I can tell you a whole lot about why they are likely to decide whether it's "suitable" or "unsuitable." And that is the key word in that part that was quoted that said "customary."
In making the suitability/work refusal decisions, they look at what your last job was like. How far were you driving before, if we're going to mention commuting distance being a factor. If you were driving 85 miles each way to the job you had, or 120 miles each way, then when laid off, decide that a job that is 90 miles each way is going to be too far to drive, you more than likely will be found to have refused suitable work.
In other words, what is customary for you? It also has to do with the line of work you're in, and the state, and as you mention, ND is one of those states where long commutes is pretty customary, particularly in construction type work, where you must go where the job is, and frequently there's a lot of empty territory between places where there is anything at all.
But I was always surprised by the number of folks who'd come in and happily announce to us that now they'd been laid off from this job that was in another city, where they'd been driving 60 miles each way to get to it, and they were so sick of commuting, and from now on were never going to take a job more than 10 miles from their home. Reality orientation coming.
Also, pay rates are looked at in the light of two factors, first, what were you making on the last job, and second, how long have you been out of work. If the pay rate of your previous job was quite a bit more than this job you have been offered, and
you have been out of work only say six to eight weeks (some states have a sort of standard "don't bother people with lesser pay rates for about six weeks" policy, some less set) they're probably not going to decide this job you've refused is anywhere near your customary pay rate and you will probably not be considered having refused appropriate work if you don't accept it.
However, this is as I have said before a sliding scale of comparison. According to the federal regs, by the time a claimant had qualified for those old federal extensions they had for a few years back, they were supposed to be willing to accept any salary above minimum wage. Supposed to, though this was not frequently enforced, except in the southeastern states, where they are notoriously not claimant friendly.
But what it comes down to is that as you get further along in your claim, you are supposed to get less and less picky about the salary of that next job. Also, you must consider, as many people forget to, that when you have been working at a place for a long time, you have been given regular increases and bonuses as you became more valuable to your employer. To get another job, even in the same industry in an equivalent setting, you may have to take a wage that is less than what you were making after ten years on the job with your former employer. That's just reasonable.
The closer you get to the end of your claim, the more you should be realizing that this is ALL OVER, no matter whether you've found a job or not, there are no extensions, no need based unemployment program, even if you are on the streets. So you should be concentrating on what you DO want to do, not what you have to take and don't have to take. It doesn't hurt your cause a bit if, when discussing this job offer with the unemployment system, you can mention to them that you have a couple of closer, more reasonably salaried jobs that you're concentrating on, are hoping for offers from, etc. This shows them that you are making an appropriate job search.
Now, on the subject of your mental health and ability to work in a stressful situation. Holy cow!! All I can say is that you must not have mentioned this in any way to the unemployment system when you were laid off and signed up for benefits in the first place. If you now begin putting restrictions on yourself about a previously unmentioned mental health issue and turn down a job with a nice letter from your psychologist that you can't take it because it might "exasperate your mental health" situation, you are practically guaranteeing that you will be slapped with a medical form such as the one you mention finding on line, and the minute you produce that medical form giving you this restriction or that restriction, particularly something so general as something like how you can't take a job with lots of stress involved, you will be almost guaranteed to be taken off your benefits and possibly to be declared overpaid for all the benefits you have received before now.
You simply cannot draw unemployment benefits and restrict yourself to a job that doesn't cause you stress or exacerbate your health conditions. You can't, in fact, put a whole lot of health limitations on what you will and will not accept, particularly if you have been dealing with these health conditions while working your previous job successfully and have been failing to mention that you're restricting your job search to jobs that would be good for you mentally. Kiss of death is certainly accurate! Unemployment is not meant in any way as a disability program for people who are in any way restricted from their usual work.
That part in the law about the job not being a danger to your health and safety means they can't ask a sixty year old long term legal secretary to climb telephone poles. It doesn't mean you don't have to accept a job if you think it would make you nervous or cause your anxiety disorder to kick up.
Not sure there's need for a consultation with an unemployment attorney right now. As chyvan has mentioned, there has been no decision denying benefits or stopping the claim because of refusal of suitable work yet. Right now everything is still pending. The claimant has very limited input into the process. As I said, the best thing the claimant can do right now is assure the unemployment system that they are really looking diligently for more suitable work. Of course during this process, they are continuing to make their weekly certifications and job searches as required, and if the determination is made that they have not refused suitable work, they'll be backpaid for the weeks they've been suspended.