AGED4B ; IHS/ASDS/EFG - PAGE 5 - AUTO/LIABILITY, WORKMAN'S COMP PAGE ; [ 05/13/2003 1:19 PM ]
;;7.0;IHS PATIENT REGISTRATION;**1,2**;MAR 28, 2003
;
S AG("N")=13
I '$D(AGAIN) D GETAW2
S AGAIN=""
VAR D DRAW
Q:$D(AGSEENLY)
W !,AGLINE("EQ")
K DIR
S DIR("A")="CHANGE which item? (1-"_AG("N")_") NONE// "
D READ^AGED1
G:$D(AG("ED"))&'$D(AGXTERN) @("^AGED"_AG("ED"))
G END:$D(DLOUT)!(Y["N")!$D(DUOUT),VAR:$D(AG("ERR"))
Q:$D(DFOUT)!$D(DTOUT)
I $D(DQOUT)!(+Y<1)!(+Y>AG("N")) W !!,"You must enter a number from 1 to ",AG("N") H 2 G VAR
S AG("C")="DTACC,DESCAI,RESPINS,RESPSSN,POLNO,APATATTY,DTWC,DTCLOSE,DESCWI,EMPL,CLMFIL,CLMNO,WPATATTY"
S AGY=Y
F AGI=1:1 S AG("SEL")=+$P(AGY,",",AGI) Q:AG("SEL")<1!(AG("SEL")>AG("N")) D @($P(AG("C"),",",AG("SEL")))
D UPDATE1^AGED(DUZ(2),DFN,3,"")
K AGI,AGY
G VAR
END K AG,DLOUT,DTOUT,DFOUT,DQOUT,DA,DIC,DR,AGSCRN,Y,ADA,WDA,ADT,WDT,ADFN,WDFN,REC
Q:$D(AGXTERN)
Q:$D(DIROUT)
Q:$D(AGSEENLY)
G ^AGED4A:$D(DUOUT)
G ^AGED13
Q
DRAW ; EP
S AG("PG")=5
S DA=DFN
D ^AGED
K ^UTILITY("DIQ1",$J)
W !,"-- AUTO OR LIABILITY INSURANCE " F A=1:1:47 W "-"
D GETAW
Q
GETAW2 ;
S (AD0,REC,ADFN)=""
F S REC=$O(^AUPNAUTO("C",DFN,REC)) Q:'REC D
. S ADFN=$P($G(^AUPNAUTO(REC,0)),U,2)
. I ADFN=DFN S AD0=REC
S (WD0,REC,WDFN)=""
F S REC=$O(^AUPNWRKC("C",DFN,REC)) Q:'REC D
. S WDFN=$P($G(^AUPNWRKC(REC,0)),U,2)
. I WDFN=DFN S WD0=REC
Q
;
GETAW ; GET LAST ENTRY FROM AUTO,LIAB/WC
F AG=1:1:13 D
. S AGSCRN=$P($T(@1+AG),";;",2,14)
. S DIC=$P(AGSCRN,U,3)
. S DR=$P(AGSCRN,U,4)
. I AG=7 W !,"-- WORKMAN'S COMPENSATION " F A=1:1:52 W "-"
. W !,AG,".",?(29-$L($P(^DD(DIC,DR,0),U))),$P(^DD(DIC,DR,0),U)," : "
. I AG>0&(AG<7)&(AD0>0) S D0=AD0 W $$GET1^DIQ(DIC,D0,DR)
. I AG>6&(AG<14)&(WD0>0) S D0=WD0 W $$GET1^DIQ(DIC,D0,DR)
Q
AMSG ; DISPLAY THIS MSG IF THERE NO ENTRY IN THE AUTO/LIAB
; GLOBAL
W !,"You must first enter the DATE OF AUTO/LIAB INJURY"
Q
;
WMSG ; DISPLAY THIS MSG IF THERE IS NO ENTRY IN THE WORKMAN'S
; COMP GLOBAL
W !,"You must first enter the DATE OF WC INJURY"
Q
;
;;;;;;;;;;;;;;;;;;;;;;;;;;;
; AUTO/LIAB ACCIDENT FIELDS
;;;;;;;;;;;;;;;;;;;;;;;;;;;
;
DTACC ; DATE OF AUTO/LIAB INJURY
W !
K DIC,DIE,DR,DA
S DIC="^AUPNAUTO("
S DLAYGO=9000031
S DIC(0)="AEMLQZ"
S DIC("S")="I $P(^(0),U,2)="_DFN
I AD0>0 D
. S Y=$P(^AUPNAUTO(AD0,0),U,1) D DD^%DT
. S DIC("B")=Y
K DD,DO
D ^DIC S AD0=+Y Q:+Y'>0
K DIC,DR,DIE
S DA=AD0
S DIE="^AUPNAUTO("
;S DR=".01;.02///^S X=DFN" ;IHS/SD/EFG AG*7*2 #4
S DR=".01;.02////^S X=DFN" ;IHS/SD/EFG AG*7*2 #4
D ^DIE
K DIC,DR,DIE
Q
DESCAI ; DESCRIPTION OF AUTO ACCIDENT INJURY
I '$D(^AUPNAUTO("C",DFN)) D AMSG H 2 D DRAW G DTACC
W !
K DIC,DR,DIE,DA,DD,DO
S DIE="^AUPNAUTO("
S DA=AD0
S DR=.03
D ^DIE
K DIC,DR,DIE,DA
Q
RESPINS ; RESPONSIBLE PARTY INSURANCE COMPANY
I '$D(^AUPNAUTO("C",DFN)) D AMSG H 2 D DRAW G DTACC
W !
K DIC,DR,DIE,DA,DD,DO
S DIE="^AUPNAUTO("
S DA=AD0
S DR=.04
D ^DIE
K DIC,DR,DIE,DA
Q
RESPSSN ; RESPONSIBLE PARTY SSN
I '$D(^AUPNAUTO("C",DFN)) D AMSG H 2 D DRAW G DTACC
W !
K DIC,DR,DIE,DA,DD,DO
S DIE="^AUPNAUTO("
S DA=AD0
S DR=.07
D ^DIE
K DIC,DR,DIE,DA
Q
POLNO ; INSURANCE POLICY NUMBER
I '$D(^AUPNAUTO("C",DFN)) D AMSG H 2 D DRAW G DTACC
W !
K DIC,DR,DIE,DA,DD,DO
S DIE="^AUPNAUTO("
S DA=AD0
S DR=.05
D ^DIE
K DIC,DR,DIE,DA
Q
APATATTY ; NAME OF PATIENT'S ATTORNEY FOR ACCIDENT/LIAB
I '$D(^AUPNAUTO("C",DFN)) D AMSG H 2 D DRAW G DTACC
W !
K DIC,DR,DIE,DA,DD,DO
S DIE="^AUPNAUTO("
S DA=AD0
S DR=.06
D ^DIE
K DIC,DR,DIE,DA
Q
;
;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;
; WORKMAN'S COMP INJURY FIELDS
;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;
;
DTWC ; DATE OF WORKMAN'S COMP INJURY
W !
K DIC,DIE,DR,DA
S DIC="^AUPNWRKC("
S DLAYGO=9000032
S DIC(0)="AEMLQZ"
S DIC("S")="I $P(^(0),U,2)="_DFN
I WD0>0 D
. S Y=$P(^AUPNWRKC(WD0,0),U,1) D DD^%DT
. S DIC("B")=Y
K DD,DO
D ^DIC S WD0=+Y Q:+Y'>0
K DIC,DR,DIE
S DA=WD0
S DIE="^AUPNWRKC("
;S DR=".01;.02///^S X=DFN" ;IHS/SD/EFG AG*7*2 #4
S DR=".01;.02////^S X=DFN" ;IHS/SD/EFG AG*7*2 #4
D ^DIE
K DIC,DR,DIE
Q
DTCLOSE ; DATE CASE CLOSED
I '$D(^AUPNWRKC("C",DFN)) D WMSG H 2 D DRAW G DTWC
K DIC,DR,DIE,DA,DD,DO
S DIE="^AUPNWRKC("
S DA=WD0
S DR=.08
D ^DIE
K DIC,DR,DIE,DA
Q
DESCWI ; DESCRIPTION OF WORKMAN'S COMP INJURY
I '$D(^AUPNWRKC("C",DFN)) D WMSG H 2 D DRAW G DTWC
W !
K DIC,DR,DIE,DA,DD,DO
S DIE="^AUPNWRKC("
S DA=WD0
S DR=.03
D ^DIE
K DIC,DR,DIE,DA
Q
CLMFIL ; WAS CLAIM FILED
I '$D(^AUPNWRKC("C",DFN)) D WMSG H 2 D DRAW G DTWC
W !
K DIC,DR,DIE,DA,DD,DO
S DIE="^AUPNWRKC("
S DA=WD0
S DR=.04
D ^DIE
K DIC,DR,DIE,DA
Q
CLMNO ; CLAIM NUMBER
I '$D(^AUPNWRKC("C",DFN)) D WMSG H 2 D DRAW G DTWC
W !
K DIC,DR,DIE,DA,DD,DO
S DIE="^AUPNWRKC("
S DA=WD0
S DR=.05
D ^DIE
K DIC,DR,DIE,DA
Q
WPATATTY ; NAME OF PATIENT'S ATTORNEY FOR WORKMAN'S COMP
I '$D(^AUPNWRKC("C",DFN)) D WMSG H 2 D DRAW G DTWC
W !
K DIC,DR,DIE,DA,DD,DO
S DIE="^AUPNWRKC("
S DA=WD0
S DR=.06
D ^DIE
K DIC,DR,DIE,DA
Q
EMPL ; PATIENT'S EMPLOYER
I '$D(^AUPNWRKC("C",DFN)) D WMSG H 2 D DRAW G DTWC
W !
K DIC,DR,DIE,DA,DD,DO
S DIE="^AUPNWRKC("
S DA=WD0
S DR=.07
D ^DIE
K DIC,DR,DIE,DA
Q
; *********************************************************************
; ON LINES BELOW:
; PIECE 1= FIELD LABEL
; PIECE 2= POSITION ON LINE TO DISPLAY FIELD LABEL
; PIECE 3= FILE NUMBER
; PIECE 4= FIELD NUMBER
1 ;
;;DATE OF ACCIDENT^24^9000031^.01
;;DESCRIPTION OF INJURY^19^9000031^.03
;;RESP. PARTY INS. CO.^20^9000031^.04
;;RESP. PARTY SSN^25^9000031^.07
;;POLICY NUMBER^27^9000031^.05
;;NAME OF PT'S ATTORNEY^19^9000031^.06
;;DATE OF INJURY^26^9000032^.01
;;DATE CASE CLOSED^24^9000032^.08
;;DESCRIPTION OF INJURY^19^9000032^.03
;;EMPLOYER^32^9000032^.07
;;WORKMAN'S COMP CLAIM FILED^14^9000032^.04
;;CLAIM NUMBER^28^9000032^.05
;;NAME OF PT'S ATTORNEY FOR THIS CASE^5^9000032^.06
AGED4B ; IHS/ASDS/EFG - PAGE 5 - AUTO/LIABILITY, WORKMAN'S COMP PAGE ; [ 05/13/2003 1:19 PM ]
+1 ;;7.0;IHS PATIENT REGISTRATION;**1,2**;MAR 28, 2003
+2 ;
+3 SET AG("N")=13
+4 IF '$DATA(AGAIN)
DO GETAW2
+5 SET AGAIN=""
VAR DO DRAW
+1 IF $DATA(AGSEENLY)
QUIT
+2 WRITE !,AGLINE("EQ")
+3 KILL DIR
+4 SET DIR("A")="CHANGE which item? (1-"_AG("N")_") NONE// "
+5 DO READ^AGED1
+6 IF $DATA(AG("ED"))&'$DATA(AGXTERN)
GOTO @("^AGED"_AG("ED"))
+7 IF $DATA(DLOUT)!(Y["N")!$DATA(DUOUT)
GOTO END
IF $DATA(AG("ERR"))
GOTO VAR
+8 IF $DATA(DFOUT)!$DATA(DTOUT)
QUIT
+9 IF $DATA(DQOUT)!(+Y<1)!(+Y>AG("N"))
WRITE !!,"You must enter a number from 1 to ",AG("N")
HANG 2
GOTO VAR
+10 SET AG("C")="DTACC,DESCAI,RESPINS,RESPSSN,POLNO,APATATTY,DTWC,DTCLOSE,DESCWI,EMPL,CLMFIL,CLMNO,WPATATTY"
+11 SET AGY=Y
+12 FOR AGI=1:1
SET AG("SEL")=+$PIECE(AGY,",",AGI)
IF AG("SEL")<1!(AG("SEL")>AG("N"))
QUIT
DO @($PIECE(AG("C"),",",AG("SEL")))
+13 DO UPDATE1^AGED(DUZ(2),DFN,3,"")
+14 KILL AGI,AGY
+15 GOTO VAR
END KILL AG,DLOUT,DTOUT,DFOUT,DQOUT,DA,DIC,DR,AGSCRN,Y,ADA,WDA,ADT,WDT,ADFN,WDFN,REC
+1 IF $DATA(AGXTERN)
QUIT
+2 IF $DATA(DIROUT)
QUIT
+3 IF $DATA(AGSEENLY)
QUIT
+4 IF $DATA(DUOUT)
GOTO ^AGED4A
+5 GOTO ^AGED13
+6 QUIT
DRAW ; EP
+1 SET AG("PG")=5
+2 SET DA=DFN
+3 DO ^AGED
+4 KILL ^UTILITY("DIQ1",$JOB)
+5 WRITE !,"-- AUTO OR LIABILITY INSURANCE "
FOR A=1:1:47
WRITE "-"
+6 DO GETAW
+7 QUIT
GETAW2 ;
+1 SET (AD0,REC,ADFN)=""
+2 FOR
SET REC=$ORDER(^AUPNAUTO("C",DFN,REC))
IF 'REC
QUIT
Begin DoDot:1
+3 SET ADFN=$PIECE($GET(^AUPNAUTO(REC,0)),U,2)
+4 IF ADFN=DFN
SET AD0=REC
End DoDot:1
+5 SET (WD0,REC,WDFN)=""
+6 FOR
SET REC=$ORDER(^AUPNWRKC("C",DFN,REC))
IF 'REC
QUIT
Begin DoDot:1
+7 SET WDFN=$PIECE($GET(^AUPNWRKC(REC,0)),U,2)
+8 IF WDFN=DFN
SET WD0=REC
End DoDot:1
+9 QUIT
+10 ;
GETAW ; GET LAST ENTRY FROM AUTO,LIAB/WC
+1 FOR AG=1:1:13
Begin DoDot:1
+2 SET AGSCRN=$PIECE($TEXT(@1+AG),";;",2,14)
+3 SET DIC=$PIECE(AGSCRN,U,3)
+4 SET DR=$PIECE(AGSCRN,U,4)
+5 IF AG=7
WRITE !,"-- WORKMAN'S COMPENSATION "
FOR A=1:1:52
WRITE "-"
+6 WRITE !,AG,".",?(29-$LENGTH($PIECE(^DD(DIC,DR,0),U))),$PIECE(^DD(DIC,DR,0),U)," : "
+7 IF AG>0&(AG<7)&(AD0>0)
SET D0=AD0
WRITE $$GET1^DIQ(DIC,D0,DR)
+8 IF AG>6&(AG<14)&(WD0>0)
SET D0=WD0
WRITE $$GET1^DIQ(DIC,D0,DR)
End DoDot:1
+9 QUIT
AMSG ; DISPLAY THIS MSG IF THERE NO ENTRY IN THE AUTO/LIAB
+1 ; GLOBAL
+2 WRITE !,"You must first enter the DATE OF AUTO/LIAB INJURY"
+3 QUIT
+4 ;
WMSG ; DISPLAY THIS MSG IF THERE IS NO ENTRY IN THE WORKMAN'S
+1 ; COMP GLOBAL
+2 WRITE !,"You must first enter the DATE OF WC INJURY"
+3 QUIT
+4 ;
+5 ;;;;;;;;;;;;;;;;;;;;;;;;;;;
+6 ; AUTO/LIAB ACCIDENT FIELDS
+7 ;;;;;;;;;;;;;;;;;;;;;;;;;;;
+8 ;
DTACC ; DATE OF AUTO/LIAB INJURY
+1 WRITE !
+2 KILL DIC,DIE,DR,DA
+3 SET DIC="^AUPNAUTO("
+4 SET DLAYGO=9000031
+5 SET DIC(0)="AEMLQZ"
+6 SET DIC("S")="I $P(^(0),U,2)="_DFN
+7 IF AD0>0
Begin DoDot:1
+8 SET Y=$PIECE(^AUPNAUTO(AD0,0),U,1)
DO DD^%DT
+9 SET DIC("B")=Y
End DoDot:1
+10 KILL DD,DO
+11 DO ^DIC
SET AD0=+Y
IF +Y'>0
QUIT
+12 KILL DIC,DR,DIE
+13 SET DA=AD0
+14 SET DIE="^AUPNAUTO("
+15 ;S DR=".01;.02///^S X=DFN" ;IHS/SD/EFG AG*7*2 #4
+16 ;IHS/SD/EFG AG*7*2 #4
SET DR=".01;.02////^S X=DFN"
+17 DO ^DIE
+18 KILL DIC,DR,DIE
+19 QUIT
DESCAI ; DESCRIPTION OF AUTO ACCIDENT INJURY
+1 IF '$DATA(^AUPNAUTO("C",DFN))
DO AMSG
HANG 2
DO DRAW
GOTO DTACC
+2 WRITE !
+3 KILL DIC,DR,DIE,DA,DD,DO
+4 SET DIE="^AUPNAUTO("
+5 SET DA=AD0
+6 SET DR=.03
+7 DO ^DIE
+8 KILL DIC,DR,DIE,DA
+9 QUIT
RESPINS ; RESPONSIBLE PARTY INSURANCE COMPANY
+1 IF '$DATA(^AUPNAUTO("C",DFN))
DO AMSG
HANG 2
DO DRAW
GOTO DTACC
+2 WRITE !
+3 KILL DIC,DR,DIE,DA,DD,DO
+4 SET DIE="^AUPNAUTO("
+5 SET DA=AD0
+6 SET DR=.04
+7 DO ^DIE
+8 KILL DIC,DR,DIE,DA
+9 QUIT
RESPSSN ; RESPONSIBLE PARTY SSN
+1 IF '$DATA(^AUPNAUTO("C",DFN))
DO AMSG
HANG 2
DO DRAW
GOTO DTACC
+2 WRITE !
+3 KILL DIC,DR,DIE,DA,DD,DO
+4 SET DIE="^AUPNAUTO("
+5 SET DA=AD0
+6 SET DR=.07
+7 DO ^DIE
+8 KILL DIC,DR,DIE,DA
+9 QUIT
POLNO ; INSURANCE POLICY NUMBER
+1 IF '$DATA(^AUPNAUTO("C",DFN))
DO AMSG
HANG 2
DO DRAW
GOTO DTACC
+2 WRITE !
+3 KILL DIC,DR,DIE,DA,DD,DO
+4 SET DIE="^AUPNAUTO("
+5 SET DA=AD0
+6 SET DR=.05
+7 DO ^DIE
+8 KILL DIC,DR,DIE,DA
+9 QUIT
APATATTY ; NAME OF PATIENT'S ATTORNEY FOR ACCIDENT/LIAB
+1 IF '$DATA(^AUPNAUTO("C",DFN))
DO AMSG
HANG 2
DO DRAW
GOTO DTACC
+2 WRITE !
+3 KILL DIC,DR,DIE,DA,DD,DO
+4 SET DIE="^AUPNAUTO("
+5 SET DA=AD0
+6 SET DR=.06
+7 DO ^DIE
+8 KILL DIC,DR,DIE,DA
+9 QUIT
+10 ;
+11 ;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;
+12 ; WORKMAN'S COMP INJURY FIELDS
+13 ;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;
+14 ;
DTWC ; DATE OF WORKMAN'S COMP INJURY
+1 WRITE !
+2 KILL DIC,DIE,DR,DA
+3 SET DIC="^AUPNWRKC("
+4 SET DLAYGO=9000032
+5 SET DIC(0)="AEMLQZ"
+6 SET DIC("S")="I $P(^(0),U,2)="_DFN
+7 IF WD0>0
Begin DoDot:1
+8 SET Y=$PIECE(^AUPNWRKC(WD0,0),U,1)
DO DD^%DT
+9 SET DIC("B")=Y
End DoDot:1
+10 KILL DD,DO
+11 DO ^DIC
SET WD0=+Y
IF +Y'>0
QUIT
+12 KILL DIC,DR,DIE
+13 SET DA=WD0
+14 SET DIE="^AUPNWRKC("
+15 ;S DR=".01;.02///^S X=DFN" ;IHS/SD/EFG AG*7*2 #4
+16 ;IHS/SD/EFG AG*7*2 #4
SET DR=".01;.02////^S X=DFN"
+17 DO ^DIE
+18 KILL DIC,DR,DIE
+19 QUIT
DTCLOSE ; DATE CASE CLOSED
+1 IF '$DATA(^AUPNWRKC("C",DFN))
DO WMSG
HANG 2
DO DRAW
GOTO DTWC
+2 KILL DIC,DR,DIE,DA,DD,DO
+3 SET DIE="^AUPNWRKC("
+4 SET DA=WD0
+5 SET DR=.08
+6 DO ^DIE
+7 KILL DIC,DR,DIE,DA
+8 QUIT
DESCWI ; DESCRIPTION OF WORKMAN'S COMP INJURY
+1 IF '$DATA(^AUPNWRKC("C",DFN))
DO WMSG
HANG 2
DO DRAW
GOTO DTWC
+2 WRITE !
+3 KILL DIC,DR,DIE,DA,DD,DO
+4 SET DIE="^AUPNWRKC("
+5 SET DA=WD0
+6 SET DR=.03
+7 DO ^DIE
+8 KILL DIC,DR,DIE,DA
+9 QUIT
CLMFIL ; WAS CLAIM FILED
+1 IF '$DATA(^AUPNWRKC("C",DFN))
DO WMSG
HANG 2
DO DRAW
GOTO DTWC
+2 WRITE !
+3 KILL DIC,DR,DIE,DA,DD,DO
+4 SET DIE="^AUPNWRKC("
+5 SET DA=WD0
+6 SET DR=.04
+7 DO ^DIE
+8 KILL DIC,DR,DIE,DA
+9 QUIT
CLMNO ; CLAIM NUMBER
+1 IF '$DATA(^AUPNWRKC("C",DFN))
DO WMSG
HANG 2
DO DRAW
GOTO DTWC
+2 WRITE !
+3 KILL DIC,DR,DIE,DA,DD,DO
+4 SET DIE="^AUPNWRKC("
+5 SET DA=WD0
+6 SET DR=.05
+7 DO ^DIE
+8 KILL DIC,DR,DIE,DA
+9 QUIT
WPATATTY ; NAME OF PATIENT'S ATTORNEY FOR WORKMAN'S COMP
+1 IF '$DATA(^AUPNWRKC("C",DFN))
DO WMSG
HANG 2
DO DRAW
GOTO DTWC
+2 WRITE !
+3 KILL DIC,DR,DIE,DA,DD,DO
+4 SET DIE="^AUPNWRKC("
+5 SET DA=WD0
+6 SET DR=.06
+7 DO ^DIE
+8 KILL DIC,DR,DIE,DA
+9 QUIT
EMPL ; PATIENT'S EMPLOYER
+1 IF '$DATA(^AUPNWRKC("C",DFN))
DO WMSG
HANG 2
DO DRAW
GOTO DTWC
+2 WRITE !
+3 KILL DIC,DR,DIE,DA,DD,DO
+4 SET DIE="^AUPNWRKC("
+5 SET DA=WD0
+6 SET DR=.07
+7 DO ^DIE
+8 KILL DIC,DR,DIE,DA
+9 QUIT
+10 ; *********************************************************************
+11 ; ON LINES BELOW:
+12 ; PIECE 1= FIELD LABEL
+13 ; PIECE 2= POSITION ON LINE TO DISPLAY FIELD LABEL
+14 ; PIECE 3= FILE NUMBER
+15 ; PIECE 4= FIELD NUMBER
1 ;
+1 ;;DATE OF ACCIDENT^24^9000031^.01
+2 ;;DESCRIPTION OF INJURY^19^9000031^.03
+3 ;;RESP. PARTY INS. CO.^20^9000031^.04
+4 ;;RESP. PARTY SSN^25^9000031^.07
+5 ;;POLICY NUMBER^27^9000031^.05
+6 ;;NAME OF PT'S ATTORNEY^19^9000031^.06
+7 ;;DATE OF INJURY^26^9000032^.01
+8 ;;DATE CASE CLOSED^24^9000032^.08
+9 ;;DESCRIPTION OF INJURY^19^9000032^.03
+10 ;;EMPLOYER^32^9000032^.07
+11 ;;WORKMAN'S COMP CLAIM FILED^14^9000032^.04
+12 ;;CLAIM NUMBER^28^9000032^.05
+13 ;;NAME OF PT'S ATTORNEY FOR THIS CASE^5^9000032^.06
