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AC040

AC040

Owned by Trang Riley (Unlicensed)
Last updated: Nov 04 2019 by Tim Holder
Data ElementCASECODE
Description

Type of benefit requested:

10 = No Lost Time
20 = Medical Only
21 = Temporary Partial Disability
25 = Controvered Med Only
30 = Volunteer
40 = Death / No Days
50 = Salary Continued
60 = Salary by Mileage

70 = Minimum Weekly Rate
TypeText
Formatvarchar
Length20
Coverage100%
Tip / Notes
Rank42

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