WCIS eNews No. 130
December 13, 2016


Supplemental Job Displacement Benefits (SJDB) must be reported to the Workers' Compensation Information System (WCIS)

The Division of Workers’ Compensation (DWC) requires that claims administrators submit the Supplemental Job Displacement (SDJB) payments/vouchers. 

The California EDI Implementation Guide for FROI/SROI version 3.0 (Section N, page 94) requires that trading partners submit the Paid to Date/Reduced Earnings/Recoveries Code (DN 95) with the Benefit Type Code (BTC) 390 for all Supplemental Job Displacement Benefits (SJDB). The amount paid for SJDB is reported under the Paid to Date/Reduced Earnings/Recoveries Amount (DN 96).

For more general information on SJDB, please visit the Division of Workers’ Compensation SJDB page.

Trading Partners who would like additional assistance or clarification regarding the reporting  of SJDB to WCIS please contact your designated trading partner.

WCIS trading partner contacts:

Johnny Lee
email: jblee@dir.ca.gov
phone: 510-286-6772
Trading partner letters A, C, G, I-L, S-V, Z

Elisema Cantu
email: ecantu@dir.ca.gov
phone: 510-286-6763
Trading partner letters B, D-F, H, M-R, W-Y

Antoinette Esqueda
email: aesqueda@dir.ca.gov
phone: 510-286-6773
Medical reports technical contact


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.dwc.ca.gov/wcis.htm.

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