The state Office of Administrative Law has approved implementing regulations for the Workers' Compensation Information System under development by the Division of Workers' Compensation.
The regulations call for workers' compensation claims administrators to begin electronically submitting first reports of occupational injury by March 1, 2000. Beginning July 1, 2000, subsequent reports, which consist of specified data from benefit notices, must be submitted electronically. This will satisfy the requirement in Section 138.4 of the State Labor Code that copies of benefit notices be sent to the Administrative Director.
Claims administrators who will be unable to meet the March 1 and July 1 deadlines may request a variance to delay reporting. Those granted a variance will have their mandatory reporting date extended until Jan. 1, 2001, after which all claims administrators must be in compliance with these reporting requirements.
The submission of medical bill/payment reports will not be required at this time, pending further rulemaking by DWC, which will take place after the International Association of Industrial Accidents Boards and Commissions (IAIABC) has finalized national standards on this subject. DWC is working with IAIABC to expedite this process.
Beginning Jan. 31, 2001, claims administrators will be required to submit an Annual Summary of Benefits for every claim with any benefit activity, including medical, during the preceding year.
Claims administrators who are already prepared to submit first reports into the system may register as trading partners with DWC and begin participating immediately. Several organizations experienced in electronic data interchange (EDI) reporting in other states have already begun sending reports to the WCIS on a pilot basis. Claims with dates of injury of Sept. 1, 1999 or after are eligible for electronic submission.
"We are particularly pleased that with the implementing regulations now in place, the California workers' compensation community can begin enjoying all of the benefits that paperless reporting brings," said DWC Administrative Director Richard P. Gannon.
Electronic reporting is well established and currently in use for workers' compensation filings in about twenty states, according to Gannon. Within the next several years, California should account for nearly half of the electronic filings nationwide, he said, pointing out that although implementing EDI necessitates some up-front investment for participants, it ultimately reduces costs by eliminating needless paper handling.
"Once this advanced system is fully operational, policymakers, the public and the community will, for the first time, have access to comprehensive data and an overview of how well the state's workers' compensation system is performing," Gannon said.
To aid in implementing the new electronic reporting requirements, DWC has developed a California EDI Implementation Guide. The guide may be downloaded as an Adobe Acrobat (.pdf) file from the DWC website at http://www.dir.ca.gov/DWC/wcis.htm. Further information about WCIS can be found on that page or by sending an email message to email@example.com.
In addition, the DWC Research Unit will host a WCIS Users Educational Forum on Nov. 15, 1999 at DWC Headquarters, 455 Golden Gate Ave. in the San Francisco Civic Center. The one-day event is free to participants and should be helpful to those users just starting to implement EDI as well as those that have been using EDI in other states.
Additional user forums will be scheduled at locations in both southern and northern California early next year, including sessions at DWC's seventh annual educational conference in Burbank and Oakland.
Those interested in attending any of the forums may email firstname.lastname@example.org to register.