational institution and is dependent upon the employee for support.
  3. Scholarships are payable to an accredited institution of higher education or an institution of technical education on behalf of a student attending that institution.
  4. The total amount awarded annually in scholarships may not exceed five hundred thousand dollars. The maximum amount payable on behalf of an applicant is ten thousand dollars per year for no more than five years, except that the combined retraining and scholarship periods for applicants successfully completing a rehabilitation program under subdivision g of subsection 4 of section 65-05.1-01 may not exceed five years.
  5. Scholarships must be awarded by a panel chosen by the organization. The organization shall adopt rules establishing selection criteria and obligations associated with the program and identifying information an applicant is required to submit to determine an appropriate scholarship award. Scholarships may be awarded at the sole discretion of the organization. There is no right to reconsideration, rehearing, or appeal from any decision regarding the award, denial, or amount of a scholarship.

Source:

S.L. 1997, ch. 545, § 3; 1999, ch. 557, § 2; 2001, ch. 581, § 1; 2003, ch. 561, § 3; 2005, ch. 610, § 3; 2011, ch. 512, § 4; 2015, ch. 480, § 4, eff August 1, 2015.

65-05-21. Marriage settlement to spouse.

If a spouse who receives compensation under the provisions of subsection 1 of section 65-05-17 remarries, there shall be paid to such spouse a lump sum equal to one hundred four weeks’ compensation. If, prior to such marriage, such spouse has received a partial lump sum settlement which covers all or any portion of the said one hundred four weeks following such spouse’s marriage, the amount of such partial lump sum settlement which covers all or any part of the said one hundred four weeks following such spouse’s marriage shall be deducted from such marriage settlement, and the spouse shall receive only the remainder, if any, over and above such deduction. Any judgment annulling such marriage shall not reinstate the right of such spouse to compensation if the action for annulment is instituted more than six months after the marriage. The provisions of this section apply only to remarriages that occur before August 1, 2003, regardless of the date of injury or date of death of the decedent.

Source:

S.L. 1919, ch. 162, § 3, subs. G, subd. a; 1921, ch. 141, § 1, subs. G, subd. a; 1925, ch. 223, § 1, subs. G, subd. a; 1925 Supp., § 396a3, subs. G, subd. a; S.L. 1927, ch. 286, § 1, subs. G, subd. a; 1929, ch. 260, § 1, subs. G, subd. a; 1939, ch. 251, § 1, subs. G, subd. a; R.C. 1943, § 65-0521; S.L. 1973, ch. 509, § 1; 1977, ch. 579, § 18; 2003, ch. 562, § 8.

Notes to Decisions

Deduction for Overpayment.

Where widow was awarded compensation for death of her husband and received partial settlement which was an advance on compensation awarded but not yet due, and later she remarried, that portion of partial settlement which had been advanced to her for compensation not accrued at time of her marriage constituted an overpayment and was properly deducted from marriage settlement. Thompson v. North Dakota Workmen's Compensation Bureau, 66 N.D. 756, 268 N.W. 710, 1936 N.D. LEXIS 223 (N.D. 1936).

65-05-22. Adjustment on cessation of compensation for death to one beneficiary.

Upon the cessation of compensation payable to a beneficiary under the provisions of this chapter, the compensation of the remaining persons entitled to compensation for the unexpired part of the period during which their compensation is payable, shall be that which such persons would have received if they had been the only persons entitled to compensation at the time of the decedent’s death.

Source:

S.L. 1919, ch. 162, § 3, subs. G, subd. h; 1921, ch. 141, § 1, subs. G, subd. h; 1925, ch. 223, § 1, subs. G, subd. h; 1925 Supp., § 396a3, subs. G, subd. h; S.L. 1927, ch. 286, § 1, subs. G, subd. h; 1929, ch. 260, § 1, subs. G, subd. h; 1939, ch. 251, § 1, subs. G, subd. h; R.C. 1943, § 65-0522; 2003, ch. 562, § 9.

65-05-23. Organization may modify apportionment of benefits in certain cases. [Repealed]

Repealed by S.L. 1997, ch. 545, § 6.

65-05-24. Accepting compensation after marriage — Penalty. [Repealed]

Repealed by S.L. 2003, ch. 562, § 13.

65-05-25. Lump sum settlements — Granted in discretion of organization — How computed.

  1. If an employee is determined to be permanently and totally disabled, the organization may pay the employee a lump sum equal to the present value of all future payments of compensation. The probability of the employee’s death before the expiration of the period during which the employee is entitled to compensation must be determined by generally accepted mortality studies. The organization may not pay the employee a lump sum unless it has first determined that there is clear and convincing evidence that the lump sum payment is in the best interest of the employee. Best interest of the employee may not be deemed to exist because the employee can invest the lump sum in another manner to realize a better yield. The employee must show a specific plan of rehabilitation which will enable the employee to return as a productive member of society.
  2. The organization and an employee may compromise to resolve a disputed claim. The contract of settlement made is enforceable by the parties. The contract may provide that the employee shall utilize the funds to engage in certain rehabilitation programs. If the employee breaches the contract, the organization may require the employee to repay the benefits received under the agreement. In cases in which the extent of disability is disputed and resolved by agreement, the concept of reopening a disability claim due to significant change in medical condition is inapplicable.
  3. If death results from an injury under the conditions specified in section 65-05-16, the organization may pay the decedent’s spouse or the guardian of the decedent’s children a lump sum equal to the present value of all future payments of compensation.
  4. Notwithstanding any other provision of law, structured settlements may be used to resolve a dispute or to provide for payment of ongoing future benefits. The organization may contract with a third-party vendor to provide structured settlement payments.

Source:

S.L. 1919, ch. 162, § 3, subs. H; 1921, ch. 141, § 1, subs. H; 1925, ch. 223, § 1, subs. H; 1925 Supp., § 396a3, subs. H; S.L. 1927, ch. 286, § 1, subs. G, subd. 1; 1929, ch. 260, § 1, subs. G, subd. 1; 1935, ch. 286, § 2, subs. G, subd. 1; 1939, ch. 251, § 1, subs. G, subd. 1; 1943, ch. 274, § 9; R.C. 1943, § 65-0525; S.L. 1945, ch. 337, § 7; 1957 Supp., § 65-0525; S.L. 1967, ch. 486, § 1; 1969, ch. 566, § 1; 1977, ch. 579, § 19; 1981, ch. 643, § 7; 1989, ch. 766, § 7; 1991, ch. 714, § 49; 1993, ch. 614, § 11; 2003, ch. 561, § 3; 2003, ch. 562, § 10; 2005, ch. 610, § 4.

Notes to Decisions

Acceptance as Waiver of Future Benefits.

Injured worker who agreed after consulting with counsel to forego any further disability benefits in exchange for a lump sum settlement from Workers Compensation Bureau was bound by the terms of the agreement and could not subsequently reapply for disability benefits based on a subsequent significant change in his medical condition. Kerzman v. North Dakota Workers Compensation Bureau, 1999 ND 44, 590 N.W.2d 888, 1999 N.D. LEXIS 48 (N.D. 1999).

Attorney Fees.

Bureau exceeded its statutory authority by denying a claimant attorney fees for representation before the bureau on his request for a lump sum settlement on the ground that his claim had not been “denied or reduced” under an administrative regulation adopted by the bureau. Moore v. North Dakota Workmen's Compensation Bureau, 374 N.W.2d 71, 1985 N.D. LEXIS 388 (N.D. 1985).

Inclusion of the phrase “or a lump sum stipulated to by the claimant after an opportunity to seek legal counsel” was not prompted by any concern to differentiate between instances in which attorney fees shall be paid for claimants seeking a lump sum settlement. Rather, the only intent that can be discerned for the amendment was to preserve the bureau’s general fund by allowing the bureau to pay a claimant less than it would otherwise have been required under the statute. Moore v. North Dakota Workmen's Compensation Bureau, 374 N.W.2d 71, 1985 N.D. LEXIS 388 (N.D. 1985).

Authority of Bureau.

The authority for the bureau to make a lump sum payment is given in this section. A lump sum “may” be paid if the bureau “determines [that] it is in the best interest of the claimant.” Schiff v. North Dakota Workers' Compensation Bureau, 480 N.W.2d 732, 1992 N.D. LEXIS 23 (N.D. 1992).

The bureau is not compelled to make a lump sum payment whenever a disabled claimant believes that it is in his “economic best interest.” Schiff v. North Dakota Workers' Compensation Bureau, 480 N.W.2d 732, 1992 N.D. LEXIS 23 (N.D. 1992).

Future Benefits.

The ordinary meaning of the phrase “present value of future payments,” with this section is the amount which, if presently received, could be invested in order to yield the sum of future benefits. Thus, present value has nothing to do with past due benefits. Effertz v. North Dakota Workers' Compensation Bureau, 481 N.W.2d 218, 1992 N.D. LEXIS 28 (N.D. 1992).

No Interest on Delayed Benefits.

This section merely authorized the bureau to pay a lump sum settlement if it is in the best interest of the claimant, the sum to be calculated by using standard mortality tables for all future payments of benefits. But, the court cannot discern any language within this section that authorizes the bureau to pay interest on delayed benefits. Effertz v. North Dakota Workers' Compensation Bureau, 481 N.W.2d 218, 1992 N.D. LEXIS 28 (N.D. 1992).

Power Limited to Bureau.

Express power to make lump-sum award, or to ascertain its necessity is not conferred upon, nor possessed by court, but is limited to discretion of bureau. Gotchy v. North Dakota Workmen's Compensation Bureau, 49 N.D. 915, 194 N.W. 663, 1923 N.D. LEXIS 42 (N.D. 1923).

Collateral References.

Workers’ Compensation: Tips or gratuities as factor in determining amount of compensation, 16 A.L.R.5th 191.

65-05-26. Burial expenses.

If death benefits are payable under section 65-05-16, the fund shall pay to the facility handling the funeral arrangements of the deceased employee burial expenses not to exceed ten thousand dollars.

Source:

S.L. 1919, ch. 162, § 3, subs. I; 1921, ch. 141, § 1, subs. I; 1925, ch. 223, § 1, subs. I; 1925 Supp., § 396a3, subs. I; S.L. 1927, ch. 286, § 1, subs. G, subd. m; 1929, ch. 260, § 1, subs. G, subd. m; 1939, ch. 251, § 1, subs. G, subd. m; 1943, ch. 274, § 10; R.C. 1943, § 65-0526; S.L. 1945, ch. 337, § 8; 1949, ch. 354, § 10; 1957 Supp., § 65-0526; S.L. 1967, ch. 484, § 8; 1973, ch. 511, § 1; 1977, ch. 579, § 20; 1981, ch. 643, § 8; 1983, ch. 700, § 4; 1997, ch. 545, § 4; 1999, ch. 557, § 3; 2009, ch. 619, § 7.

Notes to Decisions

Allowance Does Not Affect Dependency Claim.

An emergency allowance for medical services, ambulance services and funeral expenses of deceased employee does not constitute such an action upon parent’s claim for dependency as will bar his right of appeal as dependent claimant. Weisgerber v. Workmen's Compensation Bureau, 70 N.D. 165, 292 N.W. 627, 1940 N.D. LEXIS 157 (N.D. 1940).

65-05-27. Organization without probate proceedings may pay spouse of deceased claimant sum due deceased — Maximum payment.

If a compensation claimant dies, the organization, without probate proceedings, may pay to the spouse of such claimant, if living, or in the event of the claimant’s spouse’s death or incompetency, to any adult person who has assumed or paid the expenses of the last illness or funeral expense of the said claimant, the amount actually due claimant’s estate, not to exceed the sum of one thousand dollars.

Source:

S.L. 1939, ch. 251, § 1, subs. G, subd. o; 1941, ch. 305, § 3; R.C. 1943, § 65-0527; S.L. 1949, ch. 354, § 11; 1957 Supp., § 65-0527; S.L. 1959, ch. 422, § 1; 1973, ch. 512, § 1; 2003, ch. 561, § 3.

65-05-28. Examination of injured employee — Paid expenses — No compensation paid if injured employee refuses to reasonably participate.

An injured employee may select a health care provider of that injured employee’s choice to render initial treatment. Upon a determination that the injured employee’s injury is compensable, the organization may require the injured employee to begin treating with another health care provider to better direct the medical aspects of the injured employee’s claim. The organization shall provide a list of three health care providers who specialize in the treatment of the type of injury the employee sustained. At the organization’s request, the injured employee shall select a health care provider from the list. An injured employee shall follow the directives of the health care provider treating the injured employee as chosen by the injured employee at the request of the organization and comply with all reasonable requests during the time the injured employee is under medical care. Providing further that:

  1. An injured employee may not change from one health care provider to another while under treatment or after being released, without the prior written authorization of the organization. Failure to obtain approval of the organization renders the injured employee liable for the cost of treatment and the new health care provider will not be considered the attending health care provider for purposes of certifying temporary disability.
    1. Any injured employee requesting a change of health care provider shall file a written request with the organization stating all reasons for the change. Upon receipt of the request, the organization shall review the injured employee’s claim and approve or deny the change of health care provider, notifying the injured employee and the requested health care provider.
    2. Emergency care or treatment or referral by the attending health care provider does not constitute a change of health care provider and does not require prior approval of the organization.
  2. Travel and other personal reimbursement for seeking and obtaining medical care is paid only upon request of the injured employee. All claims for reimbursement must be supported by the original vendor receipt, when appropriate, and must be submitted within one year of the date the expense was incurred or reimbursement must be denied. Reimbursement must be made at the organization reimbursement rates in effect on the date of incurred travel or expense. The calculation for reimbursement for travel by motor vehicle must be calculated using miles actually and necessarily traveled. A personal reimbursement requested under this subsection is a managed care decision under section 65-02-20, subject to the appeal process as provided for in section 65-02-20. Providing further that:
    1. Payment for mileage or other travel expenses may not be made when the distance traveled is less than fifty miles [80.47 kilometers] one way, unless the total mileage equals or exceeds two hundred miles [321.87 kilometers] in a calendar month;
    2. All travel reimbursements are payable at the rates at which state employees are paid per diem and mileage, except that the organization may pay no more than actual cost of lodging, if actual cost is less;
    3. Reimbursement may not be paid for travel other than that necessary to obtain the closest available medical or hospital care needed for the injury. If the injured employee chooses to seek medical treatment outside a local area where care is available, travel reimbursement may be denied;
    4. Reimbursement may not be paid for the travel and associated expenses incurred by the injured employee’s spouse, children, or other persons unless the injured employee’s injury prevents travel alone and the inability is medically substantiated; and
    5. Other expenses, including telephone calls and car rentals are not reimbursable expenses.
  3. The organization may at any time require an injured employee to submit to an independent medical examination or independent medical review by one or more duly qualified allied health care professionals designated or approved by the organization. The organization shall make a reasonable effort to designate a duly qualified allied health care professional licensed in the state in which the injured employee resides to conduct the examination before designating a duly qualified allied health care professional licensed in another state or shall make a reasonable effort to designate a duly qualified allied health care professional licensed in a state other than the injured employee’s state of residence if the examination is conducted at a site within two hundred seventy-five miles [442.57 kilometers] from the injured employee’s residence. An independent medical examination and independent medical review must be for the purpose of review of the diagnosis, prognosis, treatment, or fees. An independent medical examination contemplates an actual examination of an injured employee, either in person or remotely if appropriate. An independent medical review contemplates a file review of an injured employee’s records, including treatments and testing. The injured employee may have a duly qualified health care provider designated by that employee present at the examination or later review the written report of the allied health care professional performing the independent medical examination, if procured and paid for by that injured employee. Providing further that:
    1. In case of any disagreement between allied health care professionals making an examination on the part of the organization and the injured employee’s allied health care professional, the organization shall appoint an impartial allied health care professional duly qualified who shall make an examination and shall report to the organization.
    2. The injured employee, in the discretion of the organization, may be paid reasonable travel and other per diem expenses under the guidelines of subsection 2. If the injured employee is working and loses gross wages from the injured employee’s employer for attending the examination, the gross wages must be reimbursed as a miscellaneous expense upon receipt of a signed statement from the employer verifying the gross wage loss.
  4. If an injured employee, or the injured employee’s representative, refuses to submit to, or in any way intentionally obstructs, any examination or treatment, or refuses to reasonably participate in medical or other treatments or examinations, the injured employee is medically noncompliant. If the organization determines an injured employee is medically noncompliant without good cause, the organization shall discontinue disability and vocational rehabilitation benefits. At any time the injured employee is medically noncompliant, efforts by the injured employee to come into compliance are not considered successful compliance until the injured employee has been compliant for a period of at least sixty days. If the period of medical noncompliance continues for sixty days following the date disability and vocational rehabilitation benefits are discontinued, or a second instance of medical noncompliance occurs without good cause, the organization may not pay any further disability and vocational rehabilitation benefits, regardless of whether the injured employee sustained a significant change in medical condition due to the work injury. The period of noncompliance must be deducted from the period for which compensation is payable to the injured employee.
  5. If an injured employee undertakes activities, whether or not in the course of employment, which exceed the treatment recommendations of the injured employee’s health care provider regarding the work injury, and the health care provider determines the employee’s injury or condition has been aggravated or has worsened as a result of the injured employee’s activities, the organization may not pay benefits relative to the aggravation or worsening, unless the activities were undertaken at the demand of an employer. An employer’s account may not be charged with the expenses of an aggravation or worsening of a work-related injury or condition unless the employer knowingly required the injured employee to perform activities that exceed the treatment recommendations of the injured employee’s health care provider.

Source:

S.L. 1919, ch. 162, § 16; 1925 Supp., § 396a16; S.L. 1941, ch. 305, § 5; R.C. 1943, § 65-0528; S.L. 1973, ch. 513, § 1; 1975, ch. 584, § 9; 1977, ch. 579, § 21; 1989, ch. 765, § 6; 1989, ch. 766, § 8; 1991, ch. 714, § 50; 1995, ch. 625, § 1; 1999, ch. 550, § 2; 2003, ch. 561, § 3; 2009, ch. 615, § 2; 2009, ch. 623, § 1; 2009, ch. 624, § 1; 2011, ch. 512, § 5; 2017, ch. 439, § 3, eff August 1, 2017; 2019, ch. 523, § 12, eff August 1, 2019; 2019, ch. 525, § 8, eff July 1, 2019.

Notes to Decisions

Aggravation Benefits.

The 1995 amendment to this section, which precludes aggravation benefits if the employee undertakes activities exceeding the treatment recommendations of his physician, applied to claimant’s reapplication for aggravation benefits where claimant did not have the right to claim aggravation benefits at the time of the original 1992 injury, but rather only at the time the aggravation occurred in 1997. Tangen v. North Dakota Workers Compensation Bureau, 2000 ND 135, 613 N.W.2d 490, 2000 N.D. LEXIS 140 (N.D. 2000).

Appointment of Third Physician.

Claimant was not entitled to appointment of third physician due to disagreement of two physicians where both physicians had been designated by the claimant and paid by the bureau; this section applied only when there was a disagreement between a physician selected and paid by the bureau and a physician selected and paid by the claimant. Ambroson v. North Dakota Workmen's Compensation Bureau, 210 N.W.2d 85, 1973 N.D. LEXIS 112 (N.D. 1973).

Burden of Proof.

If the employer or the Bureau invokes this section, legislative history demonstrates an intention to place the burden upon them to demonstrate that the employee performed activities beyond his restrictions. Tangen v. North Dakota Workers Compensation Bureau, 2000 ND 135, 613 N.W.2d 490, 2000 N.D. LEXIS 140 (N.D. 2000).

Intentional Obstruction of Testing.

A claimant who attempts to manipulate a functional capacity evaluation by willfully failing to perform to the full extent of his or her abilities may be found to have intentionally obstructed the test, and benefits may be suspended under N.D.C.C. § 65-05-28(4). Zueger v. North Dakota Workers Compensation Bureau, 1998 ND 175, 584 N.W.2d 530, 1998 N.D. LEXIS 190 (N.D. 1998).

Knowing and Intentionally Exceeding Work Restrictions.

District court’s judgment denying benefits reversed and case remanded where the Bureau’s findings failed to support an application of this section where neither the Bureau nor the ALJ determined that claimant knew of the specific light work restrictions and intentionally exceeded those known restrictions. Holen v. North Dakota Workers Compensation Bureau, 2000 ND 145, 615 N.W.2d 141, 2000 N.D. LEXIS 156 (N.D. 2000).

Payment of Cross-Examination.

Where, in disagreement between physicians making examination on part of bureau and employee’s physician, bureau appointed impartial physician, bureau could refuse to pay expenses of cross-examination of its physician or physicians by claimant. Froysland v. North Dakota Workers Compensation Bureau, 432 N.W.2d 883, 1988 N.D. LEXIS 233 (N.D. 1988).

Proximity to Claimant.

In a workers’ compensation case, a benefits claimant failed to show prejudice because an independent medical examination was not conducted closer to his residence; the claimant failed to show how that prejudiced him or discredited the opinion of his physician. Whedbee v. N.D. Workforce Safety, 2014 ND 79, 845 N.W.2d 632, 2014 N.D. LEXIS 90 (N.D. 2014).

Suspension of Benefits.

The legislature intended different meaning for the words “examination” and “treatment” used in this section; the Bureau may suspend benefits for an employee’s refusal to reasonably participate under subsection (4) only if the particular procedure constituted “treatment.” Ali v. North Dakota Workers Compensation Bureau, 1998 ND 146, 583 N.W.2d 115, 1998 N.D. LEXIS 168 (N.D. 1998).

Bureau’s decision to suspend benefits because worker failed to “reasonably participate” in examination was not in accordance with law; this section only provides for suspension of benefits for refusing to submit to or “intentionally obstructing” examination, as failure to “reasonably participate” refers to the worker’s involvement in the treatment. Ali v. North Dakota Workers Compensation Bureau, 1998 ND 146, 583 N.W.2d 115, 1998 N.D. LEXIS 168 (N.D. 1998).

Workforce Safety and Insurance’s decision to discontinue a worker’s benefits was supported by a preponderance of the evidence where the worker failed to provide sufficient evidence of a good cause for her failure to attend an independent medical examination. Bjerklie v. Workforce Safety & Ins., 2005 ND 178, 704 N.W.2d 818, 2005 N.D. LEXIS 209 (N.D. 2005).

Where WSI properly terminated a claimant’s benefits under N.D.C.C. §§ 65-05.1-04, 65-05-28(4) for the claimant’s noncompliance with a functional capacity evaluation, a district court abused its discretion in finding that WSI acted without substantial justification and in awarding attorney’s fees under N.D.C.C. § 28-32-50. Drayton v. Workforce Safety & Ins., 2008 ND 178, 756 N.W.2d 320, 2008 N.D. LEXIS 180 (N.D. 2008).

North Dakota Workforce Safety and Insurance (WSI) erred in finding that the employee failed to show that his wage loss was the result of his compensable left shoulder injury because the fact that his noncompensable vertebral artery occlusion made it impractical for him to either return to work or undergo surgery necessary to return him to employment did not break the causal connection, the employee had not unreasonably refused to undergo surgery for his left shoulder injury, and WSI's notice of intention to discontinue/reduce benefits seemed to foreclose a functional capacity assessment. Brockel v. N.D. Workforce Safety & Ins., 2014 ND 26, 2014 N.D. LEXIS 24 (Feb. 13, 2014).

Collateral References.

Employee’s reimbursement for travel expenses incurred in obtaining treatment of work-related injury, 36 A.L.R.5th 225.

Law Reviews.

North Dakota Supreme Court Review, 77 N.D. L. Rev. 589 (2001).

65-05-28.1. Employer to select preferred provider.

Notwithstanding section 65-05-28, any employer subject to this title may select a preferred provider to render medical treatment to employees who sustain compensable injuries. “Preferred provider” means a designated provider or group of providers of medical services, including consultations or referral by the provider or providers.

Source:

S.L. 1995, ch. 626, § 1; 2003, ch. 564, § 9; 2007, ch. 569, § 5.

Law Reviews.

Are Employees Obtaining “Sure and Certain Relief” Under the 1995 Legislative Enactments of the North Dakota Workers’ Compensation Act?, 72 N.D. L. Rev. 349 (1996).

65-05-28.2. Preferred provider — Use required — Exceptions — Notice.

  1. During the first thirty days after a work injury, an employee of an employer that has selected a preferred provider under this section may seek medical treatment only from the preferred provider for the injury. Treatment by a provider other than the preferred provider is not compensable and the organization may not pay for treatment by a provider who is not a preferred provider, unless a referral was made by the preferred provider. A provider who is not a preferred provider may not certify disability or render an opinion about any matter pertaining to the injury, including causation, compensability, impairment, or disability. This section does not apply to emergency care nor to any care the employee reasonably did not know was related to a work injury.
  2. An employee of an employer that has selected a preferred provider may elect to be treated by a different provider provided the employee makes the election and notifies the employer in writing before the occurrence of an injury.
  3. After thirty days have passed following the injury, the employee may make a written request to the organization to change providers. The employee shall make the request and serve it on the employer and the organization at least thirty days before treatment by the provider. The employee shall state the reasons for the request and the employee’s choice of provider.
  4. If the employer objects to the provider selected by the employee under subsection 2 or 3, the employer may file an objection to the change of provider. The employer shall detail in the objection the grounds for the objection and shall serve the objection on the employee and the organization within five days of service of the request. The employee may serve, within five days of service of the employer’s objection, a written response on the employer and the organization in support of the request for change of provider. Within fifteen days after receipt of the response or of the expiration of the time for filing the response, the organization shall rule on the request. Failure of the organization to rule constitutes approval of the request. Treatment by the employee’s chosen provider is not compensable until the organization approves the request. The preferred provider remains the treating provider until the organization approves the employee’s request to change providers.
  5. An employer that selects a preferred provider shall give notice and post notice as required under this subsection.
    1. An employer shall give written notice of the identity and the terms of the preferred provider program:
      1. To the employer’s employees when the employer makes an initial selection of a preferred provider.
      2. To the employer’s employees when the employer changes the selection of the preferred provider.
      3. To an employee at the time of hire.
      4. To the employer’s employees at least annually after the initial notice.
    2. An employer that has selected a preferred provider shall display notice of the identity of the preferred provider and the terms of the preferred provider program in a conspicuous manner at fixed worksites, and wherever feasible at mobile worksites, and in a sufficient number of places to reasonably inform employees of the identity of the preferred provider and of the terms of the preferred provider program.
    3. Failure to give written notice, to properly post notice, or to reasonably inform employees of the terms of the preferred provider program as required under this subsection invalidates the selection for the employee’s claim.

Source:

S.L. 1995, ch. 626, § 2; 1999, ch. 550, § 3; 2003, ch. 561, § 3; 2009, ch. 625, § 1; 2013, ch. 505, § 1.

Notes to Decisions

Requirements.

Workforce Safety & Insurance (WSI) did not err in finding that the employer failed to comply with the specific statutory requirements of N.D.C.C. § 65-05-28.2(5); WSI did not err in concluding that the employer’s selection of a designated medical provider was invalid and that the employee was permitted to select his own medical provider. Indus. Contrs. v. Workforce Safety & Ins., 2009 ND 157, 772 N.W.2d 582, 2009 N.D. LEXIS 168 (N.D. 2009).

65-05-29. Assignment of claims void — Claims exempt.

  1. Any assignment of a claim for compensation under this title is void. All compensation and claims therefor are exempt from claims of creditors except any of the following:
    1. A child support obligation ordered by a court of competent jurisdiction.
    2. A claim by job service North Dakota for reimbursement of unemployment benefits, for the amount that was paid by job service North Dakota during the period for which the claimant is found eligible for temporary total or permanent total disability benefits, not to exceed the disability award actually made by the organization.
    3. A claim by the organization for any payments made due to:
      1. Clerical error, mistake of identity, innocent misrepresentation by or on behalf of the recipient, or any other circumstance of a similar nature, all not induced by fraud, in which cases the recipient shall repay it or recoupment of any unpaid amount may be made from any future payments due to the recipient on any claim with the organization;
      2. An adjudication by the organization or by order of any court, if the final decision is that the payment was made under an erroneous adjudication, in which cases the recipient shall repay it or recoupment of any unpaid amount may be made from any future payments due to the recipient on any claim with the organization;
      3. Fraud, in which case the recipient shall repay the payment or the unpaid amount of the sum may be recouped from any future payments due to the recipient on any claim with the organization;
      4. Overpayment due to application of section 65-05-09.1; or
      5. A claim by the organization for premiums, penalties, and interest under chapter 65-04.
    1. Notwithstanding paragraph 2 of subdivision c of subsection 1, during the sixty days immediately following the date of injury, if the organization accrues a health care provider expense or makes a payment for a medical expense and the organization later determines the medical expense is for the care and treatment of a noncompensable injury, disease, or other condition, the injured employee is not liable for the medical expense accrued or paid by the organization before the earlier of:
      1. The third day following the date the organization makes a determination the medical expense is for a noncompensable injury, disease, or condition; or
      2. The third day following the date the injured employee or medical provider reasonably should have known the medical expense is for a noncompensable injury, disease, or condition.
    2. Medical expenses incurred under this subsection may not be charged against an employer’s account for purposes of experience rating.

Source:

S.L. 1919, ch. 162, § 22; 1925 Supp., § 396a22; R.C. 1943, § 65-0529; S.L. 1987, ch. 755, § 1; 1989, ch. 766, § 9; 1991, ch. 54, § 31; 2003, ch. 561, § 3; 2009, ch. 611, § 11; 2009, ch. 626, § 1; 2013, ch. 502, § 4; 2019, ch. 523, § 13, eff August 1, 2019.

Notes to Decisions

Authority of Bureau.

Subdivision (3) (now (1)(c)(1)) authorizes the bureau to make a claim for payments made, among other reasons, due to innocent misrepresentations by a recipient, or “made under an erroneous adjudication.” Johnson v. North Dakota Workers' Compensation Bureau, 484 N.W.2d 292, 1992 N.D. LEXIS 105 (N.D. 1992).

Collateral References.

Right of health or accident insurer to intervene in workmen’s compensation proceeding to recover benefits previously paid to claimant or beneficiary, 38 A.L.R.4th 355.

65-05-30. Filing of claim constitutes consent to use of information received by health care provider.

  1. The filing of a claim with the organization constitutes a consent to the use by the organization, in any proceeding by the organization or to which the organization is a party in any court, of any information, including prior and subsequent prognosis reports, medical records, medical bills, and other information concerning any health care or health care services which was received by any health care provider, hospital, or clinic in the course of any examination or treatment of the claimant.
  2. The filing of a claim with the organization authorizes a health care provider, hospital, or clinic to disclose to the organization, or authorized representative of the organization, information or render an opinion regarding the injured employee’s claim with the organization. As used in this subsection, an opinion may include a statement regarding liability, causation, or a pre-existing condition or other information the organization deems necessary for the administration of this title. The filing of a claim with the organization authorizes a health care provider, hospital, or clinic to disclose any information to the organization deemed necessary for the administration of this title to the organization’s representative, or the employer, except any information directly disclosed to the employer must be relevant to the employee’s work injury or to return-to-work issues.
  3. If a health care provider furnishes information or an opinion under this section:
    1. That health care provider does not incur any liability as a result of furnishing that information or opinion.
    2. The act of furnishing that information or opinion may not be the sole basis for a disciplinary or other proceeding affecting professional licensure. However, the act of furnishing that information or opinion may be considered in conjunction with another action that may subject the health care provider to a disciplinary or other proceeding affecting professional licensure.

Source:

S.L. 1941, ch. 305, § 4; R.C. 1943, § 65-0530; S.L. 1977, ch. 579, § 22; 1989, ch. 766, § 10; 2003, ch. 561, § 3; 2005, ch. 610, § 5; 2015, ch. 481, § 1, eff March 19, 2015; 2019, ch. 523, § 14, eff August 1, 2019.

Notes to Decisions

Scope of Consent.

District court did not abuse its discretion under N.D.C.C. § 65-02-11, in restricting the Workforce Safety and Insurance (WSI) from requiring the claimant’s treating physician and physician’s assistant to review the WSI’s videotaped surveillance of the claimant in preparation for or during their ex parte, investigatory depositions, because the WSI’s attempt to require the treating physician and physician’s assistant to view the videotaped surveillance and answer questions relating to the videotape at the investigatory stage sought to interfere with the existing physician-patient relationship and went beyond the scope of the consent granted by the claimant in N.D.C.C. § 65-05-30. State v. Altru Health Sys., 2007 ND 38, 729 N.W.2d 113, 2007 N.D. LEXIS 38 (N.D. 2007).

Law Reviews.

Evidence in Workmen’s Compensation Cases, Daniel E. Buchanan, 54 N.D. L. Rev. 173 (1977).

North Dakota Supreme Court Review (State v. Altru Health Sys.), 83 N.D. L. Rev. 1085 (2007).

65-05-31. False statement — Penalty. [Repealed]

Repealed by S.L. 1975, ch. 106, § 673.

65-05-32. Privacy of records and hearings — Penalty.

Information contained in the claim files and records of injured employees is confidential and is not open to public inspection, other than to organization employees or agents in the performance of their official duties. Providing further that:

  1. Representatives of a claimant, whether an individual or an organization, may review a claim file or receive specific information from the file upon the presentation of the signed authorization of the claimant. However, reserve information may not be made available to the claimant or the claimant’s representatives. Availability of this information to employers is subject to the sole discretion of the organization.
  2. Employers or their duly authorized representatives who are required to have access to an injured employee’s claim file for the performance of their duties may review and have access to any files of their own injured employees. An employer or an employer’s duly authorized representative who willfully communicates information contained in an employee’s claim file to any person who does not need the information in the performance of that person’s duties is guilty of a class B misdemeanor.
  3. Allied health care professionals treating or examining employees claiming benefits under this title, or allied health care professionals giving medical advice to the organization regarding any claim may, at the discretion of the organization, inspect the claim files and records of injured employees.
  4. If an injured employee is deceased or is unable to communicate with the organization, the organization may provide the claim file to and communicate with relevant interested parties to properly adjudicate benefits.
  5. Other persons may have access to and make inspections of the files, if such persons are rendering assistance to the organization at any stage of the proceedings on any matter pertaining to the administration of this title.
  6. The claimant’s name; date of birth; injury date; employer name; type of injury; whether the claim is accepted, denied, or pending; and whether the claim is in active or inactive pay status will be available to the public. This information may not be released in aggregate form, except to those persons contracting with the organization for exchange of information pertaining to the administration of this title or except upon written authorization by the claimant for a specified purpose.
  7. At the request of a claimant, the organization may close the medical portion of a hearing to the public.
  8. The organization may release the social security number of an individual claiming entitlement to benefits under this title to health care providers or health care facilities for the purpose of adjudicating a claim for benefits.
  9. The organization may provide an injured employee’s insurer information regarding the injured employee’s claim.
  10. he organization may provide any state or federal agency any information obtained pursuant to the administration of this title. Any information so provided must be used for the purpose of administering the duties of that state or federal agency.

Source:

S.L. 1977, ch. 579, § 1; 1989, ch. 766, § 11; 1993, ch. 620, § 4; 2001, ch. 575, § 3; 2003, ch. 561, § 3; 2005, ch. 610, § 6; 2007, ch. 574, § 1; 2015, ch. 480, § 5, eff August 1, 2015; 2019, ch. 523, § 15, eff August 1, 2019; 2021, ch. 500, § 8, eff August 1, 2021.

Note.

Section 13 of chapter 500, S.L. 2021, provides, “ APPLICATION. This Act applies to all claims regardless of date of injury.”

Law Reviews.

Evidence in Workmen’s Compensation Cases, Daniel E. Buchanan, 54 N.D. L. Rev. 173 (1977).

65-05-33. Filing false claim or false statement — Penalty.

  1. A person who claims benefits or payment for services under this title or the employer of a person who claims benefits or payments for services is guilty of a class A misdemeanor if the person or employer does any one or more of the following:
    1. Willfully files a false claim or makes a false statement or an omission in an attempt to secure payment of benefits or payment for services.
    2. Willfully misrepresents that person’s physical condition, including deceptive conduct which misrepresents that person’s physical ability.
    3. Has a claim for disability benefits that has been accepted by the organization and willfully fails to notify the organization of:
      1. Work or other activities as required under subsection 3 of section 65-05-08;
      2. The receipt of income from work; or
      3. An increase in income from work.
  2. If any of the acts or omissions in subsection 1 are committed to obtain, or pursuant to a scheme to obtain, more than one thousand dollars in benefits or payment for services, the offense is a class C felony.
  3. In addition to any other penalties provided by law, the person claiming benefits or payment for services in violation of this section shall reimburse the organization for any benefits paid based upon the false claim or, false statement, or omission, and, if applicable, under section 65-05-29 and shall forfeit any additional benefits relative to that injury.
  4. For purposes of this section, “statement” includes any testimony, claim form, notice, proof of injury, proof of return-to-work status, bill for services, diagnosis, prescription, hospital or doctor records, x-ray, test results, or other evidence of loss, injury, or expense.

Source:

S.L. 1981, ch. 643, § 1; 1989, ch. 766, § 12; 1991, ch. 714, § 51; 1995, ch. 616, § 6; 1997, ch. 534, § 4; 2001, ch. 576, § 2; 2003, ch. 561, § 3; 2017, ch. 439, § 4, eff August 1, 2017; 2021, ch. 500, § 9, eff August 1, 2021.

Note.

Section 13 of chapter 500, S.L. 2021, provides, “ APPLICATION. This Act applies to all claims regardless of date of injury.”

Cross-References.

Falsification in governmental matters, see N.D.C.C. ch. 12.1-11.

Notes to Decisions

Double Jeopardy.

The Supreme Court would not consider whether worker’s criminal judgment for making a false statement and the subsequent imposition of a penalty under this section for his failure to report income while receiving disability benefits constituted double jeopardy based on counsel’s bald assertion first raised on appeal. Unser v. North Dakota Workers Compensation Bur., 1999 ND 129, 598 N.W.2d 89, 1999 N.D. LEXIS 149 (N.D. 1999).

The administrative remedy for making a false claim or false statement to the Workers Compensation Bureau is a civil sanction, and therefore a subsequent criminal prosecution of the worker does not violate the Double Jeopardy Clause of the federal constitution. State v. Stewart, 1999 ND 154, 598 N.W.2d 773, 1999 N.D. LEXIS 169 (N.D. 1999).

Defendant was properly convicted of workers’ compensation fraud under N.D.C.C. § 65-05-33 and N.D.C.C. § 65-05-08 after pleading guilty, and was not protected from criminal prosecution pursuant to double jeopardy because the administrative proceeding for reimbursement of benefits paid was considered civil sanction under N.D.C.C. § 65-05-33. State v. Hammer, 2010 ND 152, 787 N.W.2d 716, 2010 N.D. LEXIS 159 (N.D. 2010).

Due Process.

The employee’s due process rights were not violated when the North Dakota Workers Compensation Bureau (Bureau) terminated his benefits without a hearing as the employee had notice of the termination of benefits, a summary of the Bureau’s evidence, and the opportunity to respond in writing. Sjostrand v. N.D. Workers Comp. Bureau, 2002 ND 125, 649 N.W.2d 537, 2002 N.D. LEXIS 168 (N.D. 2002), cert. denied, 538 U.S. 928, 123 S. Ct. 1578, 155 L. Ed. 2d 321, 2003 U.S. LEXIS 2274 (U.S. 2003).

Expert Testimony.

N.D.C.C. § 65-02-24 did not compel a claimant’s treating physician to become an expert for the Workforce Safety and Insurance’s investigations into alleged violations of N.D.C.C. § 65-05-33 outside of the treating physician’s (or physician’s assistant) examination or treatment of the claimant. State v. Altru Health Sys., 2007 ND 38, 729 N.W.2d 113, 2007 N.D. LEXIS 38 (N.D. 2007).

Failure to Report Income.

Evidence was sufficient to support Workers Compensation Bureau’s finding that worker had willfully failed to report income while receiving disability benefits, and to support both forfeiture of future benefits and compulsory reimbursement of the benefits already received. Unser v. North Dakota Workers Compensation Bur., 1999 ND 129, 598 N.W.2d 89, 1999 N.D. LEXIS 149 (N.D. 1999).

Forfeiture of Future Benefits.

Where employee claimed workers’ compensation benefits and made a false statement about his prior medical history, in that he falsely reported that he had not had prior problems or injuries to the back, the worker’s compensation bureau reasonably determined that claimant’s false statement was sufficiently material to support a forfeiture of future benefits, even though it was not material enough to cause the bureau to pay initial benefits. F.O.E. Aerie 2337 v. North Dakota Workers Compensation Bureau, 464 N.W.2d 197, 1990 N.D. LEXIS 259 (N.D. 1990).

In worker’s reapplication for benefits, his misstatement of his last day of work with the employer, his false statement that his physician had advised him not to work, coupled with his false statement to a Bureau claims analyst that his new job involved light duty work “pushing buttons” when in fact it involved physical labor, were sufficiently material to warrant forfeiture of future benefits. Renault v. North Dakota Workers Compensation Bureau, 1999 ND 187, 601 N.W.2d 580, 1999 N.D. LEXIS 207 (N.D. 1999).

Based on the common understanding of work, claimant made a false statement when he reported no work activity while entering as a professional in major fishing tournaments, representing a marine store at boat shows, assisting on the sales floor, accepting entrance fees paid for by the store, and buying a new boat each season at a discounted price. Furthermore, the false statements were material and willful with regard to forfeiture of future benefits as they could have misled the Bureau to consider claimant’s physical capabilities unchanged and not pursue further inquiry into the true nature of his physical activities. Jacobson v. North Dakota Workers Compensation Bureau, 2000 ND 225, 621 N.W.2d 141, 2000 N.D. LEXIS 277 (N.D. 2000).

Order terminating an employee’s workers compensation benefits was reversed and remanded because the bureau did not prove that the employee willfully made a material false statement justifying forfeiture of future benefits under this section. The employee’s failure to report the receipt of money from the sale of vegetables was not material because the amount of money did not equal 10 percent of his income under N.D.C.C. § 65-05-08(8), the bureau did not provide the notice of penalties required by N.D.C.C. § 65-05-08(3), and the employee’s failure to report his gardening and harvest activities were not willful because casual activities not engaged in for remuneration or for an employer are not reasonably understood to be work. Wanner v. N.D. Workers Comp. Bureau, 2002 ND 201, 654 N.W.2d 760, 2002 N.D. LEXIS 272 (N.D. 2002).

Imposition of Sanctions.

The worker’s compensation bureau has the authority to impose administrative sanctions under this section upon its finding of a violation of such statute, regardless of whether the claimant is even prosecuted or convicted under the section. Hayden v. North Dakota Workers Compensation Bureau, 447 N.W.2d 489, 1989 N.D. LEXIS 191 (N.D. 1989).

Intentionality and Materiality.
—Evidence.

Evidence that a worker participated in an aerobics class, played golf, and engaged in weightlifting supported the Workers Compensation Bureau’s determination that the worker’s statements to medical providers about back pain, sitting intolerance, and lack of significant medical change over a four-year period were false. Vernon v. North Dakota Workers Compensation Bur., 1999 ND 153, 598 N.W.2d 139, 1999 N.D. LEXIS 168 (N.D. 1999).

Although there was substantial evidence regarding the nature and extent of the claimant’s work activities and income, in addition to her level of physical activity, from which a reasoning mind could reasonably have found that the claimant purposefully and intentionally made false statements, her misrepresentations had not caused workforce safety and insurance (WSI) to pay medical benefits in error or caused WSI to pay disability benefits in error after her surgery, as WSI had not provided any evidence that any of the medical benefits paid after that date would not have been paid as a result of the claimant’s work-related injuries. Forbes v. Workforce Safety & Ins. Fund, 2006 ND 208, 722 N.W.2d 536, 2006 N.D. LEXIS 211 (N.D. 2006).

There was substantial evidence regarding the nature and extent of the claimant’s work activities and income, in addition to her level of physical activity, from which a reasoning mind could reasonably have found that the claimant purposefully and intentionally made false statements; the false statements were material with regard to both the forfeiture of all future benefits and to the reimbursement of all disability benefits paid by workforce safety and insurance (WSI) up to the surgery performed on the claimant. Forbes v. Workforce Safety & Ins. Fund, 2006 ND 208, 722 N.W.2d 536, 2006 N.D. LEXIS 211 (N.D. 2006).

North Dakota Workforce Safety and Insurance (WSI) failed to prove that an employee made willful and material false statements in his claim for benefits because it had the employee’s medical records, it did not ask the employee about the chiropractic treatment, and the decision did not adequately explain the interrelationship of those records with WSI’s inconsistent findings about willfulness and with its conclusory statement that the employee’s failure to disclose the treatment was material. Schoch v. N.D. Workforce Safety & Ins., 2010 ND 25, 778 N.W.2d 542, 2010 N.D. LEXIS 26 (N.D. 2010).

Administrative law judge misinterpreted the statute when deciding a worker's false statements that the worker had received no money for work from any source other than Workforce Safety and Insurance were not willful because (1) the definition of “work” given to the worker did not except the worker's efforts assisting a brother in running a business, and (2) “willfully” only required the statements to be intentional in connection with a claim, so proof of intent to defraud was not required. Welch v. Workforce Safety & Ins., 2017 ND 210, 900 N.W.2d 822, 2017 N.D. LEXIS 212 (N.D. 2017).

—In General.

To trigger the statutory consequences of this section, a false statement must be intentional, not inadvertent, and material, not peripheral. F.O.E. Aerie 2337 v. North Dakota Workers Compensation Bureau, 464 N.W.2d 197, 1990 N.D. LEXIS 259 (N.D. 1990).

This section requires a materiality test to be applied to determine whether the false claim or false statement caused benefits to be paid in error, and allows for forfeiture of additional benefits in the future, whether or not the false claim or false statement is de minimis, because false statements should have some consequence. But a false statement must be intentional to trigger thee statutory consequences. F.O.E. Aerie 2337 v. North Dakota Workers Compensation Bureau, 464 N.W.2d 197, 1990 N.D. LEXIS 259 (N.D. 1990).

A false statement may be sufficiently material to support forfeiture of future benefits, even though it was not sufficiently material to mislead the bureau into paying initial benefits or to require the reimbursement of initial benefits. Dean v. North Dakota Workers Compensation Bureau, 1997 ND 165, 567 N.W.2d 626, 1997 N.D. LEXIS 184 (N.D. 1997).

In addition to proving that a false statement was made, the bureau must prove that the false statement was made intentionally. Hopfauf v. North Dakota Workers Compensation Bureau, 1998 ND 40, 575 N.W.2d 436, 1998 N.D. LEXIS 28 (N.D. 1998).

Claimant willfully and intentionally made material false statements when claiming he had not performed any work where credible evidence was presented that claimant acted as an auctioneer and ringmaster at approximately 35 auctions during the time he was receiving benefits. Hopfauf v. North Dakota Workers Compensation Bureau, 2000 ND 94, 610 N.W.2d 60, 2000 N.D. LEXIS 99 (N.D. 2000).

While the Bureau should have stated more specifically why it discounted medical evidence in the claimant’s favor regarding his inability to willfully make false statements to the Bureau, the weight of the evidence supported the Bureau’s finding that the claimant could indeed act willfully, for example, when he operated a forklift, did landscaping, operated a Bobcat, did concrete finishing, worked with sheet metal, worked on garage doors, did bookkeeping work for his business, and made bank deposits. Horob v. North Dakota Workers Compensation Bureau, 2000 ND 114, 611 N.W.2d 875, 2000 N.D. LEXIS 112 (N.D. 2000).

Bureau did not err in finding that claimant willfully made material false statements in his claims to the Bureau for reimbursement of mileage for doctors visits where claimant’s niece’s testimony about the trips along with other circumstantial evidence was sufficient to support that finding by a preponderance of the evidence. Aalund v. North Dakota Workers Compensation Bureau, 2001 ND 32, 622 N.W.2d 210, 2001 N.D. LEXIS 28 (N.D. 2001).

Claimant willfully made false statements in connection with his claim where he failed to report activities as work, within the common understanding of work, and failed to report income from those activities under N.D.C.C. § 65-05-08(3), both of which impeded the Bureau’s process of determining eligibility. Snyder v. North Dakota Workers Compensation Bureau, 2001 ND 38, 622 N.W.2d 712, 2001 N.D. LEXIS 38 (N.D. 2001).

—Forfeiture of Future Benefits.

If the bureau is seeking forfeiture of future benefits, a false claim or false statement is sufficiently material if it is a statement which could have misled the bureau or medical experts in a determination of the claim. Hausauer v. North Dakota Workers Compensation Bureau, 1997 ND 243, 572 N.W.2d 426, 1997 N.D. LEXIS 305 (N.D. 1997).

Claimant’s false statements regarding an injury occurring in 1995 did not justify termination of all future benefits related to a 1975 injury as those false statements could not have misled the Bureau or medical experts in determination of the earlier claim because the statements had nothing to do with the claimant’s continuing need for medical expense benefits related to that injury. Horob v. North Dakota Workers Compensation Bureau, 2000 ND 114, 611 N.W.2d 875, 2000 N.D. LEXIS 112 (N.D. 2000).

Where the Bureau found claimant willfully made false statements in connection with a claim, and those false statements were material and misled the Bureau in awarding him benefits, the record supported the Bureau’s finding that claimant forfeited any additional benefits because that he willfully made material false statements in his claims for reimbursement and not because he made a minor or innocent mistake. Aalund v. North Dakota Workers Compensation Bureau, 2001 ND 32, 622 N.W.2d 210, 2001 N.D. LEXIS 28 (N.D. 2001).

Where appellant submitted a claim for benefits to North Dakota Workforce Safety and Insurance (WSI) asserting that he injured his lower back while employed as a baker, he falsely indicated on the injury report that he had no prior lower back injuries; however, his medical records and chiropractic treatment records showed that he had sustained prior lower back injury in a car accident. The Supreme Court of North Dakota upheld WSI’s decision requiring appellant to forfeit future benefits under N.D.C.C. § 65-05-33 and to reimburse $11,500.47 for benefits WSI previously paid; appellant’s willful false statements were material and actually caused benefits to be paid in error. Neuhalfen v. N.D. Workforce Safety & Ins. Fund, 2009 ND 86, 765 N.W.2d 681, 2009 N.D. LEXIS 92 (N.D. 2009).

—Materality Tests.

There are differing materiality tests used to prove the materiality of a willful false statement dependent upon which civil penalty — the civil penalty of reimbursement of benefits paid and the civil penalty of forfeiture of future benefits — is sought by the bureau. Hausauer v. North Dakota Workers Compensation Bureau, 1997 ND 243, 572 N.W.2d 426, 1997 N.D. LEXIS 305 (N.D. 1997).

Two materiality tests are applied to false claims or statements under this section: if the bureau seeks reimbursement for benefits paid, the level of materiality required is proof by the bureau that the false claim or statement caused the benefits to be paid in error; however, if the bureau is seeking only forfeiture of future benefits, no such causal connection is required and a false claim or statement is sufficiently material for forfeiture if it could mislead the bureau or medical experts in a determination of the claim. Wanner v. N.D. Workers Comp. Bureau, 2002 ND 201, 654 N.W.2d 760, 2002 N.D. LEXIS 272 (N.D. 2002).

While a failure to report income from work is material to the workers compensation bureau’s ability to determine a claimant’s entitlement to benefits and to calculate the amount of benefits, a failure to report money received apart from work is not similarly material. Wanner v. N.D. Workers Comp. Bureau, 2002 ND 201, 654 N.W.2d 760, 2002 N.D. LEXIS 272 (N.D. 2002).

—Reimbursement.

If the bureau is seeking reimbursement for benefits paid, materiality requires the bureau to prove the false claim or false statement caused the benefits to be paid in error. Hausauer v. North Dakota Workers Compensation Bureau, 1997 ND 243, 572 N.W.2d 426, 1997 N.D. LEXIS 305 (N.D. 1997).

Legislative Intent.

The legislative history of this section indicates the intent was to create a penalty for anyone who accepts disability benefits for a period during which that person is actually working. Hayden v. North Dakota Workers Compensation Bureau, 447 N.W.2d 489, 1989 N.D. LEXIS 191 (N.D. 1989).

Nature of Employment.

The language of this section does not differentiate between permanent and temporary employment. Hayden v. North Dakota Workers Compensation Bureau, 447 N.W.2d 489, 1989 N.D. LEXIS 191 (N.D. 1989).

Nature of Sanctions.

A false statement in a claim can result in the claimant being required both to reimburse the worker’s compensation bureau for benefits paid and to forfeit future benefits. F.O.E. Aerie 2337 v. North Dakota Workers Compensation Bureau, 464 N.W.2d 197, 1990 N.D. LEXIS 259 (N.D. 1990).

Odd-Lot Doctrine.

The “odd-lot” doctrine, which has not been expressly adopted in this state, does not apply to the determination of whether or not there has been a violation of this section. The doctrine is used to determine whether or not a claimant is entitled to benefits due to the nature of the disability, not whether he has returned to work. Hayden v. North Dakota Workers Compensation Bureau, 447 N.W.2d 489, 1989 N.D. LEXIS 191 (N.D. 1989).

Penalized Actions.

This section penalizes three things: false claims, false statements in a claim, and acceptance of total disability benefits for a time after the claimant has returned to work. F.O.E. Aerie 2337 v. North Dakota Workers Compensation Bureau, 464 N.W.2d 197, 1990 N.D. LEXIS 259 (N.D. 1990).

Willful Under-Performance.

Worker’s willful under-performance on a functional capacity evaluation was not a “false statement” under this section. Zueger v. North Dakota Workers Compensation Bureau, 1998 ND 175, 584 N.W.2d 530, 1998 N.D. LEXIS 190 (N.D. 1998).

Law Reviews.

North Dakota Supreme Court Review (Wanner v. North Dakota Workers’ Compensation Bureau, 2002 ND 201, 654 N.W.2d 760), see 79 N.D. L. Rev. 589 (2003).

65-05-34. False statement on employment application.

A false statement in an employment application made by an employee bars all benefits under this title if:

  1. The employee knowingly and willfully made a false representation as to the employee’s physical condition;
  2. The employer relied upon the false representation and this reliance was a substantial factor in the hiring; and
  3. There was a causal connection between the false representation and the injury.

Source:

S.L. 1991, ch. 714, § 52.

Collateral References.

Eligibility for workers’ compensation as affected by claimant’s misrepresentation of health or physical condition at time of hiring, 12 A.L.R.5th 658.

65-05-35. Closed claim — Presumption.

  1. A claim for benefits under this title is presumed closed if the organization has not paid any benefit for a period of four years.
  2. A claim that is presumed closed may not be reopened for payment of any further benefits unless the presumption is rebutted by clear and convincing evidence that the work injury is the primary cause of the current symptoms.
  3. With respect to a claim that has been presumed closed, the employee shall provide the organization written notice of reapplication for benefits under that claim. In case of award of lost-time benefits, the award may commence no more than thirty days before the date of reapplication. In case of award of medical benefits, the award may be for medical services incurred no more than thirty days before the date of reapplication.
  4. This section applies to all claims for injury, irrespective of injury date.

Source:

S.L. 1991, ch. 714, § 53; 1995, ch. 627, § 1; 2003, ch. 561, § 3; 2007, ch. 575, § 1; 2021, ch. 500, § 10, eff August 1, 2021.

Notes to Decisions

Clear and Convincing Evidence.

There was no requirement that the evidence on the cause of the claimant’s current condition be undisputed, or that his doctors state that they could say with “100 percent certainty” that the work injury was the sole cause of his current medical condition; the appropriate standard was proof by evidence which led to a firm belief that the allegations were true. Zander v. Workforce Safety & Ins., 2003 ND 194, 672 N.W.2d 668, 2003 N.D. LEXIS 215 (N.D. 2003).

65-05-36. Preferred worker program — Continuing appropriation.

For purposes of this section, “preferred worker” means a worker who has incurred a compensable injury that resulted in a disability that poses a substantial obstacle to employment. The organization may provide assistance as determined appropriate to preferred workers or employers who employ a preferred worker. In addition, employers who apply for and are approved as a preferred worker employer may not be assessed premiums on a preferred worker’s salary for three years from the date of hiring. The organization may not charge claims costs incurred as a result of an injury sustained by a preferred worker against the preferred worker’s employer’s account during the first three years after the worker is hired. The organization shall charge those claims costs to the general fund. The organization may adopt rules to regulate and manage the preferred worker program authorized by this section. An employer or preferred worker may not appeal an organization decision not to provide assistance to that employer or preferred worker under this section. Money in the workforce safety and insurance fund is appropriated on a continuing basis to provide the assistance authorized under this section.

Source:

S.L. 2001, ch. 575, § 4; 2003, ch. 561, § 3; 2003, ch. 562, § 11.

65-05-37. Retaliation by employer prohibited — Action for damages — Penalty.

An employer who willfully discharges or willfully threatens to discharge an employee for seeking or making known the intention to seek workforce safety and insurance benefits is liable in a civil action for damages incurred by the employee, including reasonable attorney’s fees. Damages awarded under this section may not be offset by any workforce safety and insurance benefits to which the employee is entitled. A willful violation of this section is a class A misdemeanor.

Source:

S.L. 2003, ch. 562, § 12.

Notes to Decisions

Summary Judgment Inappropriate.

Employer was not entitled to summary judgment on the employee’s claim because the court was not prepared to say that no reasonable juror could conclude that part of the motivation for firing the employee was related to his statement that he would file for worker’s compensation benefits and his complaints about the safety violations. Mosley v. Alpha Oil & Gas Servs., 962 F. Supp. 2d 1090, 2013 U.S. Dist. LEXIS 108758 (D.N.D. 2013).

65-05-38. Death of permanently and totally disabled employee — Surviving spouse.

In the case of the death of an injured employee who is receiving permanent total disability benefits, or additional benefits payable, if the injured employee was permanently and totally disabled for at least ten years and was married to the surviving spouse for at least ten years, the decedent’s surviving spouse is eligible to receive no more than six months of the decedent’s permanent total disability benefits, supplementary benefits, and additional benefits payable in the same manner as the deceased spouse would have been entitled to receive the benefits. A surviving spouse is eligible for benefits under this section if the organization approved the decedent for home health care services and reimbursed the surviving spouse for providing the home health care services. The surviving spouse is not eligible for benefits under this section if the surviving spouse is eligible for benefits under section 65-05-16. The eligibility of the surviving spouse to receive benefits under this section terminates upon the remarriage of the surviving spouse.

Source:

S.L. 2009, ch. 627, § 1.

Effective Date.

This section became effective August 1, 2009.

65-05-39. Chronic opioid therapy coverage and monitoring.

  1. As used in this section, “chronic opioid therapy” is opioid treatment extending beyond ninety days from initiation which is for the treatment of pain resulting from a nonmalignant, compensable condition or therapies for another nonterminal compensable condition.
  2. In order to qualify for payment for chronic opioid therapy:
    1. Chronic opioid therapy must result in an increase in function, enable an injured employee to resume working, or improve pain control without debilitating side effects;
    2. Chronic opioid therapy must treat an injured employee:
      1. Who has been nonresponsive to non-opioid treatment;
      2. Who is not using illegal substances or abusing alcohol; and
      3. Who is compliant with the treatment protocol; and
    3. The prescriber of chronic opioid therapy shall provide to the organization:
      1. At least every ninety days, documentation of the effectiveness of the chronic opioid therapy, including documentation of improvements in function or improvements in pain control without debilitating side effects; and
      2. A treatment agreement between the injured employee and the prescriber which restricts treatment access and limits prescriptions to one identified single prescriber. This paragraph does not preclude temporary coverage within a single clinic by an identified prescriber when the prescriber of record is unavailable and does not preclude a referral to a pain specialist.
  3. At the prescriber’s or organization’s request, an injured employee on chronic opioid therapy is subject to random drug testing for the presence of prescribed and illicit substances. Failure of the test or of timely compliance with the request may result in termination of chronic opioid therapy coverage.
  4. Failure to comply with any of the conditions under this section may result in the termination of coverage for chronic opioid therapy.

History. S.L. 2015, ch. 482, § 1, eff August 1, 2015.

65-05-40. Opioid therapy and benzodiazepine duration limits — Termination of coverage.

  1. The organization may not pay for opioid therapy that exceeds ninety morphine milligram equivalents of opioid medication per day, or more than a seven-day supply of an opioid medication within any single outpatient transaction during the initial thirty-day period of opioid therapy.
    1. The limitations do not apply to:
      1. Opioid therapy prescribed for active and aftercare cancer treatment;
      2. End-of-life and hospice care;
      3. Treatment for substance use disorder;
      4. An emergency room setting;
      5. An inpatient hospital setting;
      6. A long-term care facility setting; or
      7. An assisted living facility setting.
    2. Opioid therapy includes controlled substances listed in subsections 3 and 4 of section 19-03.1-07, subsection of section 19-03.1-09, subsection of section 19-03.1-11, subsections 3 and 4 of section 19-03.1-13, or any substance with similar properties or affects.
  2. The organization may not pay for benzodiazepine therapy beyond a cumulative duration of four weeks, except when approved by the organization for the treatment of an anxiety disorder. Benzodiazepine therapy includes controlled substances contained in subdivisions a, i, j, k, l, p, r, v, x, ee, mm, qq, xx, yy, aaa, and ccc of subsection 4 of section 19-03.1-11, or any substance with similar properties or affects.
  3. The organization may not pay for any combination therapies that include controlled substances from subsections 1 and 2 concurrently.
  4. A review of requests to depart from the established limits in subsections 1, 2, and 3, upon a showing of medical necessity, are dispute resolution decisions under section 65-02-20.

Source:

S.L. 2021, ch. 504, § 1, eff August 1, 2021.

CHAPTER 65-05.1 Rehabilitation Services

65-05.1-01. Rehabilitation services.

  1. The state of North Dakota exercising its police and sovereign powers declares that disability caused by injuries in the course of employment and disease fairly traceable to the employment create a burden upon the health and general welfare of the citizens of this state and upon the prosperity of this state and its citizens.
  2. The purpose of this chapter is to ensure that injured employees covered by this title receive services, so far as possible, necessary to assist the employee and the employee’s family in the adjustments required by the injury to the end that the employee receives comprehensive rehabilitation services, including medical, psychological, economic, and social rehabilitation.
  3. It is the goal of vocational rehabilitation to return the disabled employee to substantial gainful employment with a minimum of retraining, as soon as possible after an injury occurs. “Substantial gainful employment” means bona fide work, for remuneration, which is reasonably attainable in light of the individual’s injury, functional capacities, education, previous occupation, experience, and transferable skills, and which offers an opportunity to restore the injured employee as soon as practicable and as nearly as possible to ninety percent of the injured employee’s average weekly wage, or to sixty-six and two-thirds percent of the average weekly wage in the state on the date the rehabilitation report is issued under section 65-05.1-02.1, whichever is less. The purpose of defining substantial gainful employment in terms of earnings is to determine the first appropriate priority option under subsection 4 which meets this income test set out above.
  4. The first appropriate option among the following, calculated to return the employee to substantial gainful employment, must be chosen for the employee:
    1. Return to the same position.
    2. Return to the same occupation, any employer.
    3. Return to a modified position.
    4. Return to a modified or alternative occupation, any employer.
    5. Return to an occupation within the local job pool of the locale in which the claimant was living at the date of injury or of the employee’s current address which is suited to the employee’s education, experience, and marketable skills.
    6. Return to an occupation in the statewide job pool which is suited to the employee’s education, experience, and marketable skills.
    7. Retraining of one hundred four weeks or less.
  5. If the employee’s first appropriate option is an option listed in subdivision c, d, e, or f of subsection 4, the organization may pursue retraining of one hundred four weeks or less. If an option listed in subdivision a, b, c, d, e, or f of subsection 4 has been identified as appropriate for an injured employee and the employee is initially released by the health care provider to return to part-time employment with the reasonable expectation of attaining full-time employment, the organization shall pay temporary partial disability benefits under section 65-05-10 until the health care provider determines the employee is medically capable of full-time employment.
    1. If the organization concludes that none of the priority options under subsection 4 are viable, and will not return the injured employee to the lesser of sixty-six and two-thirds percent of the average weekly wage in the state, or ninety percent of the injured employee’s average weekly wage, the employee shall continue to minimize the loss of earnings capacity, to seek, obtain, and retain employment:
      1. That meets the employee’s functional capacities; and
      2. For which the employee meets the qualifications to compete.
    2. Under section 65-05-10, the organization shall award partial disability based on retained earnings capacity calculated under this section.
    3. For purposes of calculating partial disability based on a retained earnings capacity, an employee is presumed to be capable of earning the greater of the state’s hourly minimum wage times the hours of release based on a valid functional capacities examination or the wages payable within the appropriate labor market. This presumption is rebuttable only upon a finding of clear and convincing medical and vocational evidence to the contrary. If the presumption is successfully rebutted, the employee may receive partial disability benefits based on a retained earnings capacity of zero.
  6. The income test in subsection 3 must be waived when an employer offers the employee a return-to-work option at a wage lower than the income test as defined under subsection 3 or when the organization and the employee agree to waive the income test and the priority options.
  7. Vocational rehabilitation services may be initiated by:
    1. The organization on its own motion; or
    2. The employee or the employer if proof exists:
      1. That the employee has reached maximum medical recovery;
      2. That the employee is not working and is not voluntarily retired or removed from the labor force; and
      3. That the employee has made good-faith efforts to seek, obtain, and retain employment.
  8. Chapter 50-06.1 does not apply to determinations of eligibility for vocational rehabilitation made pursuant to this chapter.
  9. If retraining is the first appropriate vocational rehabilitation option identified for an employee, the employee shall notify the organization of the acceptance of the retraining option on a form provided by the organization within thirty days from the date the employee receives notice of eligibility for retraining. If the employee fails to notify the organization of the acceptance of the retraining option within the thirty-day period, the organization shall calculate a retained earnings capacity as provided in subdivision c of subsection 6. A vocational rehabilitation allowance does not accrue as weeks of temporary total disability as defined in section 65-01-02 if the employee successfully completes a retraining program approved by the organization. If the employee fails to successfully complete a retraining program approved by the organization, the vocational rehabilitation allowance paid accrues against the maximum number of weeks of temporary total disability allowed pursuant to section 65-01-02. If an employee attempts and withdraws from an approved retraining program within the first twenty weeks following commencement of the retraining program, the employee, upon request, may receive no more than one hundred eighty-two weeks of temporary partial disability benefits calculated pursuant to subdivision c of subsection 6.

Source:

S.L. 1975, ch. 584, § 1; 1989, ch. 69, § 83; 1989, ch. 771, § 1; 1991, ch. 714, § 55; 1995, ch. 628, § 2; 1997, ch. 546, § 1; 2003, ch. 561, § 3; 2005, ch. 611, § 2; 2013, ch. 499, §§ 7, 8; 2019, ch. 523, § 16, eff August 1, 2019; 2021, ch. 500, § 11, eff August 1, 2021.

Note.

Section 13 of chapter 500, S.L. 2021, provides, “ APPLICATION. This Act applies to all claims regardless of date of injury.”

Cross-References.

Public welfare vocational rehabilitation, see N.D.C.C. ch. 50-06.1.

Notes to Decisions

Constitutionality.

The 1992 limitations on vocational rehabilitation retraining benefits under this section did not violate claimant’s equal protection rights under either the federal constitution or N.D. Const., Art. I, § 21. Baldock v. North Dakota Workers Compensation Bureau, 554 N.W.2d 441, 1996 N.D. LEXIS 223 (N.D. 1996).

The 75% income limitation in subsection (3) (amended in 1995 to 662/3%) for returning injured workers to substantial gainful employment under this section is rationally related to a legitimate governmental purpose and therefore does not violate the equal protection clause of the Eagle v. North Dakota Workers Compensation Bureau, 1998 ND 154, 583 N.W.2d 97, 1998 N.D. LEXIS 160 (N.D. 1998).

Burden of Proof.

Claimant seeking disability and rehabilitative benefits did not have to prove that the work-related injury was the sole cause of her disability or even that it was a primary cause of that disability. To the contrary, the work injury need only have been a substantial contributing factor to the disability. Holtz v. North Dakota Workers Compensation Bureau, 479 N.W.2d 469, 1992 N.D. LEXIS 10 (N.D. 1992).

The Workers Compensation Bureau’s finding that the employee could physically perform duties as an accounting clerk was supported by the preponderance of the evidence. Held v. North Dakota Workers Compensation Bureau, 540 N.W.2d 166, 1995 N.D. LEXIS 209 (N.D. 1995).

The preponderance of the evidence supported the workers compensation bureau’s finding that the accounting clerk field for which the employee being trained would likely have employment which would be reasonably attainable upon the completion of his training. Held v. North Dakota Workers Compensation Bureau, 540 N.W.2d 166, 1995 N.D. LEXIS 209 (N.D. 1995).

Calculation of Earning Capacity.
—In General.

The worker’s average weekly earnings at the time of the injury constitute a reasonable formula for calculating earning capacity. Smith v. North Dakota Workers Compensation Bureau, 447 N.W.2d 250, 1989 N.D. LEXIS 188 (N.D. 1989) (decided prior to the 1989 amendments to this chapter).

Subsection (3) requires only that the job market present an opportunity for the employee to obtain a salary that comes as nearly as possible to the average weekly wage. Held v. North Dakota Workers Compensation Bureau, 540 N.W.2d 166, 1995 N.D. LEXIS 209 (N.D. 1995).

One of the rehabilitative goals of North Dakota’s workforce safety and insurance law was to return a disabled employee to substantial gainful employee with a minimum of retraining, as soon as possible after an injury has occurred, according to N.D.C.C. § 65-05.1-01(3). Since the evidence presented in the claimant’s case showed that the claimant could go to work as a store greeter despite wrist and shoulder pain the claimant had experienced in the claimant’s prior job, the evidence showed that the claimant had a residual earning capacity of $ 290 per week and was consistent with the establishment of earning capacity pursuant to N.D.C.C. § 65-05-10(3). Johnson v. N.D. Workforce Safety & Ins. Fund, 2012 ND 87, 816 N.W.2d 74, 2012 N.D. LEXIS 88 (N.D. 2012).

Administrative Law Judge (ALJ) erred in finding that an employee had a retained earnings capacity of zero because the ALJ misapplied the law by too broadly interpreting the term “valid”; the functional capacity evaluation, which noted that the employee gave a reliable effort, was “valid,” and the presumption of a retained earnings capacity was triggered, but the ALJ did not find by clear and convincing evidence that the presumption had been rebutted. State v. Taylor, 2019 ND 220, 932 N.W.2d 764, 2019 N.D. LEXIS 218 (N.D. 2019).

—“Earnings”.

For the purpose of subsection (3), the legislature unambiguously intended “earnings” and “wages” to be interpreted synonymously. Lucier v. North Dakota Workers Comp. Bureau, 556 N.W.2d 56 (N.D. 1996).

Employment Not Guaranteed.

This chapter does not require that the Workers’ Compensation Bureau’s rehabilitation plan guarantee plaintiff a job upon completion of the program. Thompson v. North Dakota Workers' Compensation Bureau, 490 N.W.2d 248, 1992 N.D. LEXIS 177 (N.D. 1992).

Rehabilitation plan gave claimant a reasonable opportunity to obtain substantial gainful employment in the state, and the fact some of the jobs claimant applied for may have required physical demands beyond the medium classification he was assigned under the plan did not make the plan unfeasible; neither a rehabilitation plan nor a vocational consultant can guarantee a claimant a job or a particular wage. Lucier v. North Dakota Workers Comp. Bureau, 556 N.W.2d 56 (N.D. 1996).

Good Faith Work Trial.

Where proffered employment as truck driver was at the same rate as worker had previously earned, and offered the opportunity to meet the wage threshold under the statute, because worker failed to make a good faith work trial in the job, her argument she could not drive enough miles to meet the wage threshold was purely speculative and did not excuse her failure to make a good faith work trial. Maginn v. North Dakota Workers Compensation Bureau, 550 N.W.2d 412, 1996 N.D. LEXIS 164 (N.D. 1996).

Interim Rehabilitation Benefits.

Where the bureau’s findings disclosed that claimant was not in a position to secure substantial gainful employment during the interim between the date of termination of his disability payments, and the beginning of his teaching position, and that during this interim he was disabled to the extent that he could not return to his previous employment or like employment, the bureau erred in its denial of disability and vocational rehabilitation benefits for the interim. Ehrmantraut v. North Dakota Workers Compensation Bureau, 469 N.W.2d 557, 1991 N.D. LEXIS 75 (N.D. 1991).

Legislative Intent.

The intent of the legislature was for the bureau to consider an individual’s medical limitations at the time that individual sustained a work-related injury. Holtz v. North Dakota Workers Compensation Bureau, 479 N.W.2d 469, 1992 N.D. LEXIS 10 (N.D. 1992).

No Entitlement to Retraining.

Bureau found that worker is now capable of performing unskilled laborer jobs in the “medium work” category that would give him earnings of about $4.50 an hour, which is the amount that he was receiving at the time of his injury, and that such jobs are available. The bureau correctly concluded that worker was not entitled to receive retraining, because the first appropriate option under the section was for him to return to a related occupation in the local or statewide job pool. Emery v. North Dakota Workers Compensation Bureau, 477 N.W.2d 202, 1991 N.D. LEXIS 186 (N.D. 1991).

Nonattendance.

Injured worker’s nonattendance at retraining program was not excused by the Workers Compensation Bureau’s subsequent determination that the program was an unsatisfactory retraining program. Hoffman v. North Dakota Workers Compensation Bureau, 1999 ND 66, 592 N.W.2d 533, 1999 N.D. LEXIS 70 (N.D. 1999).

Post-Injury Work.

Worker’s compensation bureau’s finding that claimant’s employer offered him a legitimate post-injury position was supported by a preponderance of the evidence. Baldock v. North Dakota Workers Compensation Bureau, 554 N.W.2d 441, 1996 N.D. LEXIS 223 (N.D. 1996).

North Dakota Workforce Safety and Insurance did not err in concluding that N.D.C.C. § 65-05.1-01(4)(e) was the first appropriate rehabilitation option based on an employee’s abilities where merely eliminating the need to lift large dogs by installing a $ 10,000 hoist mechanism would not necessarily allow the employee to perform her prior duties as a dog groomer. The employee’s projected income in another area of work would exceed her pre-injury income from the employer. Victor v. Workforce Safety & Ins., 2006 ND 68, 711 N.W.2d 188, 2006 N.D. LEXIS 73 (N.D. 2006).

In a worker’s compensation matter, several experts testified as to a claimant’s ability to obtain gainful employment as defined under N.D.C.C. § 65-05.1-01(3). A preponderance of evidence supported the decision to terminate the claimant’s benefits because it was for the North Dakota Workforce Safety and Insurance to weigh the credibility of the medical evidence and resolve conflicting medical opinions. Miller v. Workforce Safety & Ins., 2009 ND 109, 767 N.W.2d 154, 2009 N.D. LEXIS 118 (N.D. 2009).

ALJ’s finding that an injured employee was capable of performing the job of sheet metal worker identified in his vocational rehabilitation plan was supported by a preponderance of the evidence where his testimony, the testimony of his vocational manager, and the physical requirements of the job listed in the Dictionary of Occupational Titles established that kneeling was not a common job requirement. Beam v. N.D. Workforce Safety & Ins. Fund, 2020 ND 168, 946 N.W.2d 486, 2020 N.D. LEXIS 167 (N.D. 2020).

Pre-Existing Functional Limitations.

A vocational rehabilitation plan must take into account all of the injured worker’s functional limitations which existed at the time of the injury, not just those limitations directly caused by the current work injury. Svedberg v. North Dakota Workers Compensation Bureau, 1999 ND 181, 599 N.W.2d 323, 1999 N.D. LEXIS 200 (N.D. 1999).

Decision that a benefits claimant was able to return to work on a part-time basis was upheld on review because a vocational rehabilitation plan took into account the fact that the claimant had a preexisting hearing loss when it developed the plan; the proposed jobs considered the claimant’s prior 25 years in law enforcement and his explanation of the disability. Genter v. Workforce Safety & Ins. Fund, 2006 ND 237, 724 N.W.2d 132, 2006 N.D. LEXIS 240 (N.D. 2006).

Pre-Injury Earning Capacity.

The purpose of a vocational retraining program is to substantially rehabilitate a worker to his pre-injury earning capacity. Smith v. North Dakota Workers Compensation Bureau, 447 N.W.2d 250, 1989 N.D. LEXIS 188 (N.D. 1989) (decided prior to the 1989 amendments to this chapter).

A claimant is substantially rehabilitated if he can be employed to within ten percent of his pre-injury earning capacity, so that he is able, upon completion of the retraining program, to be employed at least at ninety percent of his pre-injury earning capacity. Smith v. North Dakota Workers Compensation Bureau, 447 N.W.2d 250, 1989 N.D. LEXIS 188 (N.D. 1989) (decided prior to the 1989 amendments to this chapter).

Prospective Application of Amendments to Chapter.

As S.L. 1989, chapter 771, amending and reenacting portions of this chapter, did not clearly express an intent that the amendments were to apply retroactively, the amendments must be applied only prospectively. Smith v. North Dakota Workers Compensation Bureau, 447 N.W.2d 250, 1989 N.D. LEXIS 188 (N.D. 1989) (holding however, that the amendments could be considered in order to fill a void in the preexisting legislation).

The 1989 amendments to this chapter applied to plaintiff ’s rehabilitation award where he did not sign a 1988 rehabilitation contract and therefore did not have a vested right to rehabilitation under that contract. Thompson v. North Dakota Workers' Compensation Bureau, 490 N.W.2d 248, 1992 N.D. LEXIS 177 (N.D. 1992).

Purpose.

The purpose of vocational rehabilitation is to return a disabled employee to substantial gainful employment with a minimum of retraining, as soon as possible after an injury. Hoffman v. North Dakota Workers Compensation Bureau, 1999 ND 66, 592 N.W.2d 533, 1999 N.D. LEXIS 70 (N.D. 1999).

Searching for Alternate Suitable Employment.

The workers compensation bureau reasonably found that the claimant was not entitled to rehabilitation benefits, where the claimant was aggressively searching for alternative suitable employment, and even though it was not successful, the search indicated that she had marketable skills. In re Claim of Olson, 419 N.W.2d 894, 1988 N.D. LEXIS 57 (N.D. 1988).

Nothing in N.D.C.C. § 65-05.1-02.1 requires the vocational consultant to include in the report an assessment of the worker’s specific job; instead, N.D.C.C. § 65-05.1-02(7) instructs the vocational consultant to assess the worker’s job options in light of the worker’s restrictions and limitations, to identify the category of work in which the worker can fairly engage. Johnson v. North Dakota Workers' Compensation Bureau, 539 N.W.2d 295, 1995 N.D. LEXIS 187 (N.D. 1995).

Subsequent Nonwork-Related Injuries.

An injured person with nonwork-related injuries which had occurred after a work-related injury and which had no causal connection to the work-related injury, may not have those subsequent injuries considered in a rehabilitation assessment. Holtz v. North Dakota Workers Compensation Bureau, 479 N.W.2d 469, 1992 N.D. LEXIS 10 (N.D. 1992).

Where claimant seeking disability and rehabilitative benefits did not claim that her disability was related to her employment, nor did she claim that her work-related dermatitis was a substantial contributing factor to any alleged disability, the bureau was not required to consider any medical limitation claimant suffered from subsequent nonwork-related injuries. Holtz v. North Dakota Workers Compensation Bureau, 479 N.W.2d 469, 1992 N.D. LEXIS 10 (N.D. 1992).

Substantial Gainful Employment.

Trial court erred in upholding an order terminating an employee’s total disability benefits and awarding the employee partial disability benefits where the employee could not be returned to substantial gainful employment, as defined in N.D.C.C. § 65-05.1-01(3), and did not have a retained earnings capacity to meet the income test of N.D.C.C. § 65-05.1-01(3); under the 1999 statutory scheme applicable in this case, if an injured worker could not be returned to substantial gainful employment as defined under N.D.C.C. § 65-05.1-01(3) and did not have a retained earnings capacity to meet N.D.C.C. § 65-05.1-01(3), then the injured worker was entitled to temporary total disability benefits or permanent total disability benefits. Rodenbiker v. Workforce Safety & Ins., 2007 ND 169, 740 N.W.2d 831, 2007 N.D. LEXIS 171 (N.D. 2007).

Despite a vocational consultant's report's lack of job market research, evidence supported a finding that Workforce Safety and Insurance provided the worker with a vocational rehabilitation plan that presented him with a reasonable likelihood of obtaining substantial gainful employment as an inspector-tester. Anderson v. Workforce Safety & Ins., 2015 ND 205, 868 N.W.2d 508, 2015 N.D. LEXIS 225 (N.D. 2015).

Vocational Rehabilitation.

Former ranch foreman thrown from a horse injured his left hip and pelvis, resulting in separation of pelvic cartilage. The bureau correctly ruled foreman was a candidate for vocational rehabilitation and was not entitled to lump sum payment of disability benefits where record contained no medical opinion saying that foreman’s physical condition and chronic pain precluded education and retraining. Schiff v. North Dakota Workers' Compensation Bureau, 480 N.W.2d 732, 1992 N.D. LEXIS 23 (N.D. 1992).

Evidence supported finding that an injured claimant refused to participate in rehabilitation options that were available to him; as such, the district court properly affirmed the Workforce Safety and Insurance order that terminated the award of rehabilitation benefits and partial disability benefits, pursuant to N.D.C.C. § 65-05.1-01. Tverberg v. Workforce Safety & Ins., 2006 ND 229, 723 N.W.2d 676, 2006 N.D. LEXIS 234 (N.D. 2006).

Workplace Safety and Insurance (WSI) appropriately exercised its continuing jurisdiction on its own motion, under N.D.C.C. § 65-05-04, to assess a claimant’s vocational rehabilitation and that the claimant was properly found in noncompliance with vocational rehabilitation; N.D.C.C. §§ 65-05.1-01(8)(a) also provided that WSI could initiate vocational rehabilitation services on its own motion. Drayton v. Workforce Safety & Ins., 2008 ND 178, 756 N.W.2d 320, 2008 N.D. LEXIS 180 (N.D. 2008).

Because the North Dakota Workforce Safety and Insurance (WSI) vocational rehabilitation plan to return a claimant to the same occupation with any employer was appropriate under N.D.C.C. § 65-05.1-01, where its goal was tailored to return claimant to substantial gainful employment which was reasonably attainable in light of claimant’s injury and which would substantially rehabilitate claimant’s earning capacity, the WSI adequately explained its reasons for disregarding medical evidence favorable to claimant, and its specific findings were supported by the evidence, a judgment denying claimant further benefits was affirmed. Shotbolt v. N.D. Workforce Safety & Ins., 2010 ND 13, 777 N.W.2d 853, 2010 N.D. LEXIS 13 (N.D. 2010).

Administrative law judge’s finding that the claimant was capable of performing the return-to-work options identified in her vocational rehabilitation plan was supported by a preponderance of the evidence, because the claimant’s treating neurologist was aware of her psychological impairments and treatments, and approved the identified return-to-work options. Bishop v. N.D. Workforce Safety & Ins., 2012 ND 217, 823 N.W.2d 257, 2012 N.D. LEXIS 229 (N.D. 2012).

North Dakota Workforce Safety and Insurance (WSI) erred in finding that the employee failed to show that his wage loss was the result of his compensable left shoulder injury because the fact that his noncompensable vertebral artery occlusion made it impractical for him to either return to work or undergo surgery necessary to return him to employment did not break the causal connection, the employee had not unreasonably refused to undergo surgery for his left shoulder injury, and WSI's notice of intention to discontinue/reduce benefits seemed to foreclose a functional capacity assessment. Brockel v. N.D. Workforce Safety & Ins., 2014 ND 26, 2014 N.D. LEXIS 24 (Feb. 13, 2014).

ALJ's conclusion that an injured worker's vocational rehabilitation plan was valid and properly considered his neck pain was affirmed where a treating physician's release of the worker to his pre-injury occupation allowed Workforce Safety and Insurance to reasonably conclude the worker was capable of performing his pre-injury occupation. Anderson v. Workforce Safety & Ins., 2015 ND 205, 868 N.W.2d 508, 2015 N.D. LEXIS 225 (N.D. 2015).

ALJ adequately addressed the inconsistencies in the medical opinions, provided a reasonable basis for her findings, and sufficiently explained the reasoning for her conclusion to disregard the medical evidence offered by another physician. Anderson v. Workforce Safety & Ins., 2015 ND 205, 868 N.W.2d 508, 2015 N.D. LEXIS 225 (N.D. 2015).

District court properly affirmed an order by Workforce Safety and Insurance because an employee was given a presumably viable rehabilitation option, his arguments concerning the cost of relocating or commuting were not ripe for review, his documented preexisting conditions were taken into account, and detailed findings were made with respect to his vocational rehabilitation plan. Higginbotham v. Workforce Safety, 2014 ND 147, 849 N.W.2d 233, 2014 N.D. LEXIS 160 (N.D. 2014).

Collateral References.

Workers’ compensation: vocational rehabilitation statutes, 67 A.L.R.4th 612.

Workers’ compensation: recovery for home service provided by spouse, 67 A.L.R.4th 765.

Law Reviews.

Are Employees Obtaining “Sure and Certain Relief” Under the 1995 Legislative Enactments of the North Dakota Workers’ Compensation Act?, 72 N.D. L. Rev. 349 (1996).

65-05.1-02. Organization responsibility.

The organization shall:

  1. Appoint a director of rehabilitation services and such other staff as necessary to fulfill the purposes of this chapter.
  2. Cooperate with such federal or state agency as shall be charged with vocational education, vocational rehabilitation, and job placement in order that any duplication of effort can be avoided, as far as possible, in any individual claim.
  3. Make determinations on individual claims as to the extent and duration of the organization involvement under this chapter.
  4. Enter into such agreements with other agencies and promulgate any rules or regulations as may be necessary or advantageous in order to carry out the purpose of this chapter.
  5. Provide such rehabilitation services and allowances as may be determined by the organization to be most beneficial to the worker within the limits of this chapter.
  6. Establish medical assessment teams, the composition of which must be determined by the organization on a case-by-case basis, as the nature of the injury may require, for the purpose of assessing the worker’s physical restrictions and limitations. The medical assessment team must be provided the medical records compiled by the worker’s treating health care providers. The medical assessment team may consult the worker’s treating health care providers prior to making its final assessment of the worker’s functional capacities. The provisions of section 65-05-28 do not apply to the medical findings made under this section.
  7. Determine and report on a case-by-case basis, as the nature of the injury may require, for the purpose of assessing the worker’s transferable skills, employment options, and the physical demand characteristics of the worker’s employment options, and determining which option available under subdivisions a through f of subsection 4 of section 65-05.1-01 will enable the worker to return to employment within the physical restrictions and limitations provided by the medical assessment team.

Source:

S.L. 1975, ch. 584, § 2; 1989, ch. 771, § 2; 1991, ch. 714, § 56; 2003, ch. 561, § 3; 2013, ch. 499, § 9; 2019, ch. 523, § 17, eff August 1, 2019.

Notes to Decisions

Assessment of Work Capacity.

Nothing in N.D.C.C. § 65-05.1-02.1 requires the vocational consultant to include in the report an assessment of the worker’s specific job; instead, N.D.C.C. § 65-05.1-02(7) instructs the vocational consultant to assess the worker’s job options in light of the worker’s restrictions and limitations, to identify the category of work in which the worker can fairly engage. Johnson v. North Dakota Workers' Compensation Bureau, 539 N.W.2d 295, 1995 N.D. LEXIS 187 (N.D. 1995).

Calculation of Earning Capacity.

The worker’s average weekly earnings at the time of the injury constitute a reasonable formula for calculating earning capacity. Smith v. North Dakota Workers Compensation Bureau, 447 N.W.2d 250, 1989 N.D. LEXIS 188 (N.D. 1989) (decided prior to the 1989 amendments to this chapter).

Worker’s compensation bureau did not err in refusing to base claimant’s average weekly wage on what he earned only during the four-week period just before his injury, where claimant alleged his hours had increased during those weeks and his supervisor told him he would continue to work increased hours, but whether claimant would have continued to work increased hours was speculation. Lucier v. North Dakota Workers Comp. Bureau, 556 N.W.2d 56 (N.D. 1996).

Medical Assessment Team.

The Workers’ Compensation Bureau’s reliance on plaintiff ’s treating physicians, complied with the statutory requirement to establish a medical assessment team on a case-by-case basis. Thompson v. North Dakota Workers' Compensation Bureau, 490 N.W.2d 248, 1992 N.D. LEXIS 177 (N.D. 1992).

North Dakota Workforce Safety & Insurance is not automatically required to establish a medical assessment team and seek a medical opinion in every case in which a worker claims an injury or preexisting condition, regardless of the factual basis for the worker’s claim; therefore, a decision not to establish a medical assessment team was not erroneous in a case where a benefits claimant had a preexisting hearing loss because the claimant was able to describe the disability, he was able to communicate with others throughout the course of his vocational plan development, and he was able to work for 25 years in law enforcement with the use of hearing aids. Genter v. Workforce Safety & Ins. Fund, 2006 ND 237, 724 N.W.2d 132, 2006 N.D. LEXIS 240 (N.D. 2006).

Pre-Injury Earning Capacity.

The purpose of a vocational retraining program is to substantially rehabilitate a worker to his pre-injury earning capacity. Smith v. North Dakota Workers Compensation Bureau, 447 N.W.2d 250, 1989 N.D. LEXIS 188 (N.D. 1989) (decided prior to the 1989 amendments to this chapter).

A claimant is substantially rehabilitated if he can be employed to within ten percent of his pre-injury earning capacity, so that he is able, upon completion of the retraining program, to be employed at least at ninety percent of his pre-injury earning capacity. Smith v. North Dakota Workers Compensation Bureau, 447 N.W.2d 250, 1989 N.D. LEXIS 188 (N.D. 1989) (decided prior to the 1989 amendments to this chapter).

Vocational Plan.

Bureau met its burden to present evidence of currently available jobs and the sufficiency of employee’s skills when it developed employee’s vocational plan and approved training him as a robotics technician. Wright v. N.D. Workers Comp. Bureau, 2001 ND 72, 625 N.W.2d 256, 2001 N.D. LEXIS 85 (N.D. 2001).

65-05.1-02.1. Vocational report.

The organization shall review all records, statements, and other pertinent information and prepare a report to the organization and employee.

  1. The report must:
    1. Identify the first appropriate rehabilitation option by following the priorities set forth in subsection 4 of section 65-05.1-01.
    2. Contain findings of why a higher listed priority, if any, is not appropriate.
  2. Depending on which option the consultant identifies as appropriate, the report also must contain findings that:
    1. Identify jobs in the local or statewide job pool and the employee’s anticipated earnings from each job; or
    2. Describe an appropriate retraining program, the employment opportunities anticipated upon the employee’s completion of the program, and the employee’s anticipated earnings.

Source:

S.L. 1989, ch. 771, § 3; 1991, ch. 714, § 57; 1997, ch. 546, § 2; 2003, ch. 561, § 3; 2005, ch. 611, § 3; 2013, ch. 499, § 10.

Notes to Decisions

Assessment of Work Capacity.

Nothing in this section requires the vocational consultant to include in the report an assessment of the worker’s specific job. Instead, N.D.C.C. § 65-05.1-02(7) instructs the vocational consultant to assess the worker’s job options in light of the worker’s restrictions and limitations, to identify the category of work in which the worker can fairly engage. Johnson v. North Dakota Workers' Compensation Bureau, 539 N.W.2d 295, 1995 N.D. LEXIS 187 (N.D. 1995).

Reasonable Opportunity to Obtain Employment.

Rehabilitation plan gave claimant a reasonable opportunity to obtain substantial gainful employment in the state, and the fact some of the jobs claimant applied for may have required physical demands beyond the medium classification he was assigned under the plan did not make the plan unfeasible; neither a rehabilitation plan nor a vocational consultant can guarantee a claimant a job or a particular wage. Lucier v. North Dakota Workers Comp. Bureau, 556 N.W.2d 56 (N.D. 1996).

65-05.1-03. Director of rehabilitation services — Duties.

The director of rehabilitation services shall:

  1. Direct the implementation of programs for injured employees in accordance with organization determinations in compliance with the purpose of this chapter.
  2. Cooperate, contact, and assist any government or private organization or agency or group of individuals or business or individual necessary or advantageous in carrying out the purpose of this chapter.
  3. Keep such records, for statistical purposes, and provide such training necessary for the organization staff as is necessary to keep pace with future developments in the area of rehabilitation services.

Source:

S.L. 1975, ch. 584, § 3; 1989, ch. 69, § 84; 1989, ch. 295, § 16; 1991, ch. 54, § 32; 2003, ch. 561, § 3; 2013, ch. 499, § 11.

65-05.1-04. Injured employee responsibility.

  1. The injured employee shall seek, obtain, and retain reasonable and substantial employment to reduce the period of temporary disability to a minimum. The employee has the burden of establishing that the employee has met this responsibility.
  2. If the injured employee is unable to obtain substantial employment as a direct result of injury, the employee shall promptly notify the organization under subdivision b of subsection 8 of section 65-05.1-01.
  3. The injured employee shall be available for testing under subsection 6 or 7 of section 65-05.1-02, and for any further examinations and testing as may be prescribed by the organization to determine whether or not a program of rehabilitation is necessary. The injured employee also shall participate in remedial or other educational services when those services are determined to be necessary by the organization.
  4. If the first appropriate rehabilitation option under subsection 4 or 6 of section 65-05.1-01 is return to the same, modified, or alternative occupation, or return to an occupation that is suited to the employee’s education, experience, and marketable skills, the employee is responsible to make a good-faith work trial or work search. If the employee fails to perform a good-faith work trial or work search, the organization may not pay additional disability benefits unless the employee meets the criteria for reapplying for benefits required under subsection 1 of section 65-05-08. If the employee meets the burden of proving that the employee made a good-faith work trial or work search and that the work trial or work search was unsuccessful due to the injury, the organization shall re-evaluate the employee’s vocational rehabilitation claim. When the first appropriate vocational rehabilitation option is identified for an employee, the organization shall notify the employee of the obligation to make a good-faith work search or good-faith work trial, and provide information to the employee regarding reinstatement of benefits if the work search or work trial is unsuccessful.
  5. If the first appropriate rehabilitation option under subsection 4 of section 65-05.1-01 is retraining, the employee shall cooperate with the necessary testing to determine whether the proposed training program meets the employee’s medical limitations and aptitudes. The employee shall attend a qualified rehabilitation training program when ordered by the organization. A qualified training program is a rehabilitation plan that meets the criteria of this title and commences within a reasonable period of time such as the next quarter or semester. The organization and the employee, by agreement, may waive the income test applicable under this subsection.
  6. If, without good cause, the injured employee fails to make a good-faith work search in return to work utilizing the employee’s transferable skills, the employee is in noncompliance with vocational rehabilitation. A good-faith work search that does not result in placement is not, in itself, sufficient grounds to prove the work injury caused the inability to acquire gainful employment. The employee shall show that the injury significantly impacts the employee’s ability to successfully compete for gainful employment in that the injury leads employers to favor those without limitations over the employee. If, without good cause, the injured employee fails to attend specific vocational testing, remedial, or other vocational services determined necessary by the organization, the employee is in noncompliance with vocational rehabilitation. If, without good cause, the injured employee fails to attend a scheduled medical or vocational assessment, fails to communicate or cooperate with the organization, or fails to attend a specific qualified rehabilitation program within ten days from the date the rehabilitation program commences, the employee is in noncompliance with vocational rehabilitation. If, without good cause, the employee discontinues a training program in which the employee is enrolled, the employee is in noncompliance with vocational rehabilitation. If at any time the employee is noncompliant without good cause, subsequent efforts by the employee to come into compliance with vocational rehabilitation are not considered successful compliance until the employee has successfully returned to the job or training program for a period of thirty days. In all cases of noncompliance by the employee, the organization shall discontinue disability and vocational rehabilitation benefits. If the period of noncompliance continues for thirty days following the date benefits are discontinued, or a second instance of noncompliance occurs without good cause, the organization may not pay any further disability or vocational rehabilitation benefits, regardless of whether the employee sustained a significant change in medical condition due to the work injury.

Source:

S.L. 1975, ch. 584, § 4; 1989, ch. 771, § 4; 1991, ch. 714, § 58; 1993, ch. 45, § 24; 1995, ch. 628, § 3; 1997, ch. 546, § 3; 2003, ch. 561, § 3; 2005, ch. 611, § 4; 2009, ch. 628, § 1; 2011, ch. 512, § 6; 2013, ch. 499, § 12.

Notes to Decisions

Applicability.

When claimant failed to meet the standard for a reapplication for benefits under N.D.C.C. § 65-05-08(1), North Dakota Workforce Safety and Insurance (WIS) properly denied his claim because he did not show an actual wage loss caused by a significant change in his compensable medical condition. N.D.C.C. § 65-05.1-04(4) did not apply, because vocational rehabilitation services were not initiated under N.D.C.C. ch. 65-05.1 and WSI did not make a determination of claimant’s first appropriate rehabilitation option. Johnson v. N.D. Workforce Safety & Ins., 2010 ND 198, 789 N.W.2d 565, 2010 N.D. LEXIS 195 (N.D. 2010).

Burden of Proof.

Where hearing officer cited evidence indicating that worker quit work for personal reasons, not because of his prior injury, and that worker did not prove that the physical requirements of his job were not in keeping with his physical capacity to perform, findings showed that he did not meet his burden of showing work trial was unsuccessful due to his prior work injury. Johnson v. North Dakota Workers' Compensation Bureau, 539 N.W.2d 295, 1995 N.D. LEXIS 187 (N.D. 1995).

Calculation of Earnings Capacity.

The worker’s average weekly earnings at the time of the injury constitute a reasonable formula for calculating earning capacity. Smith v. North Dakota Workers Compensation Bureau, 447 N.W.2d 250, 1989 N.D. LEXIS 188 (N.D. 1989) (decided prior to the 1989 amendments to this chapter).

Failure to Return to Work.

Where claimant was advised to return to work by her physician, she was obligated under this section to make herself available for modified work arranged for her before the bureau had any obligation to consider the necessity and feasibility of a rehabilitation program. Her failure to do so was noncompliance with this section and prevented the bureau from assessing or testing her capability to work and her need for rehabilitation. Risch v. North Dakota Workers Compensation Bureau, 447 N.W.2d 308, 1989 N.D. LEXIS 198 (N.D. 1989) (decided prior to the 1989 amendments to this chapter).

Workers compensation bureau’s finding worker was capable of performing modified job was supported by a preponderance of the evidence, where there was substantial medical evidence indicating worker was physically capable of performing, doctor who conducted independent medical examination specifically concluded modified position was within her physical abilities, and worker relied upon note of her doctor which contained no documentation or objective medical findings to support his cursory conclusion she could not perform. Maginn v. North Dakota Workers Compensation Bureau, 550 N.W.2d 412, 1996 N.D. LEXIS 164 (N.D. 1996).

Financial Inability.

The Workers Compensation Bureau’s conclusion that financial inability cannot constitute good cause for noncompliance with a rehabilitation plan is not in accordance with the law. Fuhrman v. North Dakota Workers Compensation Bureau, 1997 ND 191, 569 N.W.2d 269, 1997 N.D. LEXIS 237 (N.D. 1997).

Claimant presented good cause for failing to comply with his rehabilitation plan, in that he did not have the financial ability to relocate and attend an out-of-state training program. Fuhrman v. North Dakota Workers Compensation Bureau, 1997 ND 191, 569 N.W.2d 269, 1997 N.D. LEXIS 237 (N.D. 1997).

Worker whose request for a second domicile allowance was wrongfully denied by the Workers Compensation Bureau had good cause for his failure to attend a rehabilitation program located so far from the worker’s residence that it was not possible to commute to the program. Hoffman v. North Dakota Workers Compensation Bureau, 1999 ND 66, 592 N.W.2d 533, 1999 N.D. LEXIS 70 (N.D. 1999).

“Good Cause.”

Whether a worker has good cause not to attend an approved rehabilitation program turns on whether a reasonable and prudent person under the same or similar circumstances would have failed to comply. Hoffman v. North Dakota Workers Compensation Bureau, 1999 ND 66, 592 N.W.2d 533, 1999 N.D. LEXIS 70 (N.D. 1999).

Employee did not show good cause for failing to comply with a vocational rehabilitation plan because it was fundamental error for an administrative law judge to conclude that the employee did not have to comply until the employee’s appeal of an order establishing the plan was determined, as (1) the employee did not assert this as a ground for noncompliance, and (2) the employee was not relieved of compliance, absent a stay, until the appeal was resolved. Inwards v. N.D. Workforce Safety & Ins., 2014 ND 163, 851 N.W.2d 693, 2014 N.D. LEXIS 164 (N.D. 2014).

Good Faith Work Search.

Worker failed to make a good faith work search where he made no effort to find work, relying on the opinion of his vocational instructor who stated that an entry-level robotics technician “typically” begins as a field service engineer, a job the worker believed himself to be incapable of performing. Wright v. N.D. Workers Comp. Bureau, 2001 ND 72, 625 N.W.2d 256, 2001 N.D. LEXIS 85 (N.D. 2001).

No Entitlement to Rehabilitation Benefits.

Workers’ compensation claimant was not entitled to rehabilitation benefits where bureau determined that program of rehabilitation was not necessary under the facts presented, and claimant did not fulfill N.D.C.C. § 50-06.1-06’s requirement that executive director determine whether vocational rehabilitation could be satisfactorily achieved. Froysland v. North Dakota Workers Compensation Bureau, 432 N.W.2d 883, 1988 N.D. LEXIS 233 (N.D. 1988).

Noncompliance.

Claimant’s willful failure to give a maximum consistent effort during a functional capacity evaluation can constitute an act of noncompliance with a vocational rehabilitation plan under this section. Hoffman v. N.D. Workers Comp. Bureau, 2002 ND 138, 651 N.W.2d 601, 2002 N.D. LEXIS 180 (N.D. 2002).

Court properly upheld an order from the North Dakota Workforce Safety and Insurance (WSI) denying further disability and vocational rehabilitation benefits to an employee because the results of a functional capacity assessment on the employee represented a manipulated effort and an invalid representation of the employee’s physical capabilities. Finding of noncompliance under N.D.C.C. § 65-05.1-04(6) was proven by the weight of the evidence on the entire record. Thomas v. Workforce Safety & Ins., 2005 ND 52, 692 N.W.2d 901, 2005 N.D. LEXIS 52 (N.D. 2005).

Willful failure to give a maximum consistent effort in a functional capacity assessment can constitute noncompliance with vocational rehabilitation under N.D.C.C. § 65-05.1-04(6). Thomas v. Workforce Safety & Ins., 2005 ND 52, 692 N.W.2d 901, 2005 N.D. LEXIS 52 (N.D. 2005).

Workforce Safety and Insurance’s (WSI) decision to discontinue a worker’s benefits was supported by a preponderance of the evidence. The worker, who claimed that she was unable to drive to Fargo for the independent medical examination (IME), failed to provide sufficient evidence of a good cause for her failure to attend the IME. Her failure constituted noncompliance with N.D.C.C. § 65-05.1-04(6) and prevented WSI from assessing her capability to work and her need for rehabilitation. Bjerklie v. Workforce Safety & Ins., 2005 ND 178, 704 N.W.2d 818, 2005 N.D. LEXIS 209 (N.D. 2005).

Where WSI properly terminated a claimant’s benefits under N.D.C.C. §§ 65-05.1-04, 65-05-28(4) for the claimant’s noncompliance with a functional capacity evaluation, a district court abused its discretion in finding that WSI acted without substantial justification and in awarding attorney’s fees under N.D.C.C. § 28-32-50. Drayton v. Workforce Safety & Ins., 2008 ND 178, 756 N.W.2d 320, 2008 N.D. LEXIS 180 (N.D. 2008).

Pre-Injury Earning Capacity.

The purpose of a vocational retraining program is to substantially rehabilitate a worker to his pre-injury earning capacity. Smith v. North Dakota Workers Compensation Bureau, 447 N.W.2d 250, 1989 N.D. LEXIS 188 (N.D. 1989) (decided prior to the 1989 amendments to this chapter).

A claimant is substantially rehabilitated if he can be employed to within ten percent of his pre-injury earning capacity, so that he is able, upon completion of the retraining program, to be employed at least at ninety percent of his pre-injury earning capacity. Smith v. North Dakota Workers Compensation Bureau, 447 N.W.2d 250, 1989 N.D. LEXIS 188 (N.D. 1989) (decided prior to the 1989 amendments to this chapter).

Law Reviews.

North Dakota Supreme Court Review (Hoffman v. North Dakota Workers’ Compensation Bureau, 2002 ND 138, 651 N.W.2d 601), see 79 N.D. L. Rev. 589 (2003).

65-05.1-05. Rehabilitation contract. [Repealed]

Repealed by S.L. 1989, ch. 771, § 6.

65-05.1-06. Rehabilitation allowance. [Repealed]

Repealed by S.L. 1989, ch. 771, § 6.

65-05.1-06.1. Rehabilitation award.

  1. Within sixty days of receiving the final vocational report, the organization shall issue a notice of decision under section 65-01-16 detailing the employee’s entitlement to disability and vocational rehabilitation services.
  2. If the appropriate priority option is short-term or long-term training, the vocational rehabilitation award must be within the following terms:
    1. For the employee’s lost time, and in lieu of further disability benefits, the organization shall award a rehabilitation allowance. The rehabilitation allowance must be limited to the amount and purpose specified in the award, and must be equal to the disability and dependent benefits the employee was receiving, or was entitled to receive, prior to the award.
    2. The rehabilitation allowance must include, as chosen by the employee, an additional thirty percent of the rehabilitation allowance for expenses associated with maintaining a second domicile or for travel associated with attendance at a school or training institution when it is necessary for the employee to travel at least twenty-five miles [40.23 kilometers] one way. Travel must be calculated from the employee’s residence to the school or training institution. If it is necessary for an employee to travel less than twenty-five miles one way to a school or training institution, the employee may qualify for an additional rehabilitation allowance as determined in accordance with the following schedule:
    3. The rehabilitation allowance must be limited to one hundred four weeks except in cases of catastrophic injury, in which case additional rehabilitation benefits may be awarded in the discretion of the organization. Catastrophic injury includes:
      1. Paraplegia; quadriplegia; severe closed head injury; total blindness in both eyes; or amputation of an arm proximal to the wrist or a leg proximal to the ankle, caused by the compensable injury, which renders an employee permanently and totally disabled without further vocational retraining assistance; or
      2. Those employees the organization so designates, in its sole discretion, provided that the organization finds the employee to be permanently and totally disabled without further vocational retraining assistance. There is no appeal from an organization decision to designate, or fail to designate, an employee as catastrophically injured under this subsection.
    4. Notwithstanding the one hundred four-week limit of subdivision c to facilitate the completion of a retraining program, the organization may award a rehabilitation extension allowance that may not exceed twenty weeks.
    5. The rehabilitation award must include the cost of books, tuition, fees, and equipment, tools, or supplies required by the educational institution. The award may not exceed the cost of attending a public college or university in the state in which the employee resides, provided an equivalent program exists in the public college or university.
    6. If the employee successfully concludes the rehabilitation program, the organization may make, in its sole discretion, additional awards for actual relocation expenses to move the household to the locale where the injured employee has actually located work.
    7. If the employee successfully concludes the rehabilitation program, the organization may make, in its sole discretion, an additional award, not to exceed two months’ disability benefit, to assist the employee with work search.
    8. If the employee successfully concludes the rehabilitation program, the employee is not eligible for further vocational retraining or total disability benefits unless the employee establishes a significant change in medical condition attributable to the work injury which precludes the employee from performing the work for which the employee was trained, or any other work for which the employee is suited and has sustained an actual wage loss caused by the significant change in the compensable medical condition. The organization may waive this section in cases of catastrophic injury defined by subdivision c.
    9. If the employee successfully concludes the rehabilitation program, the employee remains eligible to receive partial disability benefits, as follows:
      1. Beginning the date at which the employee completes retraining, until the employee acquires and performs substantial gainful employment, the partial disability benefit is sixty-six and two-thirds percent of the difference between the injured employee’s average weekly wage, and the employee’s wage-earning capacity after retraining, as measured by the average wage in the employee’s occupation, according to criteria established by job service North Dakota in its statewide labor market survey, or such other criteria the organization, in its sole discretion, deems appropriate. The average weekly wage must be determined on the date the employee completes retraining. The benefit continues until the employee acquires substantial gainful employment.
      2. Beginning the date at which the employee acquires substantial gainful employment, the partial disability benefit is sixty-six and two-thirds percent of the difference between the injured employee’s average weekly wage, and the injured employee’s wage-earning capacity after retraining, as determined under paragraph 1, or the injured employee’s actual wage earnings after retraining, whichever is higher.
      3. The partial disability benefit payable under paragraphs 1 and 2 may not exceed the limitation on partial disability benefits contained in section 65-05-10.
      4. The partial disability benefits paid under paragraphs 1 and 2 may not together exceed one year’s duration.
      5. For purposes of paragraphs 1 and 2, “substantial gainful employment” means full-time bona fide work, for a remuneration, other than make-work. “Full-time work” means employment for twenty-eight or more hours per week, on average.
      6. The organization may waive the one-year limit on the duration of partial disability benefits, in cases of catastrophic injury under subdivision c.
  3. If the appropriate priority option is return to the same or modified position, or to a related position, the organization shall determine whether the employee is eligible to receive partial disability benefits pursuant to section 65-05-10. In addition, the organization, when appropriate, shall make an additional award for actual relocation expenses to move the household to the locale where the injured employee has actually located work.
  4. If the appropriate priority option is subdivision e or f of subsection 4 of section 65-05.1-01 or subsection 6 of section 65-05.1-01, to assist with work search the organization may award an additional award. The additional award under this subsection is awarded at the organization’s sole discretion and may not exceed an amount equal to two months of the employee’s total disability benefits calculated under section 65-05-09.

Percentage increase in Round-trip mileage rehabilitation allowance Under 10 miles 0 10 to 30 miles 10 31 to 49 miles 20

Click to view

Travel must be calculated from the employee’s residence to the school or training institution.

Source:

S.L. 1989, ch. 771, § 5; 1991, ch. 714, § 59; 1995, ch. 614, § 4; 1995, ch. 628, § 4; 1997, ch. 546, § 4; 2003, ch. 561, § 3; 2005, ch. 611, § 5; 2009, ch. 629, § 1; 2009, ch. 630, 1; 2011, ch. 512, § 7; 2013, ch. 499, §§ 13–15; 2015, ch. 480, § 6, eff August 1, 2015; 2021, ch. 500, § 12, eff August 1, 2021.

Note.

Section 13 of chapter 500, S.L. 2021, provides, “ APPLICATION. This Act applies to all claims regardless of date of injury.”

Notes to Decisions

Effect of Previous Order.

The bureau is precluded from using a benchmark different from that established by its previous order. Basing the analysis on the condition found in the previous order, the bureau’s denial of additional benefits was not supported by the evidence. 530 N.W.2d 344.

DECISIONS UNDER PRIOR LAW

Expenses of Relocating.

Former N.D.C.C. § 65-05.1-06 did not require the bureau to pay expenses incurred by a claimant in relocating in order to take advantage of a vocational retraining program. Smith v. North Dakota Workers Compensation Bureau, 447 N.W.2d 250, 1989 N.D. LEXIS 188 (N.D. 1989).

Vocational Rehabilitation.

The workers compensation bureau’s order awarding the claimant vocational rehabilitation benefits for a period of two years instead of four years was affirmed where the bureau normally awarded only two years of vocational rehabilitation benefits, the claimant was informed prior to enrolling in a four-year program that the bureau normally granted only two years of vocational rehabilitation benefits, and there were numerous two-year-degree programs which would qualify the claimant for employment. Levey v. North Dakota Workers Compensation Bureau, 425 N.W.2d 376, 1988 N.D. LEXIS 137 (N.D. 1988).

Notes to Decisions

Effect of Previous Order.

The bureau is precluded from using a benchmark different from that established by its previous order. Basing the analysis on the condition found in the previous order, the bureau’s denial of additional benefits was not supported by the evidence. 530 N.W.2d 344.

DECISIONS UNDER PRIOR LAW

Expenses of Relocating.

Former N.D.C.C. § 65-05.1-06 did not require the bureau to pay expenses incurred by a claimant in relocating in order to take advantage of a vocational retraining program. Smith v. North Dakota Workers Compensation Bureau, 447 N.W.2d 250, 1989 N.D. LEXIS 188 (N.D. 1989).

Vocational Rehabilitation.

The workers compensation bureau’s order awarding the claimant vocational rehabilitation benefits for a period of two years instead of four years was affirmed where the bureau normally awarded only two years of vocational rehabilitation benefits, the claimant was informed prior to enrolling in a four-year program that the bureau normally granted only two years of vocational rehabilitation benefits, and there were numerous two-year-degree programs which would qualify the claimant for employment. Levey v. North Dakota Workers Compensation Bureau, 425 N.W.2d 376, 1988 N.D. LEXIS 137 (N.D. 1988).

65-05.1-06.2. Contract for vocational rehabilitation services.

The organization may contract with vocational rehabilitation vendors to provide vocational rehabilitation services to injured employees. The organization shall determine the criteria that render a vocational rehabilitation vendor qualified. If additional services are determined to be necessary as a result of failed or inappropriate rehabilitation of an injured employee through no fault of the employee, the organization may contract with the vendor for additional services. If the failure or inappropriateness of the rehabilitation of the injured employee is due to the vendor’s failure to provide the necessary services to fulfill the contract, the organization is not obligated to use that vendor for additional services on that claim and the organization may refuse payment for a service that the vendor failed to perform which was a material requirement of the contract.

Source:

S.L. 1991, ch. 714, § 60; 1993, ch. 629, § 1; 2001, ch. 23, § 8; 2003, ch. 561, § 3; 2013, ch. 499, § 16.

65-05.1-06.3. Rehabilitation services pilot programs — Reports. [Effective through August 31, 2022]

The organization may implement a system of pilot programs to allow the organization to assess alternative methods of providing rehabilitation services. A pilot program may address one or more of the organization’s comprehensive rehabilitation services, including vocational, medical, psychological, economic, and social rehabilitation services. The goal of a pilot program must be to improve the outcome of the rehabilitation services offered by the organization to assist the injured employee in making adjustments necessitated from the employee’s injury and to improve the effectiveness of vocational rehabilitation services in returning an employee to substantial gainful employment. Notwithstanding laws to the contrary, a pilot program may address a broad range of approaches, including collaborative efforts between the organization and the injured employee through which there are variances from the rehabilitation services hierarchy; return-to-work trial periods during which cash benefits are suspended; intensive job search assistance; recognition of and focused services for injured employees who are at risk; and coordination of services of public and private entities. If a pilot program utilizes coordination of services of other state agencies, such as job service North Dakota, department of human services, North Dakota university system, or department of public instruction, the organization shall consult with the state agency in establishing the relevant portions of the pilot program and the state agency shall cooperate with the organization in implementing the pilot program. The organization shall provide status reports on current pilot programs in accordance with section 65-01-18.

Source:

S.L. 2009, ch. 629, § 2; 2015, ch. 480, § 7, eff August 1, 2015; 2017, ch. 439, § 5, eff August 1, 2017; 2019, ch. 526, § 2, eff August 1, 2019.

Effective Date.

This section became effective August 1, 2009.

65-05.1-06.3. Rehabilitation services pilot programs — Reports. [Effective September 1, 2022]

The organization may implement a system of pilot programs to allow the organization to assess alternative methods of providing rehabilitation services. A pilot program may address one or more of the organization’s comprehensive rehabilitation services, including vocational, medical, psychological, economic, and social rehabilitation services. The goal of a pilot program must be to improve the outcome of the rehabilitation services offered by the organization to assist the injured employee in making adjustments necessitated from the employee’s injury and to improve the effectiveness of vocational rehabilitation services in returning an employee to substantial gainful employment. Notwithstanding laws to the contrary, a pilot program may address a broad range of approaches, including collaborative efforts between the organization and the injured employee through which there are variances from the rehabilitation services hierarchy; return-to-work trial periods during which cash benefits are suspended; intensive job search assistance; recognition of and focused services for injured employees who are at risk; and coordination of services of public and private entities. If a pilot program utilizes coordination of services of other state agencies, such as job service North Dakota, department of health and human services, North Dakota university system, or department of public instruction, the organization shall consult with the state agency in establishing the relevant portions of the pilot program and the state agency shall cooperate with the organization in implementing the pilot program. The organization shall provide status reports on current pilot programs in accordance with section 65-01-19.

Source:

S.L. 2009, ch. 629, § 2; 2015, ch. 480, § 7, eff August 1, 2015; 2017, ch. 439, § 5, eff August 1, 2017; 2019, ch. 526, § 2, eff August 1, 2019; 2021, ch. 352, § 509, eff September 1, 2022.

65-05.1-07. Person furnishing training exempt from civil liability — Injured employee’s remedy.

Any person, partnership, corporation, limited liability company, association, or agency that furnishes on-the-job or other similar training to an injured employee as the result of a rehabilitation contract, without establishing an employment relationship with the injured employee, is exempt from all civil liability.

Source:

S.L. 1975, ch. 584, § 7; 1989, ch. 69, § 85; 1993, ch. 54, § 106; 2003, ch. 561, § 3; 2013, ch. 499, § 17.

65-05.1-08. Workforce safety and insurance educational revolving loan fund — Vocational rehabilitation grants — Continuing appropriation.

  1. The organization may establish a revolving loan fund to provide a low-interest loan to an injured employee or to a surviving spouse or child of an injured employee whose death resulted from a compensable injury under section 65-05-16; or to the spouse or child of an injured employee deemed to be catastrophically injured as defined in subdivision c of subsection 2 of section 65-05.1-06.1 ; or to the spouse or child of an injured employee deemed to be eligible for permanent total disability benefits as defined in section 65-01-02.
  2. The loan must be used to pursue an education at an accredited institution of higher education or an institution of technical education. In order to be eligible for a loan under this section, an individual must have obtained a high school diploma or its equivalent and either must be ineligible for retraining under this chapter or must have exhausted training and education benefits. A child of an injured employee must meet the definition of child at the time of the initial loan application in order to be eligible for a loan. The Bank of North Dakota and the organization shall establish loan eligibility requirements and make application determinations based on the established criteria. The loan application must require an applicant to demonstrate a viable education plan that will enable the individual to achieve gainful employment.
  3. The total amount loaned annually under this section may not exceed two million five hundred thousand dollars. The maximum amount payable on behalf of a loan applicant may not exceed fifty thousand dollars and must be payable within five years. A loan must be repaid within a period not to exceed twenty years. A loan must be repaid at an interest rate established by the organization which may not exceed the rate of one percent below the Bank of North Dakota’s prime interest rate. The organization shall pay the Bank of North Dakota a negotiated fee for administering and servicing loans under this section. At the organization’s discretion, moneys to establish and maintain the revolving loan fund must be appropriated from the organization’s workforce safety and insurance fund. The revolving loan fund is a special fund and must be invested pursuant to section 21-10-06. Investment income and collections of interest and principal on loans made from the revolving loan fund are appropriated on a continuing basis to maintain the fund and provide loans in accordance with this section. As determined necessary, the organization may transfer uncommitted moneys of the revolving loan fund to the workforce safety and insurance fund.
  4. The organization may implement a grant program to promote and provide necessary educational opportunities for injured employees within the vocational rehabilitation process. The organization may award a grant to promote necessary skills upgrading and to provide for the completion of remedial educational requirements which allow for optimal transition into the labor force. The total annual amount the organization may grant under this subsection may not exceed one hundred thousand dollars. The organization shall establish grant eligibility requirements and make grant determinations based on the established criteria. Moneys are appropriated on a continuing basis from uncommitted moneys in the educational revolving loan fund for the purpose of funding the grants under this subsection.

Source:

S.L. 2005, ch. 612, § 1; 2007, ch. 570, § 4; 2009, ch. 611, § 12; 2011, ch. 512, § 8; 2011, ch. 513, § 1; 2015, ch. 480, § 8, eff August 1, 2015.

CHAPTER 65-05.2 Supplementary Benefits

65-05.2-01. Eligibility for supplementary benefits.

  1. For claims filed before January 1, 2006, a workforce safety and insurance claimant who is receiving temporary total disability benefits, permanent total disability benefits, or death benefits, and who has been receiving disability or death benefits for a period of three consecutive years is eligible for supplementary benefits. Eligibility for supplementary benefits under this subsection lasts as long as the claimant is entitled to temporary total disability benefits, permanent total disability benefits, or death benefits.
  2. For claims filed after December 31, 2005, a workforce safety and insurance claimant who is receiving permanent total disability benefits or death benefits and who has been receiving disability or death benefits for a period of at least three consecutive years is eligible for supplementary benefits. Eligibility for supplementary benefits under this subsection lasts as long as the claimant is entitled to permanent total disability benefits or death benefits.

Source:

S.L. 1979, ch. 655, § 1; 1985, ch. 688, § 3; 1989, ch. 69, § 86; 1991, ch. 714, § 61; 1999, ch. 556, § 4; 2003, ch. 561, § 3; 2007, ch. 570, § 5; 2009, ch. 621, § 2.

Notes to Decisions

Date of Eligibility.

Although claimant had been receiving disability benefits for more than the required time period under N.D.C.C. § 65-05.2-01, and her benefit rate had dropped below the 60% threshold under N.D.C.C. § 65-05.2-02(1), the claimant had not been receiving permanent total disability benefits and was therefore not entitled to supplementary disability benefits until September 11, 2002, the date the insurer’s review committee declared she was incapable of rehabilitation and therefore, permanently and totally disabled. Until rehabilitation options were considered and rejected, she could not be found permanently and totally disabled and therefore eligible for supplementary benefits. The fact that the committee should have determined claimant’s status 15 months earlier and that it violated its own internal operating procedures did not warrant reversal of the decision in the absence of evidence of a persistent pattern of improper agency conduct. Baity v. Workforce Safety & Ins., 2004 ND 184, 687 N.W.2d 714, 2004 N.D. LEXIS 319 (N.D. 2004).

65-05.2-02. Supplementary benefits — Amount.

  1. A claimant whose weekly benefit rate is less than sixty percent of the state’s average weekly wage, who is eligible for supplementary benefits and who is receiving temporary total disability benefits, permanent total disability benefits, or death benefits regardless of the date of death, is entitled to receive a weekly supplementary benefit that, when added to the weekly temporary total disability benefit, permanent total disability benefit, or death benefit, equals the ratio of that claimant’s weekly benefit to the state’s average weekly wage on the date of the claimant’s first disability, times the state’s average weekly wage in effect at the date eligibility for supplementary benefits is achieved. The organization shall determine on an annual basis, for a claimant who receives a supplementary benefit under this subsection, supplementary benefit increases equal to a percentage of that claimant’s combined weekly benefit. That percentage is equal to the annual percentage change in the state’s average weekly wage. For purposes of this section, combined weekly benefit means the weekly benefit for which the claimant is eligible before any applicable social security offset plus the amount of weekly supplementary benefits for which the claimant is eligible.
  2. A claimant whose weekly benefit rate is greater than or equal to sixty percent of the state’s average weekly wage, who is eligible for supplementary benefits and who is receiving temporary total disability benefits, permanent total disability benefits, or death benefits regardless of the date of death, is entitled to receive a weekly supplementary benefit equal to a percentage of that claimant’s weekly benefit. That percentage is equal to the annual percentage change in the state’s average weekly wage. The organization shall determine on an annual basis, for that claimant, supplementary benefit increases equal to a percentage of that claimant’s combined weekly benefit. That percentage is equal to the annual percentage change in the state’s average weekly wage.
  3. An annual recalculation of supplementary benefits may not result in a rate less than the previous rate. If a claim has been accepted on an aggravation basis under section 65-05-15 and the claimant is eligible for supplementary benefits, the claimant’s supplementary benefit must be proportionally calculated.

Source:

S.L. 1979, ch. 655, § 2; 1981, ch. 645, § 1; 1983, ch. 701, § 1; 1985, ch. 688, § 4; 1987, ch. 757, § 1; 1989, ch. 772, § 1; 1991, ch. 714, § 62; 1997, ch. 545, § 5; 1999, ch. 557, § 4; 2001, ch. 582, § 1; 2003, ch. 561, § 3; 2009, ch. 621, § 3.

Notes to Decisions

Construction.

This section governing supplemental benefits provides a minimum total benefit after supplementary benefits are added to permanent disability benefit awards. Effertz v. North Dakota Workers Compensation Bureau, 525 N.W.2d 691, 1994 N.D. LEXIS 276 (N.D. 1994).

65-05.2-03. Payment of supplementary benefits from the supplementary benefit fund.

The payment of supplementary benefits to eligible recipients shall be made by the organization from the supplementary benefit fund. If the supplementary benefit fund is inadequate to pay the full amount of supplementary benefits to an eligible recipient, the levels of supplementary benefits shall be prorated for all eligible recipients. The organization shall not be required to provide a reserve in the fund to pay liability incurred as a result of such supplementary benefits.

Source:

S.L. 1979, ch. 655, § 3; 1981, ch. 645, § 3; 2003, ch. 561, § 3.

65-05.2-04. Supplementary benefit fund.

The organization periodically shall determine the amount of money earned on reserves in the workforce safety and insurance fund necessary to provide for the payment of supplementary benefits under this chapter and periodically shall transfer an adequate amount from the earnings on the reserves of the workforce safety and insurance fund to the supplementary benefit fund.

Source:

S.L. 1979, ch. 655, § 4; 1989, ch. 69, § 87; 2003, ch. 561, § 3.

CHAPTER 65-06 Volunteer Emergency Responders

65-06-01. Volunteer firefighter, emergency or disaster volunteer, community emergency response team member, in training defined.

The term “volunteer firefighter” means any active member of an organized volunteer fire department of this state and any other individual performing services as a volunteer firefighter for a municipality at the request of the chief or other individual in command of the fire department of that municipality or of any other officer of that municipality having authority to demand service as a firefighter. Firefighters who are paid a regular wage or stipend by the municipality for serving as a firefighter, or whose entire time is devoted to service as a firefighter for the municipality, for the purpose of this chapter, are not volunteer firefighters.

The term “emergency or disaster volunteer” means any individual serving without remuneration who is actively engaged in training to qualify as a disaster emergency worker or is responding to a hazard, emergency disaster, or enemy attack on this country, and who is registered with the disaster emergency organization of a municipality, which has been officially recognized by the director of the state division of homeland security.

The term “in training” means only those periods of time, during which an emergency or disaster volunteer is receiving instruction, or is engaged in exercises or operations, in preparation for qualification as a disaster emergency worker in the event of a hazard, emergency, disaster, or enemy attack on this country.

The term “community emergency response team member” means an individual registered as a community emergency response team member with the appropriate authority. For purposes of this chapter, a community emergency response team member is acting as a community emergency response team member only when the individual is receiving approved community emergency response team training or is acting as a member of a community emergency response team in an emergency or disaster.

Upon request of the organization, the disaster emergency organization of a municipality shall provide the organization with its roster of registered community emergency response team members.

The term “municipality” when used in reference to emergency or disaster volunteer means the state, cities, counties, municipalities, districts, or any other geographical entity of this state. This definition is not in any way intended to alter any interpretation or ruling in regard to the use of the term municipality when used in reference to volunteer firefighters.

Source:

S.L. 1937, ch. 178, § 2; R.C. 1943, § 65-0601; S.L. 1959, ch. 423, § 1; 1979, ch. 187, § 103; 2003, ch. 564, § 10; 2005, ch. 16, § 33.

Collateral References.

Liability of owner or occupant of premises to fireman coming thereon in discharge of his duty, 11 A.L.R.4th 597.

65-06-02. Volunteer firefighter, emergency or disaster volunteer, and community emergency response team member declared employees — Covered by workforce safety and insurance — Termination.

Volunteer firefighters, emergency or disaster volunteers, and community emergency response team members are employees of the municipalities which they serve and are entitled to the same protection and rights under the provisions of this title as are full-time paid employees of those municipalities.

Source:

S.L. 1937, ch. 178, § 1; R.C. 1943, § 65-0602; S.L. 1959, ch. 423, § 2; 1979, ch. 187, § 104; 2003, ch. 561, § 3; 2003, ch. 564, § 11.

65-06-02.1. Uniform Emergency Volunteer Health Practitioners Act — Health practitioners.

A volunteer health practitioner under subsection 2 of section 37-17.4-11 is eligible for benefits as provided under this chapter.

Source:

2009, ch. 310, § 3.

Effective Date.

This section became effective August 1, 2009.

65-06-03. Compensation benefits — How determined.

The basis of compensation and benefits to be paid to a volunteer firefighter, an emergency or disaster volunteer, volunteer health practitioner, or a community emergency response team member under the terms of this chapter shall be determined in accordance with the provisions of section 65-05-09; provided, however, that the average weekly wage of the claimant shall be determined from a computation of income derived from the claimant’s business or employment for which coverage is required or otherwise secured at the date of first disability.

Source:

S.L. 1937, ch. 178, § 3; R.C. 1943, § 65-0603; S.L. 1959, ch. 423, § 3; 1969, ch. 558, § 4; 1975, ch. 579, § 4; 1979, ch. 187, § 105; 2003, ch. 564, § 12; 2013, ch. 502, § 5; 2015, ch. 480, § 9, eff August 1, 2015.

65-06-04. Assessment of premiums.

For the purpose of making assessments of premiums to be charged against municipalities for protection of volunteer firefighters, emergency or disaster volunteers, volunteer health practitioners, and community emergency response team members, the organization shall make such survey as may seem advisable to ascertain the probable annual expenditures necessary to be paid out of the fund to carry out this chapter, and shall fix the annual charges and assessments which must be made against municipalities employing volunteer firefighters, emergency or disaster volunteers, volunteer health practitioners, and community emergency response team members. The charge must be a fixed sum for each one hundred of the population of the municipality involved and uniform as to all such involved municipalities but in proportion to the population of the municipality. In determining the amount of premium charge, the organization may apply the system of experience rating provided in this title, as applied to other risks. The organization may establish a minimum charge or assessment to be applicable to any municipality for which the fixed rate or charge multiplied by the number of hundreds of the population of the municipality would amount to less than the amount of the minimum charge or assessment. The population of a municipality shall be that shown by the latest official North Dakota state or United States government census, whichever may be the later.

Source:

S.L. 1937, ch. 178, § 4; R.C. 1943, § 65-0604; S.L. 1959, ch. 423, § 4; 1969, ch. 567, § 1; 1979, ch. 187, § 106; 2003, ch. 561, § 3; 2003, ch. 564, § 13; 2013, ch. 502, § 6.

65-06-05. Reimbursement by state for liability in excess of premiums collected.

Whenever liability on claims against the fund credited to the classification of emergency or disaster volunteers and trainees or volunteer health practitioners as defined under chapter 37-17.4 exceeds the amount of premiums paid into the fund, such excess liabilities are a general obligation of the state of North Dakota and must be reimbursed to the organization for credit to the workforce safety and insurance fund by legislative appropriation.

Source:

S.L. 1959, ch. 423, § 5; 1979, ch. 187, § 107; 1991, ch. 714, § 63; 2003, ch. 561, § 3; 2009, ch. 310, § 2.

CHAPTER 65-06.1 Civil Air Patrol Members

65-06.1-01. Civil air patrol member defined.

“Civil air patrol member” means a volunteer civilian member of the civil air patrol engaged in official state activities authorized under chapter 54-45.

Source:

S.L. 1977, ch. 29, § 5; 1991, ch. 613, § 3.

65-06.1-02. Civil air patrol members declared employees — Covered by workforce safety and insurance.

Civil air patrol members are deemed employees of the civil air patrol and eligible for coverage under this title when engaged in official state activities authorized under chapter 54-45.

Source:

S.L. 1977, ch. 29, § 5; 1991, ch. 613, § 4; 2003, ch. 561, § 3.

65-06.1-03. Compensation benefits — How determined.

The basis for compensation and benefits for civil air patrol members under this chapter shall be determined under section 65-05-09, except that the claimant’s weekly wage shall be determined through computation of income derived from the claimant’s business or employment.

Source:

S.L. 1977, ch. 29, § 5.

65-06.1-04. Reimbursement for liability in excess of collected premiums.

Whenever claim liability against the fund credited to the classification of civil air patrol members exceeds the amount of premiums paid into the fund, the excess liabilities are a general obligation of the state of North Dakota and must be reimbursed to the organization for credit to the workforce safety and insurance fund through legislative appropriation. The adjutant general may use the funds available to the adjutant general under the Federal Employment Compensation Act liability coverage to satisfy the obligation under this section.

Source:

S.L. 1977, ch. 29, § 5; 1991, ch. 714, § 64; 1997, ch. 26, § 5; 2003, ch. 561, § 3.

CHAPTER 65-06.2 Inmates of Penal Institutions

65-06.2-01. Inmate defined.

For the purposes of sections 65-06.2-02 and 65-06.2-03, an “inmate” is a person who is confined against the inmate’s will in a city or county penal institution or is a person who, as a criminal defendant before a court, is ordered or elects to perform public service for a city or county in conjunction with or in lieu of a jail sentence. The term “inmate” does not include an individual injured while incarcerated in the North Dakota state penitentiary or any of its affiliated facilities or an individual injured in a fight, riot, recreational activity, or other incident not directly related to the inmate’s work assignment.

Source:

S.L. 1985, ch. 170, § 2; 1991, ch. 717, § 1; 1997, ch. 541, § 2; 2001, ch. 583, § 1.

65-06.2-02. Coverage of inmates — Conditions.

  1. If an inmate in performance of work in connection with the maintenance of the institution, or with any industry maintained within the institution, or with any public service activity, sustains a compensable injury, the inmate may be awarded and paid benefits under the provisions of this title, upon being released from the institution or after discharge from public service.
  2. Claims under this chapter must be filed and processed pursuant to section 65-05-01, except that an inmate also has one year from the date of first release from the institution or discharge from public service to file a claim.
  3. Workforce safety and insurance benefits under this chapter accrue and are payable from the time of the inmate’s release from the institution or after discharge from public service. Disability benefits must be computed according to the methods provided in chapter 65-05. The inmate’s weekly wage must be computed using either the actual wage paid to the inmate or the federal minimum wage as of the date of injury, whichever is higher.
  4. If a former inmate receiving disability benefits under the provisions of this chapter is recommitted or sentenced by a court to imprisonment in a penal institution, the disability benefits are payable pursuant to subsection 2 of section 65-05-08.

Source:

S.L. 1985, ch. 170, § 2; 1989, ch. 69, § 88; 1991, ch. 714, § 65; 1997, ch. 542, § 6; 2003, ch. 561, § 3.

Collateral References.

Workers’ compensation: incarceration as terminating benefits, 54 A.L.R.4th 241.

Law Reviews.

A Time for Recognition: Extending Workmen’s Compensation Coverage to Inmates, 61 N.D. L. Rev. 403 (1985).

65-06.2-03. Workers’ compensation coverage of inmates.

Any county or city, by resolution of the governing body, may elect to cover its inmates with workforce safety and insurance benefits in accordance with this chapter. Any county or city that makes this election is not liable to respond in damages at common law or by statute for injuries to or the death of any inmate whenever the provisions of this chapter have been met and the premiums as set by the organization are not in default.

Source:

S.L. 1985, ch. 170, § 2; 1989, ch. 69, § 89; 2003, ch. 561, § 3.

Law Reviews.

A Time for Recognition: Extending Workmen’s Compensation Coverage to Inmates, 61 N.D. L. Rev. 403 (1985).

65-06.2-04. Workers’ compensation coverage for inmates engaged in work programs through roughrider industries.

The director of the department of corrections and rehabilitation may elect to provide and request from the organization a program of modified workers’ compensation coverage established under this chapter and according to administrative rules and fee schedules of this chapter. The modified workers’ compensation coverage is for inmates incarcerated at the penitentiary and engaged in work in a prison industries work program through roughrider industries, whether the program is operated by roughrider industries or by contract with another entity or private employer. An inmate who sustains a compensable injury arising out of and in the course of work in a prison industries work program through roughrider industries may only receive workforce safety and insurance benefits under the modified workers’ compensation coverage established for that purpose.

Source:

S.L. 1997, ch. 541, § 3; 2001, ch. 583, § 1; 2003, ch. 561, § 3; 2007, ch. 569, § 6.

65-06.2-05. Modified coverage of inmates engaged in work programs through roughrider industries — Conditions.

Except as otherwise provided in this chapter, all claims for workforce safety and insurance benefits under this section and sections 65-06.2-04, 65-06.2-06, and 65-06.2-08 are subject to title 65. A claim under this section and sections 65-06.2-04, 65-06.2-06, and 65-06.2-08 must be filed according to section 65-05-01. While an inmate is incarcerated at the penitentiary, the penitentiary shall pay the reasonable medical expenses of that inmate at penitentiary medical payment levels, if that inmate incurs a compensable injury while working in a prison industries work program through roughrider industries. If an inmate sustains a compensable injury while working in a prison industries work program through roughrider industries, disability, vocational rehabilitation allowance, and permanent partial impairment benefits may not accrue or be paid while the inmate is incarcerated and may only be paid after the inmate is discharged from the penitentiary. If the director of the department of corrections and rehabilitation and the organization determine that an inmate who suffers a compensable injury under this chapter is in need of vocational rehabilitation services while the inmate is incarcerated, the penitentiary and the organization may provide vocational rehabilitation services to the inmate. An injury resulting from a fight, riot, recreational activity, or other activity or incident other than the inmate’s actual performance of work duties in a prison industries work program through roughrider industries is not compensable under this title.

Source:

S.L. 1997, ch. 541, § 4; 2001, ch. 583, § 1; 2003, ch. 561, § 3.

65-06.2-06. Rulemaking — Participation in state entities account.

The organization, in cooperation with the department of corrections and rehabilitation and the risk management division of the office of management and budget, shall adopt administrative rules and fee schedules for a program of modified workers’ compensation coverage established and provided under this section and sections 65-06.2-04, 65-06.2-05, and 65-06.2-08. The administrative rules and fee schedules must provide for the classification of inmates engaged in work in a prison industries work program through roughrider industries, the computation of premium, the payment of claims charges against the classification, the payment of medical bills, coverage under the workforce safety and insurance account for state entities under section 65-04-03.1, and the reimbursement by roughrider industries to the organization for all claim benefit costs charged against that classification, as well as any allocated loss adjustment expense and all administrative expenses, including the expense of issuing the coverage, for the life of the claim in excess of premiums, coverage under the workforce safety and insurance account for state entities, and medical expenses paid by roughrider industries. Roughrider industries shall contribute to the risk management workers’ compensation fund and participate in the workforce safety and insurance account for state entities under section 65-04-03.1 to cover the costs in excess of premiums and medical expenses paid. The organization shall determine and the risk management division shall assess a premium against roughrider industries for the cost of coverage under the workforce safety and insurance account for state entities and roughrider industries shall pay that premium.

Source:

S.L. 1997, ch. 541, § 5; 2001, ch. 583, § 1; 2003, ch. 561, § 3; 2015, ch. 483, § 1, eff August 1, 2015.

65-06.2-07. State reimbursement for liability in excess of collected premiums.

Whenever total costs and expenses charged to the classification of the modified workers’ compensation program established under this chapter exceeds the amount of premiums paid into the fund and any payments from the risk management workers’ compensation fund under the workforce safety and insurance state entities account under section 65-04-03.1, those excess costs and expenses are a general obligation of the state and the state shall reimburse the organization for credit to the workforce safety and insurance fund through legislative appropriation to the extent not covered by any program of excess coverage or reinsurance. This modified workers’ compensation coverage may not be effective unless the organization has, in its sole discretion, purchased excess coverage or reinsurance that does not exclude claims under this section.

Source:

S.L. 1997, ch. 541, § 6; 2001, ch. 583, § 1; 2003, ch. 561, § 3; 2015, ch. 483, § 2, eff August 1, 2015.

65-06.2-08. No liability for damages — Inmates are not employees.

The state and its employees and the department of corrections and rehabilitation and its divisions, departments, and employees may not be held liable for damages at common law or by statute if an inmate covered under a program of modified workers’ compensation coverage under this chapter sustains a compensable injury while working in a prison industries work program through roughrider industries. An inmate covered under a program of modified workers’ compensation coverage under this chapter is not an employee of the state or the department of corrections and rehabilitation and its divisions and departments, except for the purpose of modified workers’ compensation coverage under this chapter.

Source:

S.L. 1997, ch. 541, § 7; 2001, ch. 583, § 1; 2003, ch. 561, § 3.

65-06.2-09. Safety and performance review. [Repealed]

Source:

S.L. 1997, ch. 541, § 8; 2001, ch. 583, § 1; 2003, ch. 561, § 3; 2009, ch. 482, § 96; 2011, ch. 514, § 1; Repealed by 2019, ch. 524, § 14, eff August 1, 2019.

CHAPTER 65-07 Employer’s Coverage

65-07-01. Employer, spouse and children of employer, self-employed, and volunteers may secure coverage.

Any employer, by special contract with the organization, may secure workforce safety and insurance coverage for injuries to the employer’s own person or for the employer’s own death. Any employer also may secure coverage for that employer’s spouse and children. Self-employed persons may contract with the organization for workforce safety and insurance coverage for themselves. In addition, any volunteer organization, not otherwise provided for under this title, may contract with the organization for workforce safety and insurance coverage for its own members while its members are engaged in the specific activity provided for in the contract.

Source:

S.L. 1923, ch. 351, § 1; 1925 Supp., § 396a29; S.L. 1941, ch. 305, § 6; R.C. 1943, § 65-0701; S.L. 1973, ch. 514, § 1; 1977, ch. 579, § 23; 1981, ch. 639, § 2; 1999, ch. 550, § 4; 2003, ch. 561, § 3.

65-07-02. Organization may refuse to contract for coverage.

The organization, on receipt of an application for insurance, shall determine whether the applicant is a good insurance risk and may deny such special contract if the organization determines it is in the best interests of the organization to do so.

Source:

S.L. 1923, ch. 351, § 1; 1925 Supp., § 396a29; S.L. 1941, ch. 305, § 6; R.C. 1943, § 65-0702; S.L. 1973, ch. 514, § 2; 2003, ch. 561, § 3; 2005, ch. 604, § 6.

65-07-03. Determination of weekly wage for premium purposes.

If the organization enters a contract for insurance under this chapter, the premium for the protection must be based on:

  1. The amount of money derived on an annual basis from the business of an employer or self-employed person as outlined in subdivision b of subsection 6 of section 65-01-02 for purposes of determining the premium for coverage of an employer, an employer’s spouse, or a self-employed person. This amount may not be less than the limited payroll required to be reported for an employee in subsection 1 of section 65-04-04.2.
  2. A reasonable wage or fee as determined by the organization for employees in the same class of industry that the volunteer organization is engaged.
  3. Actual wages paid to a clerk, an assessor, a treasurer, or a member of the board of supervisors of an organized township, if the contract for insurance is to provide protection for a person mentioned in this subsection and that person is not employed by the township in any other capacity.
  4. Actual wages paid to an employer’s child if that child is under the age of twenty-two.

Source:

S.L. 1923, ch. 351, § 1; 1925 Supp., § 396a29; S.L. 1941, ch. 305, § 6; R.C. 1943, § 65-0703; S.L. 1947, ch. 379, § 1; 1957 Supp., § 65-0703; S.L. 1969, ch. 558, § 5; 1973, ch. 514, § 3; 1975, ch. 579, § 5; 1993, ch. 622, § 3; 1997, ch. 527, § 6; 1997, ch. 547, § 1; 2001, ch. 584, § 1; 2003, ch. 561, § 3; 2005, ch. 604, § 7; 2013, ch. 502, § 7; 2019, ch. 523, § 18, eff August 1, 2019.

65-07-04. Benefits. [Repealed]

Repealed by S.L. 1999, ch. 550, § 5.

CHAPTER 65-07.1 Vocational Training and Work Evaluation Programs

65-07.1-01. Definitions.

For purposes of this chapter:

  1. “Employee” means a participant in a vocational training or work evaluation program when the request of the sponsoring agency or organization has been approved by the organization under subsection 2. The participant shall not be deemed to be employed in hazardous employment.
  2. “Employer” means any agency or organization that sponsors a participant in a vocational training or work evaluation program when such designation has been requested by the agency or organization and has been approved by the organization.
  3. “Workstation” means any person, corporation, limited liability company, or agency who through a formal contract with a sponsoring agency or organization is furnishing facilities, tools, or instruction to any participant in a vocational training or work evaluation program.

Source:

S.L. 1975, ch. 585, § 1; 1993, ch. 54, § 106; 2003, ch. 561, § 3.

Cross-References.

Word defined by statute always has same meaning, see N.D.C.C. § 1-01-09.

Collateral References.

Tort liability of public schools and institutions of higher learning for accidents associated with chemistry experiments, shopwork and manual or vocational training, 35 A.L.R.3d 758.

65-07.1-02. Vocational training or work evaluation programs — Organization may contract.

Whenever an agency or organization has been approved as an employer under subsection 2 of section 65-07.1-01, the organization may contract with the agency or organization for the coverage of participants in a program of vocational training or work evaluation. The premium for the coverage must be based on a reasonable wage or fee as determined by the organization for employees in the same class of industry that the employer is engaged.

Source:

S.L. 1975, ch. 585, § 2; 2003, ch. 561, § 3; 2013, ch. 502, § 8.

65-07.1-03. Employer and workstation not liable for civil damages — Employee may elect.

Any employer or workstation, as defined in this chapter, shall not be liable to respond in damages at common law or by statute for injuries to or the death of any employee, as defined in this chapter, whenever the employer has complied with the provisions of this chapter and during the period for which premiums, as set by the organization, have been paid. Any employee who elects, before injury or death, not to come under the provisions of this chapter may do so by notifying the organization, employer, and workstation of such election in writing.

Source:

S.L. 1975, ch. 585, § 3; 2003, ch. 561, § 3.

65-07.1-04. Benefits — Filing procedures.

In the event that the organization has contracted with a sponsoring agency or organization to provide such coverage, any participant in a vocational training or work evaluation program who suffers an injury or disease as defined in section 65-01-02, while in the course of such participation shall be entitled to such medical, surgical, and hospital benefits and supplies as the nature of the injury may require. In addition, the organization shall provide such other benefits, to the extent as provided or limited by this title, as are specifically set out in the contract with the sponsoring agency or organization. All original claims shall be filed within such time and in accordance with such procedures as provided in chapter 65-05.

Source:

S.L. 1975, ch. 585, § 4; 2003, ch. 561, § 3.

CHAPTER 65-08 Extraterritorial Application

65-08-01. Extraterritorial coverage — When and how furnished.

  1. An employee who suffers an injury while working outside this state, on account of which the employee or the employee’s dependents would have been entitled to workforce safety and insurance benefits provided by this title had such injury occurred within this state, is entitled to benefits, or that employee’s dependents in the event of the employee’s death are entitled to benefits if at the time of injury:
    1. The employment is principally localized in this state, as determined by the following:
      1. The employer has a place of business in this state;
      2. The employee regularly works at or from that place of business;
      3. The employment contract is entered in this state; and
      4. In the case of an employee leasing company, the company retains control over the employee and does not lease the employee to an out-of-state employer;
    2. The employee is working under a contract of hire, made in this state in employment not principally localized in any state, if:
      1. The employer has a place of business in this state;
      2. The employment contract is entered in this state; and
      3. In the case of over-the-road trucking, the employer retains control over the driver, dispatches employees from this state, and does not lease the driver to out-of-state employers; but trip leasing does not end coverage;
    3. The employee is working under a contract of hire made in this state in employment principally localized in another state and that state’s workforce safety and insurance law is not applicable to the employer, as provided by a reciprocal agreement;
    4. The employee is working under a contract of hire made in this state for employment outside the United States and the workforce safety and insurance law of that other jurisdiction is not applicable to the employer; or
    5. The employee is a resident of another state, and is hired by a North Dakota employer or that employer’s authorized agent for temporary employment, the situs of which is located in another state, and the temporary employment is necessary to the principal employment of the North Dakota employer, provided that the other state recognizes the coverage under this title as the sole remedy of the employee against the employer for the injury or death.
  2. The payment or award of benefits under the workforce safety and insurance law of another state, territory, province, or foreign nation to an employee or the employee’s dependents otherwise entitled on account of the injury or death to workforce safety and insurance benefits of this state bars a claim for benefits under this title.
  3. An employment relationship that is principally localized outside of this state is exempt from this title while the employee is temporarily within this state unless the workforce safety and insurance law of the state in which the employment is principally localized provides that the workforce safety and insurance remedy in this state is the exclusive remedy for the employee or the dependents of an employee who died as the result of an injury in this state.
  4. An employer whose employment results in significant contacts with this state shall acquire workforce safety and insurance coverage in this state unless a reciprocal agreement between the states is entered which provides that the other state will likewise recognize that an employment relationship entered into in this state is exempted from the application of the workers’ compensation insurance law of the other state. An employment has significant contacts with this state when:
    1. Any employee earns or would have been expected to earn twenty-five percent or more of the employee’s gross annual wage or income from that employer from services rendered in this state; or
    2. Twenty-five percent of the employer’s gross annual payroll is payable to employees for services rendered in this state.
    3. An employer hires an employee in this state for work in this state.
  5. An employer who opens an employer account with the organization under this section is obligated to report all wages earned in this state, regardless of whether the significant contacts factors set forth in subsection 4 have been met.

Under this subsection, an employee injured in this state may elect to file a claim in this state notwithstanding that the employee had another remedy in the state in which the employment was principally localized. A claim filed under this subsection is subject to section 65-05-05. The time limits within which the organization shall issue a decision on a claim, as specified in sections 65-01-16 and 65-02-08, do not begin to run for claims filed under this section until the first date the organization may begin to process the claim as set forth in section 65-05-05.

Source:

S.L. 1919, ch. 162, § 10; 1923, ch. 350, § 1; 1925 Supp., § 396a10; S.L. 1931, ch. 313, § 1; 1935, ch. 286, § 4; 1941, ch. 303, § 2; R.C. 1943, § 65-0801; S.L. 1949, ch. 354, § 12; 1955, ch. 354, § 3; 1957 Supp., § 65-0801; S.L. 1967, ch. 487, § 1; 1989, ch. 766, § 13; 1991, ch. 718, § 1; 1993, ch. 630, § 1; 1997, ch. 532, § 5; 2001, ch. 578, § 13; 2003, ch. 561, § 3; 2005, ch. 607, § 4; 2013, ch. 502, § 9; 2015, ch. 484, § 3, eff August 1, 2015.

Notes to Decisions

In General.

If there is no contract for extraterritoral coverage between an employer and the bureau, the bureau’s responsibility for compensating injuries occurring outside of North Dakota is limited by the terms of this section. North Dakota. Souris River Tel. Mut. Aid Coop. v. North Dakota Workers Compensation Bureau, 471 N.W.2d 465, 1991 N.D. LEXIS 109 (N.D. 1991).

Identifiable Out-of-State Jobsite.

Subsection (1)(b) of the statute allows compensation for injuries occurring outside this state if the employee is engaged in a service which is “incidental to and is referable to the principal employment, the situs of which is within North Dakota.” However, subsection (2) of the statute modified subsection (1)(b) by declaring that services rendered are not incidental and referable to the North Dakota employment, if the injury is sustained at an “identifiable out-of-state jobsite.” North Dakota. Souris River Tel. Mut. Aid Coop. v. North Dakota Workers Compensation Bureau, 471 N.W.2d 465, 1991 N.D. LEXIS 109 (N.D. 1991).

The “identifiable out-of-state jobsite” provision was added to this section in 1989 at the request of the bureau. It is obvious from the legislative history that the purpose of the amendment was to prevent employers from taking advantage of North Dakota’s favorable workers compensation rates while having their employees work in another state without obtaining and paying premiums for out-of-state coverage. North Dakota. Souris River Tel. Mut. Aid Coop. v. North Dakota Workers Compensation Bureau, 471 N.W.2d 465, 1991 N.D. LEXIS 109 (N.D. 1991).

Legislative Intent.

In adopting the amendment to this section, the Legislature clearly intended to limit the bureau’s liability for uncontracted coverage of employees who are injured outside of North Dakota. Souris River Tel. Mut. Aid Coop. v. North Dakota Workers Compensation Bureau, 471 N.W.2d 465, 1991 N.D. LEXIS 109 (N.D. 1991).

DECISIONS UNDER PRIOR LAW

No Extraterritorial Coverage.

Where there was no express contract providing for extraterritorial coverage, an appointive peace officer of county receiving injuries outside state in course of his employment was not entitled to compensation on account of his injuries. MacArthur v. North Dakota Workmen's Compensation Bureau, 62 N.D. 572, 244 N.W. 259, 1932 N.D. LEXIS 216 (N.D. 1932).

No Extraterritorial Effect.

Workers’ compensation act did not have extraterritorial effect. Altman v. North Dakota Workmen's Compensation Bureau, 50 N.D. 215, 195 N.W. 287, 1923 N.D. LEXIS 86 (N.D. 1923).

North Dakota Contract Performed Elsewhere.

Where person was employed under North Dakota contract to perform work in state of Washington, employment in Washington was not merely an incident to hazardous occupation covered by workers’ compensation act. Altman v. North Dakota Workmen's Compensation Bureau, 50 N.D. 215, 195 N.W. 287, 1923 N.D. LEXIS 86 (N.D. 1923).

Sovereign Immunity.

State of South Dakota is not liable, on principles of comity, for injuries of its employees of an enterprise carried on in North Dakota, at least in suit in courts of latter state. Paulus v. State, 52 N.D. 84, 201 N.W. 867, 1924 N.D. LEXIS 113 (N.D. 1924).

Collateral References.

Workmen’s compensation act: voluntary payment of compensation under statute of one state as bar to claim or ground for reduction of claim of compensation under statute of another state, 8 A.L.R.2d 628.

65-08-02. Reciprocity in extraterritorial application of compensation acts of various states provided. [Repealed]

Repealed by S.L. 1991, ch. 718, § 2.

65-08-03. Evidence that nonresident employer carries extraterritorial workforce safety and insurance coverage.

A certificate from the executive secretary or other duly authorized officer of workforce safety and insurance or similar organization of another state certifying that an employer of such other state is insured under the Workforce Safety and Insurance Act or similar act thereof, and has provided extraterritorial coverage insuring that employer’s employees while working within this state, is prima facie evidence that such employer carries such workforce safety and insurance.

Source:

S.L. 1939, ch. 252, § 2; R.C. 1943, § 65-0803; S.L. 1989, ch. 69, § 91; 2003, ch. 561, § 3.

65-08-04. Agreements between states relating to conflicts of jurisdiction.

The organization, through the action of the director, may enter into agreements with the workforce safety and insurance agencies of other states relating to conflicts of jurisdiction where the contract of employment is in one state and the injuries are received in the other state, or where there is a dispute as to the boundaries or jurisdiction of the states and when such agreements have been executed and made public by the respective state agencies, the rights of the employee hired in such other state and injured while temporarily employed in this state, or hired in this state and injured while temporarily employed in another state, or where the jurisdiction is otherwise uncertain, must be determined pursuant to such agreements and confined to the jurisdiction provided in such agreements. Where such an agreement exists, any provisions of this chapter which conflict with the provisions of that agreement are superseded by the provisions of that agreement.

Source:

S.L. 1967, ch. 487, § 3; 1989, ch. 69, § 92; 1989, ch. 295, § 18; 2003, ch. 561, § 3.

CHAPTER 65-08.1 Workforce Safety and Insurance Company

65-08.1-01. Definitions.

In this chapter, unless the context otherwise requires:

  1. “Company” means the workforce safety and insurance company or other organization established by the organization to provide additional workforce safety and insurance coverage.
  2. “Employers’ liability coverage” means an insurance product that provides coverage for injury-related claims suffered by an employee that are not covered by title 65.
  3. “Extraterritorial workforce safety and insurance coverage” means coverage provided under section 65-08-01.
  4. “Incidental operations” means operations of an employer for fewer than thirty days in a state with which the employer has no other significant contacts.
  5. “Other states insurance” means an insurance product that provides workforce safety and insurance coverage to an employer for that employer’s employee while the employee is working at an incidental operation in a state in which the employee is eligible to file for workforce safety and insurance benefits if the employee suffers a work-related illness or injury or dies as a result of work activities in that state.
  6. “Principally localized” means the employer has a place of business in this state, the employee regularly works at or from that place of business, the employment contract is entered in that state, and in case of an employee leasing company, the company retains control over the employee and does not lease the employee to an out-of-state employer.

Source:

S.L. 1993, ch. 631, § 1; 2003, ch. 561, § 3.

Cross-References.

Word defined by statute always has same meaning, see N.D.C.C. § 1-01-09.

65-08.1-02. Workforce safety and insurance additional coverages.

The organization may establish a casualty insurance organization, organized as a stock or mutual company, a risk pool, a reciprocal exchange, a risk retention or purchasing group, or a reinsurer with the limited purpose of offering extraterritorial workforce safety and insurance coverage or other states insurance. The casualty insurance organization may be established only upon the director’s determination that the organization is needed to provide sufficient workforce safety and insurance coverage for the employees and employers of this state and upon the approval of the legislative assembly or the budget section if the legislative assembly is not in session. Any request considered by the budget section must comply with section 54-35-02.9. If a stock insurance company is established, the company shall meet the stock requirements of section 65-08.1-03.

Source:

S.L. 1993, ch. 631, § 2; 2003, ch. 561, § 3; 2009, ch. 482, § 98; 2019, ch. 438, § 18, eff August 1, 2019.

Effective Date.

The 2009 amendment of this section by section 98 of chapter 482, S.L. 2009 became effective August 1, 2009.

65-08.1-03. Workforce safety and insurance company created — Stock requirements.

The North Dakota workforce safety and insurance may establish a stock insurance company to provide extraterritorial workforce safety and insurance, other states insurance, and employer’s liability insurance to North Dakota employers insured by the organization. The capital stock and surplus for the company must be paid out of the workforce safety and insurance fund. The company shall have capital stock of at least five hundred thousand dollars and a surplus of at least five hundred thousand dollars. The company may not issue an insurance policy until fifty percent of the required capital stock and all of the required surplus have been paid in, and the residue of capital stock must be paid in within twelve months from the time of filing the articles of incorporation. The organization is the sole stockholder of the company. The company must be incorporated pursuant to the laws of this state and is subject to title 26.1 unless otherwise provided.

Source:

S.L. 1993, ch. 631, § 3; 2003, ch. 561, § 3.

65-08.1-04. Board of directors — Members.

The board of directors of the company consists of the director of workforce safety and insurance and four persons appointed by the director. The director is the chairman of the board. The chairman shall appoint a secretary-treasurer for the board. Any member of the board may be removed at any time by the director.

Source:

S.L. 1993, ch. 631, § 4; 2003, ch. 561, § 3.

65-08.1-05. Workforce safety and insurance to be provided.

The company shall provide extraterritorial workforce safety and insurance or other states insurance to an employer who is insured by North Dakota workforce safety and insurance. The company may exclude coverage for a state with which workforce safety and insurance has a reciprocal agreement that recognizes an employer’s workforce safety and insurance coverage in the state in which the employer’s business is principally localized as being sufficient or for a state whose workforce safety and insurance coverage is provided through an exclusive state fund.

Source:

S.L. 1993, ch. 631, § 5; 2003, ch. 561, § 3.

65-08.1-06. Rates — Billing.

The board shall set the rates to be charged by the company for additional workforce safety and insurance coverage. The board may consult with workforce safety and insurance and its actuary in determining the appropriate rates. The company shall incorporate its billings with the billings of the organization to ensure that an employer receives one billing that itemizes the charges for mandatory workforce safety and insurance coverage and for the optional additional workforce safety and insurance.

Source:

S.L. 1993, ch. 631, § 6; 2003, ch. 561, § 3.

CHAPTER 65-09 Proceedings by Injured Employee Against Uninsured Employer

65-09-01. Liability of uninsured employer for injury to employees.

  1. Any employer subject to this title that is uninsured is not protected by the immunity from civil liability granted to employers under this title for injuries to that employer’s employees for damages suffered by reason of injuries sustained in the course of employment and to the dependents and legal representatives of an employee whose death results from injuries sustained in the course of employment. The employer is liable for the premiums, reimbursements, penalties, and interest provided for in this title.
  2. The organization may establish a procedure to determine whether a person is an employer required to obtain workers’ compensation coverage under this title and to require a person asserting independent contractor status to file a statement annually with the organization certifying that status. A determination under this section that a person is not required to be insured is effective for no more than one year from the date the person is notified of the determination. The organization retains continuing jurisdiction over determinations made under this section and may reconsider or revoke its decision at any time.

Source:

S.L. 1919, ch. 162, § 11; 1925, ch. 225, § 1; 1925 Supp., § 396a11; S.L. 1943, ch. 274, § 14; R.C. 1943, § 65-0901; S.L. 1973, ch. 515, § 1; 1995, ch. 619, § 10; 1999, ch. 549, § 5; 2001, ch. 578, § 14; 2003, ch. 561, § 3; 2005, ch. 607, § 5; 2019, ch. 524, § 13, eff August 1, 2019.

Notes to Decisions

Duty to Secure Payment.

One of duties imposed upon workers’ compensation bureau is to secure payment of an award from an uninsured employer. State ex rel. North Dakota Workmen's Compensation Bureau v. Broadway Inv. Co., 85 N.W.2d 251, 1957 N.D. LEXIS 148 (N.D. 1957).

Election of Remedies.

Where workman injured in course of his employment elects to proceed under workers’ compensation act, he is precluded from maintaining an action at law against his employer. Nyland v. Northern Packing Co., 56 N.D. 624, 218 N.W. 869, 1928 N.D. LEXIS 180 (N.D. 1928).

Employer-Employee Relationship.

To hold noncomplying employer liable, there must exist relationship of employer and employee. Kronick v. McLean County, 52 N.D. 852, 204 N.W. 839, 1925 N.D. LEXIS 152 (N.D. 1925); Mutual Life Ins. Co. v. State, 71 N.D. 78, 298 N.W. 773, 1941 N.D. LEXIS 138 (N.D. 1941).

A carpenter, whose employment was “both casual and not in the course of the trade, business, profession, or occupation of his employer” was not an employee within the provisions of N.D.C.C. § 65-01-02, former subsection 9 (now see subsection 16) and he could not recover damages for injuries sustained in the course of the employment from his uninsured employer under the provisions of this section. Kipp v. Jalbert, 110 N.W.2d 825, 1961 N.D. LEXIS 93 (N.D. 1961).

Employer Not Subject to Act.

Provisions of this section do not apply to an employer who is not subject to act and, where farmer-employer failed to give notice of his election to be bound by act, an injured employee had remedy of civil action against employer and three common-law defenses would be effective in action. Rosebear v. Anderson, 143 F. Supp. 721, 1956 U.S. Dist. LEXIS 3021 (D.N.D. 1956), aff'd, 245 F.2d 673, 1957 U.S. App. LEXIS 3269 (8th Cir. N.D. 1957).

Failure to Notify of Hiring Employees.

Failure to notify the workers compensation bureau of intention to hire employees, as required by former N.D.C.C. § 65-01-05 (now N.D.C.C. § 65-04-33), did not constitute a failure of the employer to be insured as provided by former N.D.C.C. § 65-04-12, and create a civil remedy under this section for injured employees, where the employer had paid his premium. Courchene v. Delaney Distribs., 421 N.W.2d 811, 1988 N.D. LEXIS 80 (N.D. 1988).

Liability Without Fault.

Noncomplying employer is liable under act for injuries, regardless of fault. Fahler v. Minot, 49 N.D. 960, 194 N.W. 695, 1923 N.D. LEXIS 46 (N.D. 1923); Lilly v. Haynes Coop. Coal Mining Co., 50 N.D. 465, 196 N.W. 556, 1923 N.D. LEXIS 126 (N.D. 1923); State ex rel. Dushek v. Watland, 51 N.D. 710, 201 N.W. 680, 1924 N.D. LEXIS 94 (N.D. 1924).

Employer was entitled to supervisory writs directing a district court to grant the employer summary judgment barring civil liability for deceased and injured workers’ injuries because no fact question existed as to whether an exception to the employer’s immunity due to the employer reporting an inaccurate payroll to Workforce Safety and Insurance (WSI) applied, as WSI (1) found no such violation, (2) did not try to collect additional premiums, and (3) gave no notice that WSI processed the workers’ claims under N.D.C.C. ch. 65-09. Plains Trucking, LLC v. Hagar, 2019 ND 226, 932 N.W.2d 541, 2019 N.D. LEXIS 227 (N.D. 2019).

Measure of Damages.

An employee electing to sue his uninsured employer is entitled to have such damages measured by rules applicable in common-law actions for negligence. Moen v. Melin, 59 N.D. 582, 231 N.W. 283, 1930 N.D. LEXIS 176 (N.D. 1930).

Release of Negligent Third Party.

An injured employee’s release of cause of action against third person negligently causing injury does not bar action against employer for failing to comply with compensation act. State ex rel. Woods v. Hughes Oil Co., 58 N.D. 581, 226 N.W. 586, 1929 N.D. LEXIS 252 (N.D. 1929).

Sovereign Immunity.

Defense of sovereign immunity is available to foreign state operating coal mine within state of North Dakota. Paulus v. State, 52 N.D. 84, 201 N.W. 867, 1924 N.D. LEXIS 113 (N.D. 1924).

Statute of Limitations.

Statute of limitations applicable to cause of action arising under this statute is six years. State ex rel. Woods v. Hughes Oil Co., 58 N.D. 581, 226 N.W. 586, 1929 N.D. LEXIS 252 (N.D. 1929).

Who May Sue.

This statute does not confine right to bring an action against noncomplying employer to personal representative of deceased employee. Olson v. Hemsley, 48 N.D. 779, 187 N.W. 147, 1922 N.D. LEXIS 101 (N.D. 1922).

Where employer has failed to comply with workers’ compensation act, dependent father of deceased employee is entitled to sue for his death. Olson v. Hemsley, 48 N.D. 779, 187 N.W. 147, 1922 N.D. LEXIS 101 (N.D. 1922).

Injured employee had a right to bring a tort action against an employer for personal injuries which the employee suffered while working for the employer, which incorrectly classified the employee as an independent contractor, because the exclusive remedy provisions of the North Dakota workers' compensation laws did not preclude the action under provisions authorizing the action for the employer willfully misrepresenting to an insurer the amount of payroll upon which a premium was based, or for willfully failing to secure coverage for employees. Vail v. S/L Servs., 2017 ND 202, 900 N.W.2d 271, 2017 N.D. LEXIS 204 (N.D. 2017).

Collateral References.

Farmowners’ liability insurance risks and coverage, 93 A.L.R.3d 472.

Construction and application of provisions of liability insurance policy expressly excluding injuries intended or expected by insured, 31 A.L.R.4th 957.

Liability insurance: intoxication and other mental incapacity avoiding application of clause in liability policy specifically exempting coverage of injury or damage caused intentionally by or at direction of insured, 33 A.L.R.4th 983.

Criminal conviction as rendering conduct for which insured convicted within provision of liability insurance policy expressly excluding coverage for damage or injury intended or expected by insured, 35 A.L.R.4th 1063.

65-09-02. Application for compensation — Common-law defenses not available — Fund subrogated to recovery — Hearing — Time for filing.

An employee whose employer is in violation of section 65-04-33, who has been injured in the course of employment, or the employee’s dependents or legal representatives in case death has ensued, may file an application with the organization for an award of compensation under this title and in addition may maintain a civil action against the employer for damages resulting from the injury or death. In the action, the employer may not assert the common-law defenses of:

  1. The fellow servant rule.
  2. Assumption of risk.
  3. Contributory negligence.

The organization is subrogated to the recovery made in the action against the uninsured employer. The subrogation interest is determined according to section 65-01-09, with the uninsured employer being the person other than the fund with a legal liability to pay damages with respect to the employee’s injury or death. An injured employee, or the dependents of an employee who died as a result of a work-related accident, shall file the original claim for compensation within one year after the injury or within two years after the death. The organization shall notify the claimant and the employer that the matter is being processed under this chapter, and subsequently shall hear and determine the application for compensation as it would for other claims before the organization. A determination by the organization that a person is not an employer required to obtain workforce safety and insurance coverage under this title is a defense to any claim that the person failed to obtain coverage for the time period during which the determination is effective.

Source:

S.L. 1919, ch. 162, § 11; 1925, ch. 225, § 1; 1925 Supp., § 396a11; S.L. 1943, ch. 274, § 14; R.C. 1943, § 65-0902; S.L. 1969, ch. 568, § 1; 1973, ch. 515, § 2; 1975, ch. 581, § 12; 1981, ch. 640, § 3; 1995, ch. 619, § 11; 1999, ch. 549, § 6; 2001, ch. 578, § 15; 2003, ch. 561, § 3.

Notes to Decisions

Common-Law Right.

Common-law right of an injured employee to sue for damages when injured is not taken away by this statute, since he has an option of theories upon which to proceed. State ex rel. Workmen's Compensation Fund v. E. W. Wylie Co., 79 N.D. 471, 58 N.W.2d 76, 1953 N.D. LEXIS 55 (N.D. 1953).

Injured employee had a right to bring a tort action against an employer for personal injuries which the employee suffered while working for the employer, which incorrectly classified the employee as an independent contractor, because the exclusive remedy provisions of the North Dakota workers' compensation laws did not preclude the action under provisions authorizing the action for the employer willfully misrepresenting to an insurer the amount of payroll upon which a premium was based, or for willfully failing to secure coverage for employees. Vail v. S/L Servs., 2017 ND 202, 900 N.W.2d 271, 2017 N.D. LEXIS 204 (N.D. 2017).

Employer was entitled to supervisory writs directing a district court to grant the employer summary judgment barring civil liability for deceased and injured workers’ injuries because no fact question existed as to whether an exception to the employer’s immunity due to the employer reporting an inaccurate payroll to Workforce Safety and Insurance (WSI) applied, as WSI (1) found no such violation, (2) did not try to collect additional premiums, and (3) gave no notice that WSI processed the workers’ claims under N.D.C.C. ch. 65-09. Plains Trucking, LLC v. Hagar, 2019 ND 226, 932 N.W.2d 541, 2019 N.D. LEXIS 227 (N.D. 2019).

Notice of Hearing.

When claim is filed with bureau under this statute, bureau must fix date for hearing application and serve notice of hearing upon alleged employer in manner provided for service of summons in civil action, and on other interested parties by registered mail. Burkhardt v. State, 77 N.D. 232, 42 N.W.2d 670, 1950 N.D. LEXIS 122 (N.D. 1950).

Option of Employee.

Where employee is injured in the course of his employment and at the time of the injury the employer is uninsured for workers’ compensation coverage, this section gives the employee the option of either pursuing a civil action against the employer or filing an application for workers’ compensation benefits; where such employee has not been awarded workers’ compensation benefits pursuant to former N.D.C.C. § 65-09-03, the option to pursue a civil action against the uninsured employer is not negated by fact that employer, subsequent to the injury, has paid the premiums, penalties and interest required by former N.D.C.C. § 65-09-04 (now N.D.C.C. § 65-04-33). Shaughnessy v. Bohnet, 303 N.W.2d 337, 1981 N.D. LEXIS 244 (N.D. 1981).

Release.

Where injured workman, whose employer did not comply with workers’ compensation act, stipulated that negligence actions against employer would be dismissed, with prejudice, and district court entered order so dismissing negligence causes of action against employer, workman was not entitled to proceed with a further cause of action against employer for additional damages for employer’s noncompliance with Workers' Compensation Act. Kempel v. Streich, 196 N.W.2d 589, 1972 N.D. LEXIS 164 (N.D. 1972).

Law Reviews.

Are Employees Obtaining “Sure and Certain Relief” Under the 1995 Legislative Enactments of the North Dakota Workers’ Compensation Act?, 72 N.D. L. Rev. 349 (1996).

65-09-03. Award — Payroll reports — Notice — Premium — Judgment. [Repealed]

Repealed by S.L. 2001, ch. 578, § 17.

65-09-04. Premiums and penalties to be paid by employer. [Repealed]

Repealed by S.L. 2001, ch. 578, § 17.

CHAPTER 65-10 Appeals

65-10-01. Appeal from decision of organization.

If the final action of the organization denies the right of the claimant to participate at all in the fund on the ground that the injury was self-inflicted, or on the ground that the accident did not arise in the course of employment, or upon any other ground going to the basis of the claim, or if the organization allows the claimant to participate in the fund to a lesser degree than that claimed by the claimant, if such allowance is less than the maximum allowance provided by this title, the claimant may appeal to the district court of the county wherein the injury was inflicted or of the county in which the claimant resides. An employer may also appeal a decision of the organization in any injury case or an organization decision issued under chapter 65-04, in the manner prescribed in this section. An appeal involving injuries allegedly covered by insurance provided under contracts with extraterritorial coverage shall be triable in the district court of Burleigh County. Any appeal under this section shall be taken in the manner provided in chapter 28-32. Any appeal to the district court shall be heard on the record, transmitted from the organization, and, in the discretion of the court, additional evidence may be presented pertaining to the questions of law involved in the appeal.

Source:

S.L. 1919, ch. 162, § 17; 1925 Supp., § 396a17; S.L. 1935, ch. 286, § 6; R.C. 1943, § 65-1001; S.L. 1945, ch. 337, § 9; 1949, ch. 354, § 14; 1951, ch. 342, § 3; 1951, ch. 344, § 10; 1955, ch. 354, §§ 5, 16; 1957 Supp., § 65-1001; S.L. 1963, ch. 427, § 3; 1965, ch. 458, § 1; 1967, ch. 488, § 1; 1979, ch. 107, § 11; 2001, ch. 578, § 16; 2003, ch. 561, § 3.

Cross-References.

Administrative appeals, see N.D.C.C. § 28-32-42.

Notes to Decisions

Appeal by Employer.

An employer may appeal a workers’ compensation bureau decision the same way in which a claimant may appeal — to the district court of the county where the injury occurred or the county where the claimant resides. Basin Elec. Power Coop. v. North Dakota Workers Compensation Bureau, 541 N.W.2d 685, 1996 N.D. LEXIS 1 (N.D. 1996).

Jurisdiction.

District court properly dismissed a claimant’s appeal for lack of jurisdiction because he did not meet the statutory requirements to file the appeal in the county in which the injury occurred or the county in which he resided, the Workforce Safety and Insurance had a statutory lien on the claimant’s third party recovery, and he did not pay any of the sums secured by the lien as statutorily required. Decker v. Workforce Safety & Ins., 2021 ND 117, 2021 N.D. LEXIS 117 (N.D. 2021).

Appeal from District Court.

Compensation proceeding is not triable de novo in supreme court and findings of trial court are presumed to be correct unless clearly opposed to preponderance of evidence. Dehn v. Kitchen, 54 N.D. 199, 209 N.W. 364, 1926 N.D. LEXIS 135 (N.D. 1926); Klemmens v. North Dakota Workmen's Compensation Bureau, 54 N.D. 496, 209 N.W. 972, 1926 N.D. LEXIS 48 (N.D. 1926).

In an appeal from judgment of district court rendered in an appeal from decision of bureau, supreme court, on demand for trial de novo, reviews whole record as any case tried to court without jury may be reviewed. Gullickson v. North Dakota Workmen's Compensation Bureau, 83 N.W.2d 826, 1957 N.D. LEXIS 127 (N.D. 1957), limited, Geo. E. Haggart, Inc. v. North Dakota Workmen's Compensation Bureau, 171 N.W.2d 104, 1969 N.D. LEXIS 81 (N.D. 1969).

On an appeal from a decision of the district court reviewing a decision of the workers’ compensation bureau, the supreme court will review the whole record from the district court. Fancher v. North Dakota Workmen's Compensation Bureau, 123 N.W.2d 105, 1963 N.D. LEXIS 105 (N.D. 1963).

Although the district court’s analysis is entitled to respect, the North Dakota supreme court will review the decision of the bureau, rather than that of the district court. Holmgren v. North Dakota Workers Compensation Bureau, 455 N.W.2d 200, 1990 N.D. LEXIS 101 (N.D. 1990).

In determining whether the bureau’s findings of fact are supported by a preponderance of the evidence, the supreme court does not make independent findings of fact or substitute its judgment for that of the agency. It determines only whether a reasonable mind could have determined that the factual conclusions were proved by the weight of the evidence from the entire record. Westman v. North Dakota Workers Compensation Bureau, 459 N.W.2d 540, 1990 N.D. LEXIS 167 (N.D. 1990).

Appealable Order.

An order of the workers compensation bureau finding that the claimant made false statements in connection with his claim and dismissing that claim was a final appealable order, and the court has jurisdiction to review it. McCarty v. North Dakota Workers Compensation Bureau (Oral Logic), 1998 ND 9, 574 N.W.2d 556, 1998 N.D. LEXIS 12 (N.D. 1998).

Burden of Proof.

On an appeal from decision of bureau disallowing claim for compensation for injury, claimant has burden of proving that injury for which compensation is claimed was received in course of employment. Moug v. Workmen's Compensation Bureau, 70 N.D. 656, 297 N.W. 129, 1941 N.D. LEXIS 212 (N.D. 1941).

A workers’ compensation claimant, when appealing to a district court, has the burden to show that the court has jurisdiction. Boyko v. North Dakota Workmen's Compensation Bureau, 409 N.W.2d 638, 1987 N.D. LEXIS 379 (N.D. 1987).

Bureau As Party.

Workers’ compensation bureau becomes party to litigation only where claimant appeals from bureau’s denial of his right to share in compensation fund, and on further appeal from decision of trial court taken either by claimant or bureau. Henderson v. Scott, 72 N.D. 616, 10 N.W.2d 490, 1943 N.D. LEXIS 100 (N.D. 1943).

Certiorari.

Certiorari will not lie to review finding of workers’ compensation bureau as to matter of fact within, and not touching, its jurisdiction. State ex rel. Craig v. North Dakota Workmen's Compensation Bureau, 53 N.D. 649, 207 N.W. 555, 1925 N.D. LEXIS 15 (N.D. 1925).

Change of Venue.

District court to which a decision of the workers compensation bureau was appealed could properly change the venue of the appeal by transferring the case to the district court of the place of injury pursuant to N.D.C.C. § 28-04-07, the district court of appropriate venue under this section. Hayden v. North Dakota Workers Compensation Bureau, 447 N.W.2d 489, 1989 N.D. LEXIS 191 (N.D. 1989).

The general change of venue statute, N.D.C.C. § 28-04-07, does not grant a district court authority to transfer an appeal from a workers’ compensation bureau decision to the proper district court. Basin Elec. Power Coop. v. North Dakota Workers Compensation Bureau, 541 N.W.2d 685, 1996 N.D. LEXIS 1 (N.D. 1996).

Consent to Suit.

Express authority given by this section to claimants to prosecute appeals to courts, is not consent to suit by fund or state. Watland v. North Dakota Workmen’s Comp. Bureau, 58 N.D. 303, 225 N.W. 812 (1929), overruled on other grounds, Bulman v. Hulstrand Constr. Co., 521 N.W.2d 632 (N.D. 1994), explained, Henderson v. Scott, 72 N.D. 616, 10 N.W.2d 490, 1943 N.D. LEXIS 100 (N.D. 1943).

Construction with N.D.R.Civ.P. 60(b).

In view of the district court’s purely appellate function in the administrative process and the nature of a motion for relief from judgment, we conclude Rule 60(b) is inconsistent with the statutory appeal procedures of the Administrative Agencies Practice Act and appeal of an administrative agency decision may not be taken under it. Lewis v. North Dakota Workers Compensation Bureau, 2000 ND 77, 609 N.W.2d 445, 2000 N.D. LEXIS 88 (N.D. 2000).

Construction with Former Section 28-32-15.

This section and former N.D.C.C. § 28-32-15 (now N.D.C.C. § 28-32-42) must be read together. Westman v. North Dakota Workers Compensation Bureau, 459 N.W.2d 540, 1990 N.D. LEXIS 167 (N.D. 1990).

This section grants a claimant a right to appeal under the specific circumstances it addresses. It does not, either explicitly or implicitly, limit the broader appeal rights contained within former N.D.C.C. § 28-32-15 (now N.D.C.C. § 28-32-42). Westman v. North Dakota Workers Compensation Bureau, 459 N.W.2d 540, 1990 N.D. LEXIS 167 (N.D. 1990).

Construing former N.D.C.C. § 28-32-15, now N.D.C.C. § 28-32-42, and this section together, N.D.C.C. § 28-32-42 authorizes a claimant to appeal from a decision of the bureau which grants benefits if that decision substantially affects the rights of the claimant. Westman v. North Dakota Workers Compensation Bureau, 459 N.W.2d 540, 1990 N.D. LEXIS 167 (N.D. 1990).

The catchall provision of former N.D.C.C. § 28-32-15 (now N.D.C.C. § 28-32-42) does not apply to appeals from final actions of the workers compensation bureau, and an appeal of such an action cannot be entertained by a district court under its general jurisdiction. Basin Elec. Power Coop. v. North Dakota Workers Compensation Bureau, 541 N.W.2d 685, 1996 N.D. LEXIS 1 (N.D. 1996).

Denial of Review.

Claimant whose claim has been allowed by bureau and who thereafter makes application for review of award thus made, has no right of appeal from action of bureau in denying his application for such review. Ethen v. North Dakota Workmen's Compensation Bureau, 62 N.D. 394, 244 N.W. 32, 1932 N.D. LEXIS 193 (N.D. 1932).

Where bureau decided that compensation previously awarded should not be increased because of subsequently discovered injury arising out of same accident, final action of bureau was not appealable. Schmidt v. North Dakota Workmen’s Comp. Bureau, 74 N.D. 520, 23 N.W.2d 26 (1946), decided prior to the amendment to N.D.C.C. § 65-05-04.

Exhaustion of Remedies.

A claimant seeking review of a Workers Compensation Bureau order denying benefits need not exhaust administrative remedies before appealing to the district court. Lende v. N.D. Workers' Comp. Bureau, 1997 ND 178, 568 N.W.2d 755, 1997 N.D. LEXIS 199 (N.D. 1997).

Failure to Appeal.

An appeal must be taken from decision of bureau within thirty days, and after this period has elapsed, decision, having become final because of no appeal is not rendered reviewable by subsequent denial of an application for another hearing upon an additional showing. Hanson v. North Dakota Workmen's Compensation Bureau, 56 N.D. 525, 218 N.W. 215, 1928 N.D. LEXIS 167 (N.D. 1928).

Where a worker failed to file a direct appeal to the district court challenging the Workers Compensation Bureau’s determination that the factual and legal grounds listed in her request for rehearing were insufficient, the district court did not abuse its discretion in denying her petition for an alternative writ of mandamus. Frank v. Traynor, 1999 ND 183, 600 N.W.2d 516, 1999 N.D. LEXIS 205 (N.D. 1999).

Finding of Proximate Cause.

Question of proximate cause of employee’s death is one of fact, and findings of trial court in that respect will not be disturbed. Gotchy v. North Dakota Workmen's Compensation Bureau, 49 N.D. 915, 194 N.W. 663, 1923 N.D. LEXIS 42 (N.D. 1923).

Historical Review.

For a case discussing history of statutes concerning appealability and review of decisions of the workers compensation bureau, see Westman v. North Dakota Workers Compensation Bureau, 459 N.W.2d 540, 1990 N.D. LEXIS 167 (N.D. 1990).

Informal Order.

A claimant’s appeal would be dismissed because he did not make a request for consideration after the bureau issued its informal order denying lost-time disability benefits. Freezon v. North Dakota Workers Compensation Bureau, 1998 ND 23, 574 N.W.2d 577, 1998 N.D. LEXIS 23 (N.D. 1998).

Judgment for Interest.

Judgment of court awarding interest in compensation case, assuming interest is not allowable under compensation act, is not void and is not subject to collateral attack. Hanson v. North Dakota Workmen's Compensation Bureau, 63 N.D. 479, 248 N.W. 680, 1933 N.D. LEXIS 201 (N.D. 1933).

Jurisdiction.

Appeals from the workers compensation bureau are statutory in nature and are not matters of original jurisdiction for the district courts but rather involve exercise of the appellate jurisdiction of the district courts conferred by statute; the statutory requirements for filing a notice of appeal from an administrative agency are thus jurisdictional and do not refer to venue. Boyko v. North Dakota Workmen's Compensation Bureau, 409 N.W.2d 638, 1987 N.D. LEXIS 379 (N.D. 1987).

Law Applicable.

On an appeal to district court, court is limited in its consideration of questions presented on appeal to law as it existed at time of bureau’s action upon claim. MacArthur v. North Dakota Workmen's Compensation Bureau, 62 N.D. 572, 244 N.W. 259, 1932 N.D. LEXIS 216 (N.D. 1932).

Personal Injury Suit.

Trial court appropriately postponed decision of the questions in a personal injury suit against the employer until appeal of workers’ compensation decision was concluded. Westman v. Dessellier, 459 N.W.2d 545, 1990 N.D. LEXIS 155 (N.D. 1990).

Review of Evidence.

On appeal from decision of bureau district court must review evidence contained in record certified from bureau to determine whether findings of fact made by bureau are supported by evidence and its decision is in accordance with law. Burkhardt v. State, 78 N.D. 818, 53 N.W.2d 394, 1952 N.D. LEXIS 80 (N.D. 1952); Gullickson v. North Dakota Workmen's Compensation Bureau, 83 N.W.2d 826, 1957 N.D. LEXIS 127 (N.D. 1957), limited, Geo. E. Haggart, Inc. v. North Dakota Workmen's Compensation Bureau, 171 N.W.2d 104, 1969 N.D. LEXIS 81 (N.D. 1969).

If district court finds evidence does not support findings of fact and conclusions of law made by bureau, such findings and conclusions will be modified or reversed, and new findings of fact, conclusions of law and order for judgment made by district court. Gullickson v. North Dakota Workmen's Compensation Bureau, 83 N.W.2d 826, 1957 N.D. LEXIS 127 (N.D. 1957), limited, Geo. E. Haggart, Inc. v. North Dakota Workmen's Compensation Bureau, 171 N.W.2d 104, 1969 N.D. LEXIS 81 (N.D. 1969).

Separate Dependency Claims.

Claims of parents against fund, based upon dependency, are separate claims upon which each parent may have separate right of appeal to district court. Weisgerber v. Workmen's Compensation Bureau, 70 N.D. 165, 292 N.W. 627, 1940 N.D. LEXIS 157 (N.D. 1940).

When Appeal Allowed.

District court may not entertain an appeal from workers’ compensation bureau until bureau denies compensation on grounds going to basis of claimant’s right. Crandall v. North Dakota Workmen's Compensation Bureau, 53 N.D. 636, 207 N.W. 551, 1925 N.D. LEXIS 14 (N.D. 1925).

Refusal of bureau to permit claimant to participate in fund on ground that his claim was not seasonably filed is denial of “right of the claimant to participate at all” in fund and is subject to review on appeal. Pearce v. North Dakota Workmen's Compensation Bureau, 67 N.D. 512, 274 N.W. 587, 1937 N.D. LEXIS 107 (N.D. 1937).

Where claim for compensation was denied by bureau without investigation and no appeal was taken and within year from accident second claim was filed on account of same injury, board’s action in considering and denying second claim was final action from which an appeal could be taken. Bergstrand v. North Dakota Workmen's Compensation Bureau, 69 N.D. 447, 287 N.W. 631, 1939 N.D. LEXIS 171 (N.D. 1939).

An appeal from final action of bureau may be taken only where bureau denies claimant right to participate at all in compensation fund on any ground. Weisgerber v. Workmen's Compensation Bureau, 70 N.D. 165, 292 N.W. 627, 1940 N.D. LEXIS 157 (N.D. 1940).

A workers compensation bureau decision on review of a prior award pursuant to a subsequent application based upon a change in the employee’s condition may be appealed to the courts. Lass v. North Dakota Workmen's Compensation Bureau, 415 N.W.2d 796, 1987 N.D. LEXIS 426 (N.D. 1987).

Because this section specifically provides for jurisdiction for appeals from final action of the workers compensation bureau, either in the county of residence of the claimant or the county wherein the injury was inflicted, former N.D.C.C. § 28-32-15 (now N.D.C.C. § 28-32-42) is inapposite in the instance in which the injury occurs in this state, and jurisdiction for appeal does not lie in the county where the hearing is held. Boyko v. North Dakota Workmen's Compensation Bureau, 409 N.W.2d 638, 1987 N.D. LEXIS 379 (N.D. 1987).

By denying future benefits, the workers compensation bureau denied the claimant the right to participate in the fund not only presently but also in the future, although he might well be entitled to participate in the fund in the future if his medical condition should change; thus, his appeal of the bureau’s order denying further benefits was authorized. Lass v. North Dakota Workmen's Compensation Bureau, 415 N.W.2d 796, 1987 N.D. LEXIS 426 (N.D. 1987).

Absent an appeal from an order denying benefits, a workers compensation bureau decision not to reopen a claim for consideration of new or additional evidence of medical condition at the time of a denial which is sought to be reopened is not appealable, but a bureau decision not to reopen a claim upon a request based upon a change in the claimant’s medical condition since the original decision is appealable. Lass v. North Dakota Workmen's Compensation Bureau, 415 N.W.2d 796, 1987 N.D. LEXIS 426 (N.D. 1987).

A claimant’s time for appeal does not begin to run until a notice of decision is given by the worker’s compensation bureau. Tooley v. Alm, 515 N.W.2d 137, 1994 N.D. LEXIS 89 (N.D. 1994).

The 30-day appeal period never began to run because the Workers Compensation Bureau never served claimant with a notice of a final determination upon reconsideration after the order become final, and thus claimant’s appeal was timely. Lende v. N.D. Workers' Comp. Bureau, 1997 ND 178, 568 N.W.2d 755, 1997 N.D. LEXIS 199 (N.D. 1997).

DECISIONS UNDER PRIOR LAW

New Evidence.

The district court has no power on appeal to hear additional evidence and if additional evidence has become available, the court should remand to the bureau to hear the new evidence and reconsider its decision. Knutson v. North Dakota Workmen's Compensation Bureau, 120 N.W.2d 880, 1963 N.D. LEXIS 79 (N.D. 1963) (decided before 1965 amendment).

When Appeal Allowed.

Under former N.D.C.C. § 65-01-14(4), appeal of a workers compensation bureau’s final action denying a claim applied only following a request for reconsideration, and the necessity of a request for reconsideration in workers compensation cases prevailed over the general provisions in former N.D.C.C. §§ 28-32-14 and 28-32-15 (now N.D.C.C. §§ 28-32-40 and 28-32-42, respectively). McArthur v. North Dakota Workers Compensation Bureau, 1997 ND 105, 564 N.W.2d 655, 1997 N.D. LEXIS 104 (N.D. 1997).

Collateral References.

Exclusion or inclusion of terminal Sunday or holiday in computing time for taking or perfecting appeal from decision of workmen’s compensation board, 61 A.L.R.2d 482.

Statute permitting new action after failure of original action commenced within period of limitations, as applicable in cases where original action failed for lack of jurisdiction, 6 A.L.R.3d 1043.

Law Reviews.

Administrative Law, Judicial Review of Administrative Decisions in North Dakota, 24 Bar Briefs, State Bar Ass’n of N.D. 211 (1948).

Judicial Review of Decisions of the Workmen’s Compensation Bureau of North Dakota, 3 Dak. L. Rev. 16 (1930).

65-10-02. Determination by court — Judgment paid by organization.

On appeal, the court shall determine the right of the claimant. If it determines the right in the claimant’s favor, it shall fix the claimant’s compensation within the limits prescribed in this title, and any final judgment so obtained shall be paid by the organization out of the fund in the same manner as awards are paid.

Source:

S.L. 1919, ch. 162, § 17; 1925 Supp., § 396a17; S.L. 1935, ch. 286, § 6; R.C. 1943, § 65-1002; 2003, ch. 561, § 3.

Notes to Decisions

Limits on Jurisdiction of Board.

In exercise of its continuing jurisdiction bureau may not review final judgment of award, insofar as such judgment determines right of claimant up to date of judgment, nor correct same for errors of law inherent in its rendition. Hanson v. North Dakota Workmen's Compensation Bureau, 63 N.D. 479, 248 N.W. 680, 1933 N.D. LEXIS 201 (N.D. 1933).

Lump-Sum Award.

Upon an appeal, court has power to determine right of claimant and to fix compensation within limits prescribed in compensation act, but it does not have express power to award lump sum. Gotchy v. North Dakota Workmen's Compensation Bureau, 49 N.D. 915, 194 N.W. 663, 1923 N.D. LEXIS 42 (N.D. 1923).

65-10-03. Cost of appeal and attorney’s fees fixed by the organization.

The organization shall pay the cost of the judicial appeal and the attorney’s fees for an injured employee’s attorney if the employee prevails as provided under section 65-02-08. The maximum fee set by the organization may be exceeded upon application of the injured employee to the organization, upon a finding the claim had clear and substantial merit, and the legal or factual issues involved in the appeal were unusually complex, but a court may not order that the maximum fee be exceeded.

Source:

S.L. 1919, ch. 162, § 17; 1925 Supp., § 396a17; S.L. 1935, ch. 286, § 6; R.C. 1943, § 65-1003; S.L. 1951, ch. 342, § 4; 1957 Supp., § 65-1003; S.L. 1963, ch. 427, § 4; 1967, ch. 488, § 2; 1969, ch. 559, § 2; 1979, ch. 656, § 1; 1989, ch. 767, § 2; 1995, ch. 614, § 5; 1997, ch. 533, § 3; 2003, ch. 561, § 3; 2017, ch. 436, § 2, eff August 1, 2017.

Note.

Section 3 of chapter 436, S.L. 2017 provides, “ APPLICATION. This Act applies to administrative and judicial appeal decisions issued on and after the effective date of this Act.”

Notes to Decisions

Appeal from Final Action.

District court had no power, under the predecessor to this section, to tax and allow an attorney’s fee, except in a case where an appeal was taken from a final action of the bureau in denying the right of claimant to participate at all in the workers’ compensation fund. Wallace v. Workmen’s Comp. Bureau, 70 N.D. 193, 293 N.W. 192 (1940), decided prior to the enactment of N.D.C.C. § 65-10-03; distinguished, Boe v. State, 71 N.D. 132, 299 N.W. 253, 1941 N.D. LEXIS 146 (N.D. 1941).

Attorney’s Fees.

Attorney fees may be allowed as cost only to a claimant that prevails on appeal. Steele v. North Dakota Workmen's Compensation Bureau, 273 N.W.2d 692, 1978 N.D. LEXIS 188 (N.D. 1978).

The phrase “attorney’s fee” as used in this section refers to expenses incurred for the services of an attorney. Howes v. North Dakota Workers Compensation Bureau, 429 N.W.2d 730, 1988 N.D. LEXIS 259 (N.D. 1988), cert. denied, 489 U.S. 1014, 109 S. Ct. 1126, 103 L. Ed. 2d 189, 1989 U.S. LEXIS 904 (U.S. 1989).

N.D.C.C. §§ 65-02-08 and 65-10-03 and N.D.C.C. § 28-32-50 are not irreconcilable, and the goals and intent of the legislature can be harmonized. The Supreme Court of North Dakota concludes a prevailing injured employee is entitled to attorney’s fees in actions against Workforce Safety and Insurance (WSI) under N.D.C.C. §§ 65-02-08 and 65-10-03 up to the statutory limit, but when WSI denies or reduces the employee’s benefits without substantial justification, N.D.C.C. § 28-32-50 may be applied to award the employee reasonable attorney’s fees. Rojas v. Workforce Safety & Ins., 2006 ND 221, 723 N.W.2d 403, 2006 N.D. LEXIS 227 (N.D. 2006).

N.D.C.C. §§ 65-02-08 and 65-10-03 guarantee an automatic award of attorney’s fees to the prevailing party, but N.D.C.C. § 28-32-50 requires the party to not only prevail but also requires proof that the agency acted without substantial justification; the language of N.D.C.C. § 28-32-50 is expansive and inclusive, and does not exclude actions against WSI. The Supreme Court of North Dakota concludes these statutes are not irreconcilable and apply in different situations, and therefore can be harmonized. Rojas v. Workforce Safety & Ins., 2006 ND 221, 723 N.W.2d 403, 2006 N.D. LEXIS 227 (N.D. 2006).

Trial court erred in affirming the decision of Workforce Safety & Insurance (WSI) to pay a claimant only $9,876 for costs and attorney’s fees after he won his appeal to have his benefits reinstated, based upon the maximum amount WSI could pay under the fee cap in N.D.C.C. §§ 65-02-08 and 65-10-03, because the general attorney fee provision for administrative actions, N.D.C.C.§ 28-32-50, could apply to WSI cases where the claimant alleged that WSI acted without substantial justification in reducing or denying benefits. Therefore, the case was remanded for a determination as to whether the WSI acted without substantial justification warranting an additional award of attorney’s fees under N.D.C.C. § 28-32-50. Rojas v. Workforce Safety & Ins., 2006 ND 221, 723 N.W.2d 403, 2006 N.D. LEXIS 227 (N.D. 2006).

Where WSI properly terminated a claimant’s benefits under N.D.C.C. §§ 65-05.1-04, 65-05-28(4) for the claimant’s noncompliance with a functional capacity evaluation, the claimant did not prevail on appeal and was not entitled to attorney’s fees under N.D.C.C. § 65-10-03. Drayton v. Workforce Safety & Ins., 2008 ND 178, 756 N.W.2d 320, 2008 N.D. LEXIS 180 (N.D. 2008).

Claimant Ordered to Pay Costs.

This section requires determination that appeal by claimant is frivolous before claimant can be ordered to pay bureau for cost incurred in appeal. Jones v. North Dakota Workmen's Compensation Bureau, 334 N.W.2d 188, 1983 N.D. LEXIS 292 (N.D. 1983).

Costs to Prevailing Party Only.

Where district court affirms bureau’s decision denying claimant right to share in compensation fund, unsuccessful claimant is not entitled to have an attorney’s fees taxed as costs against bureau, even though proceedings have been prosecuted in good faith. Boe v. State, 71 N.D. 132, 299 N.W. 253, 1941 N.D. LEXIS 146 (N.D. 1941); Bateman v. State, 71 N.D. 139, 299 N.W. 257, 1941 N.D. LEXIS 228 (N.D. 1941).

Upon an appeal from decision of workers’ compensation bureau, reasonable attorney’s fees to be fixed by trial judge are taxable as costs to prevailing appellant only. Feist v. North Dakota Workmen's Compensation Bureau, 80 N.W.2d 100, 1956 N.D. LEXIS 163 (N.D. 1956).

Interest.

Judgment of court awarding interest in compensation case, assuming interest is not allowable under compensation act, is not void and is not subject to collateral attack. Hanson v. North Dakota Workmen's Compensation Bureau, 63 N.D. 479, 248 N.W. 680, 1933 N.D. LEXIS 201 (N.D. 1933).

Mandamus Proceeding.

District court cannot award attorney’s fees in proceeding to obtain writ of mandamus to allow inspection of records of bureau. Wallace v. Workmen’s Comp. Bureau, 70 N.D. 193, 293 N.W. 192 (1940), decided prior to the enactment of N.D.C.C. § 65-10-03; distinguished, Boe v. State, 71 N.D. 132, 299 N.W. 253, 1941 N.D. LEXIS 146 (N.D. 1941).

Pretrial Costs.

The costs of taking depositions and subpoenaing expert witnesses for cross-examination, being not a part of the “appeal” process, are not set by the appellate court but are governed by former N.D.C.C. § 28-32-09 (now N.D.C.C. § 28-32-33). Howes v. North Dakota Workers Compensation Bureau, 429 N.W.2d 730, 1988 N.D. LEXIS 259 (N.D. 1988), cert. denied, 489 U.S. 1014, 109 S. Ct. 1126, 103 L. Ed. 2d 189, 1989 U.S. LEXIS 904 (U.S. 1989).

Although an injured worker was denied workers’ compensation, his appeal, challenging an agency decision that his injury while traveling home from work was not in the course of employment, was not frivolous and attorney’s fees would be awarded. Cody v. North Dakota Workmen's Compensation Bureau, 413 N.W.2d 316, 1987 N.D. LEXIS 409 (N.D. 1987).

DECISIONS UNDER PRIOR LAW

Review of Appeal.

What is reasonable attorney’s fee in any given proceeding was matter primarily for trial court to determine, and such determination would not be disturbed on appeal unless it was clearly wrong. TWETEN v. NORTH DAKOTA WORKMEN'S COMPENSATION BUR., 69 N.D. 369, 287 N.W. 304, 1939 N.D. LEXIS 163 (N.D. 1939).

Collateral References.

Workers’ compensation: availability, rate, or method of calculation of interest on attorney’s fees or penalties, 79 A.L.R.5th 201.

Law Reviews.

North Dakota Supreme Court Review (Rojas v. Workforce Safety and Ins.), 83 N.D. L. Rev. 1085 (2007).

CHAPTER 65-11 Safety Engineer [Repealed]

[Repealed by S.L. 1997, ch. 537, § 2]

CHAPTER 65-12 Boiler Inspector [Repealed]

[Repealed by S.L. 1993, ch. 301, § 15]

Note.

For present provisions, see N.D.C.C. ch. 26.1-22.1.

CHAPTER 65-13 Uniform Crime Victims Reparations Act [Repealed]

[Repealed by S.L. 1993, ch. 135, § 24]

Note.

For present provisions, see N.D.C.C. ch. 54-23.4.

CHAPTER 65-14 Employee Information Program on Hazardous Substances [Repealed]

[Repealed by S.L. 2003, ch. 564, § 14]

08/06/2021 06:52AM FROM_EDEN_\\fabwebd5\data\EDEN_Prod\shared\ProductBuild\FolioOutput_NDCODE_1-1628246935907

08/06/2021 06:52AM Pete_NFO_build

08/07/2021 05:33AM Pete_NFO_build

2021/08/10 02:20:55 IET005-ChkNukSliceNFO Validate links, remove links

08/10/2021 02:24AM Pete_CheckNuke_4xNFO_build