65-05-08.1. Verification of disability

65-05-08.1. Verification of disability 1. An injured employee's health care provider shall certify the period of disability and the extent of the injured worker's abilities and restrictions. 2. A health care provider certifying disability shall include in the report filed with the organization: a. The medical basis established by medical evidence supported by objective medical findings for the certification of disability; b. Whether the employee is totally disabled, or, if the employee is not totally disabled, whether the employee is able to return to any employment, and a statement of the employee's restrictions and physical limitations; and c. A professional opinion as to the expected length of, and reason for, the disability. 3. A health care provider may not certify or verify past disability commencing more than sixty days before the health care provider's examination of the employee. 4. The report must be filed on a form furnished by the organization, or on any other form acceptable to the organization. 5. The injured employee shall ensure the required reports for any period of disability are filed. 6. Prior to the expiration of a period of disability certified by a health care provider, if a report certifying an additional period of disability has not been filed, or upon receipt of a report or other evidence indicating an injured employee who is receiving disability benefits has been or will be released to return to work, the organization shall send a notice to that employee of the organization's intention to discontinue benefits, including an explanation of the reason for discontinuing benefits, an explanation of the injured employee's right to respond, and the procedure for filing the required report or challenging the proposed action. Thereafter, if the required certification is not filed, the organization shall discontinue disability benefits, effective twenty-one days after the date the notice of intention to discontinue benefits is mailed or the date on which the injured employee actually returned to work, whichever occurs first.