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Bureau of Workers' Compensation

Announcements

bullet December WCAIS EDI Enhancements - Please note the WCAIS updates and enhancements scheduled for December 2015 and make sure that your system is updated accordingly. Click for more about the December updates.
bullet Attention Workers’ Compensation Providers and Insurers: - Read the bureau's response to questions regarding ICD-10.
bullet Upcoming EDI Code Changes - In March 2016 there will be four coding changes for which you need to update your EDI coding to prevent a rejection. These changes are necessary for completion of the Forms Solution project, which will allow elements provided on EDI transactions to generate LIBC forms starting June 2016. Click to view the coding changes.
bullet The 2014 Workers’ Compensation and Workplace Safety Annual Report is available now. View the 2014 Annual Report here.
bullet Upcoming EDI Code Change - Effective September 2015, Claim Type code will be mandatory on all FROI transactions. You must update your systems to prevent rejections caused by a missing Claim Type code.

In April we announced we would be mandating the use of the Claim Type code on all FROIs to improve reporting in WCAIS. The update will improve the accuracy of each claim and will allow the bureau to provide the community with more accurate figures on how many indemnity and medical-only claims occur in Pennsylvania per year.
bullet Submitting Paper Forms - It is imperative when submitting paper forms to the bureau that all two-sided (duplex) forms be submitted as a single, full page image in duplex form. This is important to ensure that the scanners can read them and that they are uploaded to the proper claim. Detailed information on submitting paper forms can be found here.
bullet 2015 National Safety Council (NSC) Training Offered
bullet PATHS now has a Facebook page! Follow us on Facebook for our latest health and safety training offerings and all your workplace safety resource needs. PATHS is a one-stop shop for FREE training and information, offering resources such as webinars, PowerPoints, safety talks, videos and even classroom training. Visit the PATHS page to browse these resources and to learn how to reduce workers’ compensation costs through accident prevention and qualification for a workers’ compensation premium discount!
bullet No Assessment for the Self-Insurance Guaranty Fund in 2014 - The Bureau of Workers' Compensation has determined that the existing asset level of the Self-Insurance Guaranty Fund, or SIGF, remains sufficient to cover the claims being paid from the fund. As a result, the bureau will not issue an assessment against existing self-insurers for the maintenance of the SIGF in 2014 unless a sudden influx of new claims against the fund should occur.

This will be the 5th consecutive year in which existing self-insurers have been given relief from payment of an SIGF assessment. The SIGF is continuing the payment of workers' compensation benefits to injured workers who were employed by insolvent, former self-insured employers.
bullet The statewide average weekly wage for injuries occurring on and after Jan. 1, 2015 is $951.00 per week and represents an increase of 2.0 percent from 2014. Additional information on the statewide average weekly wage is available here.
bullet Inadvertent Submission of a Document – If you inadvertently upload a document to the Actions tab of a claim in WCAIS or use the forms generation feature to submit a document in error, please contact our EDI unit at RA-CMDEDI@pa.gov. Once a document is filed with the bureau, it is part of the legal record, so we cannot delete a document from the claim. However, if the document type (NCP, NCD etc…) doesn't match the form submitted, or if the claim-specific data (claimant name, DOI, or SSN) doesn't match the claim it was uploaded onto, we will re-index the document to the correct document type or claim. If both the document type and claim-specific data matches the form and claim it is housed in, we will not delete or re-index the document. In this situation, you must upload a written explanation stating that you created the document in error. You must then send this document to the claimant as well as upload the document to the Documents and Correspondences tab of the claim in WCAIS as a miscellaneous document. To make the purpose of the document clear, it is helpful to include a brief sentence to describe the intent of the document.

For more information about EDI and important EDI notices, visit the EDI Alerts/Updates page.
bullet Changes to the WC Act as made by ACT 184 (HB1846): View the amendments.
bullet Reminder – Records Requests: Please note that if you are a registered user of WCAIS and are listed in WCAIS as an interested party on a claim, you can access and print the records directly by accessing the claim through the WCAIS System on demand. By viewing and printing your documents through WCAIS, you can access the requested information 24 hours a day, seven days a week.

If you are not registered to use the WCAIS system, you can register by visiting the WCAIS website at http://www.portal.state.pa.us/wcais. Click the "User Registration" tab.
bullet WC Forms June 30, 2014, Mandate: The BWC WCAIS Team is currently evaluating the process for the use of revised BWC forms that require signatures, such as agreements and supplemental agreements, in relation to the previously announced June 30, 2014, use date.

Until further determination has been communicated, the bureau will continue to accept the pre-WCAIS and post-WCAIS version of a form that requires the claimant's signature, such as agreements and supplemental agreements. Note that this applies only to BWC forms. The most recent revised WCOA forms as available on the website must still be submitted.

Please also note that BWC forms will only be returned if there is no EDI transaction filed to establish a claim. Thank you for your attention concerning this matter.
bullet Attorneys Updating Interested Party Information: Please use the new LIBC-113 Interested Party Update Request Form to update parties, names, addresses and unique identifiers (FEIN, SSN, etc.) for interested parties in a matter. Submit completed forms to the judge or judge's secretary at the commencement of a hearing or via mail/email anytime upon receipt of party information requiring an update. If at the appeal level, please provide the form with any changes to WCAB Secretary William Trusky.

The Interested Party Update Request Form, along with instructions for completing the form, can be downloaded from the WCOA Forms Spreadsheet.
bullet Message to insurance community regarding incorrect claim conversions and proper reporting of Social Security Numbers.
bullet Attorneys Filing UEGF Notices of Claims: In addition to filing your UEGF LIBC-551 Notice of Claim online, you must also submit hard copies to the Department containing the Claimant's original signature. Department policy requires that notice to the Department be provided by mail, as set forth in 34 Pa. Code § 123.802, which states: "Notice to the Fund shall consist of completing and mailing the [Notice]..." and "[t]he Notice will be deemed filed as of the date of the Notice's deposit in the United States Mail... ."

Notices filed solely online will not be processed if hard copies containing the Claimant's original signature are not also filed with the Department. Mail hard copies to the addresses listed on the Notice of Claim.
bullet The Bureau of Workers' Compensation has suspended the Annual Claim Status Report. This decision was based on discussions with, and feedback from, the workers' compensation community. The bureau retains the right to reinstate future reports, as necessary.

In an effort to meet the needs of stakeholders while ensuring compliance with the workers' compensation law, the bureau encourages you to continue to file appropriate and timely EDI transactions to avoid the need for reinstatement of the ACSR. If you haven't already done so, please submit SROI URs for all legacy claims. (Information regarding Claims EDI Release 3 is available here.)

Send questions regarding the ACSR to: RA-CMDEDI@pa.gov.
bullet The Bureau of Workers' Compensation has published the final version of the Electronic Data Interchange (EDI) Claims Implementation Guide and its supporting documents on the Workers' Compensation Automation & Integration System (WCAIS) project website at www.dli.state.pa.us/wcais. The final version of the guide provides technical information, procedures and explanations to help claims administrators prepare and navigate future EDI processes.
bullet General workers' compensation information for injured workers now available in Spanish. Información general sobre la compensación de los empleados para aquellos empleados que han sufrido accidentes/lesiones en el trabajo está disponible en Español.
bullet WC FORMS NOTICE: The workers' compensation forms listed on the Department of Labor & Industry website are provided for your immediate use. However, the Bureau of Workers' Compensation and the Workers' Compensation Office of Adjudication require their use on the effective dates noted on the website. Previous versions of these forms submitted after their effective dates will not be accepted and will be returned to the filing party.
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To arrange Safety Committee Training, please contact the Bureau of Workers' Compensation, Health & Safety division at 717-772-1635 or email Ra-li-bwc-SAFETY@pa.gov.
bullet Utilization Review Announcement: A Utilization Review Request may now be filed online through WCAIS. When filing, it is important to remember that the request must be filed within 30 days of the receipt of the bill and report that pertain to the start date of the treatment submitted for utilization review. If filing by paper, please use the LIBC-601 (REV 11-13).
bullet Fee Review Announcement: Appeals of fee review determinations to a hearing officer should be filed on the Request for Hearing to Contest Fee Review Determination, form LIBC-606. Appeals will be heard by Fee Review Hearing Officers or workers' compensation judges who have been specially appointed as Fee Review Hearing Officers. The form, and additional information, is available here.
bullet Notice Regarding Applications for Fee Review: Please note that with the inception of WCAIS, an application for Fee Review can now be filed online as well as by paper. If filing by paper, please utilize forms LIBC-507 and LIBC-9 with REV 9/13. Additional information about the application for fee review is available.
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Please note that the Bureau of Workers' Compensation does not issue certificates of non-insurance. To obtain a certificate of non-insurance, contact the Pennsylvania Compensation Rating Bureau, United Plaza Building, Suite 1500, 30 S. 17th St., Philadelphia, PA 19103-4007, Phone: 215-568-2371.
bullet Attention workers' compensation medical providers and repricers: Read the bureau's statement of purpose of adoption of usual and customary charge reference.
bullet Are you a Pennsylvania employer performing work in Ohio? Find out why you must have Ohio workers' compensation coverage for your employees.
bullet PA Employer WC Insurance Info. is now available.
bullet Current versions of Pennsylvania's various workers' compensation Rules and Regulations and Statements of Policy are available.
bullet Attention PA Employers: Required Workplace Posters are available free of charge from the Department of Labor & Industry.
bullet In order to comply with federal regulations, changes were made to Unemployment Compensation (UC) Chapter 61 regulations, which took effect February 12, 2011. See, 34 Pa. Code Section 61.25, "Confidentiality of Information and Fees," which contains provisions which limit the use of unemployment compensation information in courts. Section 61.25 (a)(2) is the rule of confidentiality of information and discusses the issue of competent evidence, while (a)(3) enumerates permissible disclosures of unemployment compensation information. These changes will impact requests from workers' compensation practitioners. Text of Chapter 61 is available here.
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