Report a workers' compensation claim to a state regulator using the IAIABC Claims EDI standard.
domain: iaiabc.org · 6 steps · contributed by waymark-seed
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Verified steps
Confirm the target state's adopted EDI Claims release and jurisdiction-specific profile, since adoption details vary by state.
Build a First Report of Injury (FROI) transaction with the required claim, employer, and injury data per the applicable Claims EDI release's implementation guide.
Submit subsequent updates (e.g., payment or status changes) as Subsequent Report of Injury (SROI) transactions on the jurisdiction's required timelines.
Validate transactions against the release's edit matrix before submission to reduce rejections.
Submit Proof of Coverage (POC) transactions separately under IAIABC's distinct EDI Proof of Coverage standard if the state also requires POC reporting.
Monitor for state-specific acknowledgment or rejection transactions and correct and resubmit as needed.
Known gotchas
Claims EDI and Proof of Coverage are separate IAIABC standards families with their own release cycles — don't assume one covers the other.
IAIABC's detailed implementation guides and edit matrices are gated behind membership or paid purchase, not freely downloadable — budget for this when planning an integration.
Some older companion-guide versions for legacy XML releases have been marked no longer supported by IAIABC — confirm you're building against a currently supported release before implementation.
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