Code indicating a Yes or No condition or response

INJ01 designates if there is a pre-existing disability. A "Y" indicates this is a pre-existing disability; an "N" indicates there is no known pre-existing disability.

Code which identifies a specific location

INJ02 is a number assigned by the contractholder to identify the employer's location of accident.

Code indicating a Yes or No condition or response

INJ03 designates whether this is a work-related injury. A "Y" indicates this is a work-related injury; an "N" indicates that the injury is not work-related.

Code indicating a Yes or No condition or response

INJ04 designates if the accident occured on the employer's premises. A "Y" indicates the accident did occur on the employer's premises; an "N" indicates the accident did not occur on the employer's premises.

Code identifying cause of injury

Code identifying the nature of injury sustained by claimant

Code identifying the part of body

Code identifying source of injury

Code identifying the extent of medical treatment received by the claimant immediately following the accident

Code identifying the county within a state

INJ10 is the county of injury site.

Code defining international postal zone code excluding punctuation and blanks (zip code for United States)

INJ11 is the postal code of injury site.