DEPT OF DEFENSE FECA Electronic Data Interchange (EDI)

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DEPT OF DEFENSE FECA Electronic Data Interchange
(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-1s and CA-2s
  submitted within 10 days from the date of injury,
  and CA-7s 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.

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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.

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Medical Information

• For CA-1s 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 1500s or UB 92s. 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

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The 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.o
  sd.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.

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The 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.

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Step One Enter employees SSN and date of
birth. This information allows the system to
access the employees 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.
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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 Guard ERS Kelly Casey 935 E.
Confederate Ave. Bldg 21 PO BOX 17965 Atlanta, GA
30316
8
PUBLIC
JOHN
F
999-99-9999
05/01/1960
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.
When all required fields have been completed, the
system will take you to the next screen, injury
description.
Yellow fields are optional, and should only be
completed if appropriate
Gray fields are read-only, and cannot be altered.
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The default value for this field is 1200 a.m on
the date the form is completed. Please enter the
actual date and time of the injury
10
Unless there is a specific reason for not
electing COP (such as ineligibility), this block
should be checked.
The employees section of the document is now
complete. Be sure to give employee the receipt
of notice, which will print when form is
complete.
11
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.
12
Make sure that this date corresponds with the
date of injury given by the employee.
13
If the employees 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.
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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)
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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.
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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
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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.
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Now that the supervisor has printed a copy, the
system will allow the claim to be transmitted. To
transmit the record, click submit claim.
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Other Information

• Please ensure that HRO or HRO Representatives
  receive ALL original signed CA-1s or CA-2s
  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-1s and CA-2s will be
  maintained at HRO.
• CA-7s must be submitted to OWCP within 7 days of
  signature date. CA-7s 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.

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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
• kelly.casey_at_ga.ngb.army.mil