eClaims Overview
The Board has adopted a national standard for claim administrators to electronically submit employer claims data. The standard is the International Association of Industrial Accident Boards and Commissions' (IAIABC) Claims Electronic Data Interchange (EDI) Release 3.0. This electronic filing of claims data was implemented in phases, beginning in spring 2013, and provides timely, accurate, and credible electronic reporting.
Approximately 40 states currently use the IAIABC EDI standard for claim submissions. Most national carriers already utilize the standard in those 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 claim administrators in the workers' compensation industry to ensure that their electronic filings are accurate and the acceptance rate meets the established 90% target. Electronic claims filing supports the Board's continuing effort to improve services to injured workers of New York and their employers.
The Board is supporting transparent and continuous two-way communications with all stakeholders.
For more information on the IAIABC Claims Release 3.0, please visit the EDI Implementation Guide section of the IAIABC website at: www.iaiabc.org 
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Questions can be directed to: eClaims@wcb.ny.gov
eClaims Recent News
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.
