Voting Results - IRR CLM910 New DN for Date an Injury Became Reportable
Business Requirement / Issue: Indiana has a need to identify the date an injury becomes reportable (see attached Original IRR Request).
Requester's Proposed Resolution: New DN for Date Injujry Became Reportable is desired (see attached Proposed Resolution Details).
Voting for IRR CLM910 completed on Monday, December 7, 2020. The proposed resolution was APPROVED along with the implementation timeline.
A total of 31 responses were received consisting of 23 Yes Votes, 3 No Vote and 5 Abstentions. Per the requirements of the IRR process, a two-thirds majority is required for an IRR to be considered approved. The outcome of this vote exceeded the two-thirds requirement with 88% in favor of the proposed resolution. A detailed report of the voting results for CLM910 is attached.
Thank you.
Steve
Monica Blackwell wrote:
Hi Steve - According to our guidelines, if approved, this DN would be placed into a filler space within the file layout. There will not be a file expansion for this new DN because we have options of filler space to use. After a jurisdiction has added this new DN requirement to their tables, it cannot be required for 180 days. I hope this resolves your concerns.
The voting period for this IRR has begun and will extend through 12/07/20. A ballot for this IRR was sent to the voting body via email on 11/16/20. The voting body is comprised of current IAIABC jurisdictional and EDI members in good standing. Each eligible organization is allowed one vote per IRR. It is the responsibility of the designated voter (or the alternate, if the designated voter is not available) to discuss the issue up for vote with all stakeholders within their organization and vote accordingly.
Hi Steve - According to our guidelines, if approved, this DN would be placed into a filler space within the file layout. There will not be a file expansion for this new DN because we have options of filler space to use. After a jurisdiction has added this new DN requirement to their tables, it cannot be required for 180 days. I hope this resolves your concerns.
Steve Bennett, Vice President, Workers' Compensation Programs for the American Property Casualty Insurance Association ("APCIA"): APCIA supports the proposed new Data Element Number ("DN") to EDI claimm reports. The new DN will hopefully streamline determinations of timeliness in states such as Indiana and reduce the amount of reporting disputes. APCIA, however, is concerned with implementation as the new DN will require IT involvement and computer programming changes and possible file expansion to accomadate the new data elements. Accordingly, we would request that the IAIABC provide an adequate implementation period for the new DN. We would suggest an implementation period of one year. Thank you.
Steve
The Final 14-Day Review period has begun for this IRR and will extend through 11/13/20. Please respond to this post with any additional feedback. Voting is scheduled to begin on 11/16/20.
Gregg, I have made all corrections on IRR 910 at the bottom. They are highlighted in yellow. If you have any questions, please do not hesitate to contact me.
Thank you,
Idaho requires the claim to be filed within 10 days of the injury or occupational disease requiring treatment by a physician or resulting in absence from work for one day or more. The worker has up to one year from the date of injury to seek medical treatment.
For example, a worker may be injured on 6/01/20 but does not seek treatment until 10/01/20. The injury becomes reportable 10/01/20 for an injury occurring on 6/01/20.
Richelle Flores, State of Idaho Industrial Commission
In Nebraska our reporting trigger is within 10 days of the Employer having knowledge of an injury. We accept all claims types including Medical Only and Notification Only. Below for reference is the language from our statutes:
48-144.01.
Injuries; reports; time within which to file; terms, defined.
(1) In every case of reportable injury arising out of and in the course of employment, the employer or workers' compensation insurer shall file a report thereof with the Nebraska Workers' Compensation Court. Such report shall be filed within ten days after the employer or insurer has been given notice of or has knowledge of the injury.
(2) For purposes of this section:
(a) Reportable injury means an injury or diagnosed occupational disease which results in: (i) Death, regardless of the time between the death and the injury or onset of disease; (ii) time away from work; (iii) restricted work or termination of employment; (iv) loss of consciousness; or (v) medical treatment other than first aid;
(b) Restricted work means the inability of the employee to perform one or more of the duties of his or her normal job assignment. Restricted work does not occur if the employee is able to perform all of the duties of his or her normal job assignment, but a work restriction is assigned because the employee is experiencing minor musculoskeletal discomfort and for the purpose of preventing a more serious condition from developing;
(c) Medical treatment means treatment administered by a physician or other licensed health care professional; and
(d) First aid means:
(i) Using a nonprescription medication at nonprescription strength. For medications available in both prescription and nonprescription form, a recommendation by a physician or other licensed health care professional to use a nonprescription medication at prescription strength is not first aid;
(ii) Administering tetanus immunizations. Administering other immunizations, such as hepatitis B vaccine and rabies vaccine, is not first aid;
(iii) Cleaning, flushing, or soaking wounds on the surface of the skin;
(iv) Using wound coverings, such as bandages and gauze pads, and superficial wound closing devices, such as butterfly bandages and steri-strips. Using other wound closing devices, such as sutures and staples, is not first aid;
(v) Using hot or cold therapy;
(vi) Using any nonrigid means of support, such as elastic bandages, wraps, and nonrigid back belts. Using devices with rigid stays or other systems designed to immobilize parts of the body is not first aid;
(vii) Using temporary immobilization devices, such as splints, slings, neck collars, and back boards, while transporting accident victims;
(viii) Drilling of a fingernail or toenail to relieve pressure or draining fluid from a blister;
(ix) Using eye patches;
(x) Removing foreign bodies from the eye using only irrigation or a cotton swab;
(xi) Removing splinters or foreign material from areas other than the eye by irrigation, tweezers, cotton swabs, or other simple means;
(xii) Using finger guards;
(xiii) Using massages. Using physical therapy or chiropractic treatment is not first aid; and
(xiv) Drinking fluids for relief of heat stress.
Rhode Island – See general law cite below. Per our Event Table, we require a First Report within 10 calendar days of the claim administrator having knowledge of the injury (48 hours for fatal injury). An injury is reportable after three days of lost time or any medical treatment. We also encourage err'ing on the side of reporting, and accept all incident-only reports.
§ 28-32-1. Reports required from employers.
(a) Every employer who is or becomes subject to the provisions of chapters 29 – 38 of this title shall report to the director, in writing or in any other manner specified by the director, every personal injury sustained by an employee arising out of and in the course of his or her employment connected and referable to the employment, if that injury proves fatal or incapacitates the employee from earning full wages for a period of at least three (3) days, or requires medical treatment regardless of the period of incapacity.
(b) If the injury is immediately fatal, the report shall be made within forty-eight (48) hours after it occurs; if it proves fatal later, the report shall be made within forty-eight (48) hours after death occurs and comes to the knowledge of the employer; if the injury is not fatal, the report shall be made within ten (10) days after the injury, or if the incapacity is due to an occupational disease then within ten (10) days after the incapacity shall come to the knowledge of the employer.