North Dakota Administrative Code › Title 92 - Workforce Safety and Insurance › Article 92-01 - General Administration › Chapter 92-01-02 - Rules of Procedure - North Dakota Workers' Compensation Act › Section 92-01-02-25 - Permanent impairment evaluations and disputes

Current through Supplement No. 393, July, 2024
1.
				Definitions:
a. Amputations and loss as used
				in subsection 11 of North Dakota Century Code section 65-05-12.2.
"Amputation of a thumb" means disarticulation at the
				  metacarpal phalangeal joint.
"Amputation of the second or distal phalanx of the thumb"
				  means disarticulation at or proximal to the interphalangeal joint.
"Amputation of the first finger" means disarticulation at the
				  metacarpal phalangeal joint.
"Amputation of the middle or second phalanx of the first
				  finger" means disarticulation at or proximal to the proximal interphalangeal
				  joint.
"Amputation of the third or distal phalanx of the first
				  finger" means disarticulation at or proximal to the distal interphalangeal
				  joint.
"Amputation of the second finger" means disarticulation at
				  the metacarpal phalangeal joint.
"Amputation of the middle or second phalanx of the second
				  finger" means disarticulation at or proximal to the proximal interphalangeal
				  joint.
"Amputation of the third or distal phalanx of the second
				  finger" means disarticulation at or proximal to the distal interphalangeal
				  joint.
"Amputation of the third finger" means disarticulation at the
				  metacarpal phalangeal joint.
"Amputation of the middle or second phalanx of the third
				  finger" means disarticulation at or proximal to the proximal interphalangeal
				  joint.
"Amputation of the fourth finger" means disartriculation at
				  the metacarpal phalangeal joint.
"Amputation of the middle or second phalanx of the fourth
				  finger" means disarticulation at or proximal to the proximal interphalangeal
				  joint.
"Amputation of the leg at the hip" means disarticulation at
				  or distal to the hip joint (separation of the head of the femur from the
				  acetabulum).
"Amputation of the leg at or above the knee" means
				  disarticulation at or proximal to the knee joint (separation of the femur from
				  the tibia).
"Amputation of the leg at or above the ankle" means
				  disarticulation at or proximal to the ankle joint (separation of the tibia from
				  the talus).
"Amputation of a great toe" means disarticulation at the
				  metatarsal phalangeal joint.
"Amputation of the second or distal phalanx of the great toe"
				  means disarticulation at or proximal to the interphalangeal joint.
"Amputation of any other toe" means disarticulation at the
				  metatarsal phalangeal joint.
"Loss of an eye" means enucleation of the eye.
b. "Maximum medical improvement"
				means the injured employee's recovery has progressed to the point where
				substantial further improvement is unlikely, based on reasonable medical
				probability and clinical findings indicate the medical condition is
				stable.
c. "Medical dispute" means
				an employee has reached maximum medical improvement in connection with a work
				injury and has been evaluated for permanent impairment, and there is a
				disagreement between health care providers arising from the physical evaluation
				that affects the amount of the award. The dispute to be reviewed must clearly
				summarize the underlying medical condition. It does not include disputes
				regarding proper interpretation or application of the American medical
				association guides to the evaluation of permanent impairment, sixth edition. It
				does not include disputes arising from an impairment percentage rating or an
				impairment opinion given by a health care provider when the health care
				provider is not trained in the American medical association guides to the
				evaluation of permanent impairment, sixth edition, and when the health care
				provider's impairment percentage rating or impairment opinion do not meet the
				requirements of subsection 5 of North Dakota Century Code section
				65-05-12.2.
d. "Potentially
				eligible for an impairment award" means the medical evidence in the claim file
				indicates an injured employee has reached maximum medical improvement and has a
				permanent impairment caused by the work injury that will likely result in a
				monetary impairment award.
e.
				"Treating health care provider" means an allied health care professional who
				has physically examined or provided direct care or treatment to the injured
				employee.