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Workers' Compensation Board

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Proof of Coverage Disability Benefits
DB 820/829 Filing Requirements

Effective October 1, 2005, the Board no longer accepts paper DB-820/829 forms for statutory coverage. All transactions effecting or affecting a statutory Disability Benefits policy must be submitted to the Board electronically.

Statutory coverage is a Disability Benefits policy that covers all employees eligible under the Disability Benefits Law, provides the same benefits in all respects as provided under Section 204 and requires employee contributions not in excess of those authorized under Section 209.

Since our automation efforts have not, as yet, addressed Plan or Plan Class coverage, paper DB-820/829 forms must still be filed for all non-statutory policies. Form DB-820.1, if necessary, must also be submitted on paper.

Plans are policies that may cover all or only a class (or classes) of employees, provide benefits that differ from those provided under Section 204 and may require employee contributions that differ from those authorized under Section 209.

Acceptable Methods of Transmission

Effective October 1, 2005, carriers must submit DB-820/829 data to the Board for statutory policies using one of two methods:

  • Flat File Transmission – Carriers can register with the Board, at no cost, to send data via flat file through a secure file transfer process and receive an acknowledgment file indicating acceptance and rejection of transactions.
  • Web Submission – Carriers can use the Board's web-based application to electronically submit DB-820/829 data. The Board will acknowledge accepted and rejected transactions and there is no cost to the carrier for the use of the web-based process.