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Electronic Filing of Claims

The 121 st Maine Legislature enacted legislation that required the State of Maine Workers’ Compensation Board to adopt rules mandating electronic filing. The legislation directed the Board to proceed by the consensus based rulemaking process. A committee was formed consisting of representatives from the insurance community, self insureds, WC Board of Directors, and WCB staff. Recommendations were forwarded and unanimously approved by the Board of Directors.

The WCB uses the International Association of Accident Boards and Commissions (IAIABC) Claims Release 3 for all claims EDI filings and IAIABC POC Release 2.1 for all proof of coverage EDI filings.  Currently the WCB requires two types of claims reports to be filed electronically: First Report of Injury and Notice of Controversy. The WCB also requires the WCB-1A form to be filed electronically. Fax transmission is not an accepted method to meet the context of electronic filing discussed above.  The production deadline for the electronic submission for each of the forms is identified in the Electronic Filing/EDI Rule.

Additional documentation will be posted on the WCB website as it becomes available.

The links below provide the actual rules approved by the Board pertaining to claims EDI filing and proof of coverage EDI filing.

Claims Electronic Filing/EDI Rule

Proof of Coverage Electronic Filing/EDI Rule

 

If you have any questions please contact:
Paul J. Fortier, Agency Technology Officer,
at 207-287-3818 or paul.fortier@maine.gov