Footwear

1. An order is required from the primary health care provider with documentation of objective medical evidence that supports the necessity for purchase of footwear directly due to the compensable work injury. a. The order must be obtained and submitted to the organization prior to consideration of purchase. b. The order must include the date of an in-person office visit that coincides with the date of the order and a specific description of the footwear being requested. 2. The organization shall purchase one pair of footwear per claim during the acute rehabilitation phase. 3. The organization shall pay a medical service provider for modifications to regular footwear purchased by an injured employee after a billing is received by the medical service provider if the modifications are due to the work injury and there is objective medical evidence to support the necessity of the modifications. 4. Custom orthotic inserts and custom-made medical orthotic shoes must be preapproved by the organization. There must be objective medical evidence to support custom orthotic inserts and custom-made medical orthotic shoes must be a necessity due to the work injury. 5. The organization shall approve the footwear prior to purchase. If the footwear is approved, the organization shall pay the medical service provider after a billing is received. The organization may not prepay an injured employee to purchase footwear and may not place orders for footwear for an injured employee. 6. An appeal of a decision made by the organization under this section must be adjudicated pursuant to North Dakota Century Code section 65-02-20.