Claims EDI R3.1 Implementation and Compliance Reminder

New York State Workers' Compensation Board sent this bulletin at 12/30/2021 02:49 PM EST

Claims EDI R3.1 Implementation and Compliance Reminder

The Claims EDI R3.1 upgrade implementation date is Monday, January 24, 2022. All trading partners will be required to submit R3.1 transactions starting at that time.

Onboarding

Trading partners who use the Secure File Transfer Protocol (sFTP) flat-file submission method must complete onboarding testing no later than January 7, 2022. EDI 3.1 will be put in production on January 24, 2022, regardless of whether all trading partners have completed the onboarding process.

Any trading partner who submits through sFTP flat file and has not successfully passed the sFTP testing by January 24, 2022, should use the eClaims Web Data Entry application to submit R3.1 production transactions, as this will eliminate the risk of rejected transactions. You will be held to the Ongoing Monitoring Requirements listed in Section 3.9 of the EDI R3.1 Implementation Guide and are subject to penalties imposed by the Board.

Important Upcoming Dates

Please be aware of these upcoming key dates for the Claims EDI R3.1 implementation schedule:

  • January 7, 2022 – Onboarding testing ends
  • January 20, 2022 – Claims EDI R3.0 flat file submissions can be submitted until 6:00 p.m. ET
  • January 21, 2022 – Web Data Entry (WDE) and eCase are unavailable beginning at 5:00 p.m. ET
  • January 24, 2022 – Claims EDI R3.1 is live at 7:00 a.m. ET

EDI Compliance Reminder

Claim Administrators should ensure the appropriate First Report of Injury / Second Report of Injury (FROI/SROI) transaction is filed for every case with a current, ongoing payment. This reminder extends to all cases regardless of their age or status (open or closed) with the Workers’ Compensation Board (Board). Compliance with this EDI mandate may not be 100 percent, especially in instances where there are ongoing payments in closed cases. 

It is vital that all data in the Board’s system concerning ongoing payments in individual workers’ compensation cases is up-to-date and accurate, especially as we move toward creating the Board’s new business information system, OnBoard, 

Your anticipated cooperation with this directive is greatly appreciated.

Failure to abide will:

  • create obstacles to fulfilling the Board’s electronic reporting mandate,
  • negatively impact the effectiveness of the planned migration of data from CIS to OnBoard, and
  • interfere with the Board’s ability to monitor the effectiveness of the workers’ compensation system once OnBoard is implemented.

Failure to abide by this directive may also result in the assessment of penalties against Claim Administrators consistent with workers’ compensation law and regulations. 

Should you have any questions, please email eClaims31@wcb.ny.gov. You can also find additional information on the eClaims frequently asked questions webpage.

More information

Visit the OnBoard Project webpage to stay up to date on project news, feedback opportunities and resources.

For more details on the Claims EDI R3.1 upgrade and future webinars, visit the eClaims section of the Board’s website. To review past presentations, visit the eClaims Presentations section of the Board’s website.

You can also subscribe to have the OnBoard Project news sent straight to your inbox!