# Title 92 — Workforce Safety and Insurance

## Article 92-01 — General Administration

## Chapter 92-01-03 — Decision Review Office

### § 92-01-03-01. History and functions of the decision review office.

1. History. Legislation enacting the decision review office was passed in 1995 and is codified as
North Dakota Century Code section 65-02-27. The legislation took effect on August 1, 1995.
2. Functions. The program has been developed to educate and provide assistance to injured
employees in the workers' compensation system. The goal is to resolve claims disputes in a
timely and professional manner. If an employee has a concern with a claim, the employee
may contact the decision review office and request assistance.
History: Effective April 1, 1996; amended effective May 1, 2000; July 1, 2010.
General Authority: NDCC 65-02-08
Law Implemented: NDCC 65-02-27
### § 92-01-03-02. Definitions.

In this chapter:
1. "Act" means the North Dakota Workers Compensation Act.
2. "Attempt to resolve" means a prompt, active, honest, good-faith effort by the claimant to settle
disputes with the organization, through the office.
3. "Benefits" means an obligation of the organization to provide a claimant with assistance as
required by the Act.
4. "Certificate of completion" means the form sent to the claimant when the office closes its file,
which acknowledges the claimant made a good-faith effort to resolve the dispute.
5. "Claimant" means an employee who has filed a claim for benefits with the organization.
6. "Decision review specialist" means a person employed by the office to assist a claimant in a
disputed claim.
7. "Disputed claim" means a challenge to an order issued by the organization.
8. "Interested party" means:
a. The claimant.
b. The claims adjuster assigned to that claimant's claim.
c. A claims supervisor.
d. The claimant's employer or immediate supervisor.
e. The claimant's treating doctor.
f. A member of the organization's legal department.

g. Any other person the decision review specialist determines appropriate.
9. "Office" means the decision review office.
10. "Order" means an administrative order issued pursuant to North Dakota Century Code chapter
28-32 or section 65-01-16.
11. "Organization" means workforce safety and insurance, or the director, or any department
heads, assistants, or employees of the organization designated by the director to act within
the course and scope of their employment in administering the policies, powers, and duties of
the Act.
History: Effective April 1, 1996; amended effective May 1, 2000; July 1, 2004; July 1, 2010; January 1,
2018.
General Authority: NDCC 65-02-08
Law Implemented: NDCC 65-02-27
### § 92-01-03-03. Request for assistance - Timely request for consideration or rehearing.

A claimant shall request assistance with the resolution of a dispute that arises from an order in
writing within forty-five days from the date of service of the order. An oral request is sufficient to toll the
statutory time limit for requesting rehearing if that request is followed by a written request for assistance
which is received by the office within ten days after the oral request was made.
History: Effective April 1, 1996; amended effective May 1, 1998; May 1, 2000; July 1, 2010; January 1,
2022.
General Authority: NDCC 65-02-08
Law Implemented: NDCC 65-01-16, 65-02-27
### § 92-01-03-04. Procedure for dispute resolution.

1. An injured employee may contact the office for assistance at any time. The injured employee
shall contact the office to request assistance with a dispute arising from an order within forty-
five days of the date of service of the order. An injured employee shall make an initial request
in writing for assistance with an order.
2. In an attempt to resolve the dispute, the decision review specialist may contact any interested
parties. After oral or written contact has been made with the appropriate interested parties, the
decision review specialist will attempt to accomplish a mutually agreeable resolution of the
dispute between the organization and the injured employee. The decision review specialist
may facilitate the discussion of the dispute but may not modify a decision issued by the
organization.
3. If an injured employee has attempted to resolve the dispute and an agreement cannot be
reached, the decision review specialist shall issue a certificate of completion. The decision
review specialist will issue the certificate of completion to the injured employee by regular mail
or electronic means and will inform the injured employee of the right to pursue the dispute
through hearing. To pursue a formal rehearing of the claim, the injured employee shall file a
request for rehearing with the organization's legal department within forty-five days after the
certificate of completion is issued.
4. If an injured employee has not attempted to resolve the dispute, the office shall notify the
injured employee by letter, sent by regular mail, or electronic means, of the injured employee's
nonparticipation in the office and that no attorney's fees shall be paid by workforce safety and
insurance should the injured employee prevail in subsequent litigation. The decision review
specialist shall inform the injured employee of the right to pursue the dispute through hearing.
To pursue a formal rehearing of the claim, the injured employee shall file a request for

rehearing with the organization's legal department within forty-five days after the letter of
noncompliance is issued.
5. If an agreement is reached, the organization must be notified and an order or other legal
document drafted based upon the agreement.
6. The office will complete action within thirty days from the date that the office receives an
injured employee's request for assistance. This time frame may be extended if the decision
review specialist is in the process of obtaining additional information.
History: Effective April 1, 1996; amended effective May 1, 1998; May 1, 2000; July 1, 2004; July 1,
2006; July 1, 2010; April 1, 2012; January 1, 2018; January 1, 2022; January 1, 2026.
General Authority: NDCC 65-02-08
Law Implemented: NDCC 65-01-16, 65-02-27
### § 92-01-03-05. Informal benefit review conference - Notice.

Repealed effective May 1, 2000.
