Workers’ Compensation in Pennsylvania is a form-driven practice, as dictated by the Pennsylvania Workers’ Compensation Act. Six years ago, however, the Bureau of Workers’ Compensation introduced the workers’ compensation automation and integration system (WCAIS). WCAIS rolled out in phases and, beginning in 2013, increasingly required claims professionals to process claims information electronically rather than by submission of paper forms. Before WCAIS, in order to accept or deny a claim, claims professionals completed a paper form, served it and filed it with the bureau. Now, with WCAIS fully implemented and the ability to process claims via electronic data interchange (EDI) transactions, the bureau has stopped accepting many paper forms.
Specifically, as of Sept, 16, 2016, with the implementation of the EDI forms solution enhancement, the bureau stopped accepting paper filings of the notice of compensation payable (LIBC-495), notice of temporary compensation payable (LIBC-501), notice stopping temporary compensation payable (LIBC-502), and notice of denial (LIBC-496). Now, once a claims professional makes a decision regarding compensability, they input the data codes for an EDI transaction and transmit it electronically to the bureau through WCAIS. If the bureau accepts the EDI transaction, a bureau form generates. The claims professional is responsible for serving the generated form on the claimant and the EDI transaction serves as the official bureau record. These forms are the sole means for accepting and denying claims in Pennsylvania.
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