EDI Reporting Rules

EDI Reporting Rules (BWC – Commonwealth of Pennsylvania)

BWC uses IAIABC Claims Release 3.0 standards for all EDI submissions. Data format must be in compliance with the standard data format described in the Systems Rules. Required BWC requires the electronic submission of injury reports as part of its EDI Implementation. For all data and information which is submitted to BWC via EDI in connection with filing for which a copy is required by law to be provided to another party, a true and correct copy of such data and information must be provided to that party consistent with the Act, regulations and/or any applicable Department-issued policy statement or written guidance.

Some business scenarios may also require the submission of forms to BWC. These forms are available for download from the DLI website, and should be completed and filed with BWC. The specific forms and their reporting requirements are outlined in the PA Event Table. The claim administrator should indicate the presence of an agreement by populating the Award/Order Date (DN0299) with the date the parties entered into the agreement in the accompanying EDI Transaction. These forms are required by the PA Workers’ Compensation Act to be signed by one or more of the interested parties.

BWC has the forms available for download from the DLI website in support of existing FROI/SROI claims management processes. These forms should not be filed with BWC because an EDI transaction is sufficient for BWC reporting in the scenarios identified in the PA Event Table, but a copy of the information that was submitted via the EDI transaction must be sent to the employee/claimant as required by the PA Workers’ Compensation Act. Claim administrators may use LIBC forms currently generated by their system or, for FROI transactions, the LIBC-90 generated by WCAIS.

To learn more about EDI and become a certified  EDI Professional please visit our course schedule page.

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