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DWCNewsline 30-10: Division of Workers' Compensation issues 15-day notice of revisions to proposed Workers' Compensation Information System regulations

May 26, 2010

The Division of Workers' Compensation (DWC) has modified its proposed Workers’ Compensation Information Systems (WCIS) regulations.

The implementation of DWC’s 12-point plan is designed to monitor and control medical costs and the proposed WCIS improved reporting element is a piece of that.

A 15-day notice of modification was posted on the DWC Web site at http://www.dir.ca.gov/dwc/DWCPropRegs/WCIS_Regs/WCIS_Regulations.htm.

The WCIS collects comprehensive workers’ compensation claims information from claims administrators via electronic data interchange (EDI) using standards set by the International Association of Industrial Accident Boards and Commissions (IAIABC). WCIS’s statistical data is used by DWC and researchers to guide policy determinations, evaluate system costs, and assist in measuring indemnity payments for injured workers and their dependents. California workers’ compensation claims administrators began to transmit basic claim information to WCIS in March 2000. In September 2006, claims administrators began to submit medical bill payment data on each claim.

Members of the public may comment on the revisions until 5 p.m. on Thursday, June 10, 2010.

The revisions in this draft of the regulations include:
  • Clarification that the effective date of the WCIS regulations will be 12 months after the approved regulations are filed with the Secretary of State.
  • The addition of Data Element No. 657 (Rendering Bill Provider Country Code) and Data Element No. 734 (Service Adjustment Units) to the medical bill reporting requirements.
  • The clarification of reporting requirements set forth in the revised California EDI Implementation Guide for First and Subsequent Reports of Injury (Version 3.0) and the revised California EDI Implementation Guide for Medical Bill Payment Records (Version 1.01)
  • The clarification of reporting requirements for medical lien lump sum payments or settlements.