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eClaims Transaction Reports for Mailing to Parties

eClaims

In addition to electronically filing First and Subsequent Reports of Injury (FROI/SROI) to the WCB, claim administrators are required to notify parties of interest via paper mailing. Information regarding the generation and mailing requirements for servable paper documents can be found in Section 3.6 of the NYS eClaims Implementation Guide and the NYS Event Table.

The WCB has developed a printable report format of the electronic FROI/SROI filing that contains the information regarding acceptance, partial denial, controversy, and all reports of payments on a claim. This report must be mailed to the claimant and the claimant’s representative, pursuant to §300.22, within one business day of electronic filing with the WCB. The date such notice is actually mailed or otherwise transmitted shall be the date of transmittal, regardless of when received by the intended recipient. Furthermore, Section 110 of the Workers’ Compensation Law provides that a copy of the employer’s report of injury be provided, upon request to the injured worker.

The following table provides a sample of each report completed with data from the NYS Business Scenarios. Consult the NYS Event Table to determine when, and to whom, each report should be mailed. Please note that Section 3.6 of the NYS eClaims Implementation Guide includes multiple electronic options for how claim administrators can obtain their FROI/SROI transaction report for each successfully submitted filing, thus, relieving the claim administrator from the burden of manually generating the paper reports. Note: Only forms that are required for mailing are include in the zip files. Please see 3.6.4 of the NYS eClaims Implementation Guide for more information. Any forms that are not in the zip file can be printed from eCase or eClaims Inquiry.

Sample FROI zip file created by WCB - New zip file samples effective 04/7/2017. See eClaims change log #276 for more details.

Sample SROI zip file created by WCB - New zip file samples effective 04/7/2017. See eClaims change log #276 for more details.

Sample Transaction Reports
FROI 00 - Original (Mailing to parties is optional)
FROI 01 - Cancel
FROI-02 - Change (Not included in zip file. Required for mailing only if Full Denial Reason Code or Denial Reason narrative changes or Agreement to Compensate changes from Without Liability to With Liability.)
FROI 04 - Denial
FROI AQ - Acquired Claim (Mailing to parties is optional)
FROI AU - Acquired/Unallocated (Mailing to parties is optional)
FROI UR - Upon Request (Mailing to parties is optional)
SROI 02 - Change (Not included in zip file. Required for mailing only if Full Denial Reason Code or Denial Reason Narrative changes or Agreement to Compensate changes from Without Liability to With Liability.)
SROI 04 - Denial
SROI AP - Acquired/Payment = With Liability
SROI AP - Acquired/Payment = Without Liability
SROI CA - Change in Benefit Amount
SROI CB - Change in Benefit Type
SROI CD - Compensable Death
SROI EP - Employer Paid - Agreement to Compensate Code = With Liability
SROI EP - Employer Paid - Agreement to Compensate Code = Without Liability
SROI ER - Employer Reinstatement
SROI IP - Agreement to Compensate Code = With Liability
SROI IP - Agreement to Compensate Code = Without Liability
SROI PD - Partial Denial
SROI PY - Payment Report = With Liability
SROI PY - Payment Report = Without Liability
SROI RB - Reinstatement of Benefit
SROI RE - Reduced Earnings
SROI S1 - Suspension, RTW or Medically Determined/Qualified to RTW
SROI S2 - Suspension, Medical Non-Compliance
SROI S4 - Suspension, Claimant Death
SROI S5 - Suspension, Incarceration
SROI S7 - Suspension, Benefits Exhausted
SROI SD - Suspension, Directed By Jurisdiction
SROI SJ - Suspended Pending Appeal or Judicial Review
SROI SA - Sub-Annual (Mailing to parties is optional)
SROI UR - Upon Request (Mailing to parties is optional)

Contact eClaims@wcb.ny.gov if you will be generating your own paper transaction reports.



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