Oklahoma Administrative Code › Title 810 - Oklahoma Workers' Compensation Commission › Chapter 1 - General Information › Section 810:1-1-2 - Definitions

Current through Vol. 41, No. 20, July 1, 2024
In addition to the terms defined in 85A O.S. § 2, the
				following words and terms, when used in this Chapter, shall have the following
				meaning, unless the context clearly indicates otherwise:
"Administrative Law Judge"
means an Administrative
				Law Judge of the Commission to whom the Commission has delegated by order or
				otherwise, the authority to conduct a hearing.
"Affidavit of Exempt Status"
means an affidavit
				authorized by 85A O.S., § 36 which any individual or business entity that
				is not required to secure compensation pursuant to the AWCA may execute and
				file with the Oklahoma Workers' Compensation Commission.
"AWCA"
means the Administrative Workers'
				Compensation Act, 85A O.S. § 1, et seq.
"Claimant"
means a person who claims benefits for
				an alleged work injury, occupational disease or illness, or death, pursuant to
				the provisions of the AWCA.
"Claim administrator"
means the trading partner
				sending electronic transactions to the Commission, which can be an insurer
				filing directly with the Commission on its own behalf, or a servicing
				company/third party administrator filing on behalf of the insurer.
"Claim Information"
means data submitted via First
				Report of Injury (FROI) or Subsequent Report of Injury (SROI).
"Commission"
means the Oklahoma Workers'
				Compensation Commission, a designee, or an Administrative Law Judge to whom the
				Commission has delegated responsibility as authorized by 85A O.S. § 21(D).
"Electronic Data Interchange"
means the
				transmission of claim information through electronic means, in a format
				established by the Commission.
"Electronic equivalent"
means a
				Commission-approved means of filing an electronic form through the Commission's
				case system. In all cases where a party is required to mail a Commission form
				to the opposing party, a copy may be sent by electronic mail when an electronic
				mail address is known. In all cases where a paper form is required to be filed
				to effect a certain purpose, an electronic equivalent, if available, may also
				be filed to effect that purpose.
"EDI"
means electronic data interchange.
"Executive Director"
means the Executive Director
				of the Commission.
"
FROI
" means first report of injury.
"Insurer"
means the entity responsible for making
				electronic filings as prescribed by law and these rules. This term includes
				self-insurers.
"Mandatory EDI implementation date"
means
				September 1, 2018.
"Self-insurer"
means any duly qualified individual
				employer or group self-insurance association authorized by the Commission to
				self-fund its workers' compensation obligations.
"SROI"
means subsequent report of injury.
"Trading Partner"
means an entity that has
				registered with the Commission to exchange data through Electronic Data
				Interchange.
"Workers' Compensation Commission fee schedule"
means a state mandated schedule of maximum allowable reimbursement levels for
				health care providers, including hospitals, ambulatory surgical centers, and
				inpatient rehabilitation facilities, rendering reasonable and necessary health
				care services and supplies to an injured employee for a compensable injury
				pursuant to the Oklahoma workers' compensation laws.
"Written"
means that which is expressed in
				writing, and includes electronic records.