EDI Implementation Guide & Supporting Documents

The forms provided here are meant to assist Trading Partners who use EDI to report claim data to the Bureau of Workers' Compensation.

EDI Claims Implementation Guide

The Bureau of Workers' Compensation has published the Electronic Data Interchange (EDI) Claims Implementation Guide and its supporting documents. This version of the guide provides technical information, procedures and explanations to help claims administrators prepare and navigate future EDI processes.

Submit any comments, questions and suggestions you have regarding the guide to the bureau’s EDI section via the Customer Service “Submit a Question” feature from the WCAIS Dashboard. We will consider your input as we make revisions to it in the future.

EDI Crossover Documents

The following EDI Release 3 crossover documents are being provided to assist with the implementation of Claims EDI Release 3 filing requirements. Submit any comments, questions and suggestions you have regarding the guide to the Bureau’s EDI section via the Customer Service “Submit a Question” feature from the WCAIS Dashboard.

Note: Please continue to check for the posting of additional scenarios/revisions.

LIBC-336LIBC-337LIBC-338LIBC-339
LIBC-340LIBC-380LIBC-392aLIBC-494c
LIBC-495LIBC-496LIBC-498LIBC-501
LIBC-502LIBC-751LIBC-755LIBC-757
LIBC-761LIBC-762LIBC-763LIBC-764

EDI Forms Solution DN Mapping

The following EDI Forms Solution Data Element (DN) Mapping reference documents are being provided to assist filers with determining the appropriate EDI fields to populate to ensure accuracy in form filing.

LIBC-495 DN Mapping
LIBC-496 DN Mapping
LIBC-501 DN Mapping
LIBC-502 DN Mapping

Supporting Documents: