WCIS e.News
#10    December 12, 2000

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Occasional announcements and technical updates regarding
California's Workers' Compensation Information System (WCIS),
from the California Division of Workers' Compensation
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IAIABC Release 2 in California

The Division of Workers' Compensation is pleased to announce the capacity to support IAIABC Release 2 First and Subsequent Reports of Injury, in the IAIABC's proprietary "flat file" format. Installation and testing of our software has been successful and we encourage Trading Partners ready to transmit Release 2 flat files to submit their Trading Partner Profiles.

As described in WCIS e.News #9, the Release 2 standards continue to undergo testing and modification by the IAIABC. A few changes have been approved since the first version of Release 2 dated October 1998 and documented in the December 1999 guide. Additional changes have been proposed through Issue Resolution Requests and are currently being considered. Since California is programming to accept Release 2 files now, we have made choices about whether or not to implement changes not yet documented in the IAIABC's Implementation Guide. Additionally, our internal processing has imposed some constraints on Release 2 reporting. This WCIS e.News is intended to provide an overview of Release 2 implementation in California and describe modifications to the Release 2 standards we have adopted.

Interchange Version ID The WCIS will require First Reports of Injury and Subsequent Reports of Injury be transmitted in separate batches. The Interchange Version ID field identifies the Batch Type (type of transactions within a batch) and the Release Number (release level of records in batch). A First Report batch should contain the Batch Type Code of "FRI" and a Subsequent Report batch should contain the Code of "SRI". The Release Number remains as documented with a value of "02" for Release 2 files.

Originally the standards were written to accommodate separate or mixed batches of First Reports and Subsequent Reports. However, the only Batch Type Code was "148". A jurisdiction was unable to distinguish mixed batches from separate batches. By adding Batch Type Code values for First Reports and Subsequent Reports submitted separately, the standard adds flexibility. Some jurisdictions will allow mixed batches of transactions identified with the "148" Code. However, to improve and simplify processing, California will only accept separated batches. For history of the change, please see the IAIABC IRR 429.

Release 2 Data Elements On an interim basis, California has implemented Release 2 by translating Release 2 formatted files to an equivalent Release 1 file. Therefore, many Release 2 elements will not be edited and are considered optional until California revises its processing of Release 2 files. Any change in our processing will be announced well in advance and will not occur before July 2001. The Release 2 data elements that are considered optional are:

Rel. 2 DN#

  1. Release 2 Data Element Name

124

Actual Reduced Earnings

125

Benefit Adjustment End Date

126

Benefit Credit Code

127

Benefit Credit Start Date

128

Benefit Credit End Date

129

Benefit Credit Weekly Amount

145

Current Date Last Day Worked

146

Death Result of Injury Indicator

147

Deemed Reduced Earnings

155

Employee Mailing Country Code

173

Denial Reason Code

174

Gross Weekly Amount

195

Payment Issue Date

212

Non-Consecutive Period Code

218

Payment Amount

222

Payment Reason Code

227

Reporting Period Code

228

Returned to Work with Same Employer Indicator

240

Denial Effective Date

241

Settlement Type Code

242

Reduced Earnings Week Number

329

Employer UI Number

Revised Data Requirements (Section L of the California EDI Implementation Guide) for California’s interim Release 2 processing are attached.

Structural Integrity When processing a batch of Release 2 records, the structural integrity will be evaluated by verifying that: each record is the correct length, and the sequence of Record Type Qualifiers and Secondary Type Qualifiers (as found in the Address and Text Records) is valid in accordance with the IAIABC Record Hierarchy.

Due to the hierarchical layout of the batch, if an error is detected in the length of a record or the order of records, any information following the error is unreliable. Therefore, any error detected when evaluating structural integrity will result in the entire batch being rejected. The resulting error is shown on data element DN0000 with error number "061 Event Criteria Not Met." Additionally, a batch reject in Release 2 shows the value of "HD" in the Application Acknowledgment Code (DN111) rather than a Transaction Rejected "TR" value.

Employment (EMP) Record Length California has implemented the EMP (Employment) record length of 70 characters. The November 30, 1998 IAIABC EDI Implementation Guide showed the record length as 69 and the length of the Wage Period Code field as one (1) character. A revision was adopted to report the Wage Period Code the same in Release 2 as it was in Release 1. The result is that Wage Period Code has a length of two (2) digits rather than one (1) thereby increasing the overall EMP record length to 70. The December 1, 1999 IAIABC Guide shows the correct length as 70. For history of the change, please see IRR 401.

Claims Administrator Contact (CON) record The CON record contains the Name and Phone Number of the contact person, generally the claims adjuster, for the Claim Administrator. This record has been moved in the hierarchy from level 2.1 to level 6.1 and described with a Maximum Occurrence of 1 CON per KEY. This change in hierarchy level enables less repetition of data when the Claim Administrator contact changes. Please note, the Claim Administrator Claim Representative (DN140) reported in the Claim Administrator CON record is not a data element collected by California. Therefore, it is optional to report the CON record to California and it is acceptable to place the CON record at level 2.1 or at 6.1. For history of the change, please see IRR 439.

Acquired Claim (AQ) Maintenance Type Code The AQ MTC will not be supported in California at this time. Any transaction submitted with an AQ MTC will be rejected with an error code of "058 Code/ID invalid" and the Trading Partner should resubmit the data with an Acquired/Unallocated (AU) MTC.

Release 2 ANSI ASC X12 As of now an IAIABC Implementation Guide is not yet available covering the X12 formats and mapping. For the convenience of the regulated community California is willing to support Release 2 in the X12 format when it is ready. However, there are no provisions in the regulations to allow further delay in reporting by EDI until the Release 2 X12 formats are ready. With mandatory transition to Release 2 delayed (see WCIS e.News #9), you may either develop Release 1 formats (Flat or X12) and migrate to Release 2 later or develop Release 2 Flat files now.

Return to Work Type Code (DN189) and Physical Restrictions Indicator (DN224) The Release 1 Return to Work Qualifier (DN71) was replaced in Release 2 by Return to Work Type Code and Physical Restrictions Indicator. Since California is translating the Release 2 file into a Release 1 equivalent, these two data elements are being combined into one, the Return to Work Qualifier. The translation of two Release 2 data elements into one Release 1 element is not a problem, but mapping errors that occur on one data element back into the correct one of the two data elements cannot be accomplished. Therefore, any errors that occur on Return to Work Type Code or Physical Restrictions Indicator will be attributed to DN189, Return to Work Type Code. Errors will never be attributed to DN 224, Physical Restrictions Indicator.

<End of this WCIS e.News>
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Contents of this bulletin do not change existing regulatory requirements; they provide additional or revised detail about the technical implementation of those requirements. All technical changes will subsequently be reflected in other WCIS documentation. Any bulletin can be forwarded as needed, but should be forwarded in its entirety and without modification. If you have received a forwarded copy of this bulletin and are concerned about its authenticity, you can view this and previous bulletins on our WCIS web site: www.dir.ca.gov/dwc/wcis.htm.

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