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InjuryIncidentClaim

Name	Type	Additional information
Location Code	string	None.
Location Name	string	None.
Incident ID (System Generated)	string	None.
Incident Internal Id (System Generated)	string	None.
Incident Title (No Personal data to be entered)	string	None.
Incident Type	string	None.
Were multiple people injured as part of this incident?	string	None.
Is this a MSHA Related Incident?	string	None.
Is this a MSHA Related Incident Location?	string	None.
Date of Incident	date	None.
Time of Incident	string	None.
Time undetermined	string	None.
Day Of Week	string	None.
Length of Normal Workday	string	None.
Work Shift	string	None.
Time Work Day Began	string	None.
HasPotentialToSerious	string	None.
Description of Incident	string	None.
Incident Occurred on Employer's Premises	string	None.
Address of Incident Location	string	None.
City of Incident Location	string	None.
County of Incident Location	string	None.
Country of Incident Location	string	None.
State/Province of Incident Location	string	None.
Postal Code/Zip Code of Incident Location	string	None.
Department	string	None.
Pin Location	string	None.
Responsible Department	string	None.
Responsible Supervisor	string	None.
Location of Injury Scene	string	None.
Date Reported to Employer	date	None.
Time Reported to Employer	string	None.
ContractorInvolvedYN	string	None.
ContractorName	string	None.
ContractorDetails	string	None.
ContractorTrainedYN	string	None.
WasAssetinvolved	string	None.
Assets	string	None.
Confirm Significance Level ID Of Incident	string	None.
Confirm Significance Level Of Incident	string	None.
Would you like to submit a Workers Compensation claim?	string	None.
Personnel Type ID	integer	None.
Personnel Type	string	None.
Employee / Individual Involved (Prefix, First, M.I., Last)	string	None.
Employee Id	string	None.
Employee's Social Security Number **	string	None.
Date of Birth **	date	None.
Gender	string	None.
Occupation/Job Title	string	None.
Hire Date	date	None.
Pay Rate Type	string	None.
Time in Current job	string	None.
Time in Current job Unit	string	None.
Employee / Individual Department	string	None.
Supervisor (First, M.I., Last)	string	None.
Supervisor's Email	string	None.
Supervisor Phone	string	None.
Employee Home Address	string	None.
Employee City	string	None.
Employee State	string	None.
Employee Postal Code/Zip Code	string	None.
Employee Home Phone Number	string	None.
Marital Status	string	None.
Years at Company	string	None.
Number Of Dependents	integer	None.
Type of Employment	string	None.
Current Weekly Wage	decimal number	None.
Hourly Wage	decimal number	None.
Hours Worked per Week	decimal number	None.
Days worked Per Week	integer	None.
Hours worked Per Day	integer	None.
State Hired	string	None.
Employment Status	string	None.
Was Employee Paid in Full for Date of Injury?	string	None.
Any Prior WC Injuries?	string	None.
Do you want to further classify Unsupervised Contract Employee	string	None.
Type of Client Personnel	string	None.
Client Company	string	None.
Name of Contractor	string	None.
Name of Sub-Contractor	string	None.
Will employee's salary continue?r	string	None.
Was Employee treated offsite?	string	None.
Where was employee treated	string	None.
Explain Why	string	None.
If this injury had occurred in a slightly different matter, could it have caused a serious injury or fatality	string	None.
Did this incident involve an in-patient hospitalization, amputation, or a loss of an eye?	string	None.
Has OSHA been contacted?	string	None.
Please Identify OSHA Contact Details (Name and Phone Number)	string	None.
Nature of Injury / Illness	string	None.
Cause of Illness/Injury	string	None.
Injured Body Part	string	None.
What was the employee doing just before the incident occurred?	string	None.
Please describe what object or substance directly harmed the employee? If this question does not apply, enter 'not applicable'	string	None.
Specific Work Activity when the incident occurred	string	None.
Was any Machine / Equipment involved?	string	None.
Machine/Equipment Number	string	None.
Reviewed by EHS Representative	string	None.
Review Date	date	None.
Is this a Needlestick Injury?	string	None.
Type	string	None.
Brand	string	None.
Model	string	None.
Identify Initial Treatment	string	None.
Was Drug Testing Performed	string	None.
Explain why	string	None.
RIDDOR Classification	Collection of RiddorClassificationDetails	None.
Most Severe Case	string	None.
Current Case	string	None.
Health & Safety / WC Contact Name	string	None.
Employer Telephone Number	string	None.
Employer Title	string	None.
Employer Mailing Address	string	None.
Employer City	string	None.
Employer State	string	None.
Employer Postal Code/Zip Code	string	None.
Employer Location Code	string	None.
Employer SIC	string	None.
Nature of Business	string	None.
Employer FEIN Number	string	None.
Employer Name	string	None.
Workers Comp Claim	string	None.
Is This Claim Work Related	string	None.
Jurisdiction State	string	None.
Did the incident result in fatality?	string	None.
Date fatality occurred	date	None.
Did the employee lose any time from work?	string	None.
What was the first full day out?	date	None.
Do you know the Date Employee Last Worked?	string	None.
Date Employee Last Worked	date	None.
Has the employee returned to work?	string	None.
Date Returned to Work	date	None.
Return to Work Status	string	None.
Estimated Return to Work Date	date	None.
Reqs Sharps Inj Log	string	None.
Work Comp Id	string	None.
Incident Reported By	string	None.
Reporters Email	string	None.
Reporters Phone	string	None.
Injury Date	date	None.
Injury Day	string	None.
Injury Time	string	None.
Claim Time Workday Began	string	None.
Was employee sent to Hospital / Clinic to receive Medical Treatment?	string	None.
Initial Medical Treatment	string	None.
Hospital / Clinic Name	string	None.
Hospital Address	string	None.
Hospital City	string	None.
Hospital State	string	None.
Hospital Postal Code/Zip Code	string	None.
Hospital Phone	string	None.
Hospital Fax	string	None.
Clinic/Doctor Name	string	None.
Do you question the Validity of the claim?	string	None.
Provide details	string	None.
Other Comments	string	None.
Is Claim Form Completed?	string	None.
Claim Submission Status	string	None.
Claim Submitted By	string	None.
Claim Submitted Date	date	None.
Claim Status	string	None.
Date Claim Closed	date	None.
Total Cost Incurred	decimal number	None.
Total Cost Paid	decimal number	None.
Total Outstanding Cost	decimal number	None.
Total Developed Cost	decimal number	None.
Incident Severity ID	integer	None.
Incident Severity SIF	string	None.
Actual Severity	string	None.
Potential Secction YN	string	None.
Display Cause YN	string	None.
Are there any Witnesses identified?	string	None.
Witness Information	Collection of WitnessOutboundDetails	None.
Name	string	None.
Title	string	None.
Phone	string	None.
Incident Status	string	None.
Incident Created By Employee ID	string	None.
Incident Created By	string	None.
Incident Created Date	date	None.
Incident Last Updated By	string	None.
Incident Last Updated Date	date	None.
Was This Claim Work Related	string	None.
ManagementReviewStatus	string	None.
Lost Time Days	decimal number	None.
Restricted Duty Days	decimal number	None.
Recordable (Yes/No)	string	None.
Workers Comp Claim#	string	None.
Reason for Non Work Related Classification	string	None.
Is This a Company defined Recordable Case ?	string	None.
Worker Comp Id	string	None.
Please identify the severity of the Incident	string	None.
Filing State	string	None.
Is Claim Submission Required?	string	None.
Claim #	string	None.
Recent Cost Update	string	None.
Was employee sent to Hospital/Clinic to receive Medical Treatment?	string	None.
Root Cause Details	Collection of RootCause	None.
5Y Details	Collection of _5WhyMethodology	None.
5Ys	Collection of Why	None.
Investigation questions Details	Collection of InvestigationQuestionsDetails	None.
Investigation Responsibility Details	Collection of InvResponsilbilityDetails	None.
Investigation Responsibility assignee Details	Collection of InvResponsebilityAssignee	None.
Final root cause statement Details	Collection of FinalrootCauseSTMT	None.
Action Items Details	Collection of ActionItemsDetails	None.
Contributing Factors Details	Collection of ContributingFactor	None.
Ergo Details	Collection of ErgonomicDetails	None.
Case Classification	Collection of ClassificationOfCase	None.
Case Progression Tracking	Collection of CaseProgressionTracking	None.
WCC InjuryIllness	Collection of WCCInjuryIllness	None.
Employee first name	string	None.
Employee middle name	string	None.
Employee Last name	string	None.
Employee suffix	string	None.
supervisor first name	string	None.
supervisor middle name	string	None.
Supervisor Last name	string	None.
supervisor suffix	string	None.
Incident Own id	string	None.
USLocationYN	integer	None.
Work_activity_done	string	None.
OccuredDepartment	string	None.
InitialMedicalTreatment	string	None.
ReportPrepByName	string	None.
ReportPrepByPhone	string	None.
ReportPrepByTitle	string	None.
Management review Details	Collection of ManagementReview	None.
Status of Worker's compensation	string	None.
Chargable (Yes / No)	string	None.
Current Case Start Date	date	None.
Current Case End Date	date	None.
Date OSHARecordable Determined	date	None.