1. DN0435 has been assigned to the new approved element REDUCED EARNINGS NET WEEKLY AMOUNT DUE BY CLAIM ADMINISTRATOR


2. The data will be added to the SROI Reduced Earnings segment in positions 41 through 51

Voting for IRR CLM857 completed on Thursday, January 25, 2018. The proposed resolution to clarify reporting instructions for Reduced Earnings and capture weekly amount paid when multiple weeks are reported was approved along with the implementation timeline.

A total of 31 responses were received consisting of 25 Yes votes, 0 No vote and 6 Abstentions. Per the requirements of the IRR process, a two-thirds majority is needed for an IRR to be considered approved. The outcome of this vote exceeded the two-thirds requirement with 100% in favor of the proposed resolution.

Origami's realizes we should have pointed this out earlier, but in case this IRR gets sent back to committee, we would like these comments noted.   

From the â€‹FINAL proposed documentation​ for IRR CLM857

Under the SROI-CA section, it is proposed that a new DP rule be added to the SROI-CA that states:  "An MTC CA would not be triggered when Actual or Deemed Reduced Earnings yield a Reduced Earnings Net Weekly Amount Due By Claim Administrator of zero."  

Under the proposal for the new DN for "REDUCED EARNINGS NET WEEKLY AMOUNT DUE BY CLAIM ADMINISTRATOR" there is a DP rule that states: "This amount may be zero if the Actual (DN0124) or Deemed (DN0147) Reduced Earnings exceeded an amount that would entitle the claimant to temporary partial benefits for that week, in that the weekly compensation rate required by the jurisdiction."

When we were reviewing the final proposal for this IRR in preparation for voting, we ended up with a few questions, because the two statements above are not as crystal clear as they could be or some may interpret as slightly contradictory.  If we are having questions now, it is possible others will in the future, and come up with a difference of interpretation. 

In the new DP rule for the SROI-CA: was the intention to make the DP rule to note that if a reduced earnings loop is not applicable (DN0124/DN0147 = $0.00) then the should not be present to show the values of $0.00? As we know, the red earn loop is not applicable to a claim more often than it is applicable. 

And in the DP rule for the new DN, it specifically mentions that if the amounts for either DN0124 or DN0147 are $0.00, those can be reported as zero (which could be interpreted as slightly contradictory to the above DP rule), which would ordinarily go against what you would send in a monetary field, due to the rule in section 2 that states "Spaces indicate absence of data." 

Posted By: Gregg Lutz

Business Requirement / Issue: Reduced Earnings reporting is inconsistent and lacks payment detail when multiple weeks are reported.



Final Proposed Resolution: Clarify reporting instructions for Reduced Earnings and capture weekly amount paid when multiple weeks are reported.

Supporting Scenario

The voting period for this IRR has begun and will extend through 1/25/18. A ballot for this IRR was sent to the voting body via email on 1/4/18. 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.