Maintain Case Details
|
|
|
|
The following details are displayed under “Incident Details” section (fetched and displayed from “Maintain Incident Details” screen):
Employment Unit |
From the drop-down list box, select the place where the employee is treated. The combo is defaulted with various options for you to choose. Mandatory. |
Case Number |
The case number of the incident. |
Privacy Requested |
This indicates whether the employee has requested for the privacy of the incident. |
Employee |
The name of the employee injured during the incident. |
Establishment Where Incident Occurred |
The establishment to record the actual incident details |
Injury / Illness |
This indicates whether the employee is injured or sick. |
Jurisdiction |
This indicates the jurisdiction through which the case details can be recorded. |
Exact Location of the Incident |
The exact location where the incident occurred. |
Impact of Incident |
The impact of the incident. |
Incident Date & Time |
The date and time on which the incident occurred. |
Date of Injury / Onset of Illness |
The date on which the employee was injured. |
Reported By |
The name of the person who reported the employee injury details. |
Reported Date & Time |
The date and time on which the incident is reported. |
How Did Incident Occur |
The cause of the incident. |
Action Just Before Incident |
The action took place just before the incident. |
Agency of Incident |
The agency of the incident. |
Enter the following details under “Details of Injury / Illness” section:
Type of Injury / Illness |
From the drop-down list box, select the required option. The combo is defaulted with various types of injury / illness for you to choose. The drop-down displays “Select” by default on launch of the page. Mandatory. |
Body Parts Affected |
From the drop-down list box, select the required option. The combo is defaulted with various options that indicate the list of body parts affected due to injury. The drop-down displays “Select” by default on launch of the page. Mandatory. |
Object / Substance harmed the employee |
A detailed description of the object / substance harmed the employee due to the incident. Mandatory. |
Illness / Injury Description |
A detailed description of the illness / injury. Mandatory. |
Enter the following details under “Treatment Details” section:
Treated At |
From the drop-down list box, select the place where the employee is treated. The combo is defaulted with various options for you to choose. Mandatory. |
Treated By |
The name of the physician who treated the employee. |
Facility Name |
The name of the facility, i.e., the Hospital/Clinic where the employee is treated. Mandatory. |
Address Line 1 |
The address details of the hospital. Mandatory. |
Country |
From the drop-down list box, select the required country (where the hospital is located). The combo is defaulted with a list of countries for you to choose. Mandatory. |
State |
From the drop-down list box, select the required state (where the hospital is located). The combo is defaulted with a list of states for you to choose. The drop-down displays “Select” by default on launch of the page. Mandatory. |
City |
From the drop-down list box, select the required city (where the hospital is located). The combo is defaulted with a list of cities for you to choose. Mandatory. |
Zip |
The zip code of the city in numeric format (in 5 digits). Mandatory. |
Enter the following details under “Impact of Incident” section:
Case Classification |
From the drop-down list box, select the required option. The combo is defaulted with various class classification options for you to choose. Mandatory. |
Date of Death |
The date of death of the employee to be recorded here, if the Case classification is chosen as ‘Death’. |
Impact Assessment by HCP |
From the drop-down list box, select the required option that indicates the employee condition assessed by the Health Care Professional. The combo is defaulted with “High”, “Low” and “Medium” options for you to choose. The drop-down displays “Select” by default on launch of the page. Mandatory. |
No of Days Away From Work |
The number of days the employee was away from work. |
Date of Return to Work |
The date on which the employee reported to work i.e., the date when the employee began to work again. |
Position Returned To |
The designation of the employee on returning to work. This is recorded if any change in position is given to the employee. Help facility available |
No. of Days on Job Transfer / Restriction |
The number of days the employee was in transfer or restricted to work. |
Hours of Restriction |
The number of hours the employee is restricted to work. This can also be recorded in terms of hours/day/week as specified in the combo. |
Duties Restricted |
The list of duties restricted to the employee. |
Enter the following details under “Incident Outcome” section:
Select the check box next to “Referred to workers compensation claim” if the incident details are referred to workers compensation claim.
Recordable |
Select “Yes” radio button if the incident is recordable otherwise select “No”. By default the option would be “Yes” on screen launch. Mandatory. |
Case Status |
Select the radio button next to Case Status as to whether it is “Pending for Authorization” or “Authorized”. By default the Case status would be ‘Pending for Authorization’ when created for the first time. Mandatory. |
Click “Save” to save the details entered.
A success message “Case details saved successfully” appears.