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eClaims Question and Answer from 201/301 Training

eClaims Training

Held in November/December 2012

  1. Will the employer still have to sign the C-2

    The employer does not have to sign the C-2. The trading partner agreement will have an attestation that the information being submitted is correct, etc.

  2. Will the employer have to retain a copy of the FROI per Section 110?

    The employer or employer's designee shall record any injury or illness incurred by one of its employees in the course of employment using the form prescribed by the chair for reporting injuries under subdivision 2 of this section. Such form, a copy of which shall be provided to the injured employee upon request, shall be maintained by the employer or employer designee, for at least eighteen years, and shall be subject to review by the chair at any time. Such form need not be filed with the chair unless the status of such injury or illness changes resulting in a loss of time from regular duties or in medical treatment which would require reporting in accordance with subdivision two of this section.

  3. If I file a FROI with the WCB that doesn't meet the reporting criteria (first aid only) will it cause a higher premium?

    Any injury or illness which is not required to be reported in accordance with subdivision two of this section, shall not be used as a basis for determining experience modification rates, provided the employer pays in the first instance or reimburses the employer's insurer for the treatment rendered to the employee.

  4. Will filing SROI Sub Annuals replace the WCB's requirement for an annual report to the Self-Insurance Unit? (SI-4)

    We will discuss this with the Self-Insurance Office at the WCB.

  5. Do you want us to report a 0% for DN0084 (Permanent Impairment Percentage)?

    It is not necessary to report a 0% for DN0084 (Permanent Impairment Percentage)

  6. What if a document needs to be attached to the FROI/SROI as it was previously attached with current C-2, C-669, C-7 or C-8/8.6?

    If this document is not in e-case, then document should be sent to WCB via mail, fax, or email.

  7. How do I report a new period of Temporary Total after a break in period?

    201 Training Slides #84-87

  8. What do I file if one body part is being denied?

    A SROI-PD may be filed in regards to the indemnity payments. However, to deny additional injury sites and/or medical issues the Claim Administrator should continue to use the C-8.1 Process and/or Medical Treatment Guidelines Process. See NYS Business Scenario 5-4.

  9. Can I serve a combined SROI-SD with a SROI-PY to the parties?

    No. SROI reports must be served individually.

  10. How do I report a payment of an attorney fee on SROI-PY?

    The attorney fee should be reported in OBT340 (Total Claimant's Legal Expenses)

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