Evidence status: CURRENT WSI COVERAGE AND MONITORING FRAMEWORK. North Dakota WSI ties chronic-opioid payment to recurring documentation, functional benefit, treatment compliance, and random drug testing.
Every 90 days
The prescriber must provide WSI documentation of the effectiveness of chronic opioid therapy at least every 90 days. The documentation must address improvement in function or improvement in pain control without debilitating side effects.
Random drug testing
At the request of the prescriber or WSI, an injured employee receiving chronic opioid therapy is subject to random drug testing for prescribed and illicit substances. Failure of the test or failure to comply with the request in a timely manner may result in termination of chronic-opioid coverage.
Agreement compliance
The injured employee must comply with the treatment protocol. Failure to comply with any condition in §65-05-39 may result in termination of WSI coverage for chronic opioid therapy.
WSI’s current policy mirrors the statute
WSI’s current public Chronic Opioid Therapy policy repeats the statutory requirements and identifies the treatment agreement as a document the prescriber must provide to WSI. The policy states that the agreement restricts treatment access and limits prescriptions to one identified prescriber.
Separate ongoing-opioid management guidance
WSI also publishes an Ongoing Management of Opioids policy describing continuing assessment of analgesia, activities of daily living, adverse effects, and aberrant drug-related behavior. That clinical guidance supports documentation and monitoring but should not be confused with the statutory agreement itself.
Primary sources
Reviewed: October 4, 2026.