IN THE SUPREME COURT

STATE OF NORTH DAKOTA

2022 ND 213

Cliff Provins, Appellant

 v.

Workforce Safety and Insurance Fund, Appellee

 and

Environmental LLC/Center Coal Co., Respondent

No. 20220060

Appeal from the District Court of Stark County, Southwest Judicial District, 

the Honorable William A. Herauf, Judge.

AFFIRMED.

Opinion of the Court by Jensen, Chief Justice.

Dean J. Haas, Bismarck, ND, for appellant.

Mitchell D. Armstrong, Bismarck, ND, for appellee.

FILED 

IN THE OFFICE OF THE 

CLERK OF SUPREME COURT 

DECEMBER 8, 2022 

STATE OF NORTH DAKOTA
1

Provins v. WSI

No. 20220060

Jensen, Chief Justice.

[¶1] Cliff Provins appeals from a district court judgment affirming an 

administrative law judge’s (“ALJ”) decision that affirmed a Workforce Safety 

and Insurance (“WSI”) order denying liability for his post-traumatic stress 

disorder (“PTSD”) and ending disability benefits in November 2019. We 

conclude the ALJ did not err in concluding Provins’s PTSD was not 

compensable and a reasoning mind could reasonably conclude his physical 

injuries did not cause his PTSD. We affirm.

I

[¶2] In May 2019 Provins sustained injuries to his ribs and chest at work 

when a trailer fell on him while he was working underneath it. WSI accepted 

his claim for benefits for physical injuries to the scalp, chest and ribs, and 

internal organs (liver contusion). Provins was treated for those injuries and 

was subsequently diagnosed with PTSD. In August 2020 WSI issued an order 

denying benefits in connection with his PTSD and discontinuing disability 

benefits as of November 5, 2019. Provins requested an administrative hearing.

[¶3] In April 2021 an ALJ held an evidentiary hearing on the issues of 

whether Provins’s PTSD was compensable and whether he was entitled to 

disability benefits. In July 2021 the ALJ issued findings of fact, conclusions of 

law, and an order affirming WSI’s order. The ALJ determined Provins’s PTSD 

was not a compensable injury and discontinued disability benefits after 

November 5, 2019.

[¶4] Provins petitioned for reconsideration. In August 2021 the ALJ issued 

an order on reconsideration, amending the prior decision to address disability 

benefits in the event his PTSD was determined to be compensable on appeal. 

The ALJ concluded Provins was not entitled to disability benefits after 

November 15, 2019, based on his termination from employment after he had 

returned to work following his injury. Provins appealed to the district court, 

which affirmed the ALJ’s decision.
2

II

[¶5] “Courts exercise limited appellate review of administrative agency 

decisions under the Administrative Agencies Practice Act, N.D.C.C. ch. 28-32.” 

State by & through Workforce Safety & Ins. v. Tolman, 2020 ND 223, ¶ 5, 950 

N.W.2d 144. In an appeal, a reviewing court must affirm an order of an 

administrative agency unless:

1. The order is not in accordance with the law.

2. The order is in violation of the constitutional rights of the 

appellant.

3. The provisions of this chapter have not been complied with in 

the proceedings before the agency.

4. The rules or procedure of the agency have not afforded the 

appellant a fair hearing.

5. The findings of fact made by the agency are not supported by a 

preponderance of the evidence.

6. The conclusions of law and order of the agency are not 

supported by its findings of fact.

7. The findings of fact made by the agency do not sufficiently 

address the evidence presented to the agency by the appellant.

8. The conclusions of law and order of the agency do not 

sufficiently explain the agency’s rationale for not adopting any 

contrary recommendations by a hearing officer or an 

administrative law judge.

N.D.C.C. § 28-32-46. On appeal from a district court order reviewing an ALJ’s 

decision, this Court reviews the ALJ’s decision and not that of the district 

court. N.D.C.C. § 28-32-49.

[¶6] “When reviewing an appeal from a final order issued by an independent 

ALJ, courts apply the same deferential standard of review to the ALJ’s factual 

findings as used for agency decisions.” Tolman, 2020 ND 223, ¶ 6 (quoting 

Beam v. N.D. Workforce Safety & Ins. Fund, 2020 ND 168, ¶ 14, 946 N.W.2d 

486); see also State ex rel. Workforce Safety & Ins. v. Questar Energy Servs., 

Inc., 2017 ND 241, ¶ 7, 902 N.W.2d 757.

Recognizing the ALJ had the opportunity to observe witnesses and 

the responsibility to assess the credibility of witnesses and resolve 
3

conflicts in the evidence, in reviewing the ALJ’s findings of fact we 

do not make independent findings or substitute our judgment for 

that of the ALJ; we determine only whether a reasoning mind 

reasonably could have determined the findings were proven by the 

weight of the evidence from the entire record.

Tolman, at ¶ 6 (quoting Beam, at ¶ 14). We do not give deference to an 

independent ALJ’s legal conclusions, and questions of law are fully reviewable 

on appeal. Id.

III

[¶7] Provins argues that the physical injuries he suffered when he was 

crushed under a trailer are at least 50 percent of the “proximate cause” of his 

PTSD, and the PTSD is therefore a “compensable injury” under N.D.C.C. § 65-

01-02(11)(a)(6), formerly codified at N.D.C.C. § 65-01-02(10)(a)(6).

[¶8] A claimant has the burden to prove by a preponderance of evidence that 

the claimant has sustained a “compensable injury” and is entitled to workers’ 

compensation benefits. N.D.C.C. § 65-01-11; State ex rel. Workforce Safety & 

Ins. v. Sandberg, 2021 ND 39, ¶ 13, 956 N.W.2d 342; Davenport v. Workforce 

Safety & Ins. Fund, 2013 ND 118, ¶ 13, 833 N.W.2d 500. A claimant must prove 

the medical condition for which benefits are sought is causally related to a work 

injury. Davenport, at ¶ 13; Bergum v. N.D. Workforce Safety & Ins., 2009 ND 

52, ¶ 11, 764 N.W.2d 178. To establish this “causal connection,” a claimant must 

demonstrate the claimant’s employment was a “substantial contributing 

factor” to the disease or injury and need not show the employment was the sole 

cause of the injury. Davenport, at ¶ 13; Bruder v. N.D. Workforce Safety & Ins. 

Fund, 2009 ND 23, ¶ 8, 761 N.W.2d 588.

[¶9] Regarding whether a “compensable injury” includes a “mental or 

psychological condition,” N.D.C.C. § 65-01-02(10), at the relevant time, 

provided in part:

“Compensable injury” means an injury by accident arising out of 

and in the course of hazardous employment which must be 

established by medical evidence supported by objective medical 

findings.
4

a. The term includes:

. . . .

(6) A mental or psychological condition caused by a 

physical injury, but only when the physical injury is 

determined with reasonable medical certainty to be at 

least fifty percent of the cause of the condition as 

compared with all other contributing causes combined, 

and only when the condition did not pre-exist the work 

injury.

. . . .

b. The term does not include:

. . . .

(10) A mental injury arising from mental stimulus.

(Emphasis added.) 

[¶10] In Davenport, 2013 ND 118, ¶ 17, this Court construed N.D.C.C. § 65-01-

02(10)(a)(6) and N.D.C.C. § 65-01-02(10)(b)(10) and explained that the “causal 

connection” necessary in this context to establish when a mental or 

psychological condition is compensable under the statutory scheme:

The legislature permits compensation for mental or 

psychological conditions “only when the physical injury is 

determined with reasonable medical certainty to be at least fifty 

percent of the cause of the condition as compared with all other 

contributing causes combined.” N.D.C.C. § 65-01-02(10)(a)(6). A 

compensable injury does not include a “mental injury arising from 

mental stimulus.” N.D.C.C. § 65-01-02(10)(b)(10). The plain 

language of those provisions requires a physical injury to be at

least 50 percent of the cause of a mental or psychological condition 

and contemplates a comparative assessment of other causes 

contributing to a mental or psychological condition. That language 

authorizes benefits only when at least a 50 percent causal 

connection exists between the claimant’s physical injury and mental

or psychological condition and does not permit benefits for an 

indeterminate relationship between a claimant’s work situation 

and the claimant’s mental or psychological condition.

(Emphasis added.)
5

[¶11] Under N.D.C.C. § 65-02-08, the legislature authorized WSI to 

promulgate and enforce administrative rules necessary to carry out Title 65, 

N.D.C.C. WSI has adopted N.D. Admin. Code § 92-01-02-02.5, further 

clarifying the requisite “causal connection” under N.D.C.C. § 65-01-02(10)(a)(6)

for when a physical injury is at least 50 percent of the cause of the mental or 

psychological condition and defining what the phrase “other contributing 

causes” includes. At the time relevant here, N.D. Admin. Code § 92-01-02-02.5

(2018), which WSI adopted to implement N.D.C.C. § 65-01-02, provided:

As used in subparagraph 6 of subdivision a of subsection 10 of 

North Dakota Century Code section 65-01-02:

1. “A mental or psychological condition” must be directly 

caused by a physical injury. To be directly caused it must 

be shown with objective medical evidence that the mental 

or psychological condition is the physiological product of 

the physical injury.

2. “Other contributing causes” include emotional 

circumstances that generally accompany work-related 

injuries, such as the loss of function, loss of self-esteem, 

loss of financial independence, divorce, loss of career or 

employment position, disruption to lifestyle or family 

units, anxiousness, uncertainty, or compromised ability to 

participate in lifestyles, hobbies, or pastimes.

(Emphasis added.) 

A

[¶12] Properly promulgated administrative rules have the force and effect of 

law. N.D.C.C. § 28-32-06. An administrative rule that exceeds or supersedes 

an agency’s statutory authority or conflicts with the statute it implements, 

however, is void or invalid. Sloan v. N.D. Workforce Safety & Ins., 2011 ND 

194, ¶ 10, 804 N.W.2d 184 (citing N.D. Dep’t of Human Servs. v. Ryan, 2003 

ND 196, ¶ 10, 672 N.W.2d 649; Little v. Tracy, 497 N.W.2d 700, 704 (N.D. 1993); 

Moore v. N.D. Workmen’s Comp. Bureau, 374 N.W.2d 71, 74 (N.D. 1985); Steele 

v. N.D. Workmen’s Comp. Bureau, 273 N.W.2d 692, 701 (N.D. 1978)). “Whether 

an administrative agency has acted within its statutory authority presents a 

question of law, which is fully reviewable on appeal.” Sloan, at ¶ 10.
6

[¶13] An administrative agency is bound by its own duly issued regulations 

and has a reasonable range of informed discretion. Martin v. Stutsman Cnty. 

Soc. Servs., 2005 ND 117, ¶ 13, 698 N.W.2d 278. Administrative regulations, 

as derivatives of statutes, are construed under well-established principles for 

statutory construction. Sloan, 2011 ND 194, ¶ 14. Statutory construction 

requires related provisions to be interpreted together, when possible, to 

harmonize and give meaning to each provision. See id.; Martin, at ¶ 13.

[¶14] While not identified as a separate issue on appeal, Provins appears to 

suggest the phrase “directly caused by” a physical injury in N.D. Admin. Code 

§ 92-01-02-02.5 is at odds or inconsistent with the language of N.D.C.C. § 65-

01-02(10)(a)(6), providing compensability for mental or psychological 

conditions when the physical injury is at least 50 percent of “the cause of the 

condition.” Provins contends WSI’s promulgation of N.D. Admin. Code § 92-01-

02-02.5, requiring proof the “mental or psychological condition is the 

physiological product of the physical injury,” alters and grafts additional 

language onto the statutory non-compensability subsection, N.D.C.C. § 65-01-

02(10)(b)(10), which only denies mental injury claims arising from mental 

stimulus. Provins contends WSI’s rule is inconsistent with the coverage for 

mental injuries under N.D.C.C. § 65-01-02(10)(a)(6) and argues the rule’s 

wholesale denial of “all” mental injury claims cannot be the legislature’s intent. 

[¶15] The plain language of N.D.C.C. § 65-01-02(10)(a)(6) necessarily 

contemplates limited compensability for a mental or psychological condition

because “the physical injury” must be determined with reasonable medical 

certainty to be at least 50 percent of the “cause of the condition.” As explained 

in Davenport, 2013 ND 118, ¶ 17, for a mental or psychological condition to be 

compensable, N.D.C.C. § 65-01-02(10)(a)(6) “requires a physical injury to be at 

least 50 percent of the cause of a mental or psychological condition,”

“contemplates a comparative assessment of other causes contributing to a 

mental or psychological condition,” and “authorizes benefits only when at least 

a 50 percent causal connection exists between the claimant’s physical injury 

and mental or psychological condition.” (Emphasis added.)
7

[¶16] In determining the requisite “50 percent causal connection” for 

compensability, WSI’s administrative rule provides the claimant’s physical 

injury must “directly cause” the mental or psychological condition. See N.D. 

Admin. Code § 92-01-02-02.5(1); see also Davenport, 2013 ND 118, ¶ 17. WSI’s 

rule clarifies the “at least 50 percent causal connection” required under 

N.D.C.C. § 65-01-02(10)(a)(6) does not include indirect or indeterminate causes 

of a mental or psychological condition; but rather, to be “directly caused by,” 

the “objective medical evidence” must show “the mental or psychological 

condition is the physiological product of the physical injury.” N.D. Admin. Code 

§ 92-01-02-02.5(1) (emphasis added). Under N.D.C.C. § 65-01-02(10)(a)(6), 

therefore, the requisite “50 percent causal connection” that a claimant must 

prove focuses on the claimant’s physical injury as the direct cause of the 

claimed mental or psychological condition, as opposed to other indirect or 

indeterminate causes of the condition. 

[¶17] On the basis of our review, and consistent with our Davenport decision, 

we conclude the phrase “directly caused by,” as used in N.D. Admin. Code § 92-

01-02-02.5, is not at odds or inconsistent with the “cause of the condition”

language in N.D.C.C. § 65-01-02(10)(a)(6), for purposes of determining 

compensability.

B

[¶18] Provins argues that his PTSD is a compensable mental injury arising 

from his physical injury, rather than a noncompensable mental injury arising 

from mental stimulus.

[¶19] Provins asserts that he did not experience a mere mental stimulus 

unconnected to a physical injury and that N.D.C.C. § 65-01-02(10)(a)(6) 

provides coverage for mental injury “caused by a physical injury.” He argues 

that, when read together and harmonized, the clear meaning of the statutes is 

to exclude coverage “only when there is no underlying physical injury” that is 

the proximate cause of the mental injury. He asserts that this interpretation is 

consistent with the WSI’s expert’s “initial” opinion and that his PTSD was 

triggered by an ensuing “cortisol rush” when he was crushed and pinned 
8

underneath a heavy trailer. He asserts the crush injury is the “proximate 

cause” of the nightmares and episodic flashbacks that is PTSD.

[¶20] Provins further argues that he and the doctors have not identified any 

separate mental stressors severable from his physical injury that contributed 

to his PTSD and that WSI’s re-focusing on the injuries “in and of themselves” 

is not a valid legal theory. He asserts that the evidence shows his physical 

crush injury is not simply incidental and that he would not have developed 

PTSD apart from the crush injury. He contends that the question is whether 

the physical injury is the “proximate cause” of the mental injury and that his 

PTSD is compensable because the physical injury caused him to suffer the 

nightmares and episodic flashbacks.

[¶21] WSI responds, however, that Provins’s position would result in 

compensability of mental or psychological conditions whenever there is a “nonincidental physical injury” and the mental or psychological condition is at least 

50 percent caused by the mere fact a work event occurred. WSI asserts that 

there is no dispute Provins’s claimed physical injuries have resolved and he no 

longer claims entitlement to any benefits, except in relation to PTSD; in other 

words, there no longer remains any physical injury.

[¶22] Here, the ALJ found there was no dispute that Provins suffers from 

PTSD or that his PTSD was caused by the work incident. The ALJ correctly 

observed, however, that the issue is whether his PTSD was caused by his 

physical injuries. In resolving this issue, the ALJ addressed the two specific 

arguments presented by Provins: 1) that his PTSD was caused by the physical 

injuries because it is impossible to separate the physical injuries from the 

PTSD; and 2) that PTSD is a physical injury to the brain because it alters the 

pathways between the amygdala, cingulate cortex, and hippocampus. The ALJ 

ultimately found that Provins’s physical injuries did not cause his PTSD, 

explaining as follows:

Absent finding PTSD a physical injury, the physical injuries 

suffered by Provins include a scalp contusion, contusion and strain 

of the thorax, rib injuries, and a contusion of the liver. While 

differing on the phraseology, the doctors providing opinions in this 
9

case all agreed PTSD is caused by exposure to a life-threatening 

incident. There is no dispute that the life-threatening event which 

triggered the PTSD and the physical injuries such as broken ribs 

and liver contusion stem from work incident—Provins being 

caught under a 2,000 pound trailer. However, the greater weight 

of the evidence does not show that the PTSD was caused by the 

actual physical injuries. In other words, Provins would likely still 

have PTSD even if he did not suffer broken ribs and contusion of 

the liver.

Regarding Provins[’s] second argument, neither statute, nor 

WSI’s rules, define the term “physical injury.” According to 

[Provins’s expert Dr.] Swenson, the “physical injury” would be 

damage to the amygdala, cingulate cortex, and hippocampus and 

the pathways between those parts of the brain. The evidence of 

this damage are the symptoms Provins suffers. When applying the 

definition of a compensable injury to this case, it’s clear the 

“mental or psychological condition” is PTSD. Interpreting the

damage to the brain as the statutorily required “physical injury” 

would mean PTSD is always compensable. . . . If the legislature 

intended to consider PTSD, or similar mental and psychological 

conditions, a physical injury, there would be no need for N.D.C.C. 

§§ 65-01-[02](11)(a)(6) and 65-01-[02](11)(b)(10) [formerly N.D.C.C.

§§ 65-01-02(10)(a)(6) and 65-01-02(10)(b)(10)]. Clarity could be 

provided to the statute by defining the term “physical injury.” 

However, the legislature chose to use two terms and for each term 

to have meaning, the terms must mean something different. 

“Physical injury” must refer to an injury other than the “mental or 

psychological condition.”

The ALJ held Provins’s PTSD was not compensable because the ALJ found his 

physical injuries—i.e., scalp contusion, broken ribs, and liver contusion—did 

not cause his PTSD. The ALJ concluded the law requires a link to the physical 

injury and not merely the work incident. The ALJ found Provins failed to 

establish with sufficient medical evidence that his physical injuries caused his 

PTSD. 

[¶23] Although Provins claims on appeal that his physical injuries need only 

be a “proximate cause” of his PTSD, the requisite “causal connection” under 

N.D.C.C. § 65-01-02(10)(a)(6) requires his physical injuries to be at least 50 

percent of the cause of his PTSD, contemplating a comparative assessment of 
10

other causes contributing to his PTSD. See Davenport, 2013 ND 118, ¶ 17. In 

establishing “at least a 50 percent causal connection,” N.D. Admin. Code § 92-

01-02-02.5 provides his physical injuries must “directly cause” his PTSD, 

meaning “objective medical evidence” must show his PTSD is the physiological 

product of his physical injuries.

[¶24] Provins essentially asks this Court to reweigh the evidence about the 

“causal connection” between his physical injuries and his PTSD. On this record 

and under our deferential standard of review, we conclude a reasoning mind 

reasonably could conclude Provins failed to establish the requisite causal 

connection between his physical injuries and his PTSD, as compared with all 

other contributing causes. We conclude the ALJ’s findings are supported by a 

preponderance of the evidence and support the ALJ’s conclusion denying his 

claim for benefits for his PTSD. We affirm WSI’s denial of Provins’s claim for 

benefits for his PTSD.

IV

[¶25] Provins argues that he is entitled to disability benefits because he was 

terminated at a time he was not medically released for work and for pretextual 

reasons. Section 65-05-08, N.D.C.C. (2018), addresses disability benefits, 

providing in relevant part:

6. It is the burden of the employee to show that the inability to 

obtain employment or to earn as much as the employee earned 

at the time of injury is due to physical limitation related to the 

injury, and that any wage loss claimed is the result of the 

compensable injury.

7. If the employee voluntarily limits income or refuses to accept 

employment suitable to the employee’s capacity, offered to or 

procured for the employee, the employee is not entitled to 

disability or vocational rehabilitation benefits during the 

limitation of income or refusal to accept employment unless the 

organization determines the limitation or refusal is justified.

[¶26] Provins argues WSI’s order is conclusory and offers little explanation of

the actual grounds used to deny disability benefits. He rejects that his 

disability is caused by a noncompensable PTSD, contending that if his PTSD 
11

is compensable, he is entitled to disability because his doctor had taken him 

off work in October 2019 because of his PTSD. Provins further contends he was 

not terminated from his employment for cause and was terminated for 

pretextual reasons. He asserts his termination in November 2019 occurred 

before he had been medically released for work and his employer had confirmed 

it had no work for him. He asserts his termination in the midst of total 

disability from PTSD is a “subterfuge defense” to nonpayment of disability to 

which he is entitled.

[¶27] Here, because the ALJ initially concluded Provins’s PTSD was not 

compensable, the ALJ did not address whether he was entitled to benefits after 

November 2019 due to his termination from employment. In the ALJ’s 

subsequent order on reconsideration, the ALJ reiterated that this issue is moot 

but may be relevant if his PTSD is held to be compensable on appeal. The ALJ 

found the greater weight of the evidence establishes Provins voluntarily 

limited his income and his termination for cause in November 2019 “was not 

related to his work injury or work restrictions.” The ALJ found the termination 

was because of his ongoing issues with his previous supervisor.

[¶28] Because we affirm the ALJ’s conclusion that Provins’s PTSD is not 

compensable, we therefore agree with the ALJ’s determination that this issue 

is moot.

V

[¶29] We have considered Provins’s remaining arguments and conclude they 

are either without merit or unnecessary to our decision. The judgment is 

affirmed.

[¶30] Jon J. Jensen, C.J.

Gerald W. VandeWalle

Daniel J. Crothers

Lisa Fair McEvers

Jerod E. Tufte