Workers' Compensation Electronic Data Interchange (EDI)

Effective September 1, 2018, the Oklahoma Workers’ Compensation Commission (WCC) has mandated that all Workers’ Compensation claims data be sent to the WCC electronically.  This brings Oklahoma Workers’ Comp into the “paperless” arena so many other states or lines of insurance have already mandated.  The EDI mandate is that all employers, insurance carriers, and third-party claims companies file claims and data through an interchange, rather than using paper forms.   For employers, this means that you will no longer be required to submit a copy of the Form 2 (First report of Injury) to the WCC after an injury resulting in Lost Time.   However, it is imperative to note that these First Report forms must be sent to OMAG via its claims company, CBR, to initiate a claim.  The submission email address is still NewClaim@cbremail.com.   CBR will then send this First Report information to the WCC electronically.

 Going paperless should save the WCC manpower and costs, as they no longer must enter the claims by hand, and there will be a much greater compliance rate of submission.  However, there are several areas of concern for OMAG and its member municipalities:

 Fines for non-compliance or poor compliance are expected for employers, carriers, or claims companies.   First Reports of Injury are due to the WCC within 10 days of the date the employer was notified of the injury.  The WCC can levy fines for employers who do not send this information timely.   It is imperative that municipalities send the claim to CBR as soon as possible (preferably within 24 hours, but no later than 5 days).  CBR will send the claim to the WCC within 24-72 hours of receipt, provided all mandatory information is included in the report.

 A report card may be published by the WCC identifying employers, carriers and claims companies who do not send data in timely, or do not pay benefits timely.  A claim must be accepted, denied, or an extension requested within 15 days of employer notice.  Temporary Total Disability or Wages Paid in Lieu of must be started within 15 days of the first day of Lost Time. 

 The WCC is basically going to monitor the timely filing of claims and related information, and the prompt and accurate payment of benefits.  These were never monitored by the WCC in the past.

 OMAG’s claims company, CBR, is on top of these requirements and has been testing with their vendor and with the WCC for some time now.   CBR was fully compliant with the EDI mandate on September 1. 

 Please contact OMAG or CBR for more information.  CBR inquiries can be sent to info@cbremail.com.

Best Practices for Workers' Compensation Injuries

A municipality’s costs for workers’ compensation can be controlled and reduced by following a few Best Practices.

• Risk Management - consistent training is needed.  Most people have good and bad work habits and to prevent workplace accidents, the employer needs to focus on training away a person’s bad habits.  Success requires diligence and regular training by the employer.

• Timely report the injury - your OMAG adjuster is standing by to talk to the injured worker and help but they cannot get started until the claim is reported.  The Municipality’s goal should be to report the claim to OMAG within 24 hours of the incident.  Statistics prove that a delay in reporting a claim will increase the ultimate cost of resolving the claim.

• Preferred physician - Select a medical facility that will provide immediate medical treatment for any injured worker.   If an occupational clinic in your area is not an option, employers often choose an AM/PM Urgent Care facility to readily provide treatment.  The Emergency Room may be the best option in a rural area of the state, however the cost at the ER is 500% + more expensive than an Urgent Care.

• Return-to-work - when the doctor takes an injured worker off work while they heal, they may offer the employer the opportunity to return early if the employer can accommodate “temporary” work restrictions.  These may be as simple as restricting the amount of weight they can lift, or their ability to stand, crawl or bend.  Major benefits from accommodating work restrictions are:

  • Employee remains engaged and productive

  • The employer can monitor the healing progress and encourage the worker to attend doctor visits, physical therapy or other treatment

  • A smooth transition is in place for the return to 100% fulltime duties

  • Employee loses no pay so there is no financial hardship

  • Litigation is reduced since the injured worker maintains their job, pay and receives great medical care