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  1. #1
    Join Date
    May 2014
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    2

    Default How Does North Dakota Calculate Workers Comp Settlements After IME

    I am requesting my IME next week. According to the Century Code 65-05-28 WSI has to try and find a DR. in my home state to do this. Does anyone have info on this. MY next question, What is the formula used in calculating a settlement from WSI. Thank You for any information you may have.

  2. #2
    Join Date
    Oct 1971
    Posts
    4,488

    Default Re: How Does North Dakota Calculate Their Settlements After Ime

    Quote Quoting stevenwillis33 View Post
    I am requesting my IME next week. According to the Century Code 65-05-28 WSI has to try and find a DR. in my home state to do this. Does anyone have info on this. MY next question, What is the formula used in calculating a settlement from WSI. Thank You for any information you may have.
    The code you cited pertains to the organization requesting the exam.
    I've never heard of a claimant requesting one, not sure if that's even possible if you haven't reached MMI yet.
    It may not be to your advantage to seek an IME prematurely, it's best to receive your TTD for as long as possible.

    If you don't have a lawyer, you should consult one before proceeding to protect your rights.
    Here's an excerpt from the code you cited. (see pages 18-20)

    65-05-28. Examination of injured employee - Paid expenses - No compensation paid if
    claimant refuses to reasonably participate.
    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 doctors designated or approved by the organization. The organization shall
    make a reasonable effort to designate a duly qualified doctor licensed in the state in
    which the employee resides to conduct the examination before designating a duly
    qualified doctor licensed in another state or shall make a reasonable effort to
    designate a duly qualified doctor licensed in a state other than the employee's state of
    residence if the examination is conducted at a site within two hundred seventy-five
    miles [442.57 kilometers] from the employee's residence.
    http://www.legis.nd.gov/cencode/t65c05.pdf

    See pages 12- 13 in the below link for the formula to determine your benefit.

    65-05-12.2. Permanent impairment - Compensation - Time paid.
    10.If the injury causes permanent impairment, the award must be determined based on
    the percentage of whole body impairment in accordance with the following schedule:
    http://www.legis.nd.gov/cencode/t65c05.pdf

    Tony
    Moderator Responses are based on my personal bias, experience and research - they may not be accepted in the legal community, always consult an attorney.

  3. #3
    Join Date
    May 2014
    Posts
    2

    Default Re: How Does North Dakota Calculate Their Settlements After Ime

    I am at mmi, my treating Dr. appointment is tomorrow and itll be rated as such. It says I can not get an ime unless I ask for it or at least that is my understanding. As far as the calculations go how is the formula put together. I would like to get an idea of this. I am expected to be at 20%. Is the formula you weekly amount paid *20% * the multiplier. Thank You

  4. #4
    Join Date
    Oct 1971
    Posts
    4,488

    Default Re: How Does North Dakota Calculate Their Settlements After Ime

    Quote Quoting stevenwillis33 View Post
    I am at mmi, my treating Dr. appointment is tomorrow and itll be rated as such. It says I can not get an ime unless I ask for it or at least that is my understanding. As far as the calculations go how is the formula put together. I would like to get an idea of this. I am expected to be at 20%. Is the formula you weekly amount paid *20% * the multiplier. Thank You
    You have to wait until your doctor files a report to the carrier and they notify you that you are eligible for a permanent impairment award to request an IME.
    You then have one hundred eighty days from the date of receiving this notice to request the exam.

    See : pg 11
    65-05-12.2. Permanent impairment - Compensation - Time paid.
    2. The organization shall notify the employee by certified mail, to the last-known address
    of the employee, when that employee becomes potentially eligible for a permanentthirty-five
    percent of the average weekly wage in this state on the date of the impairment
    evaluation, rounded to the next highest dollar,
    impairment award. After the organization has notified the employee, the employee
    shall file, within one hundred eighty days from the date the employee was notified, a
    written request for an evaluation for permanent impairment.
    Failure to file the written
    request within the one hundred eighty-day period precludes an award under this
    section.
    3. An injured employee is entitled to compensation for permanent impairment under this
    section only for those findings of impairment that are permanent and which were
    caused by the compensable injury. The organization may not issue an impairment
    award for impairment findings due to unrelated, noncompensable, or preexisting
    conditions, even if these conditions were made symptomatic by the compensable work
    injury, and regardless of whether section 65-05-15 applies to the claim.
    4. An injured employee is eligible for an evaluation of permanent impairment only when
    all conditions caused by the compensable injury have reached maximum medical
    improvement. The injured employee's doctor shall report to the organization the date
    an employee has reached maximum medical improvement and any evidence of
    impairment of function the injured employee has after that date. If the report states that
    the employee is potentially eligible for a permanent impairment award, the
    organization shall conduct a review and provide notice to the employee as provided by
    subsection 2. If the injured employee files a timely written request under subsection 2,
    the organization shall schedule an impairment evaluation by a doctor qualified to
    evaluate the impairment.
    http://www.legis.nd.gov/cencode/t65c05.pdf

    The chart says a 20% rating would equate to a 25x multiplier.
    So you would then multiply thirty-five percent of your states average weekly wage by 25 to determine the amount of your award.

    See pg. 11
    65-05-12.2. Permanent impairment - Compensation - Time paid.
    A permanent impairment is not intended to be a periodic payment and is not intended to
    reimburse the employee for specific expenses related to the injury or wage loss. If a
    compensable injury causes permanent impairment, the organization shall determine a
    permanent impairment award on the following terms:
    1. The organization shall calculate the amount of the award by multiplying thirty-five
    percent of the average weekly wage in this state on the date of the impairment
    evaluation, rounded to the next highest dollar, by the permanent impairment multiplier
    specified in subsection 10.

    http://www.legis.nd.gov/cencode/t65c05.pdf

    Tony
    Moderator Responses are based on my personal bias, experience and research - they may not be accepted in the legal community, always consult an attorney.

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