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State Codes and Statutes

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CHAPTER 65-05.1REHABILITATION SERVICES65-05.1-01. Rehabilitation services.1.The state of North Dakota exercising its police and sovereign powers declares that<br>disability caused by injuries in the course of employment and disease fairly traceable<br>to the employment create a burden upon the health and general welfare of the<br>citizens of this state and upon the prosperity of this state and its citizens.2.The purpose of this chapter is to ensure that injured employees covered by this title<br>receive services, so far as possible, necessary to assist the employee and the<br>employee's family in the adjustments required by the injury to the end that the<br>employee receives comprehensive rehabilitation services, including medical,<br>psychological, economic, and social rehabilitation.3.It is the goal of vocational rehabilitation to return the disabled employee to<br>substantial gainful employment with a minimum of retraining, as soon as possible<br>after an injury occurs. &quot;Substantial gainful employment&quot; means bona fide work, for<br>remuneration, which is reasonably attainable in light of the individual's injury,<br>functional capacities, education, previous occupation, experience, and transferable<br>skills, and which offers an opportunity to restore the employee as soon as<br>practicable and as nearly as possible to ninety percent of the employee's average<br>weekly earnings at the time of injury, or to sixty-six and two-thirds percent of the<br>average weekly wage in this state on the date the rehabilitation consultant's report is<br>issued under section 65-05.1-02.1, whichever is less.The purpose of definingsubstantial gainful employment in terms of earnings is to determine the first<br>appropriate priority option under subsection 4 which meets this income test set out<br>above.4.The first appropriate option among the following, calculated to return the employee<br>to substantial gainful employment, must be chosen for the employee:a.Return to the same position.b.Return to the same occupation, any employer.c.Return to a modified position.d.Return to a modified or alternative occupation, any employer.e.Return to an occupation within the local job pool of the locale in which the<br>claimant was living at the date of injury or of the employee's current address<br>which is suited to the employee's education, experience, and marketable skills.f.Return to an occupation in the statewide job pool which is suited to the<br>employee's education, experience, and marketable skills.g.Retraining of one hundred four weeks or less.5.If the employee's first appropriate option is an option listed in subdivision c, d, e, or f<br>of subsection 4, the organization may pursue retraining of one hundred four weeks<br>or less. If an option listed in subdivision a, b, c, d, e, or f of subsection 4 has been<br>identified as appropriate for an injured employee and the employee is initially<br>released by the doctor to return to part-time employment with the reasonable<br>expectation of attaining full-time employment, the organization shall pay temporary<br>partial disability benefits under section 65-05-10 until the doctor determines the<br>employee is medically capable of full-time employment.Page No. 16.a.If the vocational consultant concludes that none of the priority options under<br>subsection 4 are viable, and will not return the employee to the lesser of<br>sixty-six and two-thirds percent of the average weekly wage, or ninety percent<br>of the employee's preinjury earnings, the employee shall continue to minimize<br>the loss of earnings capacity, to seek, obtain, and retain employment:(1)That meets the employee's functional capacities; and(2)For which the employee meets the qualifications to compete.b.Under section 65-05-10, the organization shall award partial disability based on<br>retained earnings capacity calculated under this section.c.For purposes of calculating partial disability based on a retained earnings<br>capacity, an employee is presumed to be capable of earning the greater of the<br>state's hourly minimum wage times the hours of release based on a valid<br>functional capacities examination or the wages payable within the appropriate<br>labor market. This presumption is rebuttable only upon a finding of clear and<br>convincing medical and vocational evidence to the contrary. If the presumption<br>is successfully rebutted, the employee may receive partial disability benefits<br>based on a retained earnings capacity of zero.7.The income test in subsection 3 must be waived when an employer offers the<br>employee a return-to-work option at a wage lower than the income test as defined<br>under subsection 3 or when the organization and the employee agree to waive the<br>income test and the priority options.8.Vocational rehabilitation services may be initiated by:a.The organization on its own motion; orb.The employee or the employer if proof exists:(1)That the employee has reached maximum medical recovery;(2)That the employee is not working and is not voluntarily retired or<br>removed from the labor force; and(3)That the employee has made good-faith efforts to seek, obtain, and<br>retain employment.9.Chapter 50-06.1 does not apply to determinations of eligibility for vocational<br>rehabilitation made pursuant to this chapter.10.If retraining is the first appropriate vocational rehabilitation option identified for an<br>employee, the employee shall notify the organization of the acceptance of the<br>retraining option on a form provided by the organization within thirty days from the<br>date the employee receives notice of eligibility for retraining. If the employee fails to<br>notify the organization of the acceptance of the retraining option within the thirty-day<br>period, the organization shall calculate a retained earnings capacity as provided in<br>subdivision c of subsection 6. A vocational rehabilitation allowance does not accrue<br>as weeks of temporary total disability as defined in section 65-01-02 if the employee<br>successfully completes a retraining program approved by the organization. If the<br>employee fails to successfully complete a retraining program approved by the<br>organization, the vocational rehabilitation allowance paid accrues against the<br>maximum number of weeks of temporary total disability allowed pursuant to section<br>65-01-02.If an employee attempts and withdraws from an approved retrainingprogram within the first twenty weeks following commencement of the retraining<br>program, the employee, upon request, may receive no more than one hundredPage No. 2eighty-two weeks of temporary partial disability benefits calculated pursuant to<br>subdivision c of subsection 6.65-05.1-02. Organization responsibility. The organization shall:1.Appoint a director of rehabilitation services and such other staff as necessary to fulfill<br>the purposes of this chapter.2.Cooperate with such federal or state agency as shall be charged with vocational<br>education, vocational rehabilitation, and job placement in order that any duplication<br>of effort can be avoided, as far as possible, in any individual claim.3.Make determinations on individual claims as to the extent and duration of the<br>organization involvement under this chapter.4.Enter into such agreements with other agencies and promulgate any rules or<br>regulations as may be necessary or advantageous in order to carry out the purpose<br>of this chapter.5.Provide such rehabilitation services and allowances as may be determined by the<br>organization to be most beneficial to the worker within the limits of this chapter.6.Establish medical assessment teams, the composition of which must be determined<br>by the organization on a case-by-case basis, as the nature of the injury may require,<br>for the purpose of assessing the worker's physical restrictions and limitations. The<br>medical assessment team must be provided the medical records compiled by the<br>worker's treating physicians.The medical assessment team may consult theworker's treating physicians prior to making its final assessment of the worker's<br>functional capacities. The provisions of section 65-05-28 do not apply to the medical<br>findings made under this section.7.Appoint one or more vocational consultants, the identity of which must be<br>determined by the organization on a case-by-case basis, as the nature of the injury<br>may require, for the purpose of assessing the worker's transferable skills,<br>employment options, and the physical demand characteristics of the worker's<br>employment options, and determining which option available under subdivisions a<br>through f of subsection 4 of section 65-05.1-01 will enable the worker to return to<br>employment within the physical restrictions and limitations provided by the medical<br>assessment team. The vocational consultant shall issue to the organization a report<br>as provided in section 65-05.1-02.1.65-05.1-02.1. Vocational consultant's report. The vocational consultant shall reviewall records, statements, and other pertinent information and prepare a report to the organization<br>and employee.1.The report must:a.Identify the first appropriate rehabilitation option by following the priorities set<br>forth in subsection 4 of section 65-05.1-01.b.Contain findings of why a higher listed priority, if any, is not appropriate.2.Depending on which option the consultant identifies as appropriate, the report also<br>must contain findings that:a.Identify jobs in the local or statewide job pool and the employee's anticipated<br>earnings from each job; orPage No. 3b.Describe an appropriate retraining program, the employment opportunities<br>anticipated upon the employee's completion of the program, and the<br>employee's anticipated earnings.3.The vocational consultant's report is due within sixty days from the date the<br>vocational assessment is performed under this chapter. However, if the vocational<br>consultant determines that retraining options must be evaluated because higher<br>priority options are not viable, the final report is due within ninety days of the<br>vocational assessment to allow the employee to assist in formulating the choice<br>among the qualified training programs.65-05.1-03. Director of rehabilitation services - Duties. The director of rehabilitationservices shall:1.Direct the implementation of programs for individual workforce safety and insurance<br>claimants in accordance with organization determinations in compliance with the<br>purpose of this chapter.2.Cooperate, contact, and assist any government or private organization or agency or<br>group of individuals or business or individual necessary or advantageous in carrying<br>out the purpose of this chapter.3.Keep such records, for statistical purposes, and provide such training necessary for<br>the organization staff as is necessary to keep pace with future developments in the<br>area of rehabilitation services.65-05.1-04. Injured employee responsibility.1.The injured employee shall seek, obtain, and retain reasonable and substantial<br>employment to reduce the period of temporary disability to a minimum.Theemployee has the burden of establishing that the employee has met this<br>responsibility.2.If the injured employee is unable to obtain substantial employment as a direct result<br>of injury, the employee shall promptly notify the organization under subdivision b of<br>subsection 8 of section 65-05.1-01.3.The injured employee shall be available for testing under subsection 6 or 7 of<br>section 65-05.1-02, and for any further examinations and testing as may be<br>prescribed by the organization to determine whether or not a program of<br>rehabilitation is necessary. The injured employee also shall participate in remedial<br>or other educational services when those services are determined to be necessary<br>by the organization or the vocational consultant. If the employee is noncompliant<br>with this subsection, the organization shall suspend benefits during the period of<br>noncompliance.4.If the first appropriate rehabilitation option under subsection 4 of section 65-05.1-01<br>is return to the same, modified, or alternative occupation, or return to an occupation<br>that is suited to the employee's education, experience, and marketable skills, the<br>employee is responsible to make a good-faith work trial or work search.If theemployee fails to perform a good-faith work trial, the organization may not pay<br>additional disability benefits unless the employee meets the criteria for reapplying for<br>benefits required under subsection 1 of section 65-05-08. If the employee meets the<br>burden of proving that the employee made a good-faith work trial or work search and<br>that the work trial or work search was unsuccessful due to the injury, the<br>organization shall reevaluate the employee's vocational rehabilitation claim. When<br>the first appropriate vocational rehabilitation option is identified for an employee, the<br>organization shall notify the employee of the obligation to make a good-faith workPage No. 4search or good-faith work trial, and provide information to the employee regarding<br>reinstatement of benefits if the work search or work trial is unsuccessful.5.If the first appropriate rehabilitation option under subsection 4 of section 65-05.1-01<br>is retraining, the employee shall cooperate with the necessary testing to determine<br>whether the proposed training program meets the employee's medical limitations<br>and aptitudes. The employee shall attend a qualified rehabilitation training program<br>when ordered by the organization. A qualified training program is a rehabilitation<br>plan that meets the criteria of this title, is the approved option of the rehabilitation<br>consultant, and commences within a reasonable period of time such as the next<br>quarter or semester. The organization and the employee, by agreement, may waive<br>the income test applicable under this subsection.6.If, without good cause, the injured employee fails to make a good-faith work search<br>in return to work utilizing the employee's transferable skills, the employee is in<br>noncompliance with vocational rehabilitation. A good-faith work search that does not<br>result in placement is not, in itself, sufficient grounds to prove the work injury caused<br>the inability to acquire gainful employment. The employee shall show that the injury<br>significantly impacts the employee's ability to successfully compete for gainful<br>employment in that the injury leads employers to favor those without limitations over<br>the employee. If, without good cause, the injured employee fails to attend specific<br>vocational testing, remedial, or other vocational services determined necessary by<br>the organization or the rehabilitation consultant, the employee is in noncompliance<br>with vocational rehabilitation. If, without good cause, the injured employee fails to<br>attend a scheduled medical or vocational assessment, fails to communicate or<br>cooperate with the vocational consultant, or fails to attend a specific qualified<br>rehabilitation program within ten days from the date the rehabilitation program<br>commences, the employee is in noncompliance with vocational rehabilitation. If,<br>without good cause, the employee discontinues a training program in which the<br>employee is enrolled, the employee is in noncompliance with vocational<br>rehabilitation.If at any time the employee is noncompliant without good cause,subsequent efforts by the employee to come into compliance with vocational<br>rehabilitation are not considered successful compliance until the employee has<br>successfully returned to the job or training program for a period of thirty days. In all<br>cases of noncompliance by the employee, the organization shall discontinue<br>disability and vocational rehabilitation benefits.If the period of noncompliancecontinues for thirty days following the date benefits are discontinued, or a second<br>instance of noncompliance occurs without good cause, the organization may not pay<br>any further disability or vocational rehabilitation benefits, regardless of whether the<br>employee sustained a significant change in medical condition due to the work injury.65-05.1-05. Rehabilitation contract. 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