Newsline No. 12-06
March 24, 2006
Workers' compensation information system (WCIS) regulations approvedAdoption of the WCIS regulations, which were amended from the original version that went into effect Nov. 5, 1999, has been approved by the Office of Administrative Law (OAL). The final regulations were filed with the secretary of state on Mar. 22, 2006 and become effective Apr. 21, 2006.
The WCIS was mandated in 1993 by Labor Code section 138.6 and claims administrators have been reporting claim information to the WCIS since 2000. This rulemaking amends the WCIS regulations in several ways: Reporting of the first report of injury and subsequent report of injury data elements has been updated to comply with changes to the electronic data interchange (EDI) system of the International Association of Industrial Accident Boards and Commissions (IAIABC). The regulations have also been amended to require claims administrators who handle more than 150 claims to report medical data information.
The subdivision of the regulations pertaining to medical data reporting becomes operative on Sep. 22, 2006, allowing claims administrators six months lead time to comply with the new reporting requirements. The regulations also allow a claims administrator to request a six month variance in reporting the medical data elements should they need additional time to comply.
Medical costs contribute significantly to the overall costs in the workers' compensation system. The medical data collected under the WCIS will enable the Department of Industrial Relations (DIR) to analyze the cost of workers' compensation medical care, the treatments provided, the types and number of physicians providing care, along with billing and payment practices. This data will also allow researchers to study relationships among medical treatment and payment patterns, as well as the interrelationships between medical data and other factors, such as claimant demographic and employer industrial characteristics.
The Division of Workers' Compensation (DWC) has worked very closely with the
workers' compensation community for several years to ensure that DWC's medical
data collection will optimally serve the needs of the community. As a result
of the many task force meetings that have been held, there is virtual consensus
that the data DWC will collect is appropriate.
The regulations as filed with the secretary of state can be found on the DWC Web site at http://www.dir.ca.gov/dwc/DWCPropRegs/WCIS_Regulations/WCIS_regulations.htm.