1129 Adjustment Reason Code Characteristic

Specifies an additional characteristic of the adjustment reason

Codes

<> 1

Primary Disability - Frozen

<> 2

Primary Disability - Non-frozen

<> 3

Dependent Disability - Frozen

<> 4

Dependent Disability - Non-frozen

<> 5

Retirement - Frozen

<> 6

Retirement - Non-frozen

<> 7

Permanent

<> 8

Temporary

<> 9

Canadian

<> 10

Joint

<> 11

Deferred

<> 12

Eligible

<> 13

Applied

<> 14

Receiving

<> 15

Defense Medical Evaluation

<> 16

Delayed Reporting Penalty (Insured)

<> 17

Engineering Services

<> 18

Expert Test (Trial)

<> 19

Expert Fees and Expenses (excluding tests and testimony)

<> 22

Fee Schedule Savings

<> 23

Fatal

<> 24

Permanent Total

<> 25

Permanent Total Supplemental

<> 26

Permanent Partial Scheduled

<> 27

Permanent Partial Unscheduled

<> 28

Temporary Total

<> 29

Temporary Partial

<> 30

Employer Liability

<> 31

Permanent Partial Disfigurement

<> 32

Unspecified Employer Payments

<> 34

Funeral Expenses

<> 35

Penalties

<> 36

Interest

<> 37

Employer's Legal Expenses

<> 38

Claimant's Legal Expenses

<> 39

Payments to Physicians

<> 40

Hospital Costs

<> 41

Other Medical

<> 42

Vocational Rehabilitation Evaluation

<> 43

Vocational Rehabilitation Education

<> 44

Other Vocational Rehabilitation

<> 45

Total Temporary Catastrophic

<> 46

Unknown Payment Type

<> 57

Vocational Rehabilitation Maintenance

<> 58

Claim Value Recovery

<> 60

Deductible Recovery

<> 61

Additional Living Expense

<> 62

Alternative Dispute Resolution Services

<> 63

Anesthesiologist

<> 64

Annuity

<> 65

Attorney Expenses

<> 66

Attorney Fees

<> 67

Auto Liability Subrogation

<> 69

Not Eligible

<> 71

Catastrophic Benefits

<> 72

Central Index Bureau Filing Fees

<> 73

Chiropractor

<> 74

Indemnity Reserves

<> 75

Medical Reserves

<> 76

Expense Reserves

<> 77

Vocational Rehabilitation Reserves

<> 78

Indemnity Payments

<> 79

Medical Payments

<> 80

Expense Payments

<> 81

Vocational Rehabilitation Payments

<> 82

Claim Payment

<> 83

Claim Reserve

<> 84

Bodily Injury Payment

<> 85

Bodily Injury Reserve

<> 86

Property Damage Payment

<> 87

Property Damage Reserve

<> 88

Comprehensive Payment

<> 89

Comprehensive Reserve

<> 90

Collision Payment

<> 91

Collision Reserve

<> 92

Salvage

<> 93

Expert Witness Fees

<> 94

Claimant Legal Expense

<> 95

Claimant Medical Evaluation

<> 96

Commercial Photographers

<> 97

Mandated Medical Exam

<> 98

Death Benefits

<> 99

Defense Attorney Fees and Expenses

<> A1

Funeral Benefits

<> A2

Hearing Attendance or Representation Fees

<> A3

Hospital - Inpatient Charges

<> A4

Hospital - Outpatient Charges

<> A5

Hospital Bill Audit

<> A6

Impairment Income Benefits

<> A7

Independent Adjustor Expense

<> A8

Independent Medical Exam

<> A9

Legal Expenses - Miscellaneous

<> AA

Chiropractic Expenses

<> AB

Dental Expenses

<> AC

Physical Therapy Costs

<> AD

Pharmaceutical Costs

<> AE

Durable Medical Costs

<> AF

Medical Travel Costs

<> AG

Employee Medical-Legal Costs

<> AH

Employer-Claim Administrator Medical-Legal Costs

<> AI

Agreed upon or Directed Medical-Legal Costs

<> AJ

Unallocated Funds

<> AK

Future Credit Recovery

<> B1

Liability Settlement

<> B2

Life Pension

<> B3

Lump Sum Remarriage Payment

<> B4

Lump Sum Settlement Amount

<> B5

Major Case of Individual Case Reporting

<> B6

Medical Equipment

<> B7

Peer Review Board Expenses

<> B8

Medical Management Services

<> B9

Medical Records or Reports

<> C1

Medical Rehabilitation

<> C2

Medical Test (Trial)

<> C3

No-fault benefit or expense (Non-Workers Compensation)

<> C4

Nursing Care

<> C5

Extended Care Facility

<> C6

State Fund - Other

<> C7

Penalties Paid on Medical Benefits

<> C8

Penalties Paid on Indemnity Benefits

<> C9

Pension Indemnity Benefit

<> D2

Personal Property or Contents

<> D3

Pharmacy

<> D4

Photographs other than Commercial

<> D5

Physiotherapy

<> D6

PPO (Preferred Provider Organization) Fees or Expenses

<> D7

Product Liability Subrogation

<> D8

Property Adjustment

<> D9

Provider Bill Audit Expense

<> E1

Radiology

<> E2

Time and Expense Fees

<> E3

Scheduled Award

<> E4

Social Security

<> E5

State Second Injury Fund

<> E6

State Supplemental Fund

<> E7

Supplemental Permanent Total Benefits

<> E9

Employee Interest

<> F1

Testing Lab

<> F2

Third Party Contribution

<> F3

Transportation - Other

<> F4

Transportation - Medical Treatment

<> F5

Treating or Panel Physician

<> F6

Utilization Review - Hospital

<> F7

Utilization Review - Physician

<> F8

Unallocated Indemnity

<> F9

Unallocated Medical

<> G2

Witness Fees and Expenses - Other than Expert Witness

<> G3

Vocational Rehabilitation Training

<> G4

Appraisal Fees

<> G5

Autopsy Fees

<> G6

Surveillance Special Investigation Fees and Expenses

<> G7

Temporary Income Benefits

<> G9

Federal Second Injury Fund

<> H2

Federal Supplemental Fund

<> H3

Flat Rate

<> H4

Employer Paid Temporary Total Disability

<> H5

Employer Paid Temporary Partial Disability

<> H6

Court Reporter Fees

<> H7

Private Investigator Fees