On the job for Core Mark International, Inc., delivery driver Oak Reile’s life changed in an instant. A fall from a loading ramp resulted in a fractured cervical spine. The diagnosis was catastrophic: quadriplegia. He was airlifted to a specialized spinal cord injury unit in Colorado. North Dakota’s Workforce Safety and Insurance (WSI) initially did its job, approving benefits for the purely physical damage: the broken vertebrae, the paralysis, the loss of bladder and bowel control.

But when the inevitable psychological fallout arrived, the system that was supposed to protect him became his adversary. A year after the accident, Reile sought treatment for adjustment disorder with depressed mood, a predictable consequence of having his life and body irrevocably altered. WSI denied the claim. The agency deployed a bureaucratic weapon of its own making to ensure Reile’s suffering remained uncovered.

THE BUREAUCRATIC TRAP

WSI did not argue that Reile’s depression was unrelated to his work injury. Instead, they hid behind a regulation they created themselves, N.D. Admin. Code § 92-01-02-02.5. State law passed by the legislature simply required a “causal connection” between a work injury and the condition. WSI’s rule went much further. It created a new, far stricter test, demanding proof that a psychological condition was the direct “physiological product of the physical injury.”

This rule created an impossible catch-22. WSI defined things that “generally accompany work-related injuries,” such as “loss of function,” “disruption to lifestyle,” and “compromised ability,” as “other contributing causes” that could *not* be the basis for a claim. In essence, WSI argued that if you are depressed because you are paralyzed and your life has been shattered, that doesn’t count. They severed the obvious connection between a physical catastrophe and its emotional consequences, creating a legal fiction to deny coverage.

Even the Administrative Law Judge (ALJ) who first heard the case was caught in this trap. The ALJ explicitly stated that Reile’s condition *was* caused by his work injury and that he *was* entitled to benefits under the actual state law. But because of WSI’s fabricated rule, the judge was forced to affirm the denial. The system admitted Reile deserved help but was bound by illegal red tape.

THE NON-FINANCIAL LEDGER

This fight was never just about paying for therapy. It was about dignity. WSI’s actions added an immense layer of bureaucratic and legal trauma on top of an already unimaginable physical and psychological burden. A state agency, whose entire purpose is to provide safety and insurance to the workforce, actively worked to invalidate an injured worker’s suffering.

They told a man confined to a wheelchair, dealing with the daily realities of quadriplegia, that his mental anguish was not a legitimate part of his injury. They forced him and his family through reconsideration, a formal hearing, a district court appeal, and finally a Supreme Court case. This is a war of attrition. The unspoken goal is to make the process so grueling that workers simply give up.

MANUFACTURING A “NO”

To justify its denial, WSI sought an “independent” medical review from a Dr. Joseph Burgarino. The agency’s letter to the doctor was not a neutral request for an opinion. It was a set of instructions. WSI quoted its own illegal regulation, guiding the doctor to separate the physical spinal cord injury from the emotional reaction to it.

Dr. Burgarino followed the instructions perfectly. He opined that the “physiological cause” of the depression was “0%,” stating that damaged neurons could not “in and of themselves create Mr. Reile’s depressive conditions.” Instead, he identified the causes as “significant grief related to the loss of sensory and motor function” and “overwhelming stress.”

In a later deposition, the doctor admitted Reile’s condition was “one hundred percent” the result of the “work injury and the spinal cord damage.” He then immediately back-pedaled, clarifying he meant it was a reaction to the “overwhelming stress.” This nonsensical distinction is the direct result of WSI’s coaching, forcing a medical professional to contort his diagnosis to fit a legally invalid framework.

LEGAL RECEIPTS

SOCIETAL IMPACT MAPPING

Public Health

WSI’s strategy creates a dangerous public health precedent. By arbitrarily separating mental health from physical health, it ensures that workers suffering from job-related trauma are denied comprehensive care. This leads to worse outcomes, longer recovery periods, and a greater burden of untreated mental illness in the community. It tells every worker in North Dakota that if they suffer a life-altering injury, they are on their own when it comes to the mental toll.

Economic Inequality

This is a blueprint for how institutions grind down individuals. Oak Reile had to secure legal representation and fight his case all the way to the state’s highest court, a process that takes years and significant resources. How many other injured workers, lacking those resources, have been denied benefits by this illegal rule and simply gave up? This tactic ensures the system only serves those who can afford to fight it, cementing a two-tiered system of justice for the working class.

THE COST OF DENIAL

WHAT NOW?

Oak Reile won his case. The Supreme Court declared WSI’s rule invalid. But the agency that created it still exists, and the corporate entities that benefit from these denials are still operating. Accountability is critical.

• CORPORATE ACTORS:

  The leadership of North Dakota Workforce Safety and Insurance who promulgated and defended this illegal rule. The employer of record is Core Mark International, Inc.

• WATCHLIST:

  Monitor the North Dakota Legislature to ensure they do not attempt to pass a new law that mirrors WSI’s invalid rule. Keep a close eye on other state-level Workers’ Compensation Boards; this tactic could be replicated elsewhere.

• THE RESISTANCE:

  The fight against bureaucratic overreach happens at the local level. Support legal aid organizations that represent injured workers. Organize mutual aid networks to provide financial and emotional support for those navigating these hostile systems. Demand transparency and accountability from the state agencies funded by your tax dollars. They work for you, not the other way around.