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Sub-Field: 9000042.11

Package: IHS Patient

WORKMAN'S COMPENSATION(#9000042)-->9000042.11

Sub-Field: 9000042.11


Information

Parent File Name Number Package
WORKMAN'S COMPENSATION(#9000042) DATE OF WC INJURY 9000042.11 IHS Patient

Details

Field # Name Loc Type Details
.01 DATE OF WC INJURY 0;1 DATE
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAR 29, 2004
  • CROSS-REFERENCE:  9000042.11^B
    1)= S ^AUPNWC(DA(1),11,"B",$E(X,1,30),DA)=""
    2)= K ^AUPNWC(DA(1),11,"B",$E(X,1,30),DA)
.02 DESC OF INJURY 0;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>45!($L(X)<3) X
  • LAST EDITED:  AUG 23, 2004
  • HELP-PROMPT:  Answer must be 3-45 characters in length.
  • DESCRIPTION:  
    Enter as specific as possible a description of the injury.
.03 CLAIM FILED 0;3 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  MAR 29, 2004
  • DESCRIPTION:  
    Was a claim filed ?
.04 CLAIM NUMBER 0;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<3) X
  • LAST EDITED:  MAR 29, 2004
  • HELP-PROMPT:  Answer must be 3-15 characters in length.
  • DESCRIPTION:  
    Enter the claim or policy number assigned to this work-related incident. This field is free text up to 15 characters and in some cases mey be the patient's SSN.
.05 NAME OF PATIENT'S ATTORNEY 0;5 FREE TEXT

  • INPUT TRANSFORM:  D NAME^AUPNPED
  • LAST EDITED:  AUG 23, 2004
  • HELP-PROMPT:  Answer must be in the form LASTNAME,FIRSTNAME
  • DESCRIPTION:  
    Enter the attorney's name the same as you do for the patient's name. 3-30 characters long. ie: LAST,FIRST MIDDLE (NO spaces after comma).
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.06 PATIENT'S EMPLOYER 0;6 POINTER TO EMPLOYER FILE (#9999999.75) EMPLOYER(#9999999.75)

  • LAST EDITED:  MAR 29, 2004
  • DESCRIPTION:  
    Enter the employer name of where the patient was employed at the time the injury occurred. The entries are taken from the EMPLOYER file and must exist prior to entry.
.07 DATE CASE CLOSED 0;7 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAR 29, 2004
  • DESCRIPTION:  
    Enter the date this case was closed.
.08 TYPE OF ACCIDENT 0;8 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>45!($L(X)<3) X
  • LAST EDITED:  MAR 29, 2004
  • HELP-PROMPT:  Answer must be 3-45 characters in length.
  • DESCRIPTION:  
    Describe what caused the injury.
.09 CLAIM STATUS 0;9 SET
  • 'P' FOR PENDING;
  • 'A' FOR ACTIVE;
  • 'C' FOR CLOSED;

  • LAST EDITED:  MAR 29, 2004
.11 ENTITY 0;10 POINTER TO INSURER FILE (#9999999.18) INSURER(#9999999.18)

  • LAST EDITED:  AUG 23, 2004
  • DESCRIPTION:  
    Enter the name of the responsible insurer or company.
.12 GROUP NAME 0;11 POINTER TO EMPLOYER GROUP INSURANCE FILE (#9999999.77) EMPLOYER GROUP INSURANCE(#9999999.77)

  • LAST EDITED:  MAR 29, 2004
.13 EFFECTIVE DATE 0;12 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAR 29, 2004
  • DESCRIPTION:  
    Enter the effective date of this claim.
.14 EXPIRATION DATE 0;13 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAR 29, 2004
  • DESCRIPTION:  
    Enter the expiration date of this claim.
.15 NOTES 1;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>45!($L(X)<3) X
  • LAST EDITED:  MAR 29, 2004
  • HELP-PROMPT:  Answer must be 3-45 characters in length.
  • DESCRIPTION:  
    Enter any applicable notes about this claim.
201 DATE LAST WORKED 2;1 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  SEP 09, 2010
202 DISABILITY START DATE 2;2 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  SEP 09, 2010
203 DISABILITY END DATE 2;3 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  SEP 09, 2010
204 WORK RETURN AUTH DATE 2;4 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  SEP 09, 2010
  • HELP-PROMPT:  Enter date authorized to return to work.
205 CONTACT INFO 2;5 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  SEP 09, 2010
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
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