§ 65-02-08 — Rulemaking power of the organization - Timeliness for issuance of decision - Fees prescribed by organization - Attorney's fees and costs

decision - Fees prescribed by organization - Attorney's fees and costs.
1. The organization shall adopt rules necessary to carry out this title. All fees on claims
for medical and hospital goods and services provided under this title to an injured
employee must be in accordance with schedules of fees adopted by the organization.
Before the effective date of any adoption of, or change to, a fee schedule, the
organization shall hold a public hearing, which is not subject to chapter 28-32.
2. The organization shall issue a decision within sixty days following the date all elements
of initial filing or notice of reapplication of claim are satisfied or a claim for additional
benefits over and above benefits previously awarded is made. The organization's
administrative rules must define satisfaction of elements of filing.
3. a. By administrative rule, the organization shall establish costs payable, maximum
costs, a reasonable maximum hourly rate, and a maximum fee to compensate an
injured employee's attorney for legal services following issuance of an
administrative or judicial order reducing or denying benefits.
b. Except for an initial determination of compensability, an attorney's fee may not
exceed twenty percent of the amount awarded, subject to a maximum fee set by
administrative rule. The amount of the attorney's fees must be determined in the
same manner as prescribed by the organization for attorney's fees. The total
amount of attorney fees paid by the organization may not exceed the fee cap
established for the highest appellate level at which the injured employee prevails.
c. The organization shall pay an attorney's fees and costs if the injured employee
prevailed in binding dispute resolution under section 65-02-20, the injured
employee prevailed after an administrative hearing under chapter 28-32, or the
injured employee prevailed at the district or supreme court as provided for under
section 65-10-03. The organization shall pay the attorney's fees and costs at the
time the injured employee prevails. The organization may not condition payment
of attorney's fees and costs upon the injured employee prevailing upon any future
appeal.
d. An injured employee does not prevail unless an additional benefit, previously
denied, is paid. An injured employee does not prevail on a remand for further
action or proceedings unless that injured employee ultimately receives an
additional benefit as a result of the remand.
e. Notwithstanding the requirement under subdivision d that an additional benefit be
paid or received, an injured employee who prevails at the administrative or district
court level is eligible for attorney's fees and costs for prevailing at that level,
regardless of whether the organization ultimately prevails upon the organization's
appeal of an administrative or district court order.

f. This subsection does not prevent an injured employee or an employer from hiring
or paying an attorney.
g. All disputes relating to payment or denial of an attorney's fees or costs must be
submitted to the court, hearing officer, or arbitrator for decision, but a court,
hearing officer, or arbitrator may not order the maximum fees be exceeded.
h. The organization shall pay an injured employee's attorney's fees and costs from
the organization's general fund. The organization is liable for its costs on appeal if
the decision of the organization is affirmed.