25.0544.02000
Sixty-ninth
Legislative Assembly
of North Dakota
Introduced by
Senators Rummel, Cleary, Hogue
Representatives Lefor, Ista
A BILL for an Act to create and enact a new section to chapter 65-05 of the North Dakota
Century Code, relating to posttraumatic stress disorder duration limits; to amend and reenact
subsection 11 of section 65-01-02 of the North Dakota Century Code, relating to workers'
compensation coverage for posttraumatic stress disorder; to provide for application; and to
provide an expiration date.
BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
SECTION 1. AMENDMENT. Subsection 11 of section 65-01-02 of the North Dakota Century
Code, as effective through August 31, 2028, is amended and reenacted as follows:
11."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.
a.The term includes:
(1)Disease caused by a hazard to which an employee is subjected in the
course of employment. The disease must be incidental to the character of
the business and not independent of the relation of employer and employee.
Disease includes effects from radiation.
(2)An injury to artificial members.
(3)Injuries due to heart attack or other heart-related disease, stroke, and
physical injury caused by mental stimulus, but only when caused by the
employee's employment with reasonable medical certainty, and only when it
is determined with reasonable medical certainty that unusual stress is at
least fifty percent of the cause of the injury or disease as compared with all
other contributing causes combined. Unusual stress means stress greater
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SENATE BILL NO. 2181
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than the highest level of stress normally experienced or anticipated in that
position or line of work.
(4)Injuries arising out of employer-required or supplied travel to and from a
remote jobsite or activities performed at the direction or under the control of
the employer.
(5)An injury caused by the willful act of a third person directed against an
employee because of the employee's employment.
(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.
(7)Posttraumatic stress disorder, if the injured employee establishes by a
preponderance of the evidence that the condition causing the posttraumatic
stress disorder was extraordinary, based on unusual stress of a greater
dimension than the day-to-day emotional strain and tension experienced by
similarly situated employees.
(a)The mental injury must be:
[1]Diagnosed by a licensed psychiatrist or psychologist;
[2]Meet the criteria established in the "Diagnostic and Statistical
Manual of Mental Disorders", American psychiatric association,
(5th edition, text revision 2022);
[3]Determined not to pre - exist the employment event; and
[4]Determined with reasonable medical certainty to be at least fifty
percent of the cause as compared to all other contributing
causes combined.
(b)The mental injury may not be the result of any of the following actions
taken in good faith by an employer:
[1]A disciplinary action;
[2]A work evaluation;
[3]A job transfer;
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[4]A layoff;
[5]A demotion; or
[6]A termination.
b.The term does not include:
(1)Ordinary diseases of life to which the general public outside of employment
is exposed or preventive treatment for communicable diseases, except the
organization may pay for preventive treatment for an exposure to a
bloodborne pathogen as defined in section 23-07.5-01 occurring in the
course of employment and for exposure to rabies occurring in the course of
employment.
(2)A willfully self-inflicted injury, including suicide or attempted suicide, or an
injury caused by the employee's willful intention to injure or kill another.
(3)Any injury caused by the use of intoxicants, including recreational marijuana
use, or the illegal use of controlled substances.
(4)An injury that arises out of an altercation in which the injured employee is an
aggressor. This paragraph does not apply to public safety employees,
including law enforcement officers or private security personnel who are
required to engage in altercations as part of their job duties if the altercation
arises out of the performance of those job duties.
(5)An injury that arises out of an illegal act committed by the injured employee.
(6)An injury that arises out of an employee's voluntary nonpaid participation in
any recreational activity, including athletic events, parties, and picnics, even
though the employer pays some or all of the cost of the activity.
(7)Injuries attributable to a pre-existing injury, disease, or other condition,
including when the employment acts as a trigger to produce symptoms in
the pre-existing injury, disease, or other condition unless the employment
substantially accelerates its progression or substantially worsens its
severity. Pain is a symptom and may be considered in determining whether
there is a substantial acceleration or substantial worsening of a pre-existing
injury, disease, or other condition, but pain alone is not a substantial
acceleration or a substantial worsening.
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(8)A nonemployment injury that, although acting upon a prior compensable
injury, is an independent intervening cause of injury.
(9)A latent or asymptomatic degenerative condition, caused in substantial part
by employment duties, which is triggered or made active by a subsequent
injury.
(10)AExcept as otherwise provided in subdivision a, a mental injury arising from
mental stimulus.
SECTION 2. AMENDMENT. Subsection 11 of section 65-01-02 of the North Dakota Century
Code, as effective after August 31, 2028, is amended and reenacted as follows:
11."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.
a.The term includes:
(1)Disease caused by a hazard to which an employee is subjected in the
course of employment. The disease must be incidental to the character of
the business and not independent of the relation of employer and employee.
Disease includes effects from radiation.
(2)An injury to artificial members.
(3)Injuries due to heart attack or other heart-related disease, stroke, and
physical injury caused by mental stimulus, but only when caused by the
employee's employment with reasonable medical certainty, and only when it
is determined with reasonable medical certainty that unusual stress is at
least fifty percent of the cause of the injury or disease as compared with all
other contributing causes combined. Unusual stress means stress greater
than the highest level of stress normally experienced or anticipated in that
position or line of work.
(4)Injuries arising out of employer-required or supplied travel to and from a
remote jobsite or activities performed at the direction or under the control of
the employer.
(5)An injury caused by the willful act of a third person directed against an
employee because of the employee's employment.
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(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.
(7)Posttraumatic stress disorder, if the injured employee establishes by a
preponderance of the evidence that the condition causing the posttraumatic
stress disorder was extraordinary, based on unusual stress of a greater
dimension than the day-to-day emotional strain and tension experienced by
similarly situated employees.
(a)The mental injury must be:
[1]Diagnosed by a licensed psychiatrist or psychologist;
[2]Meet the criteria established in the "Diagnostic and Statistical
Manual of Mental Disorders", American psychiatric association,
(5th edition, text revision 2022)
[3]Determined not to pre - exist the employment event; and
[4]Determined with reasonable medical certainty to be at least fifty
percent of the cause as compared to all other contributing
causes combined.
(b)The mental injury may not be the result of any of the following actions
taken in good faith by an employer:
[1]A disciplinary action;
[2]A work evaluation;
[3]A job transfer;
[4]A layoff;
[5]A demotion; or
[6]A termination.
b.The term does not include:
(1)Ordinary diseases of life to which the general public outside of employment
is exposed or preventive treatment for communicable diseases, except the
organization may pay for preventive treatment for an exposure to a
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bloodborne pathogen as defined in section 23-07.5-01 occurring in the
course of employment and for exposure to rabies occurring in the course of
employment.
(2)A willfully self-inflicted injury, including suicide or attempted suicide, or an
injury caused by the employee's willful intention to injure or kill another.
(3)Any injury caused by the use of intoxicants, including recreational marijuana
use, or the illegal use of controlled substances.
(4)An injury that arises out of an altercation in which the injured employee is an
aggressor. This paragraph does not apply to public safety employees,
including law enforcement officers or private security personnel who are
required to engage in altercations as part of their job duties if the altercation
arises out of the performance of those job duties.
(5)An injury that arises out of an illegal act committed by the injured employee.
(6)An injury that arises out of an employee's voluntary nonpaid participation in
any recreational activity, including athletic events, parties, and picnics, even
though the employer pays some or all of the cost of the activity.
(7)Injuries attributable to a pre-existing injury, disease, or other condition,
including when the employment acts as a trigger to produce symptoms in
the pre-existing injury, disease, or other condition unless the employment
substantially accelerates its progression or substantially worsens its
severity. Pain is a symptom and may be considered in determining whether
there is a substantial acceleration or substantial worsening of a pre-existing
injury, disease, or other condition, but pain alone is not a substantial
acceleration or a substantial worsening.
(8)A nonemployment injury that, although acting upon a prior compensable
injury, is an independent intervening cause of injury.
(9)A latent or asymptomatic degenerative condition, caused in substantial part
by employment duties, which is triggered or made active by a subsequent
injury.
(10)AExcept as otherwise provided in subdivision a, a mental injury arising from
mental stimulus.
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SECTION 3. A new section to chapter 65-05 of the North Dakota Century Code is created
and enacted as follows:
Posttraumatic stress disorder duration limits.
Disability benefits payable for posttraumatic stress disorder may not exceed:
1.Thirty-two weeks in duration from first report of injury; or
2.Two claims in an employee's lifetime.
SECTION 4. APPLICATION. This Act applies to injuries sustained on or after August 1,
2025.
SECTION 5. EXPIRATION DATE. This Act is effective through July 31, 2029, and after that
date is ineffective.
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