CHAPTER 11
ELECTRONIC DATA INTERCHANGE (EDI)
876—11.1(85,86) Purpose. The purpose of this chapter is to establish the procedure for fulfilling reporting requirements of the division of workers’ compensation.
876—11.2(85,86) Definitions. The following definitions apply to 876—Chapter 3 and this chapter.
“EDI” or “electronic data interchange”  means electronic transmission or reception, or both, of data through a telecommunications process utilizing a value-added network or the Internet as set forth in the EDI partnering agreement.
“EDI partnering agreement” means the written agreement between an entity and the division of workers’ compensation specifying the terms and manner of reporting by EDI.
“Filed” means receipt and acceptance of a report by the division of workers’ compensation. A report is considered to be “filed” on the date it is accepted (TA) by the division of workers’ compensation. A report that is submitted but rejected (TR) is not considered “filed.”
“Report” means a first report of injury (FROI) or a subsequent report of injury (SROI), or both.
“Reporter” means the person who is responsible for reporting to the division of workers’ compensation pursuant to the Iowa workers’ compensation laws and includes an employer, an employer who has been relieved from insurance pursuant to Iowa Code section 87.11, and an insurance carrier which provides an employer workers’ compensation insurance.
“Reporting” means submission of claims data and data fields of information of a report.
[ARC 4568C, IAB 7/31/19, effective 7/10/19]
876—11.3(85,86) Form of reporting. The format of EDI reporting must be the current version of the International Association of Industrial Accident Boards and Commissions (IAIABC) Release 3.1 FROI/SROI.
[ARC 4568C, IAB 7/31/19, effective 7/10/19]
876—11.4(85,86) Manner of reporting. The manner of EDI reporting is electronic.
876—11.5(85,86) Voluntary reporting deadline. Rescinded ARC 4568C, IAB 7/31/19, effective 7/10/19.
876—11.6(85,86) Mandatory reporting. All reporters are responsible for reporting by EDI 3.1. A reporter may contract with another entity for reporting, but the reporter is ultimately responsible for reporting. Each reporter or entity reporting on behalf of a reporter must sign an EDI partnering agreement.
[ARC 4568C, IAB 7/31/19, effective 7/10/19; ARC 6841C, IAB 2/8/23, effective 3/15/23]
876—11.7(85,86) Required reports.
	11.7(1) A reporter shall file reports as required by Iowa Code sections 86.11, 86.12, and 86.13, 876—subrules 3.1(1) and 3.1(2), this chapter and the partnering agreement. Reports required to be filed include, but are not limited to, the following:
	a. 	First report of injury (FROI). See 876—subrule 3.1(1);
	b. 	Subsequent report of injury (SROI). See 876—subrule 3.1(2);
	c. 	Annual report on every claim that is open on June 30 each year. The annual report shall show all benefits paid since the claim was initiated through June 30 of the current year. A final report shall be filed in lieu of the annual report if the claim is closed and the final report is filed before the date when the annual report is scheduled to be filed; and
	d. 	Final report filed at the time the claim is closed. The final report indicates that no further benefit payments are contemplated.
	11.7(2) A reporter shall file a change to FROI and SROI reports whenever a reporter is made aware that information previously submitted is incorrect. The reporter shall file a change within 45 days after being made aware that previously submitted information is incorrect. Information for which a change shall be filed includes, but is not limited to, the injured employee’s social security number, date of injury, employer’s name, and injured employee’s name. A reporter shall also correct information used in calculation of the compensation rate including, but not limited to, marital status and number of exemptions, average weekly wage, and compensation rate at the time of the employee’s injury. If a final decision by the division of workers’ compensation or a court of law changes any of the previously submitted information, the attorney for the employer and insurance carrier shall notify the reporter. The reporter shall file a change within 45 days of the final decision.
[ARC 4568C, IAB 7/31/19, effective 7/10/19]
These rules are intended to implement Iowa Code sections 85.26, 86.8, 86.11, 86.12 and 86.13.
[Filed 9/4/98, Notice 7/29/98—published 9/23/98, effective 10/28/98]
[Filed 2/15/02, Notice 1/9/02—published 3/6/02, effective 4/10/02]
[Filed 5/20/04, Notice 4/14/04—published 6/9/04, effective 7/14/04]
[Filed 11/4/05, Notice 9/14/05—published 11/23/05, effective 1/1/06]
[Filed Emergency After Notice ARC 4568C (Notice ARC 4472C, IAB 6/5/19), IAB 7/31/19, effective 7/10/19]
[Filed ARC 6841C (Notice ARC 6701C, IAB 11/30/22), IAB 2/8/23, effective 3/15/23]