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Workers' Compensation Board

Suggestions for Improvements to IAIABC Claims EDI FROI/SROI Standard

Mary Beth Goodsell, NYS WCB eClaims Program Manager, is working with the International Association for Industrial Accident Boards and Commissions (IAIABC) Claims EDI Committee in an effort to improve the national standard for the FROI/SROI process.

IAIABC Claims EDI Committee has resolved a few issues resolution requests (IRR) that will be implemented in the first version of IAIABC Claims EDI R3.1 expected to be released by the end of 2016. They are: Claim Adjuster Information on FROI, Left/Right/Bilateral for Part of Body Codes, and Increase from 50 to 500 characters on narrative fields.

There are twenty-two Claims EDI issue changes currently being discussed. As the Claims EDI Vice-Chair, Mary Beth Goodsell is always open to new suggestions and will submit IRR's within the guidelines of the standard which includes the Event and Sweep indemnity reporting concept.

Some of the current IRR's being discussed are:

  • IRR771 SROI Narrative Currently there is a narrative field on only the suspensions. Another jurisdiction opened this IRR and New York has actively supported it. On the paper Form C-8, adjusters could provide a factual basis for the initiating, change, or reinstatement of benefits. Based on stakeholder feedback, this is a valuable field that we do not currently have available on the SROI that we did have available on the paper form that was made obsolete on 5/23/14.
  • IRR772 Improve the 02 Process Change Rules IAIABC Claims EDI Committee is working to amend the current IAIABC Change Process rules since the current rules do not provide jurisdictions with the data required to determine the transaction change.
  • IRR815 Capture Suspension Reason Code on SROI A proposal is being discussed to further clarify the reason for suspension. This change could assist stakeholders and Board staff with a more concise picture of the suspension reason. IRR812 Overpayment Amount on SROI This request was opened by New York since the current standard does not allow for reporting of an overpayment. Since this is not an available data element, correspondence must be filed by the Claim Administrator.
  • IRR845 Address issues with dates related to when disability began and IRR823 Additional Return to Work data elements This could provide NY with a more accurate report of the lost time. This would assist the Board in resolving the issues that currently require further adjudication of the claim.

Please feel free to email with your comments regarding the above IRR's or make a suggestion for new IRR's within the national standard for Event and Sweep reporting of indemnity benefits for submission to the IAIABC Claims EDI Committee if you are interested in improving the FROI/SROI standard. If you are an IAIABC member please post your comments on the Claims EDI Online Community located at