Name | Description | Type | Additional information |
---|---|---|---|
Employee Name | string |
None. |
|
Classification Of Case Id | integer |
None. |
|
Classification of Case | string |
None. |
|
Date Reported | date |
None. |
|
Date First Aid Provided | date |
None. |
|
Date other Recordable case Occurred | date |
None. |
|
First Day of Restricted Duty | date |
None. |
|
Last Day of Restricted Duty | date |
None. |
|
First Day of Lost Time | date |
None. |
|
Last Day of Lost Time | date |
None. |
|
Date Fatality Occurred. | date |
None. |
|
Reason for Classification | string |
None. |
|
Reason for Classification Pick List | string |
None. |
|
Is This A Defense Based Act Case? | string |
None. |
|
Is This A Compensable Case? | string |
None. |
|
Comments | string |
None. |
|
Official Medical Diagnosis (Nature of Injury / Illness) | string |
None. |
|
Was the Corporate Medical Director contacted? | string |
None. |
|
Was Medical Treatment Rejected? | string |
None. |
|
Reason for Refusal | string |
None. |
|
Was Treatment Provided beyond First Aid? | string |
None. |
|
Was Treatment provided offsite? | string |
None. |
|
Hospital/Clinic Name | string |
None. |
|
Type | string |
None. |
|
Physician/Health care Provider | string |
None. |
|
Street | string |
None. |
|
City | string |
None. |
|
Country | string |
None. |
|
State | string |
None. |
|
Postal Code/Zip Code | string |
None. |
|
Phone | string |
None. |
|
FAX | string |
None. |
|
Was the employee treated in an emergency room | string |
None. |
|
Was employee hospitalized overnight as an in-patient | string |
None. |
|
Recording/Revision Date | date |
None. |