§ 65-01-16 — Decisions by organization - Disputed decisions

North Dakota § 65-01-16

• Jurisdiction: North Dakota
• Title 65: Workforce Safety and Insurance
• Ch. 65-01: General Provisions

Text

The following procedures must be followed in a claim for benefits, notwithstanding any
provisions to the contrary in chapter 28-32:
1. The organization shall send a copy of each initial claim form filed with the organization
to the claimant's employer, by regular mail or electronic means, along with a form for
the employer's response, if the employer's response has not been filed at the time the
claim is filed.
2. The organization may conduct a hearing on any matter within its jurisdiction by
informal internal review of the information of record.
3. The organization may issue a notice of decision for any decision made by informal
internal review and shall issue the notice of decision on the parties by regular mail or
electronic means. A notice of decision must include a statement of the decision, a
short summary of the reason for the decision, and notice of the right to
reconsideration.
4. A party has forty-five days from the day the notice of decision was issued by the
organization by regular mail or electronic means to file a written request for
reconsideration. The request for reconsideration is considered filed only upon receipt
by the organization. The employer is not required to file the request through an
attorney. The request must state the reason for disagreement with the organization's
decision and the desired outcome. The request may be accompanied by additional
evidence not previously submitted to the organization. The organization shall
reconsider the matter by informal internal review of the information of record. Absent a
timely and sufficient request for reconsideration, the notice of decision is final and may
not be reheard or appealed.
5. After receiving a request for reconsideration, the organization shall issue to the parties
by regular mail or electronic means, a notice of decision reversing the previous
decision or an administrative order that includes its findings, conclusions, and order.
The organization may issue an administrative order on any decision made by informal
internal review without first issuing a notice of decision and receiving a request for
reconsideration. If the organization does not issue an order within sixty days of
receiving a request for reconsideration, any interested party may request, and the
organization shall promptly issue, an appealable determination.
6. An employee has forty-five days from the day the administrative order was mailed in
which to file a request for assistance from the decision review office under section
65-02-27.
7. A party has forty-five days, from the date of issuance of an administrative order or from
the day the decision review office issues its notice by regular mail or electronic means
that the office's assistance is complete, in which to file a written request for rehearing.
The request must specifically state each alleged error of fact and law to be reheard
and the relief sought. The request for rehearing is considered filed only upon receipt by
the organization. Absent a timely and sufficient request for rehearing, the
administrative order is final and may not be reheard or appealed.
8. Rehearings must be conducted as hearings under chapter 28-32 to the extent the
provisions of that chapter do not conflict with this section.
9. A party may appeal a posthearing administrative order to district court in accordance
with chapter 65-10. Chapter 65-10 does not preclude the organization from appealing
to district court a final order issued by a hearing officer under this title.
10. Any notice of decision, administrative order, or posthearing administrative order is
subject to review and reopening under section 65-05-04.