Electronic Reporting System for Doctor’s First Report of Injury
Every physician who treats an injured employee must file a complete Form 5021 Doctor’s First Report of Occupational Illness or Injury (DFR) with the employer’s claims administrator within five days of the initial examination. Currently, the claims administrator is required to send a paper copy of the DFR by mail to the Department of Industrial Relations (DIR). In order to bring greater efficiency to the workers’ compensation reporting, Senate Bill (SB) 1160 requires that the physician to electronically file the DFR with DWC. The new electronic system will allow for standardized data to be submitted directly to DWC and can be used to improve the workers’ compensation system.
Am I required to file electronically?
Currently, this is a pilot program and physicians are not required to participate. However, DWC plans to draft regulations to require electronic reporting in the future with the goal of eventually phasing out paper filing.
How does it work?
Online electronic system
Physicians can electronically submit DFRs directly to DWC using the online system. The physician is then responsible for sending a copy of the form to the claims administrator.
Electronic Data Interchange
Electronic Data Interchange (EDI) is the computer-to-computer exchange of data or information in a standardized format. In workers’ compensation, EDI refers to the electronic transmission of claims information from the treating physician to the DWC. The two systems conducting data transactions through EDI systems are usually referred to as “trading partners.” All collected data elements are reviewed for valid and standardized business definitions and formats.
Large volume filers such as hospitals are invited to participate through EDI submission. Interested parties should contact the DWC at firstname.lastname@example.org for additional information on how to utilize the DFR EDI system.
Helpful information for electronic reporting of DFR:
- DFR Online System Manual to submitting a successful form.
- Coming soon California EDI Implementation Guide for Doctor’s First Report of Occupational Illness or Injury. You may contact the DWC by email at email@example.com if you are interested in submitting DFRs using EDI.
- Notice of rulemaking, text of the regulations, and the initial statements of reasons will eventually be found on the DWC rulemaking page.
Electronic Reporting System for Doctor’s First Report: