Serve & Protect Reimbursement Program

Employers eligible to participate in the Serve & Protect Reimbursement Program must meet the following requirements:

• Active account and in good standing with WSI
• Employ full-time firefighters and/or full-time law enforcement officers (see NDCC § 65-01-15.1.4 for definition of law enforcement officer.)

Reimbursement Process

An employer must complete and submit the following to [email protected]:

• Serve & Protect Reimbursement Request form
• Serve & Protect Reimbursement Request File
• Supporting documentation

WSI will accept one of the following as supporting documentation.

• Copy of the paid invoice and proof of payment for medical exam (ex. cleared check, billing statement, or credit card receipt). The invoice must include the provider’s name, location, and telephone number; employee’s name; date of medical exam; and dollar amount.
  • Copy of the EOB and proof of payment if employer reimbursed the employee for the cost of the medical exam.

An employer may only submit one form per month.

Requests for reimbursement are for employers who employ paid, full-time firefighters or law enforcement officers.

Requests must be received within 1 year from the date of medical exam.

WSI will not reimburse for:

• Medical exams prior to September 1, 2023
• Follow-up testing or additional medical appointments
• Costs covered by the employee’s health insurance

As part of the statutory requirements, an employer is required to pay for a medical exam at no expense to the employee. The medical exam schedule is based on continuous years of service as a paid, full-time firefighter or law enforcement officer regardless of where the service occurred.   

The medical exam schedule is:

• Upon hire
• 1 to 10 years of service, medical exam every 5 years
• 11 to 20 years of service, medical exam every 3 years
• 21 or more years of service, medical exam every year

Use the reimbursement schedule that corresponds with the employee's continuous years of service and date of the medical exam.

2025 Serve & Protect reimbursement schedule

2024 Serve & Protect reimbursement schedule

1. How much will WSI Reimburse?
   • WSI will reimburse an employer up to $250 maximum per employee based on the 1) employer’s paid invoice to a clinic or physician, or 2) an Explanation of Benefits (EOB) and proof of payment.
     • Employer pays the clinic or physician directly and the cost of the medical exam is $400; WSI will reimburse $250.
     • Employer has reimbursed an employee based on an EOB and proof of payment for the cost of the medical exam; WSI will reimburse the employer up to a maximum of $250.
2. When will an employer receive payment?
   • Once WSI processes the request, payment will be issued within 30 days.
3. Where can I find the information relating to the presumption clause (65-01-15.1.)
   • North Dakota Century Code t65c01 (ndlegis.gov)
4. What is accepted for the parameters of the medical exams? DOT or physicals?
   • Under the presumption clause it states - 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 indicating cardiovascular health to a reasonable degree of medical certainty
5. Is there a standardized form that needs to be completed for medical examinations which is provided by WSI?      
   • There is no standardized form required for medical examinations provided by WSI. The medical provider has the discretion to determine the appropriate tests for the individual and the necessary documentation.
6. What information is required by an employer to receive reimbursement?
   • Serve & Protect Reimbursement Request Form
   • Serve & Protect Reimbursement Request File
   • Supporting documentation - Provide a copy of the paid invoice and proof of payment for medical exam (ex. cleared check, billing statement, or credit card receipt). The invoice must include the provider’s name, location, and telephone number; employee’s name; date of medical exam; and dollar amount or a copy of the EOB and proof of payment if employer reimbursed the employee for the cost of the medical exam.
7. Who is covered under the presumption clause?
   • For purposes of this section, "law enforcement officer" means an individual 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, the Bismarck state college police department, a county sheriff's department, a city police department, or the parks and recreation department pursuant to section 55-08-04.
8. Are correctional officers covered under the presumption clause?
   • No, they are not.
9. What does total continuous years of service mean?
   • Total continuous years of service includes the total years of in state and out of state full time paid firefighter or law enforcement service with an employer
     • Continuous years of service does not include gaps of employment longer than 3 months
     • If an employee has a gap of employment longer than 3 months, years of service start over
       • Ex.  An employee works as a fulltime law enforcement office in SD for 3 years and has now moved to  ND and has currently worked 3 years for the City of Fargo police department with no gaps of employment- total continuous years of service would equal 6 years
       • Ex. An employee worked as a paid fulltime firefighter for the city of Mandan for 7 years, left to work part-time at Bismarck for 1 year, left to work fulltime at Dickinson. Continuous years of service would be 0. Since he worked part time for a year, years of service start over.
10. Is having the exams on file helpful in situations such as an Officer having a heart attack on the job?
    • In reviewing a claim when a heart attack on the job occurs for fulltime firefighters and law enforcement officers, the claims adjuster will request a copy of the medical examination.  This can either be obtained through the employer if they keep a copy or through the medical provider.
11. Are medical exams a requirement?
    • Yes, medical examinations are a requirement for paid full time law enforcement and full-time firefighters - 65-01-15.1. Presumption of compensability for certain conditions of full-time paid firefighters and law enforcement officers.
12. Is there a deadline for an employer to submit a reimbursement request?
    • Yes, requests must be received within 1 year from date of medical exam.
13. Do I fill out a separate reimbursement request form per employee? Or can I submit a reimbursement request for multiple employees at a time?
    • No, you can submit a reimbursement request with multiple employees at a time. However, you can only submit one reimbursement per month.
14. Is an employee eligible for the $250.00 reimbursement each year?
    • Depends on continuous years of service.
15. Can I submit a reimbursement request by mail?
    • No, all requests must be sent in email to [email protected]