eClaims Overview
The Board has adopted a national standard for Trading Partners to electronically submit employer claims data. The current standard is the International Association of Industrial Accident Boards and Commissions' (IAIABC) Claims Electronic Data Interchange (EDI) Release 3.1 (R3.1). There are 6 states that have adopted R3.1, and another 7 states scheduled through 2022. The Board has targeted March 15, 2021 as the date Trading Partners will transition from R3.0 to R3.1 standard for submissions to New York State. In keeping with the IAIABC guidelines, the R3.1 tables and guides will be released on March 16, 2020. In preparation for the R3.1 upgrade, the IAIABC will be conducting Claims EDI Release 3.1 training from March 31, 2020 to April 1, 2020 in Syracuse, NY. Please visit the IAIABC website
for registration information.
Most national carriers already utilize the R3.1 standard in the above jurisdictions. The technology is recognized as the national best practice for First Report of Injury/Subsequent Report of Injury (FROI/SROI) and has a proven track record.
The Board continues to collaborate with Trading Partners in the workers' compensation industry to confirm their electronic filings are accurate and meet the established 90% target acceptance rate. Electronic claims filing supports the Board's continuing effort to improve services to injured workers of New York and their employers.
Additional updates on the status of the Board's upgrade from R3.0 to the R3.1 standard will be on the eClaims website. If you would like to receive email notifications regarding eClaims updates, please sign up through WCB Notifications.
Questions? Contact the eClaims team at eclaims31@wcb.ny.gov.
eClaims Recent News
December 17, 2019
- As a part of the New York State Workers' Compensation Board's Business Process Re-engineering (BPR) & Modernization Program, we will be upgrading our current eClaims EDI platform to the International Association of Industrial Accident Boards and Commissions (IAIABC) Claims EDI standard R3.1, effective March 15, 2021.
- The IAIABC has scheduled Claims EDI R3.1 training in Syracuse, NY from March 31, 2020 to April 1, 2020. If you are interested in attending, please visit the IAIABC website.
- The R3.1 tables and guides are scheduled to be made available on March 16, 2020. If you have any questions or comments, please contact us at eclaims31@wcb.ny.gov.
- If you would like to receive email notifications regarding eClaims updates, please sign up through WCB Notifications.
December 12, 2019
- EDI Compliance Reminder: It has recently come to the Board's attention that compliance with EDI mandate may not be 100%, especially in instances where there are ongoing payments in closed cases. The Board has created and sent a reminder to Claim Administrators to ensure that the appropriate FROI/SROI transaction is filed in every case in which there is a current, ongoing payment. This reminder extends to all cases regardless of their age or status (open or closed) with the Board. View the complete reminder with more information here: EDI Compliance Reminder
December 06, 2019
- eClaims Change Log Reference document, Edit Matrix Table has been updated
The updates are summarized on the eClaims change log under Item #397 announcing the following changes: - DN0075 (Agreement to Compensate Code) – Relaxed the Population Restriction 0075-064B and 0075-064C noting that these edits will not be applied if DN0059 (Manual Classification Code) has been accepted as 7711 or 7370.
December 04, 2019
- FAQs Data Element Reporting - New FAQ #19
How do I reference a document on a SROI-CB or SROI-CA in compliance with 12 NYCRR 300.23(a) since these transactions do not allow a narrative field in IAIABC Claims EDI R3.0?
November 1, 2019
- eClaims Change Log Reference documents, Edit Matrix and SROI Data Element Requirements Table, have been updated
The updates are summarized on the eClaims change log under Items #394-396 announcing the following changes: - Added new DN0059 (Manual Classification Codes) New codes added in accordance to NYCIRB's addition of new Manual Classification Codes.
- DN0056 (Initial Date Disability Began) – Modified the Technical Condition to include DN0074 (Claim Type Code) of P (Indemnity with No Lost Time Beyond the Waiting Period). This would require Claim Administrators to send the Initial Date Disability Began anytime there is lost time, be it one day or more, on a SROI.
- DN0192 (Benefit Payment Issue Date) – Modified the Population Restriction 0192-044 to include the SROI-Sx. This would limit the Benefit Payment Issue Date from listing a future date of more than four days from the filing of the Suspension.
- Process for Section 21-a and Claims Paid Without Liability has been updated to add information regarding FROI can end §21a status and indicate an acceptance of a case.
October 1, 2019
September 20, 2019
The eClaims Inquiry application has been expanded to include the ability for Flat File (FTP) Trading Partners (Senders) to view their FTP acceptance rate performance to determine if they are meeting the 90% acceptance rate target as stated in the eClaims Implementation Guide Part 3.9. Information regarding the chart and reports is located at http://www.wcb.ny.gov/content/ebiz/eclaims/Registration/InqOverview.jsp.
September 4, 2019
- eClaims Change Log Reference documents and SROI-PY Event Table have been updated.
The updates are summarized on the eClaims change log under Items #386-393 announcing the following changes: - eClaims Refresher Training for Claim Administrators Power Point updated to include current Quick Code Reference list and Adjustments, Credits, and Redistributions slide to include that we now accept all three Benefit Credit Codes (DN0126) including M - Credit for Employer Provided Benefits in Excess of Covered Weekly Benefit.
- SROI-PY note added on Event Table, MTC Filing Instructions and eClaims Refresher Training for Claim Administrators Power Point to include an example in the description in regards to a more appropriate MTC should be filed instead of the SROI-PY. For example, an award made for an 8 week period of lost time, send SROI-IP followed by a SROI-Sx.
- All SROI-Sx NYS Business Scenarios updated to include a note to clarify that a SROI-SJ should be sent if paying pursuant to 21-a, regardless of reason for suspension. Note: If paying pursuant to 21-a, Claim Administrator should send SROI-SJ.
August 13, 2019
- eClaims Change Log eClaims tables have been updated.
The updates are summarized on the eClaims change log under Items #379-385 announcing the following changes: - DN0029 (Policy Effective Date) – Relaxed existing condition effective 7/19/19 on FROI 00/AU/04/UR per request by a Claim Administrator. This data element will no longer be required unless Insured Type Code = I (Insured). All other conditions remain unchanged.
- DN0056 (Initial Date Disability Began) - Relaxed conditional requirement effective 8/2/19 to include BTC 090 (Permanent Partial Disfigurement). The business reason for this change is an issue that was raised by a Claim Administrator for reporting issues on a facial disfigurement case with no lost time. All other conditions remain unchanged.
- DN0126 (Benefit Credit Code) – Began accepting M = Credit for Employer Provided Benefits in Excess of Covered Weekly Benefit effective 7/19/19 based on a request from a Claim Administrator. A Notice of Decision was issued on a file for a credit to employer for holiday pay. It was agreed that this code would be the most appropriate method of reporting this type of credit.
- DN0192 (Benefit Payment Issue Date) – New edit will be applied effective 2/14/2020 to the SROI-Sx and RB when BTC = 0xx in the same manner that this edit is applied today for MTC's AP, IP, and PY.
These changes will be covered at the 9/24/19 eClaims trading partner webinar. Questions regarding these changes can be sent to eClaims@wcb.ny.gov
August 09, 2019
- FAQs Appropriate MTC Filing - New FAQ #7
What MTC should I send if we are paying the claimant under 21-a and we want to suspend payments?
July 12, 2019
- eClaims Change Log eClaims tables have been updated.
The updates are summarized on the eClaims change log under Items #371-378 announcing the following changes: - FROI Event Table for FROI-02 event criteria description clarified from "on or after 1/1/19" to "all" dates of accident when DN0075 (Agreement to Compensate Code) changes from Without Liability to With Liability. This change is also noted on the mailing requirements page at http://www.wcb.ny.gov/content/ebiz/eclaims/PrintReports.jsp
- FROI Event Table for FROI-UR - Added link to legacy procedure located at http://www.wcb.ny.gov/content/ebiz/eclaims/ImpGuide/NYLegacyClaimTransitionToEDI.pdf for clarification
- SROI Event Table for SROI-CD/EP/ER/PD/RB - Removed the term "event" from disability in the criteria description as SROIs are due from disability. Only FROIs and Denials are due from disability events. Note: The MTC Filing Instructions reference document IDs #2 SROI-IP, #3 SROI-EP, #10 SROI-PD were also updated with this information.
These changes will be covered at the 9/24/19 eClaims trading partner webinar. Questions regarding these changes can be sent to eClaims@wcb.ny.gov
June 27, 2019
May 28, 2019
- Process for Section 21-a and Claims Paid Without Liability has been updated to add information regarding Volunteer Claims, Section 50 not 21-A.
