| Name | Description | Type | Additional information |
|---|---|---|---|
| IMSIncidentID | integer |
None. |
|
| IncidentClaimYN | string |
None. |
|
| WorkCompId | string |
None. |
|
| TPAID | string |
None. |
|
| IncidentReportedBy | string |
None. |
|
| ReportersEmail | string |
None. |
|
| ReportersPhone | string |
None. |
|
| InjuryDate | date |
None. |
|
| InjuryDay | string |
None. |
|
| InjuryTime | string |
None. |
|
| TimeWorkdayBegan | string |
None. |
|
| IncidentInternalId | string |
None. |
|
| ClaimWorkRelatedYn | string |
None. |
|
| EmpSSN | string |
None. |
|
| EmpFirstName | string |
None. |
|
| EmpMiddleName | string |
None. |
|
| EmpLastName | string |
None. |
|
| EmpStreet | string |
None. |
|
| EmpCity | string |
None. |
|
| EmpState | string |
None. |
|
| EmpZip | string |
None. |
|
| EmpPhone | string |
None. |
|
| EmpGender | string |
None. |
|
| EmpDOB | date |
None. |
|
| EmpMaritialStatus | string |
None. |
|
| EmpHireDate | date |
None. |
|
| EmpYearsAtComp | string |
None. |
|
| EmpNoOfDependents | integer |
None. |
|
| EmpTypeOfEmployement | string |
None. |
|
| EmpDepartment | string |
None. |
|
| EmpStateHired | string |
None. |
|
| EmpSupervisorName | string |
None. |
|
| EmpSupervisorPhone | string |
None. |
|
| EmpWeeklyWage | decimal number |
None. |
|
| EmpHourlyWage | decimal number |
None. |
|
| EmpHoursPerWeek | decimal number |
None. |
|
| EmpDaysPerWeek | decimal number |
None. |
|
| EmpHoursPerDay | decimal number |
None. |
|
| EmployementStatus | string |
None. |
|
| EmployeeID | string |
None. |
|
| EmpPaidInFull | string |
None. |
|
| EmpAnyPriorInjuriesYn | string |
None. |
|
| EmpSalaryContinueYN | string |
None. |
|
| EmployerContactName | string |
None. |
|
| EmployerTelephoneNumber | string |
None. |
|
| EmployerTitle | string |
None. |
|
| EmployerAddress | string |
None. |
|
| EmployerCity | string |
None. |
|
| EmployerState | string |
None. |
|
| EmployerZip | string |
None. |
|
| EmployerLocCode | string |
None. |
|
| EmployerSIC | string |
None. |
|
| EmployerNatureOfBusiness | string |
None. |
|
| EmployerName | string |
None. |
|
| FEINNumber | string |
None. |
|
| AccidentOccuredAtWorkYn | string |
None. |
|
| AccidentAddress | string |
None. |
|
| AccidentCity | string |
None. |
|
| AccidentState | string |
None. |
|
| AccidentZip | string |
None. |
|
| AccidentDescription | string |
None. |
|
| EmpActivityBeforeAccident | string |
None. |
|
| ObjectInvolved | string |
None. |
|
| JurisdictionState | string |
None. |
|
| DateReported | date |
None. |
|
| TimeReported | string |
None. |
|
| FatalityYn | string |
None. |
|
| FatalityDate | date |
None. |
|
| LostTimeYn | string |
None. |
|
| FirstFullDayOut | date |
None. |
|
| DateEmployeeLastWorkedYN | string |
None. |
|
| DateEmployeeLastWorked | date |
None. |
|
| EmpReturnToWorkYn | string |
None. |
|
| DateReturnToWork | date |
None. |
|
| EmpReturnWorkStatus | string |
None. |
|
| EstReturnToWorkDate | date |
None. |
|
| NatureOfinjury | string |
None. |
|
| CauseOfinjury | string |
None. |
|
| PartOfBody | string |
None. |
|
| PartOfBodyLocation | string |
None. |
|
| NeedleStickInjuryYn | string |
None. |
|
| ReqNeedleStickYn | string |
None. |
|
| EmpSentToHospYn | string |
None. |
|
| InitialTreatmentYn | string |
None. |
|
| HospName | string |
None. |
|
| HospAddress | string |
None. |
|
| HospCity | string |
None. |
|
| HosplAddressState | string |
None. |
|
| HospZip | string |
None. |
|
| HospPhone | string |
None. |
|
| HospFax | string |
None. |
|
| DoctName | string |
None. |
|
| WitnessYn | string |
None. |
|
| WitnessName | string |
None. |
|
| WitnessContact | string |
None. |
|
| ValidityOfClaimYn | string |
None. |
|
| ValidityOfClaimDetails | string |
None. |
|
| OtherComments | string |
None. |
|
| PrepByName | string |
None. |
|
| PrepByPhone | string |
None. |
|
| PrepByTitle | string |
None. |
|
| EmpOccupation | string |
None. |
|
| OshaReference | string |
None. |