Workers Compensation EDI Applications

Appendix I - Release 3 FROI Requirements

EVENT TABLE

  • AL Release 3 Event Table Guidelines (PDF)
  • AL Release 3 Event Table (PDF)

ELEMENT REQUIREMENTS

  • AL Release 3 FROI Element Requirements Instructions (PDF)
  • AL Release 3 FROI Element Requirements Table (PDF)
  • AL Release 3 FROI Conditional Requirements Table (PDF)

EDIT MATRIX

  • AL Release 3 FROI Edit Matrix Instructions (PDF)
  • AL Release 3 FROI Edit Matrix Table (PDF)
  • IAIABC EDI Error Message Dictionary (PDF)

REQUIRED BATCH CONTENTS

  • IAIABC Release 3 Header Record (PDF)
  • IAIABC Release 3 148 Record for AL (PDF)
  • IAIABC Release 3 R21 Record for AL (PDF)
  • IAIABC Release 3 Trailer Record (PDF)

FORMS

  • AL Employer's First Report of Injury (FROI) Document (PDF)
  • AL Employer's First Report of Injury (FROI) Document Definitions (PDF)

  • AL Employer's First Report of Injury (FROI) Document (Microsoft Word )

CROSS REFERENCE LIST

  • AL FROI Document and IAIABC Release 3 Cross Reference List (PDF)


For Assistance Contact: WCFROI@labor.alabama.gov