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
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.
April 1, 2019
- Training The eClaims Refresher Training for Claim Administrators PowerPoint has been updated to reflect the changes made to Claim Type Code and Agreement to Compensate Code effective 1/1/19. The revised slide deck includes updated screen shots for slides 20, 54 and 83; a new slide (slide 89) for the Web Data Entry application login and username/password reset; and an update to slide 10 to reflect changes to the severity rankings made in 2016.
- Archive Training: Course 101, Course 201, Course 301 and the Compilation of the training materials for Claim Administrator Claim Adjusters moved to the eClaims Archive.
- Archive Presentation: eClaims for Claimant and Carrier Representatives July-September 2014 moved to the eClaims Archive.
March 27, 2019
March 20, 2019
- FAQs Appropriate MTC Filing - #8 has been revised to clarify how to accept a claim after a FROI/SROI-04 has been filed.
March 5, 2019
- FAQs Appropriate MTC Filing #1 and #2 and Data Element Reporting #8, #10, #13 and # 15 have been revised to include an updated link for the NYS Business Scenarios.
February 26, 2019
- FAQs Data Element Reporting – Question #3 has been revised.
February 15, 2019
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eClaims Change Log eClaims tables have been updated.
The updates are summarized on the eClaims change log under Items #365-370.Announce relaxed edits implemented in January 2019 for DN0072 (Latest Return to Work Status Date), DN0075 (Agreement to Compensate Code), DN0144 (Current Date Disability Began), DN0145 (Current Date Last Day Worked), and DN0276 (Number of Denial Reason Narratives). These changes will be covered at the 2/26/2019 eClaims trading partner monthly webinar.
February 6, 2019
- Process for Section 21-a and Claims Paid Without Liability has been updated to add information regarding how to avoid losing 21-A status.
January 18, 2019
January 8, 2019
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eClaims Change Log eClaims tables have been updated.
The updates are summarized on the eClaims change log under Items #363-#364.Announcing a new SROI-PY event for interest due to claimant and a relaxed edit on Claim Type Code (DN0074) to allow Claim Type Code = P (Indemnity with No Lost Time Beyond Waiting Period) on SROI-AP/IP/Sx.
December 20, 2018
December 19, 2018
- FAQs Appropriate MTC filing – Question #9 has been revised.
December 13, 2018
- eClaims Change Log Correction made on the NYS eClaims Change Log to Item #343 changing “Notification of an Incident Only” to “Without Liability” and that this applies to the SROI-02 as well as the FROI-02.
- MTC Filing Instructions Correction made on the MTC Filing Instructions to ID #36 changing “Notification of an Incident Only” to “Without Liability” and that this applies to the SROI-02 as well as the FROI-02.
