Electronic Filing for NC Workers’ Compensation: Overcoming the Challenges

Computers can make tasks quicker and more efficient. But when something goes wrong on a computer, it can go really wrong. And it can be hard to determine what happened and how to best address the problem.

The North Carolina Industrial Commission requires certain documents associated with workers’ compensation claims to be filed through their Electronic Document Filing Portal or the Electronic Data Interchange. This can work to a claimant’s advantage in some situations, but it can create challenges in other cases. An attorney experienced in filing workers’ compensation claims and appealing denials can help prevent problems and correct errors in the process of completing forms and other documentation.

While our legal team cannot provide advice in a general blog like this, we can offer some suggestions for making the process smoother and resolving difficulties if they arise.

Understanding the Electronic Systems Used

The Electronic Document Filing Portal (EDFP) and Electronic Data Interchange (EDI) are separate systems that are used for different purposes. The EDFP is an entry platform for submitting documents, including forms, to the Industrial Commission. The EDI, on the other hand, is a system used for exchanging data between electronic systems, such as when insurers transmit information automatically. Claimants, insurance companies, and employers need to use electronic filing platforms when required by the rules.

There are some exceptions that apply. Medical providers, for instance, are not required to submit information electronically, although they may choose to do so. In addition, employees filing workers’ compensation claims without an attorney’s assistance are not required to submit information electronically, though they may use the system. It is important to be aware that, since the system is now set up to function almost entirely with electronically formatted information, any forms submitted in writing may be subject to processing delays.

If the EDFP system is not functioning, forms and documents should be submitted electronically via email to edfp@ic.nc.gov. However, if documents are emailed while the EDFP system is active, they will be disregarded. This could cause potential problems if the system appears to have problems that the Industrial Commission does not recognize. It may be necessary to follow up to ensure that information was received, and if not, resubmit it through an alternative means.

Registration is Required

To use the EDFP system, you must register through the NCIC Online Services Center. You create an account explaining whether you are an attorney, a representative of an insurance company, a representative of an employer, or a claimant who has or who plans to file a claim with the Industrial Commission. It is not necessary to have a North Carolina form of identification, such as a driver’s license, but you need to establish a North Carolina Identity Management account.

The rules specify that when documents must be accompanied by a filing fee, they are not considered “filed” until the payment has been received. While most documents must be filed through the EDFP, certain submissions should be submitted via email, such as documents going to the Criminal Investigations & Employee Classification Division in connection with fraud complaints.

Common Challenges with Electronic Filing

Programs that deal with electronic files have some limitations that are important to be aware of. Even when the system is operating at the highest level of proficiency, a failure to adhere to limitation standards can prevent it from working for a particular applicant. Of course, electronic file management systems can also malfunction. Here are some of the issues most frequently complained about:

• File limits: When using any electronic portal, including the EDFP, files must be in an accepted format, such as PDF. It is also critical to submit files that do not exceed size limits. When files contain medical imaging, they may be too large to upload, and it becomes necessary to modify the file. Every time a file is modified, there is a chance that mistakes will be made or the quality of the evidence will be degraded.
• Confirmation of receipt: When an applicant or other person uploads a document associated with a workers’ compensation case, they may assume the document was received if it uploaded successfully. However, this is not always the case. It is important to ensure that the document was accepted and that a timestamp showing receipt was recorded to prove that it was submitted by the deadline.
• Linking to the correct case file: New documents added to an existing case file do not always get linked to the correct file. These documents can become lost in the system and inaccessible.

To overcome these potential problems, it is important to file workers’ compensation claim documents well before the deadline to allow time to reload or make adjustments if necessary. It is also critical to check for a confirmation receipt and verify that the document was received. 

When a document needs to be reformatted to fit within file limitations, it is important to ensure that it is done in a way that does not make the document illegible or the image hard to decipher. Finally, it is wise to double-check that the case number on every document is correct and that names are spelled consistently across all submitted information.

Work with a Legal Team That Understands How to Help You Receive Full Benefits After a Workplace Injury

It can be hard to succeed in recovering the workers’ compensation benefits you deserve unless you’ve had extensive experience filing claims and satisfying the demands of insurance companies. Insurers try to avoid paying claims.

When you’re trying to recover from an injury, you don’t need additional stress; and delays can be costly to your long-term health. Allow the experienced team at Martin & Jones to assist during this challenging time. We can manage the claims process so that you can focus on healing. For a free consultation to learn more about the assistance we can provide with workers’ compensation claims, call us at 800-662-1234 or contact us online today.