Managing SI claims

A self-insuring (SI) employer agrees to manage claims as required by the laws and rules controlling self-insurance. The ultimate responsibility for administering and processing the workers' compensation claims resides with the self-insuring employer.

The claims administration process includes, but is not limited to:

• The allowance or disallowance of claims
• Payment of compensation and benefits
• Maintaining claim files
• Making the appropriate information available to the injured worker and/or their representatives for inspection
• Assisting employees in filing their applications for benefits and completing the necessary forms for processing a workers' compensation claim

The following topics have additional claims management resources for SI employers.

• SI audit requirements: All SI claims administration processes are subject to an audit by the BWC Self-Insured Department. Refer to SI audit requirements for more information.
• Procedural Guide for Self-Insured Claims Management: A reference and training guide on claims administration for self-insured employers.
• Billing and Reimbursement Manual: To understand how medical providers bill for services under the Health Partnership Program.
• Fee Look-Up Schedule: To see the rates self-insuring employers use when reimbursing for services.
• Update Claims Allowance: To update the status of a workers' compensation claim, refer here.
• Claim expenses/DWRF/Non-compliance/VSSR Claim Payment Transactions : Refer to Disabled Workers’ Relief Fund (DWRF), Violation of Specific Safety Requirements (VSSR), and Non-Compliance to view or download a breakdown of claim payment transactions.

Permanent total disability (PTD), DWRF, and other information can be found as follows:

• PTD Rate Calculation Worksheet
• Instructions for PTD Rate Calculation Worksheet
• DWRF Future Exposure Worksheet
• Life Expectancy / Present Day Value Chart
• Repayment Options for Lump Sum Advancement