Annual Report Of Adjusting Locations {DWC-857} | Pdf Fpdf Docx | California

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Annual Report Of Adjusting Locations {DWC-857} | Pdf Fpdf Docx | California

Last updated: 10/31/2022

Annual Report Of Adjusting Locations {DWC-857}

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TO: Workers' Compensation Claims Administrators RE: 2021 Annual Report of Inventory for Claims Reported During Calendar Year (CY) 2021. Title 8, California Code of Regulations, Section 10104 requires claims administrators of California workers' compensation claims to file with the Administrative Director, by April 1 of each year, an Annual Report of Inventory indicating the number of claims reported at each adjusting location for the preceding calendar year. The report for CY 2021 must be filed by April 1, 2022. Enclosed is an Annual Report of Inventory. Even if you had no claims reported in the prior year, you must complete and submit the report. Each adjusting location is required to submit an Annual Report of Inventory, whether or not they receive a form for reporting claims from this office. When completing the Annual Report of Inventory, be mindful of the following requirements: • The population of claims reported must distinguish the claims by type: indemnity claims, denied claims, and medical-only claims. • The DWC Audit Unit definition of “indemnity claim” is: a claim “… that has resulted in the payment…” of indemnity [8CCR§10100.2 (x)]. • The DWC Audit Unit definition of “adjusting location”: “Separate underwriting companies, self-administered, self-insured employers, and/or third party administrators operating at one location shall be combined as one audit subject…” (but) “… only if claims are administered under the same management at that location.…For auditing purposes, any separate office or location whose staff includes local management may be considered a single adjusting location” [8CCR§10100.2(a)].

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