N.D. Admin Code 4-11-02-03 - Reporting a work-related injury

1. The risk management workers' compensation program contact for the employing authority shall file a completed incident report which includes details of the employee's alleged injury, the cause, the contributing factors, and the action taken to prevent further occurrences. The contact shall fax the report to the office of management and budget risk management division within forty-eight hours of the occurrence or first report of the alleged injury unless the employing authority has an approved data management system to furnish monthly reports to the risk management division. All employing authorities must meet the forty-eight hour filing requirement for suspected time loss claims.

2. For injuries requiring treatment other than first aid, the employee or the employing authority, or both, shall complete a North Dakota workers' compensation claim for injury form (SFN 2828) and shall file both parts C1 and C2 of the SFN 2828 electronically with the bureau as soon as possible and no more than forty-eight hours after the employee seeks medical treatment from the preferred provider or the provider selected by the employee prior to the alleged injury.

Notes

N.D. Admin Code 4-11-02-03

Effective March 1, 2002.

General Authority: NDCC 28-32-02

Law Implemented: NDCC 65-04-03.1