WCIS eNews No. 46
October 22, 2004

New WCIS implementation guide

The draft version of the WCIS Implementation Guide, which has been posted at the DIR Website for the past four months, will be incorporated into the California DWC/WCIS Rules and Regulations in the near future.

The draft of the revised WCIS California implementation Guide is posted at http://www.dir.ca.gov/dwc/WCIS.htm.

Another version highlighting the changes in the Draft Guide since May 2000 is also available. This is posted at http://www.dir.ca.gov/dwc/WCIS.htm.

IAIABC release 2 format

Beginning May 1, 2005, WCIS can no longer accept IAIABC Release 2 formatted data. This is in accordance with WCIS' practice of maintaining standards consistent with IAIABC standards. The IAIABC has ended support of the Release 2 format. Trading partners that are submitting data in Release 2 format should take the necessary steps to switch to Release 1 by May 1, 2005.

Medical Data Collection

DWC has been holding bi-weekly teleconference meetings of the Medical EDI Task Force since it was established in July 2004. DWC anticipates that a draft Medical Implementation Guide will be posted on its Internet Forum in November. DWC expects to Beta test the system with selected Trading Partners beginning in January 2005. DWC anticipates that regulations will become effective by June 2005, and that mandatory Medical Reporting will become effective by the fourth quarter of 2005.

Tables and reports

DWC’s Research Unit (RU) has recently added a “WCIS reports and tables” section to the following WCIS link: www.dir.ca.gov/DWC/WCIS.htm http://www.dir.ca.gov/dwc/WCIS.htm. Six tables have been posted, showing the distributions by year of injury for WC claims by part of body, cause of injury, nature of injury, market share by type of insurer, and age and gender distributions. Tables and reports will be added periodically as the Research Unit produces them.

Timeliness of payments report

The California legislature has requested that, DWC renew the preparation and distribution of its “promptness of payment report.” This computer-generated paper report was produced and distributed regularly during the 1980s. The reports showed, the distributions of the number of days from first day of disability to date of first benefit payment for injured workers’ claims handled by the various claims administrators. DWC intends to begin producing quarterly Promptness of Benefits reports beginning with data for 2005, based on data submitted electronically by claims adjusters to DWC’s Workers’ Compensation Information System.

Compliance with WCIS

By statute and regulation, all California workers' compensation claims administrators must submit a First Report of Injury by EDI for every claim. Each claims administrator also must submit a subsequent report via EDI for each claim whenever benefit payments are started, changed, suspended, denied, or other specified claim events occur. DWC has drafted regulations that will impose penalties on claims administrators who fail to comply with these requirements.

If you have any questions, please contact your trading parters contact, listed below.

Alice Cantu, trading partners - B, D-F, N, O, W-Y
e-mail: ecantu@dir.ca.gov
Tel: 415.703-4418 Fax: 415.703.5911

Damon Chen, trading partners - C, G-H, M, P-R
e-mail: dcchen@dir.ca.gov
Tel. 415.703-4413 Fax: 415.703.5911

Johnny Lee, trading partners - A, I-L, S, U-V, Z
e-mail: jblee@dir.ca.gov
Tel: 415.703.4427 Fax: 415.703.5911

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: http://www.dir.ca.gov/dwc/wcis.htm.

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