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Workers Compensation - EDI FAQs

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International Association of Industrial Accident Boards and Commissions (IAIABC)

Frequently Asked Questions about the Kansas Workers Compensation EDI Program

The Kansas Division of Workers Compensation appreciates continuing input from current and potential trading partners regarding our EDI program. Past input has raised important issues and in response KDWC has continued its efforts to clarify, or even rethink its requirements.

If you have a question which is not stated in this FAQ and feel it would be helpful to include it, send your suggestions to the Division by regular mail, e-mail, or fax. Periodically, we will be updating the set of Frequently Asked Questions found on this page.

Download the latest version of the FAQs document.

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Questions and Answers:

  1. Question: Does the First Report of Injury, get sent for all claims (medical-only as well as indemnity)? Do all incidents, regardless of medical aid, get reported via EDI?

  2. Question: Is EDI now mandatory in Kansas? When will it be mandatory?

  3. Question: What industry codes (DN025) will Kansas accept?

  4. Question: How do we report medical-only claims using the Annual Report (AN)?

  5. Question: If a reporting entity chooses to report via EDI, what will its CCS (Closed Claim Study) reporting obligations be?

  6. Question: Do you have a list of approved vendors?

  7. Question: Do we submit an EDI Subsequent Report of Injury (SROI) on claims for which we previously submitted a paper Employer's Report of Accident (a paper FROI)?

  8. Question: What are the procedures for becoming an EDI Trading Partner?

  9. Question: Where can I find the Kansas EDI Implementation Guide?

  10. Question: How do I contact someone at the State of Kansas who deals with EDI?

  11. Question: What other resources are there for doing EDI with the State of Kansas?

  12. Question: Where can I find the IAIABC Release 1 Implementation Guide?

  13. Question: Where do I find the Data Dictionary?

  14. Question: I keep getting an Edit 58 Error (Code/ID Invalid) on the SROI data element DN83 Permanent Impairment Body Part Code, but I use the codes From the Body Part table on your Web site (http://www.dol.ks.gov/WC/html/wcedicode_DBR.html); can you tell me why none of the codes I use will pass the edits?

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Answers:

  1. Question: Does the First Report of Injury, get sent for all claims (medical-only as well as indemnity)? Do all incidents, regardless of medical aid, get reported via EDI?

    Answer: Either an Original First Report of Injury (00 FROI) or a Denial First Report of Injury (04 FROI), as applicable, must be submitted to KDWC following an accident or occupational exposure "...if the personal injuries which are sustained by such accidents, are sufficient wholly or partially to incapacitate the person injured from labor or service for more than the remainder of the day, shift or turn on which such injuries were sustained" (K.S.A. 44-557(a)).

    KDWC understands that K.S.A. 44-557(a) merely sets the statutory floor for the timeliness reporting requirement for an Original First Report of Injury or a Denial First Report of Injury. However, any insurance carrier, third party administrator, self-insured employer, or group-funded pool may send an 00 FROI for all no-time-loss accidents that do not meet the statutory threshold for mandatory reporting. In fact, reporting entities are strongly encouraged to report any and all injuries regardless of lost time.
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  2. Question: Is EDI now mandatory in Kansas? When will it be mandatory?

    Answer: EDI is not mandatory in Kansas at this time. Kansas has made its intentions known to insurance carriers and the IAIABC (International Association of Industrial Accident Boards and Commissions) that we expect to eventually migrate to the IAIABC EDI Claims Release 3.0, with mandatory participation, but as of the latest update to this page, there is no official or even tentative target date.

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  3. Question: What industry codes (DN025) will Kansas accept?

    Answer: Kansas accepts the Standard Industry Code (SIC 1987) and both the 1997 and 2002 North American Industrial Classification System Codes (NAICS). However, we encourage our reporters to use the 2002 NAICS Codes.

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  4. Question: How do we report medical-only claims using the Annual Report (AN)?

    Answer: Within ten days before or after June 1st of any year, send to the division all medical-only claims that closed the previous calendar year (and are still closed at the time you create the Annual Report).

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  5. Question: If a reporting entity chooses to report via EDI, what will its CCS (Closed Claim Study) reporting obligations be?

    Answer: Those who choose to report via EDI are no longer required to participate in the Closed Claim Study, because the reporting requirements will be met through EDI. Please refer to " CCS Reporting Using IAIABC Standards Report Sequencing" in the Implementation Guide (page 25).

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  6. Question: Do you have a list of approved vendors?

    Answer: A list of EDI vendors that are currently submitting workers compensation claim reports in other jurisdictions, and that have proven technical and business capability to comply with the Kansas EDI Implementation Guide, can be found on our Web site at http://www.dol.ks.gov/WC/html/wcedistaff_DBR.html

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  7. Question: Do we submit an EDI Subsequent Report of Injury (SROI) on claims for which we previously submitted a paper Employer's Report of Accident (a paper FROI)?

    Answer: No, EDI is forward going only. EDI SROIs can only be submitted if you have filed an EDI First Report; this conditional requirement covers medical-only annuals (ANs) as well.

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  8. Question: What are the procedures for becoming an EDI Trading Partner?

    Answer: Contact Sharon Marion, the Kansas EDI Coordinator at Peak PSI; she will walk you through the process, and answer any testing or transmission questions or concerns. You can reach her at:

    Sharon Marion
    KS EDI Coordinator
    Helpdesk: 256.704.2021
    E-mail: KS_edi@peakpsi.com
    Direct: 310.371.3326
    Fax: 413.845.8238

    Below is a Quick Reference List of topics and page numbers in the Kansas EDI Implementation Guide that may be the most helpful in getting started with your EDI implementation process.

    Quick Reference List
    Page 19..................Executive Summary: Managing an EDI
                                     Implementation
    Page 22..................Steps to Implement EDI
    Page 25..................Reports and Data Requirements (EDI reporting
                                     requirements cross-walked with K-WC 1101-A)
    Pages 38-42..........EDI Reports and Claim Events (advising when
                                     claims should be reported)
    Pages 43 & 65.......Transaction Sequence Requirement (order in
                                     which a claim administrator will submit reports)
    Pages 51-52...........FROI & SROI Element Requirement tables
    Page 62..................Approved EDI Formats (technical data format)
    Page 63..................Data Edits (edit rules and an overview of how
                                     this process works; tables are on pages 67-75)
    Page 80..................Reporting Process Functions and Options (lists
                                     of in-house and vendor EDI solutions, tips to
                                     assess options)
    Page 86..................Kansas EDI Trading Partner Process (Trading
                                     Partner documents and data requirements)
    Page 103................KDWC Test and Production Process (testing
                                     procedure to establish technical capability)

    Kansas Trading Partner Documents
    The KS Trading Partner Agreement and Profile are also available on the website http://www.dol.ks.gov/wc/html/wcedirelease_DBR.html. Instructions are on page 95 of the Kansas EDI Release 1 Implementation Guide.

    Once completed, please fax (413.845.8238) or email (KS_edi@peakpsi.com) the documents to Sharon Marion of Peak PSI, and advise her of a convenient date for your company to begin testing.

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  9. Question: Where can I find the Kansas EDI Implementation Guide?

    Answer: The Kansas EDI Implementation Guide is only available on our web site at http://www.dol.ks.gov/WC/html/wcedirelease_DBR.html

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  10. Question: How do I contact someone at the State of Kansas who deals with EDI?

    Answer: See contact information at bottom of page.

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  11. Question: What other resources are there for doing EDI with the State of Kansas?

    Answer: The Kansas EDI Implementation Guide at http://www.dol.ks.gov/WC/html/wcedirelease_DBR.html lists many of the options available, or see contact information at bottom of page.

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  12. Question: Where can I find the IAIABC Release 1 Implementation Guide?

    Answer: The IAIABC guide is located on their web site at http://www.iaiabc.org/edi/implementation_docs/release1.0/2002-02-15_Release_1_Guide.pdf (there is no charge).

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  13. Question: Where do I find the Data Dictionary?

    Answer: The Data Dictionary can be found in Section 6 of the IAIABC Release 1 Implementation Guide (http://www.iaiabc.org/edi/implementation_docs/release1.0/2002-02-15_Release_1_Guide.pdf).

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  14. Question: I keep getting an Edit 58 Error (Code/ID Invalid) on the SROI data element DN83 Permanent Impairment Body Part Code, but I use the codes From the Body Part table on your Web site (http://www.dol.ks.gov/WC/html/wcedicode_DBR.html); can you tell me why none of the codes I use will pass the edits?

    Answer: In Kansas, TABLE 7: Part of Body Codes on our Web site is for use with data element DN36 only; DN83 must equal “99” (Whole Body). All permanent impairment ratings must be expressed as a percentage of the body as a whole. A notation of this was previously found in the table of Edit Matrix Comments following the Edit Matrix in the Guide. We have now added a notation in the Edit Matrix itself, in the DN83 cell in the column “ IAIABC Data Element Name.”

 

For assistance, contact us at:

Technology & Statics Unit
Kansas Department of Labor
Workers Compensation
800 SW Jackson, Suite 600
Topeka, KS 66612-1227
(785) 296-4120.

David Sprick    E-mail: david.sprick@dol.ks.gov
Alan Stanton    E-mail: alan.stanton@dol.ks.gov
Robert Soria    E-mail: robert.soria@dol.ks.gov

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Page last updated June 3, 2008