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Thursday, May 28, 2015

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Frequently Asked Questions (FAQs)

General Claims Information General Medical Information General Employer Information
Return-To-Work (RTW) Education & Training  

If you have a question regarding WSI programs or services you may find the answer under a link in this FAQ section. If you haven’t found the answer and still have questions, feel free to contact WSI customer service at 701-328-3800; toll free at 800-777-5033; or email us at ndwsi@nd.gov

General Claims Information

We encourage employees to work with your employer when completing claims forms.
  • Claim Filing/First Report of Injury - Injured workers, employers, and medical providers may complete forms electronically.
  • Complete a First Report of Injury (FROI) Form - Injured employees, employers, and medical providers may complete forms by hand and either mail the forms to us or fax them to us at (701) 328-3820.

Can an employer pay for the worker’s injury and not have the claim filed?

Under North Dakota Century Code all employees have the right to file a claim with Workforce Safety & Insurance. If an employer pays for the cost of the claim out of pocket and does not file the claim with WSI, the employer may be assuming liability for the claim and exposing the company to future medical costs and potential litigation. The employee may be giving up benefits due to them as well, by not filing the claim.

If a claim is filed online is there verification of the claim filed?

When a claim is filed online there is a confirmation message displayed which can be printed. Along with the confirmation message, the claim number assigned to the claim will also be provided. This claim number should be used whenever information is submitted or questions are being asked about the claim.

Who can file a claim?

A claim can be filed by the injured worker, the employer or the medical provider. The First Report of Injury does need to be completed and signed for a claim to be filed. Employers should work with their medical provider to ensure they are notified of the claim in the event the medical provider is the one filing the claim.

Why is there a different timeframe for timely report of claims? On WSI posters it states seven (7) days but employers are assessed the $250 assessment fee if the claims is not filed within 24 hours, why?

The seven (7) day filing timeframe is defined by the North Dakota Century Code. The $250 assessment fee is assessed to all claims. As an incentive program, WSI will waive this fee if the claim is filed within 24 hours or by midnight of the next WSI business day.

What is a prior injury questionnaire?

Upon filing a claim with WSI, a prior injury questionnaire may be sent for completion. This form should be completed outlining all injures (work-related or not) that have occurred to the body area the claim is being filed for.

What is defined as seasonal work?

Occupations that do not customarily operate throughout the entire year are considered seasonal work. Seasonal employment is determined by what is customary with respect to the employer at the time of the injury.

How are Disability benefits paid (wage-replacement)?

In order to receive wage replacement benefits, the primary medical doctor must provide medical verification that the employee is unable to work for five or more consecutive calendar days because of the work-related injury or illness. Wage replacement benefits vary, depending upon your average weekly wage. WSI does pay 66 2/3 of employee’s gross weekly wage, as the wage replacement benefits are not taxable. North Dakota Century Code does have a maximum and a minimum benefit amount.

My claims adjuster has changed, why?

Claims adjusters are assigned to employer accounts to ensure they are familiar with the employers and their type of work. Occasionally WSI does have turnover of staff and claims adjuster will change for an employer account or for the assigned injured worker.

What should be done if new information is obtained regarding an already accepted claim?

WSI should be notified and provided this new information.

How do I report suspected fraud?

WSI does have a Fraud & Safety Hotline at 800-243-3331 to report any suspected workers’ compensation fraud. The report is confidential upon request.

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