Field #

Name

Field Type

Description

Value/Format

1

EXTRACT-RECORD-TYPE

CHAR(1)

Record type identifier

C = Change; D = Delete

2

CASE-NUMBER

CHAR(9)

Unique identifier assigned by OWCP

3

CASE-TYPE

CHAR(1)

Indicates the relationship between this case and associated cases for the same employee

I = Independent; M = Master;
S = Subsidiary

4

CASE-PTR

CHAR(9)

Uses the Case Type field to map cases to the master case

If Case Type = M, Case Pointer = total number of subsidiary cases associated with this master case
If Case Type = S, Case pointer = Master Case Number

5

LAST-NAME

CHAR(20)

Employee’s Last Name

6

FIRST-NAME

CHAR(20)

Employee’s First Name

7

MIDDLE-NAME

CHAR(20)

Employee’s Middle Name

8

SEX

CHAR(1)

Employee’s Gender

F = Female; M = Male

9

SSN

CHAR(9)

Employee’s Social Security Number

10

DOB

DATE (8)

Employee’s Date of Birth

YYYYMMDD

11

DOD

DATE (8)

Employee’s Date of Death

YYYYMMDD

12

ADDR-1

CHAR(70)

Employee’s Address Field 1

Employee’s address

13

ADDR-2

CHAR(70)

Employee’s Address Field 2

Address continued

14

ADDR-3

CHAR(70)

Employee’s Address Field 3

Address continued

15

CITY

CHAR(20)

Employee’s City

Address city

16

STATE

CHAR(2)

Employee’s State

State abbreviation code

17

ZIP

CHAR(9)

Employee’s Zip Code

Postal Zip Code

18

PHONE-NUMBER

CHAR(10)

Employee’s Phone Number

Area Code + Phone Number

19

EMP-DOI

DATE (8)

Employee’s Date of Injury

YYYYMMDD

20

INJ-ZIP

CHAR(9)

Zip Code of location where injury occurred

Postal Zip Code

21

EXTENT-OF-INJ

CHAR(1)

Indicates seriousness of injury

0 = fatal;      1 = no time lost
2 = first aid;  8 = inoculation
X = non-fatal, lost time

22

FATAL-IND

CHAR(1)

For fatal cases indicates claimed relationship of employee’s death to employment

0 = Not Related to Injury
1 = Immediate Death with Injury
2 = Related to Injury

23

ANAT-LOCN-CODE

CHAR(2)

Indicates the anatomical location of the reported injury/condition

See Appendix

24

NATURE-CODE

CHAR(2)

Nature of Injury Code

See Appendix

25

CAUSE-CODE

CHAR(2)

Cause of Injury Code

See Appendix

26

FORMS-RECVD

CHAR(1)

Indicates claim form type of used

1 = CA-1; 2 = CA-2; 5 = CA-5

27

LOST-TIME-FLAG

CHAR(1)

Lost Time (Per CA-1 Filing Instructions)

Y= Yes; N =No

Field #

Name

Field Type

Description

Value/Format

28

NLT-NO-EXPENSE-FLAG

CHAR(1)

No Lost Time, No Medical Expense Incurred (Per CA-1 Filing Instructions)

Y= Yes; N =No

29

NLT-YES-EXPENSE-FLAG

CHAR(1)

No Lost Time, Medical Expense Incurred (Per CA-1 Filing Instructions)

Y= Yes; N =No

30

FIRST-AID-INJURY-FLAG

CHAR(1)

First Aid Injury (Per CA-1 Filing Instructions)

Y= Yes; N =No

31

INJURED-IN-POD-FLAG

CHAR(1)

Injured during performance of duty indicator (Per CA-1 Report)

Y= Yes; N =No

32

COP-FLAG

CHAR(1)

Claimant utilized Continuation of Pay benefits (Per CA-1 Report)

Y= Yes; N =No

33

CNTRVTD-IND

CHAR(1)

COP claim controverted by agency (Per CA-1 Report)

Y= Yes; N =No

34

PAY-STOPPED-DT

DATE (8)

Date employee’s pay stopped

YYYYMMDD

35

DEPENDENT-FLAG

CHAR(1)

Employee has Dependent(s)

Y= Yes; N =No

36

PAY-GRADE

CHAR(4)

Grade at time of injury

e.g., GS09, WG10

37

PAY-STEP

CHAR(4)

Step at time of injury

38

OCC-CODE

CHAR(5)

Indicates employee’s occupation code at time of injury

See Appendix

39

INJURY-TYPE-CODE

CHAR(3)

Indicates type of injury reported

See Appendix

40

INJURY-SOURCE-CODE

CHAR(4)

Indicates source of reported injury

See Appendix

41

DEPT-AGENCY-CODE

CHAR(6)

Agency Code and Agency Building Code

4 digits plus 2 alpha-numeric
Lookup available on DOL web page

42

AGENCY-RECEIVED-DT

DATE (8)

Date CA-1/CA-2 claim was received by employing agency

YYYYMMDD

43

DOL-RECEIVED-DATE

DATE (8)

Date claim was received by OWCP

YYYYMMDD

44

DATE-CASE-CREATED

DATE (8)

Date the case was created by OWCP

YYYYMMDD

45

SFC-FLAG

CHAR(1)

Administrative acceptance and Short Form Closure of eligible traumatic injury case at time of creation

Y = Currently a Short Form Closure case;
N = Previous Short Form Closure case was reopened (see next data elements);
Blank = Not Applicable

46

SFC-REOPEN-CODE

CHAR(1)

Short Form Closure reopen code

See Appendix

47

SFC-REOPEN-DATE

DATE (8)

Short Form Closure reopen date

YYYYMMDD

48

REP-ACCPT-COND

CHAR(45)

Reported condition or accepted diagnosis

Narrative, or up to 6 ICD-9 codes

49

THIRD-PARTY-IND

CHAR(2)

Indicator of Third Party Status

See Appendix

50

THIRD-PARTY-DATE

DATE (8)

Third Party Status Date

YYYYMMDD

51

CURR-ADJUD-STATUS

CHAR(2)

Current Adjudication Status

See Appendix

52

CURR-ADJUD-STATUS-DATE

DATE (8)

Current Adjudication Status Date

YYYYMMDD

Field #

Name

Field Type

Description

Value/Format

53

CURR-CASE-STATUS

CHAR(2)

Current Case Status

See Appendix

54

CURR-CASE-STATUS-DATE

DATE (8)

Current Case Status Date

YYYYMMDD

55

PREV-CASE-STATUS

CHAR(2)

Previous Case Status

See Appendix

56

PREV-CASE-STATUS-DATE

DATE (8)

Previous Case Status Date

YYYYMMDD

57

PREV-ADJUD-STATUS

CHAR(2)

Previous Adjudication Status

See Appendix

58

PREV-ADJUD-DATE

DATE (8)

Previous Adjudication Status date

YYYYMMDD

59

INIT-ADJUD-STATUS

CHAR(2)

Initial Adjudication Status

See Appendix

60

INIT-ADJUD-DATE

DATE (8)

Initial Adjudication Status Date

YYYYMMDD

61

DATE-CLOSED

DATE (8)

Date the case was last closed (after previous not closed status)

YYYYMMDD

62

DATE-REOPENED

DATE (8)

Date the case was last reopened (after previous closed status)

YYYYMMDD

63

COMP-CLAIM-DATE

DATE (8)

First CA-7 Claim Received Date

YYYYMMDD

64

WAGE-LOSS-DATE

DATE (8)

Indicates the date wage loss began

YYYYMMDD

65

QCM-FLAG

CHAR(1)

Indicates case is under Quality Case Management (QCM) tracking

Y = Yes; N = No

66

RECURRENCE-NUMBER

CHAR(2)

Recurrence claim received number (last)

00 – 99

67

RTW-CODE

CHAR(2)

Indicates Return To Work information

See Appendix

68

RTW-DATE

DATE (8)

Return To Work Date

YYYYMMDD

69

PRM-FLAG

CHAR(1)

Indicates case is under Periodic Roll Management (PRM) tracking

Y = Yes; N = No

70

REHAB-IND

CHAR(1)

Indicates Vocational Rehabilitation Status

See Appendix

71

REHAB-DATE

DATE (8)

Vocational Rehabilitation Status Date

YYYYMMDD

72

RCE-ID

CHAR(3)

Responsible Claims Examiner Code

YYYYMMDD

73

DIST-OFFICE-NUMBER

CHAR(2)

District Office Number

See Appendix

74

DATE-LAST-CHANGE

DATE (8)

Date of last record update

YYYYMMDD

A1 = Single Upper Arm
A2 = Both Upper Arms
A3 = Single Forearm
A4 = Both Forearms
A5 = Single Wrist
A6 = Both Wrists
AB = Arm And Wrist
AS = Arm Or Wrist
AX = Arm(S), Multiple Sites
AZ = Arm(S), Other
B1 = Single Breast
B2 = Both Breasts
B3 = Single Testicle
B4 = Both Testicles
B5 = Vulva/Vagina
BA = Abdomen
BC = Chest
BL = Lower Back
BP = Penis
BS = Side
BU = Upper Back
BW = Waist
BX = Undefined
BZ = Not Otherwise Classified
C1 = Single Ear Internal
C2 = Both Ears Internal
C3 = Single Eye Internal
C4 = Both Eyes Internal
CB = Brain
CC = Cranial Bones
CD =Teeth
CJ = Jaw
CK = Bones of Face, Other(S)
CL = Throat; Larynx
CM = Mouth
CN = Nose
CR = Throat; Other
CS = Sinus (ES)
CT = Tongue
CX = Head, Internal Multiple Sites
CZ = Not Otherwise Classified
EB = Both Elbows
ES = Single Elbow

F1 = Single First Finger
F2 = Both First Fingers
F3 = Single Second Finger
F4 = Both Second Fingers
F5 = Single Third Finger
F6 = Both Third Fingers
F7 = Single Fourth Finger
F8 = Both Fourth Fingers
FB = Multiple Fingers Both Hands
FS = Multiple Fingers Single Hand
G1 = Single Great Toe
G2 = Both Great Toes
G3 = Single Other Toes
G4 = Multiple Other Toes
H1 = Single Eye External
H2 = Both Eyes External
H3 = Single Ear External
H4 = Both Ears External
HC = Chin
HF = Face
HK = Neck/Throat
HM = Mouth/Lips
HN = Nose
HS = Scalp
HX = Head, External Multiple Sites
HZ = Head External Other
KB = Both Knees
KS = Single Knee
L1 = Single Hip/Thigh
L2 = Both Hips/Thighs
L3 = Single Lower Leg/Ankle
L4 = Both Lower Legs/Ankles
LB = Both Legs/Hips/Ankles/Buttocks
LS = Single Leg/Hip/Ankle/Buttock
LX = Leg(S)
LZ = Legs(S) other
MB = Both Hands
MS = Single Hand
PB = Both Feet
PS = Single Foot

R1 = Single Clavicle/Collar Bone
R2 = Both Clavicles/Collar Bones
R3 = Single Scapula/Shoulder Blade
R4 = Both Scapulae/Shoulder Blades
RB = Rib
RC = Ribs, Multiple
RP = Pelvis
RS = Sternum  Breast Bone
RV = Vertebrae  Spine; Disc
RX = Trunk, Multiple Bones
RZ = Trunk, Bones Unclassified
SB = Both Shoulders
SS = Single Shoulder
TB = Both Thumbs
TS = Single Thumb
V1 = Lung, Single
V2 = Lung, Both
V3 = Kidney, Single
V4 = Kidney, Both
V5 = Bladder, Urethra
VC = Spinal Cord
VH = Heart
VL = Liver
VS = Stomach
VI = Intestines
VL = Liver
VM = Spleen
VN = Nerve
VR = Reproductive Organs
VS = Stomach
VV = Intestines
VX = Trunk, Internal, Multiple Organs
VZ = Trunk, Internal Unclassified
XX = Multiple Anatomical Sites
XZ = Anatomic Site Not Mentioned, Other Site
00 = Mis-Coded
98 = Mis-Coded 98/All Other
99 = Old Converted

00 = Legacy Case Use 
01 = Railroad or Street Cars
02 = Aircraft
03 = Watercraft              
04 = Elevator
05 = Vehicle Accident (Driver)
06 = Vehicle Accident (Passenger)
07 = Vehicle Accident (Pedestrian)
08 = Working On/Around Vehicles
09 = Pressure Equipment    
10 = Explosion
11 = Fire/Smoke
12 = Electricity                     
13 = Flash Burn
14 = Galvo Fume Poisoning
15 = Paint/Paint Fumes/Lead  
16 = Carbon Monoxide
17 = Oil
18 = Zinc                                 
19 = Solvents
1A = Anthrax
1F = Fumes/Solvents                  
1M =Immunization
1P = Personal Protective Equipment
1R = Respiratory Distress             
1S = Smallpox
1T = Terrorism Catastrophe
20 = Fiberglass                               
21 = Carbon Dioxide
22 = Silica
23 = Dust/Gas/Chemical                   
24 = Handling Packaged Material, Weight Stated
25 = Handling Packaged Material, Weight Not Stated
26 = Handling Fabrication Metals
27 = Handling Vehicular Equipment
28 = Handling Machinery
29 = Handling Tools or Instruments
30 = Handling Fabric Containers
31 = Handling Mail Containers
32 = Handling Lumber or Dunnage
33 = Handling Furniture/Office Equip
34 = Handling Hand Trucks/Dollies
35 = Handling Munitions
36 = Handling Cable/Rope/Nets/Chains
37 = Using Windows or Doors
38 = Handling Wire                   
39 = Handling Stone/Clay/Glass/Cement
40 = Handling Trash
41 = Handling or Using Ladders
42 = Handling or Using Scaffolds
43 = Using Gangways or Platforms
44 = Handling Pallets/Hatchboards
45 = Handling Electrical Equipment
46 = Handling Magazines or Papers

47 = Handling Tool Boxes
48 = Handling Fire Extinguishers
49 = Cranking Motors
50 = Changing Tires
51 = Handling Manual Equipment
52 = Falling Desk or Chair
53 = Falling Work Bench or Table
54 = Falling Hand Truck or Dollie
55 = Falling Ladder
56 = Falling Scaffold
57 = Falling Window
58 = Falling Shelving
59 = Falling Cargo
60 = Falling Walls or Ceilings
61 = Falling Filing Cabinet
62 = Falling Machinery
63 = Falling Objects
64 = Fall On Floor/Work Surface/Aisle
65 = Fall On Stairway or Steps
66 = Fall On Walkways/Curbs/Porches
67 = Fall From Scaffold or Platform
68 = Fall From Ladder
69 = Fall From Chair/Stool/Restbar
70 = Fall From Desk/Table/Workbench
71 = Fall Into Hole/Hatch/Chute
72 = Fall On Deck
73 = Fall On Road/Highway/Street
74 = Fall From Stacked Cargo
75 = Fall On Hill or Slope
76 = Fall From Ramp/Runway/Gangplank
77 = Fall Off Dock
78 = Fall From Machinery
79 = Fall From Stopped Vehicle
80 = Fall Getting On/Off Elevator
81 = Fall Inside Moving Vehicle
82 = Fall
83 = Jumping To/From Places
84 = Striking Against Material Equip
85 = Flying Particles
86 = Hand Tools
87 = Machinery
88 = Cave-In
89 = Drowning
90 = Violence
91 = Slip - Not Falling
92 = Slip/Twist/Trip - Not Falling
93 = Weather Exposure
94 = Poison Oak/Ivy/Sumac
95 = Animals/Insects
96 = Accidental Shooting
97 = Enemy Action
98 = Dog Bite
99 = Cause Unknown

01 = Aeronautics Engineer
02 = Ash/Trash Collector
03 = Blacksmith
04 = Boilermaker
05 = Brakeman
06 = Heavy Equipment Operator
07 = Air Traffic Controller
08 = Carpenter
09 = Charwoman
10 = Chauffeur
11 = Checker
12 = Chemical Engineer
13 = Chipper/Caulker
14 = Civil Engineer
15 = Cook
16 = Reader
17 = Carrier - Rural Mail
18 = Core Maker
19 = Crane Operator
20 = Crater
21 = Doctor/Dentist
22 = Draftsman/Tracer
23 = Driver/Mechanic
24 = Electrical Engineer
25 = Electrician/Lineman
26 = Elevator Operator
27 = Engineering Aide/Helper
28 = Firefighter
29 = Fireman
30 = Fleet Workman
31 = Foreman
32 = Forester
33 = Forest Ranger
34 = Forklift/Tug/Tractor Operator
35 = Guard
36 = Inspector
37 = Instrument Worker
38 = Investigator
39 = Iron Worker
40 = Janitor
41 = Laboratory Worker
42 = Laborer
43 = Laundry Worker
44 = Lockman
45 = Longshoreman
46 = Machinist
47 =Carrier - City Mail
48 = Mail Clerk
49 = Mail Handler
50 = Mason

51 =Meat Cutter
52 = Meat Inspector
53 = Mechanic/Repairman
54 = Mechanical Engineer
55 = Melter
56 = Mess Attendant
57 = Messenger - Not Postal
58 = Mimeograph Operator
59 = Moulder
60 = Munition Handler
61 = Nurse
62 = Office Worker
63 = Oiler
64 = Operating Engineer
65 = Packer
66 = Painter
67 = Patrolman
68 = Pattern Maker
69 = Pile Driver
70 = Pipe Coverer
71 = Pipe Fitter
72 = Plasterer
73 = Plumber
74 = Pressman
75 = Printer
76 = Radio Engineer/Technician
77 = Railroad Worker
78 = Railway Postal Personnel
79 = Rigger
80 = Safety Engineer
81 = Sand Blaster
82 = Seaman/Crew Member/Deckhand
83 = Sewer
84 = Sheetmetal Worker
85 = Shipfitter
86 = Shipwright
87 = Soil Conservationist
88 = Stationary Engineer
89 = Stock Clerk
90 = Storekeeper
91 = Eam Operator
92 = Tool Maker
93 = Truck Driver
94 = Veterinarian
95 = Warehouseman/Freight Handler
96 = Ward Attendant
97 = Welder
98 = Teacher
99 = Unclassified Occupation

100 = Struck
110 = Struck by
111 = Struck by falling object
120 = Struck against
200 = Fall, Slip, Trip
210 = Fell, same level
220 = Fell, different level
230 = Slip, trip, no fall
300 = Caught
310 = Caught on

320 = Caught in
330 = Caught between
400 = Punctured, Lacerated
410 = Punctured by
420 = Cut by
430 = Stung by
440 = Bitten by
500 = Contact
510 = Contact with
520 = Contact by

600 = Exertion
610 = Lifted, strained by
620 = Stressed by
700 = Exposure
710 = inhalation
720 = Ingestion
730 = Absorption
800 = Traveling in
999 = Unclassified

0100 = Building or Working Area
0110 = Walking/Working Surface (Floor, Street, Curbs, Porches)
0120 = Stairs, Steps
0130 = Ladder
0140 = Furniture, Furnishings, Office Equipment
0150 = Boiler, Pressure Vessel
0160 = Equipment Layout (Ergonomic)
0170 = Windows, Doors
0180 = Electric, Electricity
0200 = Environmental Condition
0210 = Temperature Extreme (Indoor)
0220 = Weather (Ice, Rain, Heat, Etc.)
0230 = Fire, Flame, Smoke (Not Tobacco)
0240 = Noise
0250 = Radiation
0260 = Light
0270 = Ventilation
0271 = Tobacco Smoke
0280 = Stress (Emotional)
0290 = Confined Space
0300 = Machine or Tool
0310 = Hand Tool (Powered: Saw, Grinder, Etc.)
0320 = Hand Tool (Non-Powered)
0330 = Mechanical Power Transmission Apparatus
0340 = Guard, Shield (Fixed, Moveable, Deadman)
0350 = Video Display Terminal
0360 = Pump, Compressor, Air Pressure Tool
0370 = Heating Equipment
0380 = Welding Equipment
0400 = Vehicle
0410 = Privately-Owned Vehicle (Includes Rental)
0411 = As Driver
0412 = As Passenger
0420 = Government-Owned Vehicle
0421 = As Driver
0422 = As Passenger
0430 = Common Carrier (Airline, Bus, Etc.)
0440 = Aircraft (Not Commercially Scheduled)
0450 = Boat, Ship, Barge
0500 = Material Handling Equipment
0510 = Earthmover (Tractor, Backhoe, Etc.)
0520 = Conveyor (For Material and Equipment)
0530 = Elevator, Escalator, Personnel Hoist
0540 = Hoist, Sling Chain, Jack (For Material and Equipment)
0550 = Forklift, Crane
0560 = Handtrucks, Dollies
0600 = Dust, Mist, Vapor, Etc.

0610 = Dust (Silica, Coal, Grain, Cotton)
0620 = Fibers
0621 = Asbestos
0630 = Gases
0631 = Carbon Monoxide
0640 = Mist, Steam, Vapor, Fume
0650 = Particles (Unidentified)
0700 = Chemical, Plastic, Etc.
0710 = Chemical Dry
0711 = Corrosive
0712 = Toxic
0713 = Explosive
0714 = Flammable
0720 = Chemical Liquid
0721 = Corrosive
0722 = Toxic
0723 = Explosive
0724 = Flammable
0730 = Plastic
0740 = Water
0750 = Medicine
0800 = Inanimate Object
0810 = Box, Barrel, Container, Etc.
0820 = Paper
0830 = Metal Item, Mineral
0831 = Needle
0840 = Glass
0850 = Scrap, Trash
0860 = Wood
0870 = Food
0880 = Personal Clothing, Apparel, Shoes
0900 = Animate Object
0910 = Animal
0911 = Bite (Dog)
0912 = Bite (Other)
0920 = Plant
0930 = Insect
0940 = Human (Violence)
0950 = Human (Communicable Disease)
0960 = Bacteria, Virus (Not Human Contact)
1000 = Personal Protective Equipment
1010 = Protective Clothing, Shoes, Glasses/Goggles
1020 = Respirator, Mask
1021 = Diving Equipment
1030 = Safety Belt, Harness
1040 = Parachute
9999 = Unclassified Or Insufficient Data

00 = No Status
A0 = Accepted - No Payments Due
AC = Accepted - COP Elected
AD = Accepted - Daily Roll Payment
AF = Accepted - Fatal
AL = Accepted - Leave Elected
AM = Accepted - Medical Payments Only
AP = Accepted - Periodic Roll Payment
AR = Administratively Reviewed
AT = Accepted - Medical Payments Only - Compensation Denied
BK = Blank in System
D0 = Disallowed

D1 = Denied - Time Limitations Expired
D2 = Denied - Not Civil Employee of US Govt
D3 = Denied - Fact of Injury Not Established
D4 = Denied - Injury Not in Performance of Duty
D5 = Denied - Condition Not Related to Injury
D7 = Denied - Case Remanded by ECAB
D8 = Denied - Case Remanded by Hearings and Review
D9 = Reconsideration Request Case
SU = Suspension - Claimant Failed to Report for Examination
UD = Legacy Cases Only
UN = Unadjudicated

C1 = Closed - No Time Lost
C2 = Closed - Leave Elected
C3 = Closed - Benefits Denied
C4 = Closed - COP Accepted
C5 = Closed - All Benefits Paid
CL = Closed - Administrative
DE = Payment of Death Benefits
DR = Payment on Daily Roll
MC = Medical Benefits Only

ON = Overpayment - Compensation Terminated
OP = Overpayment - Compensation Being Paid
PN = Periodic Roll with No Re-employment Potential
PR = Payment on Periodic Roll
PS = Payment of Schedule Award
PW = Periodic Roll with LWEC
RT = Retired
UD = Under Development
UN = Unreviewed

FF = Full duty, full time
FP = Full duty, part time
LF = Light duty, full time, w/out wage loss
LP = Light duty, Part time
L$ = Light duty, Full time, wage loss

NL = No lost tine
PS = RTW, private sector
XX = Final decision w/no RTW
X1 = Migrated Data Information unavailable
UN = Unknown

1 = Closed on referral
2 = Closed Rehabilitated
3 = Closed Rehabilitated, New Employer
4 = Closed Rehabilitated, Previously Reemployed
5 = Closed, not rehabilitated,
6 = Closed with post employment services
7 = Returned to work, nurse intervention
8 = Returned to work, without VR assistance
A = Initial Interview held
B = Nurse Intervention
C = Returned to CE
D = Plan Development
E = Employed
G = Placement Assisted Reemployment

I = Plan Approved
L= Part time Light Duty
M = Medical Rehabilitation
N = Placement previous employer
P = Placement, new employer
Q = Screened
R = Referred to RS $default add status
S = Self-employed
T = Training
U = Closed by nurse, not RTW
V = Employed, assisted reemployment
W = Placement previous employer with other services
Y = Closed on referral
Z = Post employment service