Filing a Claim
Use One of Three Claim Filing Options:
WSI offers three ways for injured employees, employers, and medical providers to submit claims information. We encourage you to work with your employer when completing claims forms.
- Claim Filing/First Report of Injury
- Injured employees, 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.
Complete instructions are available for completing the FROI form by hand.
- Telephonic Filing - Injured employees, employers, and medical providers may report a claim 24 hours a day, 7 days a week by calling (701) 328-3800 or 1-800-777-5033.
The filing method you choose is entirely up to you.
Timeframes for Reporting an Injury:
- The law requires that you notify your employer of your work injury within 7 days after an accident or when the general nature of the injury becomes apparent. NOTE: Be sure to report all on-the-job injuries to your supervisor immediately, even if you do not feel it is important to see a doctor. By reporting your injury immediately, you will alert your employer to a potential hazard. Your employer is required to file a FROI form with WSI within 7 days of receiving notice of a work injury from an employee. If your employer does not submit this form, WSI may consider that to be an admission that the alleged injury may be compensable.
- WSI encourages injured employees and employers to immediately (within 24 hours of occurrence and after medical treatment is received) file a claim with WSI after a work-related injury occurs. Immediate notification allows for more effective management of the claim. If medical treatment has occurred, you will need to complete a FROI form.
The Statute of Limitations for Filing a Claim:
All claims for benefits must be filed within one year after an injury or within two years after a death. The date of injury is the first date that a reasonable person knew or should have known that a work-related injury occurred.
You Have the Right to File a Claim for a Work-Related Injury:
It is against the law for your employer to harass, discharge, refuse to hire, or, in any instance, discriminate against you for exercising your rights under the Workers' Compensation or Occupational Diseases Acts. You may report this type of conduct displayed by an employer to the North Dakota Department of Labor (www.state.nd.us/labor) for their review.
Your Employer's Responsibilities When You Have Sustained a Work-Related Injury:
Your employer is required to file a FROI form with WSI within 7 days of receiving notice of an injury from an employee. If we do not receive that form, we contact the employer to obtain a signed FROI. If WSI does not receive the form from the employer, WSI will waive the employer's section of the FROI and process the claim without it.
Confidentiality of Your Claim Information:
Most information contained in a claim file is confidential and is not open to the public. Information that is available to the public (upon request) is your name; date of birth; injury date; employer name (at the time of injury); type of injury (the body part injured); whether the claim is accepted, denied, or pending (claim status); and whether the claim is in active or inactive pay status. WSI may provide information to doctors and other health care providers who are treating you or advising WSI; vocational rehabilitation consultants; managed care representatives; and your employer at the time of your injury. Additionally, you can grant file access to anyone you wish.
Reopening a Claim:
If you are experiencing symptoms relating to a prior compensable claim, you may be eligible for reinstatement of benefits. To reopen a closed claim, you must provide clear and convincing medical evidence that the original compensable injury is the sole cause of your current symptoms.
To file for reinstatement of benefits, write a letter explaining the circumstances of your condition or complete the Worker's Notice of Reapplication form (C4), which you can obtain by calling WSI. If benefits are reinstated, disability benefits can only be paid for the 30 days prior to the date your written request is received by WSI.