dept of defense feca electronic data interchange
DESCRIPTION
TRANSCRIPT
DEPT OF DEFENSE DEPT OF DEFENSE FECA Electronic Data Interchange FECA Electronic Data Interchange (EDI)(EDI)
WHAT IS EDI? EDI stands for Electronic Data Interchange. With EDI, CA-1
and CA-2 forms are submitted thru HRO, to the Department of Labor instantaneously, eliminating paper processing and mail delays.
The purpose of the EDI project is to expedite processing of FECA claims for injured workers.
Our goal is to have all CA-1’s and CA-2’s submitted within 10 days from the date of injury, and CA-7’s submitted within 5 days of the employees’ signature date.
Employees will be assigned a claim number within 48 hours of the time the claim is received by the Department of Labor.
Faster claims processing leads to expedited medical authorizations, treatment, bill payment.
Better service leads to faster recovery.
EDI Information Flow EDI Information Flow
HOW DOES IT WORK? Employee reports the injury to his/her supervisor
IMMEDIATELY to complete a claim form. Supervisor and employee complete the electronic form,
Click PRINT, then SUBMIT, then form will be transmitted to HRO.
HRO “authenticates” the form (I.e., verifies employment status, enters appropriate codes, corrects any errors); form is then transmitted to DOL.
DOL assigns case number within 48 hours. Employee and HRO will receive a letter from OWCP stating whether the claim was accepted or denied, and the claim number.
Medical Information For CA-1’s ONE CA-16 should be issued IF medical attention
is needed. Supervisors are not required to issue a CA-16 after 4 hours from time of injury.
Employees that receive medical care should tell the medical provider that it is FEDERAL Workers compensation and their claim number. All bills MUST be submitted on HCFA 1500’s or UB 92’s. No statements will be accepted.
OWCP has contracted out their billing to an agency called ACS. Medical Providers must be enrolled in ACS in order for bills to be paid. Providers can enroll by calling 1-866-335-8319
The EDI ProcessThe EDI Process
What are the requirements for participating in EDI? Supervisor must have access to computer with internet
connection. Patience. It takes a few minutes for the forms to appear.
Where is the EDI web site?
The forms are accessible at https://isdmid1.cpms.osd.mil/web_html/static_java_edi_sup.html
The website is also located on the www.gahro.com under Forms and Publications.
A password is not required to enter a CA-1 or CA-2.
The EDI FormsThe EDI Forms
The EDI forms are patterned directly on the hard copy forms CA-1 and CA-2. Therefore, the basic instructions for completing the forms are the same as with paper. A copy of these instructions can be obtained on-line at http://www.dol.gov/esa/regs/compliance/owcp/forms.htm
The electronic format does contain certain features that may require further explanation. The following slides illustrate some of these features.
Step One: Enter employee’s SSN and
date of birth. This information allows the system to access the employee’s personnel
data.
Step Two: Indicate whether claim is for a
traumatic injury (CA-1) or an occupational
disease (CA-2)If information is correct, click “enter.” This will take you to the next screen. If incorrect, reenter, or
click “exit.”
If you get this message, STOP. Go to www.gahro.com then to
Employee Relations and complete the form. Then hand carry or mail to
Georgia National GuardERS: Kelly Casey
935 E. Confederate Ave. Bldg 21PO BOX 17965
Atlanta, GA 30316
PUBLIC JOHN
F
05/01/1960
999-99-9999
The white fields are mandatory and must be
completed by the employee. After completing each field, hit “tab” and the system will take you to the next field.
Yellow fields are optional,
and should only be completed if
appropriate
When all required fields have been completed,
the system will take you to the next screen,
“injury description.”
Gray fields are read-only, and cannot be
altered.
The default value for this field is 12:00 a.m on the date the form is completed. Please enter the actual date and time of the injury
Unless there is a specific reason for not electing COP
(such as ineligibility), this block should be checked.
The employee’s section of the document is now complete. Be sure to give employee the
receipt of notice, which will print when form is complete.
As with the paper CA-1, the witness statement is
optional. However, if a witness statement is
entered, the remaining fields on this page (name, date, address) are mandatory.
Field is limited.
Please ensure witness signs the
printed form.
Make sure that this date
corresponds with the date of injury
given by the employee.
If the employee’s pay has not
stopped, leave this field blank.
If “no” is clicked, an explanation
must be given in the box below.
If “yes” is clicked, an explanation is
mandatory.
If “yes” is entered, you must enter at least the name of the third party in item 32. If the
name is unknown, give a description (e.g.
“homeowner,” or “driver”)
If the supervisor has a substantial disagreement
about the facts surrounding the claimed
injury, click “no” and provide an explanation.
Enter the reasons for controverting COP.
Once all required fields have been entered, the supervisor
must print a copy of the completed CA-1. This record must then be signed by the supervisor, employee, and witness then submitted to
HRO for processing.EDI will tell you if there are
any errors. If there are errors the form will take you to where
you need to correct it.DO NOT FORGET TO CLICK SUBMIT AFTER YOU PRINT
After clicking the “print” button, the system generates a .pdf file using the data you have entered. The information on this file should verified, and printed if correct.
Now that the supervisor has printed a copy, the system will allow the
claim to be transmitted. To transmit the record,
click “submit claim.”
Other Information Please ensure that HRO or HRO Representatives receive ALL
original signed CA-1’s or CA-2’s submitted. Any employee who expects to enter a Leave Without Pay
Status for Workers Compensation should be coordinating with HRO or HRO Representatives.
All original CA-1’s and CA-2’s will be maintained at HRO. CA-7’s must be submitted to OWCP within 7 days of signature
date. CA-7’s are currently not electronic. Please make sure item 27, Date Employee Returned to Work is
entered. If they were injured and returned to work the same day or the next day, put that day.
For Safety Reporting, follow your local safety directives.
Additional Information
If you need more information on Workers
Compensation for the Georgia National Guard, please call
Kelly Casey, 678-569-6431, DSN 338-6431
Or e-mail at