BASIC (09-08)

A101 processing limitations may require using the Electronic Form 101 (EF101) to process claims. The EF101 is also used to process amended awards which could involve WC/PDB offset.

A. Preparing the WC/PDB offset calculation

Data from MCS or A101 will not propagate into the EF101.

Before starting the EF101 complete the WC/PDB offset determination in the T2 Interactive Computation Facility (ICF) #32WC/PDB: ADJUDICATE CLAIM or #34 WC/PDB: ONLINE RECORD ENTRY. For detailed instructions, see DI 52155.025B.

B. Complete the EF101—For complete EF101 instructions see MSOM T2PE 009.001

If the Type of Action Code on the Account Data screen (EFACCT) entered is D (disability) the two WC/PDB questions at the bottom of that screen must be completed.

WC/PDB INVOLVED (Y/N) should be answered Y for all initial or subsequent claims or amended awards when WC/PDB data coding is required.

• WC/PDB Common screens have been completed and the data needs to be posted to the MBR.

• WC/PDB offset is involved.

WC/PDB OFFSET DATA ON ICF (Y/N) should be answered Y when ICF #32 or #34 have been used to adjudicate an offset determination.

The Benefit Authorizer/Benefit Technical Examiner (BA/BTE) can access the WC/PDB data in ICF and propagate it into the MACADE action.