North Dakota to Examine Whether Their Benefits For Injuries with Pre-Existing Conditions Are Adequate

Auditors in North Dakota will conduct a fresh review of denied workers’ compensation claims and study the laws defining eligibility for certain benefits.

According to inforum.com, Workforce Safety and Insurance and the state workers’ comp agency, will audit its operations in 2008 and 2009. An independent review in 2008 by the BDMP consulting firm of Portland, Maine, concluded claims analysts appropriately denied claims. The results from the review are expected by late summer.

The performance evaluation, by Sedgewick CMS in Memphis, Tennessee will compare North Dakota’s laws limiting payment of claims for workers with pre-existing conditions or degenerative disease, such as arthritis.

In addition the review will look at:

1. The adequacy of benefits paid to retired injured workers, again in comparison to benefits from other states. In particular, the study will look at how collecting Social Security benefits affects benefits.

2. Permanent partial impairment awards, which require as a qualifying threshold a finding that 16 percent of an injured worker’s body is impaired, a higher standard than once was set by law.

3. Use of prescription narcotics by North Dakota workers compared to use in other states, as well as among localities in the state. The report will include recommendations to “control and address variations” in narcotic prescription rates and treatment methods. (workersxzcompxzkit)

4. Large contracts with vendors to determine if the cost of services was reasonable and whether contracts were appropriately bid and awarded.

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By: Anthony Van Gorp, private investigator with 25 years experience.

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers’ comp issues.

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