STANDARD DATA DICTIONARY #2264 -- ASISTS COMPENSATION CLAIM (CA7) FILE 3/24/25 PAGE 1
STORED IN ^OOPS(2264, *** NO DATA STORED YET *** SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 2.0)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
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This file will contain claim information filed by an employee for compensation relating to a specific accident incident or illness
previously filed in ASISTS. A pointer to the CA-1 or CA-2 that the CA-7 claim refers to will be stored in this file. Multiple
claims can be filed for each CA-1 or CA-2.
CROSS
REFERENCED BY: ASISTS RECORD(AC), CA7 CASE NUMBER(B), EMPLOYEE NAME(C), EMPLOYEE SSN(SSN)
2264,.01 CA7 CASE NUMBER 0;1 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>20!($L(X)<15)!'(X'?1P.E) X
LAST EDITED: APR 23, 2004
HELP-PROMPT: Answer must be 15-20 characters in length.
DESCRIPTION:
This field contains the ASISTS case number for this CA-7.
CROSS-REFERENCE: 2264^B
1)= S ^OOPS(2264,"B",$E(X,1,30),DA)=""
2)= K ^OOPS(2264,"B",$E(X,1,30),DA)
2264,.3 DATE CA7 CREATED 0;3 DATE (Required)
INPUT TRANSFORM: S %DT="ETX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JUN 25, 2004
HELP-PROMPT: System will supply date that the CA7 was created.
DESCRIPTION:
This field is a system supplied date that the CA-7 was created.
2264,.5 PERSON THAT CREATED CA7 0;4 POINTER TO NEW PERSON FILE (#200) (Required)
LAST EDITED: APR 23, 2004
HELP-PROMPT: System will use current user to file this field.
DESCRIPTION:
This field will store the DUZ for the person who created the CA-7.
2264,.7 ASISTS RECORD 0;5 POINTER TO ASISTS ACCIDENT REPORTING FILE (#2260)
LAST EDITED: APR 23, 2004
HELP-PROMPT: Enter the ASISTS record that links to this CA-7.
DESCRIPTION:
This field will link an ASISTS Claim to this CA-7.
CROSS-REFERENCE: 2264^AC
1)= S ^OOPS(2264,"AC",$E(X,1,30),DA)=""
2)= K ^OOPS(2264,"AC",$E(X,1,30),DA)
2264,.8 EMPLOYEE SSN 0;6 FREE TEXT
INPUT TRANSFORM: K:$L(X)>11!($L(X)<9) X
LAST EDITED: APR 23, 2004
HELP-PROMPT: Answer must be 9-11 characters in length.
DESCRIPTION: This field contains the employee's SSN. It is stored in this file as well as the ASISTS ACCIDENT
REPORTING File (#2260) to streamline CA-7 case number lookup.
CROSS-REFERENCE: 2264^SSN
1)= S ^OOPS(2264,"SSN",$E(X,1,30),DA)=""
2)= K ^OOPS(2264,"SSN",$E(X,1,30),DA)
This index contains the employee's SSN.
2264,.9 EMPLOYEE NAME 0;7 FREE TEXT
INPUT TRANSFORM: K:$L(X)>35!($L(X)<3) X
LAST EDITED: APR 30, 2004
HELP-PROMPT: Answer must be 3-35 characters in length.
DESCRIPTION:
This is the name of the employee who is filing for compensation.
CROSS-REFERENCE: 2264^C
1)= S ^OOPS(2264,"C",$E(X,1,30),DA)=""
2)= K ^OOPS(2264,"C",$E(X,1,30),DA)
This cross reference will be used to look-up claims using the employee's name.
2264,1 OWCP FILE NUMBER 0;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>9!($L(X)<3) X
LAST EDITED: APR 23, 2004
HELP-PROMPT: Answer must be 3-9 characters in length.
DESCRIPTION:
This field contains the OWCP File Number (also known as the DOL Case Number) for this CA-7.
2264,2 MAILING STREET ADD CA7S1;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<3) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 3-30 characters in length.
DESCRIPTION: This is the street portion of the employee's mailing address and is collected each time as it may
be different.
2264,3 MAILING CITY ADD CA7S1;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>25!($L(X)<3) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 3-25 characters in length.
DESCRIPTION:
This is the city portion of the employee's mailing address.
2264,4 MAILING STATE ADD CA7S1;3 POINTER TO STATE FILE (#5)
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter the state portion of the employee's mailing address.
DESCRIPTION:
This is the state portion of the employee's mailing address.
2264,5 MAILING ZIPCODE ADD CA7S1;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>11!($L(X)<5) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 5-11 characters in length.
DESCRIPTION:
This is the zip code portion of the employee's mailing address.
2264,6 EMPLOYEE EMAIL CA7S1;5 FREE TEXT
INPUT TRANSFORM: K:$L(X)>60!($L(X)<3) X
LAST EDITED: MAY 26, 2004
HELP-PROMPT: Answer must be 3-60 characters in length.
DESCRIPTION:
This is the employee's email address if they have one.
2264,7 DATE OF INJURY CA7S1;6 DATE
INPUT TRANSFORM: S %DT="ETX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JUN 25, 2004
HELP-PROMPT: Enter the date the injury or illness occurred.
DESCRIPTION:
This field contains the date the injury or illness occurred.
2264,8 EMPLOYEE PHONE NUMBER CA7S1;7 FREE TEXT
INPUT TRANSFORM: K:$L(X)>12!($L(X)<10) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 10-12 characters in length.
DESCRIPTION:
This is the employee's contact phone number.
2264,9 EMPLOYEE FAX NUMBER CA7S1;8 FREE TEXT
INPUT TRANSFORM: K:$L(X)>12!($L(X)<10) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 10-12 characters in length.
DESCRIPTION:
This is the employee's fax number if they have one.
2264,10 TYPE COMPENSATION CA7S2;1 SET
'1' FOR Leave without pay;
'2' FOR Leave buy back;
'3' FOR Other wage loss;
'4' FOR Schedule Award;
LAST EDITED: MAY 06, 2004
HELP-PROMPT: Enter the type of compensation this claim is filed for.
DESCRIPTION: This field will contain the type of compensation being filed for, for this claim. Only one type
can be selected per claim.
2264,11 CLAIM START DATE CA7S2;2 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter the first date this compensation claim is being filed for.
DESCRIPTION:
This field contains the first date compensation for this claim is being filed for.
2264,12 CLAIM END DATE CA7S2;3 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter the last date compensation for this claim is being filed for.
DESCRIPTION:
This field contains the ending date compensation for this claim is being filed for.
2264,13 CLAIM INTERMITTENT CA7S2;4 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter Y to indicate the dates for this claim are not continuous, otherwise, enter N.
DESCRIPTION: This field indicates whether the claim dates were continuous or not. If not continuous enter Yes,
otherwise enter No.
2264,14 OTHER WAGE TYPE CA7S2;5 FREE TEXT
INPUT TRANSFORM: K:$L(X)>18!($L(X)<3) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 3-18 characters in length.
DESCRIPTION: This field contains the description of other wage loss if that type of compensation is being
claimed.
2264,15 EXTERNALLY WORKED CA7S3;1 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter Y if employee worked outside their federal job during the claim period, otherwise enter N.
DESCRIPTION: This field indicates whether the employee was employed outside their federal job at any time during
the claim date range.
2264,16 BUSINESS NAME CA7S3;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>35!($L(X)<3) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 3-35 characters in length.
DESCRIPTION: This field contains the name of the business where the employee worked, if they worked outside
their federal job during the claim date range.
2264,17 BUSINESS STREET ADD CA7S3;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<3) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 3-30 characters in length.
DESCRIPTION:
This is the street portion of the business address where the employee worked.
2264,18 BUSINESS CITY ADD CA7S3;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>25!($L(X)<3) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 3-25 characters in length.
DESCRIPTION:
This is the city portion of the business address where the employee worked.
2264,19 BUSINESS STATE ADD CA7S3;5 POINTER TO STATE FILE (#5)
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter the state portion of the business address.
DESCRIPTION:
This field contains the state portion of the business where the employee worked.
2264,20 BUSINESS ZIPCODE ADD CA7S3;6 FREE TEXT
INPUT TRANSFORM: K:$L(X)>11!($L(X)<5) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 5-11 characters in length.
DESCRIPTION:
This field contains the zip code portion of the business where the employee worked.
2264,21 DATE BEGAN OUTSIDE WORK CA7S3;7 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter the date the employee started working outside employment.
DESCRIPTION: This date contains the first date the employee began working at an outside job during the claim
period.
2264,22 DATE END OUTSIDE WORK CA7S3;8 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter the last day of outside employment.
DESCRIPTION:
This is the last day the employee worked outside employment during the claim date range.
2264,23 OUTSIDE WORK DESCRIPTION CA7S3;9 FREE TEXT
INPUT TRANSFORM: K:$L(X)>40!($L(X)<3) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 3-40 characters in length.
DESCRIPTION: This field describes the type of outside work the employee performed for an employer while working
outside their federal job.
2264,24 1ST CLAIM FILED FOR INCIDENT CA7S4;1 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter Y if this is the first claim filed for this injury or illness, otherwise enter N.
DESCRIPTION: This field will indicate if this is the first compensation claim filed for a particular CA-1 or
CA-2.
2264,25 CHANGES SINCE LAST CLAIM CA7S4;2 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter Y if there has been changes to the employee's dependents or direct deposit information or
another type of claim filed.
DESCRIPTION: This field indicates if the employee's dependent or direct deposit information has changed or if
they have filed a claim for U.S. Civil Service, other federal retirement or disability law, or the
Department of Veterans Affairs.
2264,26 DEPENDENT INFORMATION CA7S5;0 Multiple #2264.026 (Add New Entry without Asking)
DESCRIPTION: This multiple contains the demographic information for dependents living with the employee who is
filing a request for compensation claim.
2264.026,.01 DEP SSN 0;1 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Type a Number between 0 and 999999999, 0 Decimal Digits
DESCRIPTION: This multiple contains information pertaining to dependents the employee has and is required for
properly filing a CA-7 claim.
CROSS-REFERENCE: 2264.026^B
1)= S ^OOPS(2264,DA(1),"CA7S5","B",$E(X,1,30),DA)=""
2)= K ^OOPS(2264,DA(1),"CA7S5","B",$E(X,1,30),DA)
2264.026,1 DEP NAME 0;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>35!($L(X)<3) X
LAST EDITED: APR 27, 2004
HELP-PROMPT: Answer must be 3-35 characters in length.
DESCRIPTION:
This field contains the employee's dependents name.
2264.026,2 DEP DATE OF BIRTH 0;3 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 27, 2004
HELP-PROMPT: Enter the dependents birth date.
DESCRIPTION:
This field contains the employee's dependents date of birth.
2264.026,3 DEP RELATIONSHIP 0;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>15!($L(X)<3) X
LAST EDITED: APR 27, 2004
HELP-PROMPT: Answer must be 3-15 characters in length.
DESCRIPTION:
This field contains the relationship the employee has with or to the dependent.
2264.026,4 DEP LIVING WITH YOU 0;5 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 27, 2004
HELP-PROMPT: Enter Y if the dependent is living with you, otherwise enter N.
DESCRIPTION:
This field indicates whether the dependent is living with the employee or not.
2264,27 DEP SUPPORT PAYMENT CA7S5A;1 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter Y to indicate the employee is making support payments for any dependent listed.
DESCRIPTION: This field will indicate whether the employee is making support payments for any dependent listed
in Section 5.
2264,28 DEP SUPPORT COURT ORDERED CA7S5A;2 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter Y to indicate the employee was court ordered to make the support payment, otherwise enter N.
DESCRIPTION: This field indicates whether the employee is making court ordered support payments for any
dependent listed in section 5.
2264,29 SUPPORT PAY RECIPIENT CA7S5A;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>35!($L(X)<3) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 3-35 characters in length.
DESCRIPTION: This field contains the name of the individual receiving support payments for a dependent listed in
section 5.
2264,30 SUPPORT PAY STREET ADD CA7S5A;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<3) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 3-30 characters in length.
DESCRIPTION:
This field contains the street address of the individual receiving support payments.
2264,31 SUPPORT PAY CITY ADD CA7S5A;5 FREE TEXT
INPUT TRANSFORM: K:$L(X)>25!($L(X)<3) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 3-25 characters in length.
DESCRIPTION:
This field contains the city address of the individual receiving support payments.
2264,32 SUPPORT PAY STATE ADD CA7S5A;6 POINTER TO STATE FILE (#5)
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter the state portion of the individual receiving support payments from the employee.
DESCRIPTION:
This field contains the state address of the individual receiving support payments.
2264,33 SUPPORT PAY ZIPCODE ADD CA7S5A;7 FREE TEXT
INPUT TRANSFORM: K:$L(X)>11!($L(X)<5) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 5-11 characters in length.
DESCRIPTION:
This field contains the zip code address of the individual receiving support payments.
2264,34 THIRD PARTY CLAIM CA7S6;1 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter Y if a claim will be made against a third party, otherwise enter N.
DESCRIPTION: This field indicates if the employee will file a claim against a third party for the injury or
illness. This person or organization must be someone other than the employee or Federal
government.
2264,35 PRIOR VA DISABILITY BENEFIT CA7S6;2 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter Y to indicate the employee has ever applied for or received disability from the Dept. of VA.
DESCRIPTION: This field indicates whether the employee has ever applied for or received disability benefits from
the Department of Veterans Affairs.
2264,36 PRIOR DISABILITY CLAIM NUMBER CA7S6;3 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Type a Number between 0 and 999999999, 0 Decimal Digits
DESCRIPTION: This field contains the VA claim number from a previous disability claim filed against or received
from the Department of Veterans Affairs.
2264,37 PRIOR DISABILITY VA OFFICE CA7S6;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>35!($L(X)<3) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 3-35 characters in length.
DESCRIPTION:
This field contains the full name of the VA office where the prior claim was filed.
2264,38 PRIOR DISABILITY STREET ADD CA7S6;5 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<3) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 3-30 characters in length.
DESCRIPTION: This field contains the street portion of the address for the VA office where the prior claim was
filed.
2264,39 PRIOR DISABILITY CITY ADD CA7S6;6 FREE TEXT
INPUT TRANSFORM: K:$L(X)>25!($L(X)<3) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 3-25 characters in length.
DESCRIPTION: This field contains the city portion of the address for the VA office where the prior claim was
filed.
2264,40 PRIOR DISABILITY STATE ADD CA7S6;7 POINTER TO STATE FILE (#5)
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter the state portion of VA office where the previous claim was filed.
DESCRIPTION: This field contains the state portion of the address for the VA office where the previous claim was
filed.
2264,41 PRIOR DISABILITY ZIPCODE ADD CA7S6;8 FREE TEXT
INPUT TRANSFORM: K:$L(X)>11!($L(X)<5) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 5-11 characters in length.
DESCRIPTION: This field contains the zip code portion of the address for the VA office where the previous claim
was filed.
2264,41.3 PRIOR DISABILITY DESCRIPTION CA7S6;14 FREE TEXT
INPUT TRANSFORM: K:$L(X)>40!($L(X)<3) X
LAST EDITED: MAY 06, 2004
HELP-PROMPT: Answer must be 3-40 characters in length.
DESCRIPTION:
This field will describe the nature of the prior disability.
2264,41.6 PRIOR DISABILITY MONTHLY AMT CA7S6;15 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99999999)!(X<0)!(X?.E1"."3N.N) X
LAST EDITED: MAY 06, 2004
HELP-PROMPT: Type a Number between 0 and 99999999, 2 Decimal Digits
DESCRIPTION:
This field contains the amount of the monthly disability received by the employee.
2264,42 PREV BEN FED RET/DISA LAW CA7S6;9 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter Y if the employee has applied or received payment under any other Federal Ret. or disability
law.
DESCRIPTION: This field indicates whether the employee has applied for or received payments under any other
Federal Retirement or Disability law.
2264,43 PREV BEN FED CLAIM NUMBER CA7S6;10 FREE TEXT
INPUT TRANSFORM: K:$L(X)>15!($L(X)<5) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 5-15 characters in length.
DESCRIPTION: This field will contain the claim number for the previous Federal Retirement or Disability law
claim.
2264,44 PREV BEN FED ANNUITY START DTE CA7S6;11 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter the date the annuity for the previous claim began.
DESCRIPTION: This field contains the date that the previously filed Federal Retirement or Disability claim
annuity first began.
2264,45 PREV BEN FED PAY AMOUNT CA7S6;12 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999)!(X<0)!(X?.E1"."3N.N) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Type a Number between 0 and 999999, 2 Decimal Digits
DESCRIPTION: This field contains the amount of the monthly payment for the previous Federal Retirement or
Disability law claim.
2264,46 PREV BEN FED RETIREMENT SYS CA7S6;13 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<3) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Answer must be 3-30 characters in length.
DESCRIPTION:
This is the Retirement system of the previously filed claim.
2264,47 EMP NAME FOR CA7 CA7S7;1 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter the name of the employee signing the CA-7.
DESCRIPTION:
This field contains the name of the employee that is signing the CA-7.
2264,48 EMP CA7 SIGNATURE BLOCK CA7S7;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<3) X
LAST EDITED: JUN 07, 2004
HELP-PROMPT: Answer must be 3-30 characters in length.
DESCRIPTION:
This field contains the validation code for the signature block for the employee signing the CA-7.
2264,49 EMP CA7 DATE OF SIGNATURE CA7S7;3 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter the date the employee signed the CA-7.
DESCRIPTION:
This field contains the date that the employee electronically signed the CA-7.
2264,50 DATE OF INJURY (PAGE 2) CA7S8;1 DATE
INPUT TRANSFORM: S %DT="ETX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JUN 25, 2004
HELP-PROMPT: Enter the date of injury or illness for the employee claim.
DESCRIPTION:
This field contains the date of injury or illness for the claim.
2264,51 BASE PAY TIME OF INCIDENT CA7S8;2 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999)!(X<0)!(X?.E1"."3N.N) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Type a Number between 0 and 999999, 2 Decimal Digits
DESCRIPTION:
This field contains the base pay for the employee at the time of the incident.
2264,52 PAY RATE TIME OF INCIDENT CA7S8;3 SET
'H' FOR Hourly;
'A' FOR Annum;
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter the employees pay rate at the time of the incident.
DESCRIPTION:
This field contains the pay rate for the employee at the time of the incident.
2264,53 GRADE AT TIME OF INCIDENT CA7S8;4 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Type a Number between 0 and 99, 0 Decimal Digits
DESCRIPTION:
This is the employee's grade at the time of the incident.
2264,54 STEP AT TIME OF INCIDENT CA7S8;5 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Type a Number between 1 and 99, 0 Decimal Digits
DESCRIPTION:
This is the employee's step at the time of the incident.
2264,55 ADD PAY TYPE CA7S8A;0 POINTER Multiple #2264.055
DESCRIPTION:
This multiple contains the additional pay type, the amount of additional pay, and the pay rate.
2264.055,.01 ADD PAY TYPE 0;1 POINTER TO ASISTS ADDITIONAL PAY TYPES FILE (#2262.5) (Multiply asked)
LAST EDITED: APR 27, 2004
HELP-PROMPT: Enter the additional pay type for the employee at the time work stopped.
DESCRIPTION: This field contains the type of additional pay the employee was receiving at the time of the
incident.
CROSS-REFERENCE: 2264.055^B
1)= S ^OOPS(2264,DA(1),"CA7S8A","B",$E(X,1,30),DA)=""
2)= K ^OOPS(2264,DA(1),"CA7S8A","B",$E(X,1,30),DA)
2264.055,1 ADD PAY BASE AMT 0;2 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99999999)!(X<0)!(X?.E1"."3N.N) X
LAST EDITED: APR 27, 2004
HELP-PROMPT: Type a Number between 0 and 99999999, 2 Decimal Digits
DESCRIPTION:
This field contains the base pay amount for this additional pay type.
2264.055,2 ADD PAY PAY RATE 0;3 SET
'H' FOR Hourly;
'A' FOR Annum;
LAST EDITED: APR 27, 2004
HELP-PROMPT: Enter the pay rate for this additional pay type.
DESCRIPTION:
This field contains the pay rate for this additional pay type.
2264,56 DATE EMPLOYEE STOPPED WORK CA7S8;6 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter the date the employee stopped work for this incident.
DESCRIPTION:
This field contains the date the employee stopped working for this incident.
2264,57 BASE PAY WHEN STOPPED WORK CA7S8;7 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999)!(X<0)!(X?.E1"."3N.N) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Type a Number between 0 and 999999, 2 Decimal Digits
DESCRIPTION: This is the base pay amount the employee was earning at the time they stopped working as a result
of this incident.
2264,58 PAY RATE WHEN STOPPED WORK CA7S8;8 SET
'H' FOR Hourly;
'A' FOR Annum;
LAST EDITED: APR 21, 2004
HELP-PROMPT: Enter the pay rate for the employee when they stopped working.
DESCRIPTION:
This is the pay rate for the employee at the time they stopped working after the incident.
2264,59 GRADE WHEN STOPPED WORK CA7S8;9 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Type a Number between 0 and 99, 0 Decimal Digits
DESCRIPTION:
This field contains the grade for the employee when they stopped work as a result of this incident.
2264,60 STEP WHEN STOPPED WORK CA7S8;10 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: APR 21, 2004
HELP-PROMPT: Type a Number between 0 and 99, 0 Decimal Digits
DESCRIPTION:
This is the step the employee was when they stopped work as a result of the incident.
2264,61 ADD PAY WHEN WORK STOPPED CA7S8B;0 POINTER Multiple #2264.061 (Add New Entry without Asking)
DESCRIPTION: This multiple contains the additional pay type, the amount of additional pay, and pay rate the
employee was earning at the time the employee stopped work as a result of the incident.
2264.061,.01 ADD PAY WHEN WORK STOPPED 0;1 POINTER TO ASISTS ADDITIONAL PAY TYPES FILE (#2262.5)
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter the additional type of pay when the employee stopped work.
DESCRIPTION: This is the additional type of pay the employee was earning at the time they stopped working as a
result of the incident.
CROSS-REFERENCE: 2264.061^B
1)= S ^OOPS(2264,DA(1),"CA7S8B","B",$E(X,1,30),DA)=""
2)= K ^OOPS(2264,DA(1),"CA7S8B","B",$E(X,1,30),DA)
2264.061,1 ADD PAY AMT WHEN WORK STOPPED 0;2 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99999999)!(X<0)!(X?.E1"."3N.N) X
LAST EDITED: APR 27, 2004
HELP-PROMPT: Type a Number between 0 and 99999999, 2 Decimal Digits
DESCRIPTION: This is the additional type of pay the employee was earning at the time they stopped working as a
result of the incident.
2264.061,2 ADD PAY RATE WHEN WORK STOPPED 0;3 SET
'H' FOR Hourly;
'A' FOR Annum;
LAST EDITED: APR 27, 2004
HELP-PROMPT: Enter the additional pay rate for the employee when they stopped working.
DESCRIPTION: This is the additional pay rate that the employee was earning at the time work stopped as a
result of the incident.
2264,62 REGULAR WKLY 40 HR SCHEDULE CA7S9;1 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter Y if the employee works a fixed, regular 40 hour weekly schedule.
DESCRIPTION:
This field indicates whether the employee works a fixed, regular 40 hour weekly schedule.
2264,63 REGULAR WORK SCHEDULE CA7S9;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>14!($L(X)<1) X
LAST EDITED: APR 22, 2004
HELP-PROMPT: Answer must be 1-14 characters in length.
DESCRIPTION: This field contains a listing of the days the employee is regularly scheduled to work, if working a
fixed 40 hour week. Examples of input are:
For Monday through Friday, enter 2-6
For Sunday, Wednesday through Saturday, enter 1,4-7 or 1,4,5,6,7
2264,64 LENGTH TIME IN POSITION CA7S9;3 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter Y if the employee worked in the position for a minimum of 11 months prior to the incident.
DESCRIPTION: This field indicates if the employee was working in the position for at least 11 months prior to
the incident.
2264,65 POSITION AVAILABLE CA7S9;4 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter Y if the position would have been available to the employee if the injury had not occurred.
DESCRIPTION: This field indicates if the position the employee held prior to the incident would have been
available for 11 months if the injury had not occurred.
2264,66 IRREGULAR WORK SCHEDULE CA7S9A;0 Multiple #2264.066
DESCRIPTION: This multiple collects the employees work daily schedule for the 2 weeks prior to the incident. It
includes the start and end date as well as the number of hours worked each day. The software will
prevent data from being entered for more than 2 weeks.
2264.066,.01 IRREGULAR WORK SCHEDULE WEEK 0;1 NUMBER (Multiply asked)
INPUT TRANSFORM: K:+X'=X!(X>2)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: APR 27, 2004
HELP-PROMPT: Type a Number between 1 and 2, 0 Decimal Digits
DESCRIPTION:
This field will indicate the week (1 or 2) of data that is being entered.
CROSS-REFERENCE: 2264.066^B
1)= S ^OOPS(2264,DA(1),"CA7S9A","B",$E(X,1,30),DA)=""
2)= K ^OOPS(2264,DA(1),"CA7S9A","B",$E(X,1,30),DA)
2264.066,1 IRR WK SCH START DATE 0;2 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 27, 2004
HELP-PROMPT: Enter the first date of the weekly schedule.
DESCRIPTION:
This is the date for the first day of the weekly schedule.
2264.066,2 IRR WK SCH LAST DATE 0;3 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 27, 2004
HELP-PROMPT: Enter the last date of the employees weekly work schedule.
DESCRIPTION:
This field contains the last date of the employees weekly work schedule.
2264.066,3 SUNDAY HOURS 0;4 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>24)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: APR 27, 2004
HELP-PROMPT: Type a Number between 0 and 24, 0 Decimal Digits
DESCRIPTION:
This field contains the hours the employee was scheduled to work that day.
2264.066,4 MONDAY HOURS 0;5 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>24)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: APR 27, 2004
HELP-PROMPT: Type a Number between 0 and 24, 0 Decimal Digits
DESCRIPTION:
This field contains the hours the employee was scheduled to work that day.
2264.066,5 TUESDAY HOURS 0;6 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>24)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: APR 27, 2004
HELP-PROMPT: Type a Number between 0 and 24, 0 Decimal Digits
DESCRIPTION:
This field contains the hours the employee was scheduled to work that day.
2264.066,6 WEDNESDAY HOURS 0;7 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>24)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: APR 27, 2004
HELP-PROMPT: Type a Number between 0 and 24, 0 Decimal Digits
DESCRIPTION:
This field contains the hours the employee was scheduled to work that day.
2264.066,7 THURSDAY HOURS 0;8 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>24)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: APR 27, 2004
HELP-PROMPT: Type a Number between 0 and 24, 0 Decimal Digits
DESCRIPTION:
This field contains the hours the employee was scheduled to work that day.
2264.066,8 FRIDAY HOURS 0;9 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>24)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: APR 27, 2004
HELP-PROMPT: Type a Number between 0 and 24, 0 Decimal Digits
DESCRIPTION:
This field contains the hours the employee was scheduled to work that day.
2264.066,9 SATURDAY 0;10 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>24)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: APR 27, 2004
HELP-PROMPT: Type a Number between 0 and 24, 0 Decimal Digits
DESCRIPTION:
This field contains the hours the employee was scheduled to work that day.
2264,67 HLTH BENEFITS WHEN PAY STOPPED CA7S10;1 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter Y if the employee had health coverage under FEHBP when their pay stopped.
DESCRIPTION: This field will indicate whether the employee had health coverage under FEHBP on the date their pay
stopped.
2264,68 HLTH BENEFITS CODE CA7S10;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>3!($L(X)<3) X
LAST EDITED: APR 22, 2004
HELP-PROMPT: Answer must be 3 characters in length.
DESCRIPTION:
This field contains the employee's health benefits code.
2264,69 BASIC LIFE INSURANCE CA7S10;3 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter Y if the employee had basic life insurance coverage the day that their pay stopped.
DESCRIPTION: This field indicates whether the employee was enrolled in basic life insurance coverage on the day
that their pay stopped.
2264,70 OPTIONAL LIFE INSURANCE CA7S10;4 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter Y if the employee was enrolled in optional life insurance coverage at the time their pay
stopped.
DESCRIPTION: This field will indicate whether the employee was enrolled in optional life insurance coverage on
the date their pay stopped.
2264,71 OPT LIFE INSURANCE CLASS CA7S10;5 FREE TEXT
INPUT TRANSFORM: K:$L(X)>2!($L(X)<1) X
LAST EDITED: APR 22, 2004
HELP-PROMPT: Answer must be 1-2 characters in length.
DESCRIPTION: This field contains the class of the optional life insurance if the employee had coverage on the
date that their pay stopped.
2264,72 RETIREMENT SYSTEM CA7S10;6 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter Y if the employee was covered with a retirement system at the time their pay stopped.
DESCRIPTION: This field will indicate whether the employee was enrolled in a retirement system at the time that
their pay stopped.
2264,73 RETIREMENT SYSTEM PLAN CA7S10;7 SET
'1' FOR CSRS;
'2' FOR FERS;
'3' FOR OTHER;
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter the code for the type of retirement system the employee has.
DESCRIPTION: This field will indicate what type of retirement system the employee had at the time their pay
stopped.
2264,74 COP RECEIVED START DATE CA7S11;1 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter the first date COP was received.
DESCRIPTION:
This is the begin date of continuation of pay that the employee received.
2264,75 COP RECEIVED END DATE CA7S11;2 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter the last date that the employee received COP.
DESCRIPTION:
This is the last date of continuation of pay that the employee received.
2264,76 COP INTERMITTENT CA7S11;3 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter Y if the COP the employee received was not continuous.
DESCRIPTION: This field indicates whether the employee received continuation of pay continuously or if there was
a break in benefits.
2264,77 PAY STATUS DURING CLAIM CA7S12;0 SET Multiple #2264.077 (Add New Entry without Asking)
DESCRIPTION: This multiple contains the pay status, start and end date and whether the pay status for the date
range entered was continuous or intermittent.
2264.077,.01 PAY STATUS DURING CLAIM 0;1 SET
'S' FOR Sick Leave;
'A' FOR Annual Leave;
'L' FOR Leave without Pay;
'W' FOR Work;
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter the pay status requested during this CA7 claim.
DESCRIPTION:
This field contains a pay status for the employee for leave requested during this CA-7 claim.
CROSS-REFERENCE: 2264.077^B
1)= S ^OOPS(2264,DA(1),"CA7S12","B",$E(X,1,30),DA)=""
2)= K ^OOPS(2264,DA(1),"CA7S12","B",$E(X,1,30),DA)
2264.077,1 PAY STATUS START DATE 0;2 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 27, 2004
HELP-PROMPT: Enter the first date this pay status was requested.
DESCRIPTION: This field contains the first date the pay status was requested by the employee for this CA-7
claim.
2264.077,2 PAY STATUS END DATE 0;3 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 27, 2004
HELP-PROMPT: Enter the last date for the requested pay status for this claim.
DESCRIPTION: his field contains the last date the pay status was requested by the employee for this CA-7
claim.
2264.077,3 PAY STATUS LEAVE INTERMITTENT 0;4 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 27, 2004
HELP-PROMPT: Enter Y if the time period for this pay status was not continuous, otherwise enter N.
DESCRIPTION: This field indicates whether the time period requested for this pay status was continuous or
intermittent.
2264,78 EMPLOYEE RETURNED TO WORK CA7S13;1 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter Y if the employee returned to work, otherwise enter N.
DESCRIPTION:
This field indicates whether the employee returned to work during this CA-7 claim.
2264,79 DATE EMPLOYEE RETURNED TO WORK CA7S13;2 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter the date the employee returned to work.
DESCRIPTION: This field contains the date the employee returned to work after the incident relating to this CA-7
claim.
2264,80 RETURNED TO PRE-INJURY JOB CA7S13;3 SET
'Y' FOR Yes;
'N' FOR No;
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter Y if the employee was able to return to their regular job, otherwise enter N.
DESCRIPTION: This field indicates whether the employee returned to their regular job - the one they were working
prior to the incident that resulted in this claim.
2264,81 REASON NOT RETURN TO JOB CA7S13A;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>240!($L(X)<3) X
LAST EDITED: APR 22, 2004
HELP-PROMPT: Answer must be 3-240 characters in length.
DESCRIPTION: This field contains the reason the employee was not able to return to their pre-incident 'regular'
job.
2264,82 REMARKS CA7S14;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>240!($L(X)<3) X
LAST EDITED: APR 22, 2004
HELP-PROMPT: Answer must be 3-240 characters in length.
DESCRIPTION: This field contains any remarks that the workers' compensation specialist needs to make regarding
this CA-7 claim.
2264,83 WC NAME FOR CA7 CA7S15;1 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter the name of the WC specialist who signed the claim.
DESCRIPTION:
This field contains the name of the Workers' Comp (WC) specialist who signed the claim.
2264,84 WC CA7 ELECTRONIC SIGNATURE CA7S15;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>20!($L(X)<6) X
LAST EDITED: APR 22, 2004
HELP-PROMPT: Answer must be 6-20 characters in length.
DESCRIPTION:
This field contains the WC specialist's electronic signature who signed the claim.
2264,85 WC CA7 DATE OF SIGNATURE CA7S15;3 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 22, 2004
HELP-PROMPT: Enter the date the WC specialist signed the claim.
DESCRIPTION:
This is the date that the WC specialist electronically signed the claim.
2264,86 WC CA7 TITLE CA7S15;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>20!($L(X)<3) X
LAST EDITED: APR 22, 2004
HELP-PROMPT: Answer must be 3-20 characters in length.
DESCRIPTION:
This is the WC specialist's official title.
2264,87 AGENCY NAME CA7S15;5 FREE TEXT
INPUT TRANSFORM: K:$L(X)>40!($L(X)<2) X
LAST EDITED: JUN 08, 2004
HELP-PROMPT: Answer must be 2-40 characters in length.
DESCRIPTION:
This is the official name of the agency whose WC specialist is signing this claim.
2264,88 OWCP CONTACT NAME CA7S15;6 FREE TEXT
INPUT TRANSFORM: K:$L(X)>35!($L(X)<3) X
LAST EDITED: APR 22, 2004
HELP-PROMPT: Answer must be 3-35 characters in length.
DESCRIPTION: This field contains the name of the individual who OWCP should contact should they need additional
information regarding this claim.
2264,89 OWCP CONTACT TITLE CA7S15;7 FREE TEXT
INPUT TRANSFORM: K:$L(X)>20!($L(X)<3) X
LAST EDITED: APR 22, 2004
HELP-PROMPT: Answer must be 3-20 characters in length.
DESCRIPTION: This field contains the title for the OWCP contact person should OWCP need to contact them
regarding this claim.
2264,90 OWCP CONTACT PHONE CA7S15;8 FREE TEXT
INPUT TRANSFORM: K:$L(X)>12!($L(X)<10) X
LAST EDITED: APR 22, 2004
HELP-PROMPT: Answer must be 10-12 characters in length.
DESCRIPTION: This field contains the telephone number for the individual that OWCP should contact if they need
additional information regarding this claim.
2264,91 OWCP CONTACT FAX CA7S15;9 FREE TEXT
INPUT TRANSFORM: K:$L(X)>12!($L(X)<10) X
LAST EDITED: APR 22, 2004
HELP-PROMPT: Answer must be 10-12 characters in length.
DESCRIPTION: This field contains the fax number for the individual that OWCP should contact if they need
additional information regarding this claim.
2264,92 OWCP CONTACT EMAIL CA7S15;10 FREE TEXT
INPUT TRANSFORM: K:$L(X)>50!($L(X)<3) X
LAST EDITED: JUN 08, 2004
HELP-PROMPT: Answer must be 3-50 characters in length.
DESCRIPTION: This field contains the email address for the individual that OWCP should contact if they need
additional information regarding this claim.
2264,93 WEEK WORK STOPPED CA7S9;5 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>2)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: MAY 20, 2004
HELP-PROMPT: Type a Number between 1 and 2, 0 Decimal Digits
DESCRIPTION:
The Workers' Comp specialist will enter the week of the pay period that worked stopped.
2264,94 DAY OF WEEK WORK STOPPED CA7S9;6 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>7)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: MAY 20, 2004
HELP-PROMPT: Type a Number between 1 and 7, 0 Decimal Digits
DESCRIPTION: The Workers' Comp specialist will enter an number indicating what day of the week work stopped.
Sunday = 1, Monday = 2, etc. This information will be used in conjunction with the WEEK WORKED
STOPPED for calculating continuation of pay.
2264,95 EMP VALIDATION CODE CA7S7;4 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: JUN 08, 2004
HELP-PROMPT: Type a Number between 1 and 999999999, 0 Decimal Digits
DESCRIPTION: This field contains the validation code for verification that the data has not changed after the
employee signed the CA-7 case.
2264,96 VALIDATION VERSION CA7S7;5 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: JUN 04, 2004
HELP-PROMPT: Type a Number between 1 and 99, 0 Decimal Digits
DESCRIPTION:
This field contains the version number used to encode the electronic signature code for the CA-7.
2264,97 WC VALIDATION CODE CA7S15;11 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: JUN 08, 2004
HELP-PROMPT: Type a Number between 0 and 999999999, 0 Decimal Digits
DESCRIPTION: This field contains the validation code for verification that the data has not changed after the
workers' compensation specialist has signed the CA-7 case.
2264,98 DATE CA7 RCVD FROM EMP CA7S15A;1 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JAN 22, 2008
HELP-PROMPT: Enter the date you received the form from the employee.
DESCRIPTION:
This field contains the date the CA7 form was received from the employee.
FILES POINTED TO FIELDS
ASISTS ACCIDENT REPORTING
(#2260) ASISTS RECORD (#.7)
ASISTS ADDITIONAL PAY TYPES
(#2262.5) ADD PAY TYPE:ADD PAY TYPE (#.01)
ADD PAY WHEN WORK STOPPED:ADD PAY WHEN WORK STOPPED (#.01)
NEW PERSON (#200) PERSON THAT CREATED CA7 (#.5)
EMP NAME FOR CA7 (#47)
WC NAME FOR CA7 (#83)
STATE (#5) MAILING STATE ADD (#4)
BUSINESS STATE ADD (#19)
SUPPORT PAY STATE ADD (#32)
PRIOR DISABILITY STATE ADD (#40)
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):