Section 92-01-03-04 - Procedure for dispute resolution1. A claimant may contact the office for assistance at any time. The claimant 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. A claimant must 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 claimant. The decision review specialist may facilitate the discussion of the dispute but may not modify a decision issued by the organization. 3. If a claimant 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 send the certificate of completion to the claimant and will inform the claimant of the right to pursue the dispute through hearing. To pursue a formal rehearing of the claim, the claimant shall file a request for rehearing with the organization's legal department within forty-five days after the certificate of completion is mailed. 4. If a claimant has not attempted to resolve the dispute, the office shall notify the claimant by letter, sent by regular mail, of the claimant's nonparticipation in the office and that no attorney's fees shall be paid by workforce safety and insurance should the claimant prevail in subsequent litigation. The decision review specialist shall inform the claimant of the right to pursue the dispute through hearing. To pursue a formal rehearing of the claim, the claimant shall file a request for rehearing with the organization's legal department within forty-five days after the letter of noncompliance is mailed. 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 a claimant's request for assistance. This time frame can be extended if the decision review specialist is in the process of obtaining additional information.N.D. Admin Code 92-01-03-04
Effective April 1, 1996; amended effective May 1, 1998; May 1, 2000; July 1, 2004; July 1, 2006; July 1, 2010; April 1, 2012.Amended by Administrative Rules Supplement 367, January 2018, effective 1/1/2018.Amended by Administrative Rules Supplement 2021-383, January 2022, effective 1/1/2022.General Authority: NDCC 65-02-08
Law Implemented: NDCC 65-01-16, 65-02-27