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Employers Forms

  • Application for Insurance
  • Employer's Report of Death (C9)
  • Ergonomic Grant Reimbursement Request
  • First Report of Injury
  • Fraud Report Form
  • Release of Information for Employers
  • Release of Information for Staffing and PEO
  • Safety Training & Education Program (STEP) Application
  • Transitional Job Offer (C165)

Employers

  • Claims
  • Policyholders
  • Return-to-Work
  • Safety
  • Forms
  • Resources
  • Online Services

About Us

North Dakota Workforce Safety & Insurance is the sole provider and administrator of the workers’ compensation system in North Dakota.

Reports

Careers

Are you looking for a career where you can provide the best services and solutions to injured workers, employers, and medical facilities? Join our team today. 

Fraud Awareness

North Dakota Workforce Safety & Insurance has a responsibility to the employers and employees of North Dakota to investigate all allegations of fraud. 

Contact Us

Phone:

800-777-5033

Email:

ndwsi@nd.gov

Address:

1600 E. Century Ave, Ste 1
Bismarck, ND 58503

 

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