The WCIS would like to remind trading partners that the Annual (AN) reports are due beginning Jan. 1, 2007. The following frequently asked questions guide was created in response to trading partner questions regarding the AN:
Q: When is the deadline to send the AN?
A: The deadline is no later than Jan. 31 of each year.
Q: Under what circumstances is the AN sent?
A: The AN is sent for any claim with any payment in any benefit category in the previous calendar year. The exception to this rule is for claims where there is no further benefit activity after the final (FN) report has been accepted and the FN included all the indemnity and/or non-indemnity benefit data.
Q: What needs to be reported on the AN?
A: Annual reports must report a sweep of information for all benefits, including indemnity and/or non-indemnity.
Q: Are the benefit amounts reported on the AN for the year-to-date amounts paid or for the cumulative amounts paid over the life of the claim?
A: The benefit amounts reported are for the cumulative amounts paid over the life of the claim, as of the end of the previous year. For example, if a claim began in 2005 with temporary disability payments and in 2006, permanent disability payments were paid, the AN sent in January 2007 would report the cumulative amounts paid for the temporary and the permanent disability benefits as of Dec. 31, 2006, along with any non-indemnity payments, such as medical or attorney fees.
Q: What kind of sequencing rules is the AN processed under?
A: Each AN must be preceded by an initial FROI such as the 00-Original or the AU-acquired/unallocated. All previously accepted benefits must be reported on the AN and there cannot be any new indemnity benefits reported.
Q: Can a claim be closed using the AN?
A: Only a non-indemnity claim can be closed using the AN. This is done by sending the AN with a "closed" claim status (DN 73). Indemnity claims must be closed with the FN report.
This guide can also be viewed at http://www.dir.ca.gov/DWC/WCISFAQ.htm. Please contact your trading partner liaison with any questions.