Examination of injured employee - Paid expenses - No compensation paid if injured employee refuses to reasonably participate
N.D. Cent. Code § 65-05-28
in effect65-05-28. Examination of injured employee - Paid expenses - No compensation paid if
injured employee refuses to reasonably participate.
An injured employee may select a health care provider of that injured employee's choice to
render initial treatment. Upon a determination that the injured employee's injury is compensable,
the organization may require the injured employee to begin treating with another health care
provider to better direct the medical aspects of the injured employee's claim. The organization
shall provide a list of three health care providers who specialize in the treatment of the type of
injury the employee sustained. At the organization's request, the injured employee shall select a
health care provider from the list. An injured employee shall follow the directives of the health
care provider treating the injured employee as chosen by the injured employee at the request of
the organization and comply with all reasonable requests during the time the injured employee
is under medical care. Providing further that:
1. An injured employee may not change from one health care provider to another while
under treatment or after being released, without the prior written authorization of the
organization. Failure to obtain approval of the organization renders the injured
employee liable for the cost of treatment and the new health care provider will not be
considered the attending health care provider for purposes of certifying temporary
disability.
a. Any injured employee requesting a change of health care provider shall file a
written request with the organization stating all reasons for the change. Upon
receipt of the request, the organization shall review the injured employee's claim
and approve or deny the change of health care provider, notifying the injured
employee and the requested health care provider.
b. Emergency care or treatment or referral by the attending health care provider
does not constitute a change of health care provider and does not require prior
approval of the organization.
2. Travel and other personal reimbursement for seeking and obtaining medical care is
paid only upon request of the injured employee. All claims for reimbursement must be
supported by the original vendor receipt, when appropriate, and must be submitted
within one year of the date the expense was incurred or reimbursement must be
denied. Reimbursement must be made at the organization reimbursement rates in
effect on the date of incurred travel or expense. The calculation for reimbursement for
travel by motor vehicle must be calculated using miles actually and necessarily
traveled. A personal reimbursement requested under this subsection is a managed
care decision under section 65-02-20, subject to the appeal process as provided for in
section 65-02-20. Providing further that:
a. Payment for mileage or other travel expenses may not be made when the
distance traveled is less than fifty miles [80.47 kilometers] one way, unless the
total mileage equals or exceeds two hundred miles [321.87 kilometers] in a
calendar month;
b. All travel reimbursements are payable at the rates at which state employees are
paid per diem and mileage, except that the organization may pay no more than
actual cost of lodging, if actual cost is less;
c. Reimbursement may not be paid for travel other than that necessary to obtain the
closest available medical or hospital care needed for the injury. If the injured
employee chooses to seek medical treatment outside a local area where care is
available, travel reimbursement may be denied;
d. Reimbursement may not be paid for the travel and associated expenses incurred
by the injured employee's spouse, children, or other persons unless the injured
employee's injury prevents travel alone and the inability is medically
substantiated; and
e. Other expenses, including telephone calls and car rentals are not reimbursable
expenses.
3. The organization may at any time require an injured employee to submit to an
independent medical examination or independent medical review by one or more duly
qualified allied health care professionals designated or approved by the organization.
The organization shall make a reasonable effort to designate a duly qualified allied
health care professional licensed in the state in which the injured employee resides to
conduct the examination before designating a duly qualified allied health care
professional licensed in another state or shall make a reasonable effort to designate a
duly qualified allied health care professional licensed in a state other than the injured
employee's state of residence if the examination is conducted at a site within two
hundred seventy-five miles [442.57 kilometers] from the injured employee's residence.
An independent medical examination and independent medical review must be for the
purpose of review of the diagnosis, prognosis, treatment, or fees. An independent
medical examination contemplates an actual examination of an injured employee,
either in person or remotely if appropriate. An independent medical review
contemplates a file review of an injured employee's records, including treatments and
testing. The injured employee may have a duly qualified health care provider
designated by that employee present at the examination or later review the written
report of the allied health care professional performing the independent medical
examination, if procured and paid for by that injured employee. Providing further that:
a. In case of any disagreement between allied health care professionals making an
examination on the part of the organization and the injured employee's allied
health care professional, the organization shall appoint an impartial allied health
care professional duly qualified who shall make an examination and shall report
to the organization.
b. The injured employee, in the discretion of the organization, may be paid
reasonable travel and other per diem expenses under the guidelines of
subsection 2. If the injured employee is working and loses gross wages from the
injured employee's employer for attending the examination, the gross wages
must be reimbursed as a miscellaneous expense upon receipt of a signed
statement from the employer verifying the gross wage loss.
4. If an injured employee, or the injured employee's representative, refuses to submit to,
or in any way intentionally obstructs, any examination or treatment, or refuses to
reasonably participate in medical or other treatments or examinations, the injured
employee is medically noncompliant. If the organization determines an injured
employee is medically noncompliant without good cause, the organization shall
discontinue disability and vocational rehabilitation benefits. At any time the injured
employee is medically noncompliant, efforts by the injured employee to come into
compliance are not considered successful compliance until the injured employee has
been compliant for a period of at least sixty days. If the period of medical
noncompliance continues for sixty days following the date disability and vocational
rehabilitation benefits are discontinued, or a second instance of medical
noncompliance occurs without good cause, the organization may not pay any further
disability and vocational rehabilitation benefits, regardless of whether the injured
employee sustained a significant change in medical condition due to the work injury.
The period of noncompliance must be deducted from the period for which
compensation is payable to the injured employee.
5. If an injured employee undertakes activities, whether or not in the course of
employment, which exceed the treatment recommendations of the injured employee's
health care provider regarding the work injury, and the health care provider determines
the employee's injury or condition has been aggravated or has worsened as a result of
the injured employee's activities, the organization may not pay benefits relative to the
aggravation or worsening, unless the activities were undertaken at the demand of an
employer. An employer's account may not be charged with the expenses of an
aggravation or worsening of a work-related injury or condition unless the employer
knowingly required the injured employee to perform activities that exceed the
treatment recommendations of the injured employee's health care provider.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://ndlegis.gov/cencode/t65c05.pdf#nameddest=65-05-28Fetched: 10/16/2026