Update from EDI Systems

DN0442: Net to Zero Code

Definition: Indemnity benefit are owed to the injured worker, but because of a full offset due to an adjustment, credit, or reduced earnings, the Net Weekly Amount has been reduced to zero. This code is only present during the time the benefit is being reduced to zero. This code should not be used in conjunction with 2xx Employer Paid Benefits.

Record: R22

Format: 1 A/N

Values: Z = Net to Zero

DP Rule:

• The Net to Zero Code should be present on any SROI transaction (including the Suspension) for the duration of the benefit being net to zero.
• An event transaction other than a 02 should be used when adding or removing the Net to Zero Code (example: CA, CB, etc). SROI 02 cannot be required after a suspension (SX) when the Net to Zero Code no longer applies.  
• The conditions that require this field to be reported should be indicated in the Jurisdiction’s Event Table.  
• Refer to Net to Zero Population Rules in Section 4. 

File Layout:

Rec   DN         Data Element Name    Format Length  Beg End

R22 0442        Net to Zero Code          A/N      1            646 646

Voting for IRR CLM914 completed on Monday, January 25, 2021. The proposed resolution was APPROVED along with the implementation timeline.

A total of 25 responses were received consisting of 21 Yes Votes, 0 No Votes and 4 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 100% in favor of the proposed resolution. A detailed report of the voting results for CLM914 is attached.

The voting period for this IRR has begun and will extend through 1/25/21. A ballot for this IRR was sent to the voting body via email on 1/4/21. 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.

The Final 14-Day Review period has begun for this IRR and will extend through 12/28/20. Please respond to this post with any additional feedback.

The Net to Zero Effectiveness Workgroup has completed their work today.  Please see the attached proposed resolution and scenarios that will be reviewed in our dedicated Net to Zero Claims Committee meeting on December 2nd from 1pm - 3pm cst.  Please feel free to post any comments here if you are able to review the documents ahead of time or if you are unable to make the meeting. 

This workgroup has worked hard and I'm very proud of this accomplishment!