Publication of Injured Worker's Social Security Number on the EOB

With each technical/professional review methodology that is submitted to the Health Care Services division for approval, a sample Explanation of Benefits (EOB) is required for Agency review.   In 2005, the Agency notified all interested parties, including Carriers, Service Companies/TPA's, Technical/Professional Review Entities, that the Health Care Services division was only requiring the last four digits of an injured worker's social security number on the sample Explanation of Benefits (EOB) form (WCA-739).  As efforts to increase the protection of Personally Identifiable Information (PII) have continued to expand in scope, this directive remains in effect today.

Providers and carriers must still maintain each injured worker's social security number as this information is required when filing any dispute or when providers file an Application for Mediation or Hearing Form 104B. 

For any further questions or clarification regarding the above information, please call the Health Care Services division at 517-284-8898.