OhioBWC - Employer - Service: (Detail claim data) - Details
Detail claim data
The detail claim data report allows BWC personnel and Ohio employers
to view individual claim information to help better manage workers’
compensation claims. Claim numbers listed include all claims associated
with an individual policy as a result of combination, transfer or merger
of accounts. This report is downloadable as a comma separated value file.
To take advantage of the most complete claims information available to you,
we recommend you also download its companion report, the claim costs detail
report. This report provides additional cost and reserve data relevant to
The detail claim data report provides detailed information about each claim
listed. The definitions below will help you better understand those details.
Claim number — A numeric identifier assigned to any new claim
Benefit type — Identifies a claim as
medical only (MO) or lost time (LT).
IW (Injured worker) name — Identifies the name of the injured worker
Date of injury (DOI) — Identifies the date on which the
industrial injury or occupational disease occurred
— The stage a claim is in at any given time, i.e., new, allowed, etc.
Claim status date — Identifies the effective date of the current
Filing lag — The number of calendar days that have passed between
the date of injury and the date of claim filing. For example, a claim
filed on Jan. 19 for an injury which happened on Jan. 14 would have a
filing lag of five days.
MO to LT conversion lag — This applies only to claims which have
been reclassified from medical only to lost time. This is the number of
calendar days that have passed between the date a claim was filed and
the date on which the reclassification occurred. This field will be
blank if the claim has been disallowed or dismissed.
Latest actual return-to-work date — Identifies the most recent RTW date.
The field will be blank if return to work has not occurred, if the date
is unknown, or if the date is in the future. This field will also be blank
if the claim has been disallowed or dismissed.
Number of disability episodes — The number of times where the last
day worked (LDW) and RTW date pairs indicate one or more calendar days absent.
This field will be blank if the claim has been disallowed or dismissed.
Calendar days absent — The number of calendar days between LDW and RTW.
If a claim has more than one LWD (e.g. LDW = 1/5, RTW = 1/8, LDW = 1/15, RTW = 1/20),
calendar days absent will not include those days between a RTW and the next LDW.
When an injured worker is deceased and the date of death is on
(or one day after) the date of injury, the calendar days absent will be
blank. If the date of death is more than one day after the date of injury,
calendar days absent will equal the number of calendar days between LDW
and date of death. Similarly, if a claim reaches settlement of both indemnity
and medical or indemnity alone, calendar days absent will equal the
number of calendar days between LDW and the claim status date.
LDW = 2/5; RTW = 2/7; days absent = one
This field will be blank if we have disallowed or dismissed the claim.
LDW = 2/5; RTW = 2/6; days absent = zero
LDW = 2/5; death (or settlement) = 2/15; days absent = nine
ICD-9 code — The code associated with the injury most likely to keep an
injured worker off work (i.e. primary ICD-9 code). ICD-9 codes are the result
of a statistical classification system (International Classification of Diseases,
9th Edition) that arranges diseases and injuries into groups according to established
Note: The unique combination of injury and occupation that results in the
longest expected period of time off work determines the primary ICD-9 code
as identified by Ohio’s return-to-work benchmarks. Occupation is determined
by the National Council on Compensation Insurance manual number or
Standard Occupational Classification (SOC) code listed in the claim. Ohio only has
expected periods of time off work for a select combination of injuries and
ICD-9 description - Text that defines the primary ICD-9 code associated
with a claim. In addition to descriptions of specific injuries and diseases,
you may see the following:
Catastrophic injury claim - Identifies a claim where the nature of the
injuries makes return to work improbable;
Potentially severe complications – Identifies a claim which includes
one or more injuries which make return to work within the optimal time frame
Primary injury not identified – Identifies a claim in which we cannot
identify the primary ICD-9 code.
Manual number — An NCCI code used for premium rate making. The code defines the
degree of risk associated with a particular industry and its germane occupations.
Manual numbers will not appear if the employer is a state agency or public taxing district.
SOC code — The federal government uses this occupational code to categorize
occupations. SOC codes will only appear if the employer is a state agency or
public taxing district. BWC updates SOC data quarterly. Therefore, you may see claims
on the claim detail report for which no SOC data is present.
Optimal days to RTW (ORTW) — The number of calendar days associated with the
unique combination of injury and occupation that results in the longest expected
period of time off work, as identified by Ohio’s return-to-work benchmarks.
Optimal days absent — The number of days absent associated with the ORTW.
Since the ORTW counts days until the expected RTW, the optimal days absent will
generally be one day less than the ORTW standard. For example, if the ORTW for a
particular injury and occupation is three days, the injured worker who last worked
on Jan. 5 would be expected to return to work on Jan. 8 (three days later).
These two dates, however, represent only two days absent (Jan. 6 and 7).
Variance in days absent — The difference between calendar days absent
and optimal days absent. Negative numbers indicate injured workers have returned to
work more quickly than anticipated.