Claim Process

What You Can Expect From WSI

  • North Dakota Workforce Safety & Insurance (WSI) will register a claim upon receiving a First Report of Injury (FROI). A claim number will be assigned to your claim (generally within 24 hours).
  • You will receive a letter informing you of the name of your claims adjuster and your claim number. This letter informs you that your claim has been received and registered.  A decision to accept or deny the claim has not yet been made. Please provide this claim number when contacting WSI, or your medical facility.
  • The claims adjuster will review the facts and gather any additional information needed to make a decision to accept or deny the claim based on North Dakota law. A notice informing you of claim acceptance or denial will be mailed to you and your employer.
  • One of the following decisions will be made on your claim:
    • Accepted: You and your employer will receive a notice of decision that WSI is accepting your claim. If you are eligible for wage-loss benefits you will receive payments that are not taxable. We will periodically mail you an injured worker income and work status letter (FL214), which you must complete and submit to WSI so there is no interruption in your wage-loss benefits. When visiting your doctor, take along a Capability Assessment form (C3) that you have received from us. After your doctor has completed the form, mail one copy to WSI, have your doctor keep one copy, and provide your employer with a copy so they are aware of your medical status.
    • Denied: You and your employer will receive a notice of decision that WSI is denying your claim.  The decision is mailed to you and your employer and it provides the reasons for the denial. See Disputing a Claim Decision.
  • All claims are one of two types:
    • Wage-loss claim: If you will be off work for five or more consecutive days or if you have a loss of earnings, the claim is a wage-loss claim. The claims adjuster will contact you, your employer, and your medical provider to gather additional information to help with the processing of the claim.
    • Medical only claim: If you will not be off work for five or more consecutive days the claim is a medical only claim. The medical management of the claim and processing of medical bills will begin immediately once the claim has been accepted.

Worker’s Responsibilities

  • You are responsible to minimize your disability.  Ask your doctor if you have restrictions and what they are.  Follow all restrictions, both on and off the job.
  • Keep in touch with your employer and provide them with periodic updates on your condition. At the completion of each medical appointment, your doctor will complete a Capability Assessment form (C3). For each medical appointment provide your employer with a copy of this form.
  • Notify WSI immediately if:
    • You perform any type of work activity whether you receive pay or not
    • You change your address or telephone number
    • You apply for either Social Security disability or retirement benefits or are found to be eligible for these benefits
    • The status of your dependents changes, i.e. birth of child, school graduation, adoption