SAN FRANCISCO -- Workers' compensation insurance carriers and self insured employers in California will be relieved of a substantial amount of required paperwork as the state's new Workers' Compensation Information System begins phasing into operation on March 1, the Department of Industrial Relations (DIR) has announced.
The new information system, developed and administered by DIR's Division of Workers' Compensation (DWC), will electronically gather data on all workers' compensation claims filed in California from the first report of injury through to conclusion of the case. It will, for the first time, provide an overview of operations of the state's workers' compensation system, allowing policymakers to track its performance and determine the need for further improvements.
It is estimated that eventually millions of paper forms that are currently filed with the department -- which then processes and stores them -- will be eliminated. The first paper reports to be replaced by electronic filing will be the Employer's Report of Occupational Injury or Illness (Form 5020), a one-page form that is sent to DIR's Division of Labor Statistics and Research.
This is the form employers fill out and file with their workers' compensation insurance carrier to comply with the state Labor Code requirement that they report every job-related injury or illness that results in lost work time or which requires medical treatment beyond first aid.
As of March 1, insurance carriers, self insured employers, and their claims administrators are beginning to submit this data electronically into the new Workers' Compensation Information System.
According to an interpretive bulletin signed by DIR Chief Deputy Director Daniel M. Curtin, this meets the requirements of the State Labor Code Section 6409.1 and California Code of Regulations Section 14001, which state that the data may be filed by submitting the paper form or "by use of computer input media prescribed by the Division and compatible with the Division's computer equipment."
Ultimately it is expected that many employers will take advantage of paperless reporting by submitting the required data to their insurance carrier electronically, and the carrier will then merely resubmit the electronic file to the Workers' Compensation Information System.
In addition, the new electronic information system will, in the future, relieve health care organizations (HCOs) certified by the Division of Workers' Compensation of some their mandated reporting requirements as well.
HCOs are required to report information regarding health care delivered to injured workers, as specified in Section 9778 of Title 8, California Code of Regulations, to DWC. Under these recently revised regulations, an HCO will no longer be required to provide the duplicative information once the claims administrator begins reporting this data electronically. They must still report all other required information to the Division.
HCOs are medical care providers who contract with insurers and employers to treat injured workers in a managed care setting.
More than 75 organizations have already begun the process of connecting to the new system, in advance of the March 1 reporting deadline. Seven claims administrators have completed all testing and have "fully demonstrated their ability to transmit complete, valid, accurate data" to the system. The early adapters are: AIG Claim Services, Inc. of Chicago, IL; Kemper Insurance Company of Long Grove, IL; Liberty Mutual Insurance Group of Portsmouth, NH; RSKCO Claims Services of Chicago, IL; State Farm Insurance of Thousand Oaks, CA; Gallagher Basset Services, Inc. of Ithaca, IL; and ICW Group of Irvine, CA.
Implementation of the Workers' Compensation Information System was mandated by legislation that was part of the 1993 reforms of the state's workers' compensation system. It utilizes recognized national standards for data interchange established by the International Association of Industrial Accident Boards and Commissions.
One of the state's first forays into electronic e-government, California's system will be one of the most flexible in the country, allowing a variety of ways to transmit data, including via the internet and commercial value added networks, and in a number of file formats. Unlike comparable systems in other states, California's system is designed to support any third party Electronic Data Interchange vendors that meet the national standards.
The system has strong security provisions in place to keep the data private, and the legislation mandating the system includes clear guarantees that the data will be confidential. Access to individually identifiable data is provided - beyond DIR - only to the state Department of Health Services and to independent researchers who can assure that the data will be kept confidential.
Further information about the WCIS can be found by visiting the DIR Web site at http://www.dir.ca.gov/DWC/WCIS.htm.