Insurers and Self-Insurers

How to use the Insurers' Pending Reports

Frequently asked questions about the Insurers' Pending Report

  1. Are the claims listed here late? 
     Not necessarily, since the Insurers’ pending report is just a reflection of what we have in our database. It simply shows what information we are expecting for every open, non-litigated claim that we have on our system.  For example, if we receive a first report, the pending report will immediately reflect the fact that we are waiting for the first WKC-13 for this claim. That does not necessarily mean that the WKC-13 is late. 

  2. We sent you the information requested, e.g. WKC-13A or a final WKC-13, but the Pending Report shows that you do not have it yet. Why? 
     If the WKC-13A was submitted via the Internet it may need to be reviewed by our staff, and the pending report request will not be updated (or, sometimes, the claim’s status changed) until this occurs. Please do not re-submit the same information. If the information sent is not complete, or the report not final, we will let you know either by a letter or through the pending report. If the claim has not been updated in a timely manner to reflect the information sent, contact us. If the information requested was sent to us on  hard copy form it is possible that we have not yet keyed it into our database. When you log into the system the first page to which you are taken lists the mail date on which we are currently working. If you sent the information to us earlier and think that it might have been misplaced, please contact us.

  3. What if I have password trouble?
     If you cannot remember your password or think that your account is locked, then go to the WAMS Main (or instruction) Page:
    • choose "I am a Security Administrator" or "I am a Report User"
    • then follow instructions in the "Forgot your User ID or Password?" section

  4. What if all of our claims are not showing up? 
     Please contact us if you think we are missing claims. It is possible that we have an incorrect insurer associated with the claim, the claim is closed, litigated  or we never received the first report of injury.

  5. What if I use the claim search function, and I receive the message “no matches found. Please try your search again”?
    You should check your search criteria for accuracy and/or make sure that you have selected the correct insurance carrier, TPA, or self-insured employer from the Insurer or Claim Handler drop down menu.  It may be the case that the claim in question is either closed, litigated, filing complete or ready to close on our database.  You can now search for these claims.  See below.

  6. How can I search for claims that are closed, litigated, filing complete or ready to close?
    On the claim search screen select the “claim not pending required report” radio button and then select and enter the appropriate search criteria.

  7. If the search returns a closed claim, what can I do with it?
     Click the WC Number hyperlink, and you will be taken to the claim detail screen.  If you need to look at the payment history, click the View Payments button. If you need to re-open the claim in order to report further payments, click the Re-Open Claim button.

  8. If the search returns a litigated claim, what can I do with it?
    Click the WC Number hyperlink, and you will be taken to the claim detail screen.  For this type of claim you will only be able to view the payment history.  In order to do this, click on the View Payments button.  Any information that you need to report must be sent via paper.

  9. If the search returns a filing complete or ready to close claim, what can I do with these types of claims?
    Click the WC Number hyperlink, and you will be taken to the claim detail If you need to look at the payment history, click the View Payments button.  If you need to reset the claim status in order to report further payments, click the Reset Status button.

  10. What does it mean if a claim is in filing complete or ready to close status?
    These types of claims are still open on our database, but we already have all of the required reports.

  11. How up to date is this information? 
     This information is as current as our database, as it is a real-time reflection of the information in our system. You can even hit your refresh button to see any changes made to our database while you are logged in. Please check the processing date, listed on the page you are taken to after logging in, to see the mail date that we are currently processing.

  12. How often should we look at this?
    We recommend you set up a routine process so that someone in your office is responsible for accessing this information on a regular basis. We believe the Insurers’ Pending Report is a powerful tool that can help you improve your claims reporting process, and we strongly encourage any insurer with voluminous claims to provide claims-handling staff with web site access. This report will be especially helpful to any claims office that has been relying on mailed warning notices before submitting required reports

  13. What is the best way to respond to the report? 
     If you click on the WC Claim number you will go to a screen with details on that particular claim. There is an Email Reply button that you can use to send us an email about the claim. This is a good way to drop us a quick explanatory note on a claim or to give us a small piece of information we might be missing, such as a correction, amount of child support being paid, etc. Do not use this feature to send us information about the claim that can be sent via the Internet WKC-13, TPD worksheet or 13A.  Such submissions via the Email Reply feature will not be processed.

  14. How can I get details on a particular claim?
     Click on the WC Claim number which is a hyperlink. This will take you to the claim detail screen. From here you can also click on the View Payments button to see all of the payment information associated with the claim.

  15. Do we still get hard copy letters requesting information or quarterly reports letting us know what you need?
     The pending report replaces the Division’s former practice of mailing hard copy "courtesy" or warning notices and quarterly "monins" reports for required reports that were overdue. Hard copy forfeiture notices will be issued for overdue required reports, without a prior hard copy notice. When we request information or do not know that a required report is due, we will send a hard copy notice. For example, we request an updated WKC-13 180 days after the date we received the most recent WKC-13. When the 180 days expires, we will send a hard copy request since we still do not know that a WKC-13 is officially due.

  16. Does the pending report tell us when you expect to receive the required information?
     Yes. We have added a Due Date column that tells you our deadline for receiving the required information based on the claim's status.  The claim detail screen also contains status messages in red, and some of them have their own due dates that may be different from the date in the Due Date column.

  17. The report says you need a medical report, but the doctor will not give us one? 
     What we expect from you is an expected date as to when you hope to obtain a medical report and send it to us. If you have made several attempts to get one without success, either let us know or request the worker to get one and provide us with a copy of the request. We will try to help you obtain a medical report.

  18. This is a no lost time (medical only) claim. Do we still need to respond? 
     Yes. You can close the claim yourself right over the Internet. Click on the WC claim number and then click on the Send WKC-13 button. Under the claim status section select the No Lost Time radio button and enter the return to work date. Our program will automatically close the claim as no lost time. In those rare cases where the claim is no lost time but there is permanent disability, please do not close the claim out as no lost time.

  19. This is not our claim. How can we get it off of our report? 
     Please contact us via the Email Reply button or the phone, and let us know that you believe you are not the responsible carrier. We will research this and assign the correct carrier. If you are not the carrier the claim will drop off of your report when we make the correction to our database.

  20. Can I save my reports in a spreadsheet so I can sort them and share them with others in our office? 
     Yes. Follow the instructions for downloading Pending and Assessment Report Data

  21. What is the "expecting wage information" status and why is it sometimes broken down into two separate listings? 
     This status is a listing of all claims for which we need some sort of wage information. The first sub-list is entitled "Expecting Wage Information Supplement, WKC13A". On this list you will find all of the claims, NOT under wage investigation, for which we need a WCK-13A. The second sub-list, "Expecting Reply to Wage Investigation Correspondence", lists all of the claims which are currently under a wage investigation.