Part 6 - Coding Values

1

1st Report

18th Month

20th Month

2

2nd Report

30th Month

32nd Month

3

3rd Report

42nd Month

44th Month

4

4th Report

54th Month

56th Month

5

5th Report

66th Month

68th Month

6

6th Report

78th Month

80th Month

7

7th Report

90th Month

92nd Month

8

8th Report

102nd Month

104th Month

9

9th Report

114th Month

116th Month

A

10th Report

126th Month

128th Month

H

Header Record Correction (including link data-1st Reports Only)

E

Exposure Record Correction (1st Reports Only)

L

Loss Record Correction

T

Total Record Correction

M

Multiple Record Type Corrections

Alabama (AL)

01

Louisiana (LA)

17

Ohio (OH)

34

Alaska (AK)

54

Maine (ME)

18

Oklahoma (OK)

35

Arizona (AZ)

02

Maryland (MD)

19

Oregon (OR)

36

Arkansas (AR)

03

Massachusetts (MA)

20

Pennsylvania (PA)

37

California (CA)

04

Michigan (MI)

21

Puerto Rico (PR)

58

Colorado (CO)

05

Minnesota (MN)

22

Rhode Island (RI)

38

Connecticut (CT)

06

Mississippi (MS)

23

South Carolina (SC)

39

Delaware (DE)

07

Missouri (MO)

24

South Dakota (SD)

40

District of Columbia (DC)

08

Montana (MT)

25

Tennessee (TN)

41

Florida (FL)

09

Nebraska (NE)

26

Texas (TX)

42

Georgia (GA)

10

Nevada (NV)

27

Utah (UT)

43

Hawaii (HI)

52

New Hampshire (NH)

28

Vermont (VT)

44

Idaho (ID)

11

New Jersey (NJ)

29

Virginia (VA)

45

Illinois (IL)

12

New Mexico (NM)

30

Washington (WA)

46

Indiana (IN)

13

New York (NY)

31

West Virginia (WV)

47

Iowa (IA)

14

North Carolina (NC)

32

Wisconsin (WI)

48

Kansas (KS)

15

North Dakota (ND)

33

Wyoming (WY)

49

Kentucky (KY)

16

01

Standard Workers Compensation & Employers Liability Policy

09

Non-Standard Policy

01

Voluntary Policy

02

Normal Assigned Risk Policy

07

Assigned Risk Policy originally assigned by another DCO (NC only)

01

Non-Standard Code Does Not Apply

99

Self-Insured in conjunction with a self-insured group

00

No Deductible

01

Medical Losses Only

02

Indemnity Losses Only

03

Medical and Indemnity Losses

00

No Deductible Applies

01

Per Claim

02

Per Accident

03

Per Policy (Aggregate)

06

Coinsurance Only

09

Per Policy and Accident (Aggregate)

10

Per Claim and Policy (Aggregate)

12

Variable - As per ASWG decision to allow flexibility for reporting deductible programs not otherwise defined

P

Previously Reported

R

Revised

00

For use with Statistical Codes

01

State Act or Federal Act Excluding USL & HW and Federal Coal Mine Health and Safety Act

02

USL & HW "F" or USL & HW Coverage on Non-F-Classes

0059

In Connection with Abrasive Sand Blasting

0066

In Connection with Incidental Foundries-Non-Ferrous Metals

0065

In Connection with Incidental Foundries-Steel

0067

In Connection with Incidental Foundries-Iron

9803

$100/100/1,000

9804

$100/100/2,500

9805

$100/100/5,000

9806

$100/100/10,000

9807

$500/500/500

9809

$500/500/1,000

9810

$500/500/2,500

9811

$500/500/10,000

9812

$1,000/1,000/1,000

9813

*$1,000/1,000/2,500

N/A Assigned Risk 04/01/12

9814

*$1,000/1,000/5,000

N/A Assigned Risk 04/01/12

9815

*$1,000/1,000/10,000

N/A Assigned Risk 04/01/12

9816

*Over $1,000/1,000/10,000

N/A Assigned Risk 04/01/12

9823

*$100/100/1,000

N/A Assigned Risk 04/01/12

9824

*$100/100/2,500

N/A Assigned Risk 04/01/12

9825

*$100/100/5,000

N/A Assigned Risk 04/01/12

9826

*$100/100/10,000

N/A Assigned Risk 04/01/12

9827

*$500/500/500

N/A Assigned Risk 04/01/12

9828

*$500/500/1,000

N/A Assigned Risk 04/01/12

9829

*$500/500/2,500

N/A Assigned Risk 04/01/12

9830

*$500/500/5,000

N/A Assigned Risk 04/01/12

9831

*$500/500/10,000

N/A Assigned Risk 04/01/12

9832

*$1,000/1,000/1,000

N/A Assigned Risk 04/01/12

9833

*$1,000/1,000/2,500

N/A Assigned Risk 04/01/12

9834

*$1,000/1,000/5,000

N/A Assigned Risk 04/01/12

9835

*$1,000/1,000/10,000

N/A Assigned Risk 04/01/12

9836

*Over $1,000/1,000/10,000

N/A Assigned Risk 04/01/12

9837

*All Other Increased Limits

N/A Assigned Risk 04/01/12

9817

*$50,000

N/A Assigned Risk 04/01/12

9818

*$100,000

N/A Assigned Risk 04/01/12

9819

*$200,000

N/A Assigned Risk 04/01/12

9820

*$300,000

N/A Assigned Risk 04/01/12

9821

*$400,000

N/A Assigned Risk 04/01/12

9822

*$500,000

N/A Assigned Risk 04/01/12

9840

*Over $500,000

N/A Assigned Risk 04/01/12

9848

Additional Premium to Balance Increased Limits to Minimum Premium

9664

Subject to Premium before Experience Modification

9721

Premium Credit Applied Before Experience Modification

9723

Premium Debit Applied Before Experience Modification

1111

No Exposure Unit Reports

9037

Rate Deviation Premium Adjustment Credit

0931

Short Rate Penalty Premium

0930

Waiver of Subrogation

9841

Drug Free Workplace Credit-Subject to Experience Rating

9849

Additional Premium to Balance Minimum Premium

0277

Assigned Risk Adjustment Program (ARAP)

9984

Experience in Connection with Either Construction or Operation Work Performed for or Under the Direction of the Nuclear Regulatory Commission or any Government Agency

9985

Radiation Exposure NOC: Operations Involving Research, Manufacturing, Handling, Transportation, Use of or Exposure to Radiation Materials - Other than Government Agency Atomic Energy Project

9663

Deductible Credit-Not subject to Experience Modification

9846

Drug Free Workplace Credit

9722

Premium Credit Applied After Experience Modification

9724

Premium Debit Applied After Experience Modification

0990

Additional Premium to Balance Minimum Premium

0771

In connection with Code 4771 - Explosives or Ammunition Mfg: NOC

7445

In connection with Code 7405 - Air Carrier Scheduled: Flying Crew

7453

In connection with Code7431- Air Carrier - Commuter: Flying Crew

9034

Credit

9887

Credit

9889

Debit

0133

In Connection with Asbestos Experience

0179

Not Otherwise Classified (NOC)

9880

Workplace Safety Credit Program

0900

Expense Constant

0063

Stock/Type A

0064

Non-Stock/Type B

9740

Terrorism

9741

Catastrophe (other than Certified Acts of Terrorism)

0156

In Connection with Code 1005-Surface

0164

In Connection with any class other than Coal Mining where there is liability under Federal Coal Mine Health and Safety Act

9757

Audit Noncompliance Charge

0012

Paid Furloughed Employees

03/01/2020

06/30/2023

Refer to Part 3-F-2-Nonpayroll Exposure for details on Paid Furloughed Employees.

Code 0012 must be used as a Statistical Code to report the payments only; or it may be used as a Classification Code to report the payments with a zero rate and zero premium.

0

Open

1

Closed

2

Reopened

01

Death

02

Permanent Total Disability

05

Temporary Total or Temporary Partial Disability

06

Medical Only Claims

07

Contract Medical or Hospital Allowance

09

Permanent Partial Disability

01

State or Federal Act, excl. USL & HW

02

USL & HW "F" or non "F" Coverage

01

Trauma

02

Occupational Disease

03

Cumulative Injury other than Disease

01

No Recovery

02

Second Injury Fund Only

03

Subrogation Only (Third Party)

04

Subrogation with Second Injury Fund (Third Party)

01

Workers Compensation Only

02

Employers Liability Only

03

Workers Compensation including Employers Liability

04

Liability Over

00

Claim Not Subject to Settlement

03

Stipulated Award (Carrier/Claimant Settlement)

04

Findings and Award (Judicial Award)

05

Dismissal or Take Nothing (Non-Compensable)

06

Compromise Settlement

09

All Other Settlements

00

The claim is not administered by a certified managed care organization

01

The claims medical losses are administered by a certified managed care organization

02

The claims medical losses are administered by a health maintenance organization

03

The claims medical losses are administered by a preferred provider organization

04

The claims medical losses are administered by an exclusive provider organization

05

The claims medical losses are administered by an independent practice association

I. HEAD

10

Multiple Head Injury

Any combination of below parts

11

Skull

*

12

Brain

*

13

Ears

Includes: hearing, inside eardrum

14

Eyes

Includes: optic nerves, vision, eyelids

15

Nose

Includes: nasal passage, sinus, sense of smell

16

Teeth

*

17

Mouth

Includes: lips, tongue, throat, taste

18

Other Facial Soft Tissue

*

19

Facial Bones

Includes: jaw

II. NECK

20

Multiple Neck Injury

Any combination of below parts

21

Vertebrae

Includes: spinal column bone, "cervical segment"

22

Disc

Includes: spinal column cartilage, "cervical segment"

23

Spinal Cord

Includes: nerve tissue, "cervical segment"

24

Larynx

Includes: cartilage and vocal cords

25

Soft Tissue

Other than larynx or trachea

26

Trachea

*

III. UPPER EXTREMITIES

30

Multiple Upper Extremities

Any combination of below parts, excluding hands and wrists combined

31

Upper Arm

Humerus and corresponding muscles, excluding clavicle and scapula

32

Elbow

Radial head

33

Lower Arm

Forearm-radius, ulna and corresponding muscles

34

Wrist

Carpals and corresponding muscles

35

Hand

Metacarpals and corresponding muscles-excluding wrist or fingers

36

Finger(s)

Other than thumb and corresponding muscles

37

Thumb

*

38

Shoulder(s)

Armpit, rotator cuff, trapezius, clavicle, scapula

39

Wrist(s) & Hand(s)

*

IV. TRUNK

40

Multiple Trunk

Any combination of below parts

41

Upper Back Area

(Thoracic Area) Upper back muscles, excluding vertebrae, disc, spinal cord

42

Lower Back Area

(Lumbar Area and Lumbo Sacral) Lower Back muscles, excluding sacrum, coccyx, pelvis, vertebrae, disc, spinal cord

43

Disc

Spinal column cartilage other than cervical segment

44

Chest

Including ribs, sternum, soft tissue

45

Sacrum and Coccyx

Final nine vertebrae-fused

46

Pelvis

*

47

Spinal Cord

Nerve Tissue other than cervical segment

48

Internal Organs

Other than heart and lungs

49

Heart

*

60

Lungs

*

61

Abdomen

Excluding injury to internal organs including groin

62

Buttocks

Soft tissue

63

Lumbar and/or Sacral Vertebrae (Vertebra NOC Trunk)

Bone portion of the spinal column

V. LOWER EXTREMITIES

50

Multiple Lower Extremities

Any combination of below parts

51

Hip

*

52

Upper Leg

Femur and corresponding muscles

53

Knee

Patella

54

Lower Leg

Tibia, fibula and corresponding muscles

55

Ankle

Tarsals

56

Foot

Metatarsals, heel, Achilles tendon and corresponding muscles-excluding ankle or toes

57

Toes

*

58

Great Toe

*

VI. MULTIPLE BODY PARTS

64

Artificial Appliance

Braces, etc.

65

Insufficient Information to Properly Identify-Unclassified

Insufficient information to identify part affected

66

No Physical Injury

Mental disorder

90

Multiple Body Parts (Including Body Systems and Body Parts)

Applies when more than one major body part has been affected, such as an arm and a leg and multiple Internal Organs

91

Body Systems and Multiple Body Systems

Applies when functioning of an entire body system has been affected without specific injury to any other part, as in the case of poisoning, corrosive action, inflammation, affecting internal organs, damage to nerve centers, etc. Does not apply when the systemic damage results from an external injury affecting an external part such as a back injury that includes damage to the nerves of the spinal cord.

99

Whole Body

*

I. SPECIFIC INJURY

01

No Physical Injury

i.e., Glasses, contact lenses, artificial appliance, replacement of artificial appliance

02

Amputation

Cut off extremity, digit, protruding part of body, usually by surgery i.e., leg, arm

03

Angina Pectoris

Chest pain

04

Burn

(Heat Burns or Scald):The effect of contact with hot substances

(Chemical Burns): Tissue Damage resulting from Corrosive Action chemicals, fumes, etc. (acids, alkalies)

07

Concussion

Brain, cerebral

10

Contusion

Bruise-intact skin surface hematoma

13

Crushing

To grind, pound or break into small bits

16

Dislocation

Pinched nerve, slipped/ruptured disc, herniated disc, sciatica, complete tear, HNP Subluxation, MD dislocation

19

Electric Shock

Electrocution

22

Enucleation

Removal of organ or tumor

25

Foreign Body

*

28

Fracture

Breaking of a bone or cartilage

30

Freezing

Frostbite and other effects of exposure to low temperature

31

Hearing Loss or Impairment

Traumatic only; a separate injury not the sequelae of another injury

32

Heat Prostration

Heat stroke, sun stroke, heat exhaustion, heat cramps and other effects of environmental heat. Does  not include sunburn.

34

Hernia

The abnormal protrusion of an organ or part through the containing wall of its cavity

36

Infection

The invasion of a host by organisms such as bacteria, fungi, viruses, mold, protozoa or insects, with or without manifest disease

37

Inflammation

The reaction of tissue to injury characterized clinically by heat, swelling, redness and pain

38

Adverse reaction to a vaccination or inoculation

*

40

Laceration

Cut, scratches, abrasions, superficial wounds, calluses, wound by tearing

41

Myocardial Infarction

Heart attack, heart conditions, hypertension, the inadequate blood flow to the muscular tissue of the heart

42

Poisoning-General (Not OD or Cumulative Injury)

A systemic morbid condition resulting from the inhalation, ingestion or skin absorption of a toxic substance affecting the metabolic system, the nervous system, the circulatory system, the digestive system, the respiratory system, the excretory system, the musculoskeletal system, etc. includes chemical or drug poisoning, metal poisoning, organic diseases and venomous reptile and insect bites. Does not include effects of radiation, pneumoconiosis, corrosive effects of chemicals, skin surface irritations, septicemia or infected wounds

43

Puncture

A hole made by the piercing of a pointed instrument

46

Rupture

*

47

Severance

To separate, divide or take off

49

Sprain or Tear

Internal derangement, a trauma or wrenching of a joint, producing pain and disability depending upon degree of injury to ligaments

52

Strain or Tear

Internal derangement, the trauma to the muscle or musculotendinous unit from violent contraction or excessive forcible stretch

53

Syncope

Swooning, fainting, passing out, no other injury

54

Asphyxiation

Strangulation, drowning

55

Vascular

Cerebrovascular and other conditions of circulatory systems NOC; excludes heart and hemorrhoids; includes strokes, varicose veins-non-toxic

58

Vision Loss

*

59

All Other Specific Injuries NOC

*

II. OCCUPATIONAL DISEASE OR CUMULATIVE INJURY

60

Dust Disease NOC

All other pneumoconiosis

61

Asbestosis

Lung disease, a form of pneumoconiosis, resulting from protracted inhalation of asbestos particles

62

Black Lung

The chronic lung disease or pneumoconiosis found in coal miners

63

Byssinosis

Pneumoconiosis of cotton, flax and hemp workers

64

Silicosis

Pneumoconiosis resulting from inhalation of silica (quartz) dust

65

Respiratory Disorders

Gases, fumes, chemicals, etc.

66

Poisoning-Chemical (Other than Metals)

Man-made or organic

67

Poisoning-Metal

Man-made

68

Dermatitis

Rash, skin or tissue inflammation including boils, etc. generally resulting from the direct contact with irritants or sensitizing chemicals such as drugs, oils, biologic agents, plants, woods or metals which may be in the form of solids, pastes, liquids, or vapors and which may be contacted in the pure state or in compounds or in combination with other materials; do not include skin tissue damage resulting from corrosive action of chemicals, burns from contact with hot substances, effects of exposure to radiation, effects of exposure to low temperatures or inflammation or irritation resulting from friction or impact

69

Mental Disorder

A clinically significant behavioral or psychological syndrome or pattern typically associated with either a distressing symptom or impairment function. i.e., acute anxiety, neurosis, stress, non-toxic depression

70

Radiation

All forms of damage to tissue, bones or body fluids produced by exposure to radiation

71

All Other Occupational Disease Injury NOC

*

72

Loss of Hearing

*

73

Contagious Disease

*

74

Cancer

*

75

AIDS

*

76

VDT-Related Diseases

Video display terminal diseases other than carpal tunnel syndrome

77

Mental Stress

*

78

Carpal Tunnel Syndrome

Soreness, tenderness and weakness of the muscles of the thumb caused by pressure

on the median nerve at the point at which it goes through the carpal tunnel of the wrist

79

Hepatitis C

*

80

All Other Cumulative Injury, NOC

*

83

COVID-19

*

III. MULTIPLE INJURIES

90

Multiple Physical Injuries Only

*

91

Multiple Injuries Including Both Physical and Psychological

*

I. BURN OR SCALD-HEAT OR COLD - CONTACT WITH

01

Chemicals

Includes hydrochloric acid, sulfuric acid, battery acid, methanol, antifreeze

02

Hot Objects of Substances

*

03

Temperature Extremes

Non-impact injuries resulting in a burn due to hot or cold temperature extremes. Includes freezing or frostbite.

04

Fire or Flame

*

05

Steam or Hot Fluids

*

06

Dust, Gases, Fumes or Vapors

Includes inhalation of carbon dioxide, carbon monoxide, propane, methane, silica (quartz), asbestos dust and smoke

07

Welding Operation

Includes welder’s flash (burns to skin or eyes as a result of exposure to intense light from welding)

08

Radiation

Includes effects of ionizing radiation found in X-rays, microwaves, nuclear reactor waste, radiating substances and equipment. Includes non-ionizing radiation such as sunburn.

09

Contact With NOC

Not otherwise classified in any other code. Includes cleaning agents and fertilizers.

11

Cold Objects or Substances

*

14

Abnormal Air Pressure

*

84

Electrical Current

Includes electric shock, electrocution and lighting

II. CAUGHT IN, UNDER OR BETWEEN

10

Machine or Machinery

Running or meshing objects, a moving and a stationary object, two or more moving objects

12

Object Handled

Includes medical hospital bed & parts, wheelchair, clothespin vise

13

Caught In, Under or Between NOC

Not otherwise classified in any other code

20

Collapsing Materials (Slides of Earth)

Either man made or natural

III. CUT, PUNCTURE, SCRAPE INJURED BY

15

Broken Glass

*

16

Hand Tool, Utensil; Not Powered

Includes needle, pencil, knife, hammer, saw, axe, screwdriver

17

Object Being Lifted or Handled

Includes being cut, punctured or scraped by a person or object being lifted or handled

18

Powered Hand Tool, Appliance

Includes drill, grinder, sander, iron, blender, welding tools, nail gun

19

Cut, Puncture, Scrape NOC

Not otherwise classified in any other code. Includes power actuated tools

IV. FALL, SLIP OR TRIP INJURY

25

From Different Level (Elevation)

Includes collapsing chairs, falling from piled materials, off wall, catwalk, bridge

26

From Ladder or Scaffolding

*

27

From Liquid or Grease Spills

*

28

Into Openings

Includes mining shafts, excavations, floor openings, elevator shafts

29

On Same Level

*

30

Slip or Trip, Did not Fall

Slip or trip and did not come in contact with floor or ground

31

Fall, Slip or Trip NOC

Not otherwise classified in any other code. Includes tripping over object, slipping on organic material, slip but fall not specified

32

On Ice or Snow

*

33

On Stairs

*

V. MOTOR VEHICLE

40

Crash of Water Vehicle

*

41

Crash of Rail Vehicle

*

45

Collision or Sideswipe With Another Vehicle

Vehicle collision, both vehicles in motion

46

Collision with a Fixed Object

Collision occurring with standing vehicle or stationary object

47

Crash of Airplane

*

48

Vehicle Upset

Includes overturned or jack-knifed

50

Motor Vehicle NOC

Not otherwise classified in any other code. Includes injuries due to sudden stop or start, being thrown against interior parts of the vehicle and vehicle contents being thrown against occupants.

VI. STRAIN OR INJURY BY

52

Continual Noise

Injury to the ears or hearing due to cumulative effects of constant or repetitive noise

53

Twisting

Free bodily motion that imposes stress or strain on some part of body. Includes assumption of unnatural position, involuntary motions induced by sudden noise, fright or loss of balance.

54

Jumping or Leaping

*

55

Holding or Carrying

Applies to objects or people. Includes restraining a person.

56

Lifting

Includes objects or people

57

Pushing or Pulling

Includes objects or people

58

Reaching

*

59

Using Tool or Machinery

*

60

Strain or Injury by NOC

Not otherwise classified in any other code

61

Welding or Throwing

Physical effort or overexertion from attempts to resist a force applied by an object being handled

97

Repetitive Motion

Cumulative injury or condition caused by continual, repeated motions; strain by excessive use. Includes Carpal Tunnel Syndrome.

VII. STRIKING AGAINST OR STEPPING ON

65

Moving Part of Machine

*

66

Object Being Lifted or Handled

*

67

Sanding, Scraping, Cleaning Operation

Includes scratches or abrasions caused by sanding, scraping, cleaning operations

68

Stationary Object

*

69

Stepping on Sharp Object

*

70

Striking Against or Stepping on NOC

Not otherwise classified in any other code

VIII. STRUCK OR INJURED BY (INCLUDES KICKED, STABBED, BIT, ETC.)

NOTE: Applies to cases in which the injury was produced by the impact created by the source of injury, rather than by the injured person.

74

Fellow Worker, Patient or Other Person

Struck by co-worker, either on purpose or accidentally. Includes being struck by a patient while lifting or moving them not in the act of a crime.

75

Falling or Flying Object

*

76

Hand Tool or Machine in Use

*

77

Motor Vehicle

*

78

Moving Parts of Machine

*

79

Object Being Lifted or Handled

Includes dropping object on body part.

80

Object Handled By Others

Includes another person dropping object on injured person's body part

81

Struck or Injured NOC

Not otherwise classified in any other code. Includes kicked, stabbed, bitten

85

Animal or Insect

Includes bite, sting or allergic reaction

86

Explosion or Flare Back

Rapid expansion, outbreak, bursting or upheaval. Includes explosion of cars, bottles, aerosol cans or buildings. “Flare back” involves superheated air and combustible gases at temperatures below the ignition temperature.

IX. RUBBED OR ABRADED BY

Not otherwise classified in any other code. Includes foreign body in ears.

94

Repetitive Motion

Caused by repeated rubbing or abrading; applies to non-impact cases in which the injury was produced by pressure, vibration or friction between the person and the source of injury. Includes callous, blister.

95

Rubbed or Abraded by, NOC

*

X. MISCELLANEOUS CAUSES

82

Absorption, Ingestion or Inhalation NOC

Not otherwise classified in any other code. Applies only to non-impact cases in which the injury resulted from inhalation, absorption (skin contact) or ingestion of harmful substances, or vaccinations.

83

Pandemic

Includes disease epidemic that has been spread across a large region

87

Foreign Matter (Body) in Eye(s)

Injury to eyes resulting from foreign matter that is not otherwise classified in any other code

88

Natural Disasters

Injury resulting from natural disaster. Includes hurricane, earthquake, tornado, flood, forest fire

89

Person in Act of a Crime

Specific injury, other than gunshot, caused as a result of contact between injured person and another person in the act of committing a crime. Includes robbery or criminal assault.

90

Other Than Physical Cause of Injury

Stress, shock, or psychological trauma that develops in relation to a specific incident or cumulative exposure to conditions.

91

Mold

Includes mildew

93

Gunshot

Injury is caused by the discharge of a firearm. Includes instances where injury arises from being struck by the fired projectile, burned by muzzle blast or deafened by report of gunshot

96

Terrorism

An act that causes injury to human life, committed by one or more individuals as part of an effort to coerce a population group(s) or to influence the policy or affect the conduct of any government(s) by coercion

98

Cumulative NOC

Cumulative, not otherwise classified in any other code. Involves cases in which cause of injury occurred over a period of time, any condition increasing in severity over time

99

Other-Miscellaneous NOC

Not otherwise classified in any other code

Y

Claim includes Vocational Rehabilitation Costs

N

Claim does not include Vocational Rehabilitation Costs

Y

Claim has been settled by an agreement to a lump sum amount

N

Claim has not been settled with a lump sum agreement

00

Not Fraudulent

01

Partially Fraudulent

02

Fully Fraudulent