DI 52120: State Specific Workers' Compensation (WC) Procedures
TN 6 (07-13)
The North Dakota Workforce Safety & Insurance Organization (WSI) handles WC cases. WSI is the sole provider and administrator of the WC system in North Dakota. All employers, except those authorized to self-insure, must purchase WC insurance from the State fund, rather than from private insurance companies.
A. Types of WC payments
You can locate types of WC payments under the North Dakota WC law, Title 65, Chapter 65-05 of the North Dakota Code.
NOTE: For vocational rehabilitation (VR) payments, which apply to all states including North Dakota VR benefits paid in lieu of WC, follow instructions in DI 52110.005.
1. Wage replacement
Following are the types of wage replacement that apply in North Dakota:
Temporary Total (TT) – reverse offset applies, see DI 52120.185E in this section.
Permanent Total (PT) – reverse offset applies, see DI 52120.185E.
Temporary Partial (TP) – (reverse offset does not apply):
Paid when wages are reduced because of a physical limitation related to the injury;
Paid for up to only five years for those suffering a loss of earnings capacity after June 30, 1991; and
Ends when wages return to at least 90% of gross weekly pre-injury wages.
NOTE: You may waive the five-year limit on the duration of partial disability benefits in cases of catastrophic injury or when the injured worker currently works and has long-term restrictions that limit him or her to working less than twenty-eight hours per week. Classify these benefits as long-term temporary partial benefits. Long-term TP is payable for the duration of the disability and only applies to WC claims with a date of first disability or date of successful reapplication occurring after 06/30/1991.
2. Permanent Partial Impairment (PPI) benefits
Code these PPI benefits as permanent partial (PP). For PP benefits, see DI 52120.185G in this section.
B. Cost-of-living Adjustments (COLA)
WSI provides long-term TP disability inflation adjustment to workers with a disability date or date of successful reapplication, occurring after 06/30/1991. A worker is eligible beginning on the first day of July, after the fifth full year and every year thereafter.
C. Attorney fees
WSI generally pays attorney fees directly to the attorney from WSI’s general fund or reimburses the employee for fees he or she paid to the attorney directly from the fund (i.e., separately from the award). WSI will include attorney fees as part of an employee’s award only in rare cases.
D. Retirement Insurance Benefit (RIB) considerations
If the worker is entitled to PT, North Dakota offsets Social Security retirement benefits.
E. When reverse offset for TT and PT awards applies
SSA recognizes North Dakota’s reverse offset plan because it was in effect prior to 02/18/1981. Payment types TT or PT WC are subject to the state offset depending on the date of injury and date compensation received, as follows:
TT or PT WC received prior to 01/01/1990, North Dakota applied reverse offset only if the WC injury occurred on or after 01/01/1980. If the WC injury occurred prior to 01/01/1980, SSA DIB offset applied (not reverse offset).
Effective 01/01/1990 (due to a change in the law), North Dakota applied reverse offset to TT or PT WC, regardless of the date of WC injury. For more information on reverse offset, see DI 52105.001.
F. WC awards not under the reverse offset plan
There are three types of awards, regardless of the injury date, that the State will not reduce, even if there is a rating of “total”. SSA offsets the following awards:
Stipulated settlement - a compromise between the State and the worker; paid as a lump sum;
Permanent impairment award - paid as a lump sum or as periodic payments; and
Scheduled injury award - paid as a lump sum or as periodic payments.
The State can identify these awards and provide payment information to us upon receiving our request. We may pay these awards in lieu of, or in addition to other periodic payments.
G. How to process TT or PT cases
North Dakota WSI receives a cross-match report that identifies workers receiving TT or PT payments who also receive Social Security benefits. When a match occurs, WSI contacts the servicing field office to verify the Social Security benefits. WSI then notifies the worker of the amount and effective date of the reverse offset. If the reverse offset is retroactive, WSI will establish an overpayment and suspend WC payments until recovery of the overpayment is complete.
If the worker receives TT or PT WC payments:
Do not impose offset.
Enter “Y” under “REVERSE JURISDICTION INVOLVED (Y/N)” on the MCS WPCL screen (MSOM COMMON 001.003), ICF WCCD screen (MSOM ICFT2 031.012), and the appropriate START date.
Diary the case for one year for possible future changes in the type or amount of WSI benefits.
The State has no process for notifying us of any changes in benefits. WSI considers notifying us to be the claimant’s responsibility. If WSI receives a signed SSA-1709 (Request for Workers’ Compensation/Public Disability Benefit Information) on file for the WSI claim, upon SSA’s request, WSI will fax a “Cost Paid Summary” to us. The summary shows all payments from date of inquiry to the present. The SSA-1709 on file does not expire. We encourage FO staff to obtain an SSA-1709 at the earliest point of contact. Send fax requests of the SSA-1709 to WSI at 701-328-3820.
If the State changes a “total” rating (TT or PT) to a “partial” rating (TP or PP), impose offset the date the “partial” rating begins.
H. How to process other types of North Dakota WC awards
When processing other types of WC awards, follow these instructions:
Apply offset to stipulated settlements, permanent impairment awards, and scheduled injury awards.
Prorate lump sum awards from the date of the award.
Do not apply offset to TT or PT periodic benefits made in addition to these awards.