Whedbee v. North Dakota Workforce Safety & Insurance Fund, 845 N.W.2d 632

Dennis Whedbee suffered a compensable below‑the‑elbow left arm amputation in an oil‑rig explosion and sought a myoelectric prosthesis; WSI approved a body‑powered prosthesis instead.
Whedbee was treated in Pennsylvania by Dr. Marshall Balk, who recommended a myoelectric device as beneficial for daily activities and durable enough for work.
WSI obtained an independent medical examination by Dr. Ronald Bateman (Edina, MN), who recommended a body‑powered prosthesis citing durability, cost, shoulder strain, and environmental susceptibility of myoelectric devices.
WSI denied the myoelectric prosthesis as not the most cost‑effective option; the binding dispute resolution panel affirmed WSI’s decision.
The district court affirmed; Whedbee appealed arguing abuse of discretion, due process violations (no oath/testimony, no ALJ, committee decision), improper IME location, and that his treating physician’s opinion should control.
The Supreme Court of North Dakota affirmed WSI: no abuse of discretion, no due process violation, no prejudice from IME location, and statutory provisions preclude giving the treating‑physician rule effect in managed care decisions.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether WSI’s denial of a myoelectric prosthesis was an abuse of discretion	Whedbee: myoelectric is medically appropriate and cost‑effective	WSI: body‑powered prosthesis is the best medical solution in a cost‑effective manner based on medical reviews	Not an abuse of discretion; decision rational and supported by medical opinions
Whether Whedbee’s due process rights were violated by the managed‑care review process	Whedbee: lack of sworn testimony, no ALJ, committee decision denied procedural protections	WSI: statute vests broad discretion; no termination of benefits and no property interest in a particular device	No due process violation; no protected property interest and procedure excluded by statute
Whether WSI erred by using an IME located out of state (Edina, MN)	Whedbee: IME too far from his Pennsylvania residence; prejudiced his case	WSI: statute requires reasonable effort to select in‑state or within 275 miles; no record of objection or prejudice	No prejudice shown; Whedbee failed to show statutory violation harmed him
Whether the treating physician’s opinion should control over the IME	Whedbee: treating physician Balk should be given controlling weight or WSI must explain weight assigned	WSI: statutory treating‑physician weight rule does not apply to managed care decisions under N.D.C.C. § 65‑02‑20	Treating‑physician rule inapplicable to managed care; Whedbee failed to show controlling weight required

Sonsthagen v. Sprynczynatyk, 663 N.W.2d 161 (N.D. 2003) (defines abuse of discretion standard for hearing officers)
Sloan v. N.D. Workforce Safety & Ins., 804 N.W.2d 184 (N.D. 2011) (decision arbitrary if not product of rational mental process)
Ennis v. Williams Cnty. Bd. of Comm’rs, 493 N.W.2d 675 (N.D. 1992) (statutory discretion and property‑interest analysis for due process)
Whitecalfe v. N.D. Dept. of Transp., 727 N.W.2d 779 (N.D. 2007) (two‑step due process inquiry: property interest and procedural adequacy)
Drayton v. Workforce Safety & Ins., 756 N.W.2d 320 (N.D. 2008) (due process considerations when terminating continuing benefits)
Johnson v. N.D. Workers Comp. Bureau, 539 N.W.2d 295 (N.D. 1995) (prejudice requirement when statutory remedies are absent)
Mathews v. Eldridge, 424 U.S. 319 (U.S. 1976) (three‑factor due process balancing test)