Section 92-01-02-02.3 - First report of injury1. An employer's notice of injury filed with the organization pursuant to North Dakota Century Code section 65-05-01.4 must be the first report of injury form or any other written submission which clearly contains at least the following information: a. The injured employee's name and address.b. The injured employee's social security number.c. The employer's name and address.d. The employer's workers' compensation account number.e. A description of the nature of the injury. f. The location where the injury occurred.g. A description of how the injury occurred.h. A description of the type of work done by the injured employee.i. The name and address of the injured employee's health care provider, if known.j. The names and addresses of any witnesses to the injury, if known.2. Following receipt of the employer's notice of injury, the organization shall determine whether a claim has been filed by the injured employee. If no claim has been filed, the organization shall notify the injured employee by regular mail addressed to the injured employee at the address given by the employer or at the last-known address of the injured employee that the employer's notice has been received and shall inform the injured employee of the filing requirements of North Dakota Century Code section 65-05-01. N.D. Admin Code 92-01-02-02.3
Effective January 1, 1996; amended effective July 1, 2006.Amended by Administrative Rules Supplement 376, April 2020, effective 4/1/2020.General Authority: NDCC 65-02-08
Law Implemented: NDCC 65-05-01.4, 65-05-01.5