Table of Contents

style	Square

Background and strategic fit

The purpose of this Integration is to pull over different incident information (Near Miss and Injury Illness) to support our growing customer base to analyze the data they are entering through the ProcessMAP solution.This document provides information on how to consume the API's by the end Users.

Assumptions

Individual APIs being used for Injury & Claim and Near Miss
For Injury/Illness the Incident type field will have comma separate value in case it is a combined Incident with other Incident Types
- Data will be sent only for the Injury/Illness
ProcessMAP system User permissions would not be considered while exposing the data
ProcessMAP assumes anyone who is accessing the Outbound API has required authority to access Personal Information
User would have to input single Location Code(e.g. Westlake) each time to consume that Location data
Data to be accessed with a limitation of 2 years duration at a time to avoid any performance issues.
Data will be shown in Readable JSON format
Fields Names in the Response would be Product Field Naming. Customer will have to use mapping documentation
User accessing this endpoint through a valid Token & ConsumerId, provided by ProcessMAP, will have access to complete data
Witness Details Information will be as nested
BodyParts -- Will be separated by , and side will be mentioned in braces Ex: Arm (L)(R)
For Nature, Cause and BodyParts -- IF Other(List) is selected then others description will be appended with '-' Ex: Other(List) --- Some Text
For Employee, Supervisor, Reported By -- LastName, MiddleName, First name and Prefix will be combined as shown as single (Prefix(if available) + Firstname+ MiddleName(if available) + LastName)
For Witness the First Name, Middle Name, Last Name will not be appended as no field is mandatory
Incident Status will be included in the json output
DATETIME, INT and FLOAT data will be shown as NULL when there is no data
Pin Location Information and Default CAPA is not considered for this release
The data that is being shown in response is in EST Date time format ONLY.

User Interaction

Near Miss

...

Certain fields are auto-populated in Application but the same will not reflect in JSON until the form is saved

User Interaction

Near Miss

Incident Details

Request

GET papi/v1/imsoutbound/nearmissincidents?locationCode={locationCode}&dateFrom={dateFrom}&dateTo={dateTo}&lastSyncedDate={lastSyncedDate}

...

Name	Description	Type	Additional information
locationCode	Represents the unique code of location for which Incident records to return.	string	Required
dateFrom	Represents the starting date of Incident records to return.	date	Required but value optional
dateTo	Represents the ending date of Incident records to return.	date	Required but value optional
lastSyncedDate	Represents the data from incident created date or incident modified date.	date	Required but value optional

...

[
{
"Incident ID (System Generated)": "US-TESTING LOCATION-19-I-0018Sample_String",
"Incident Title/Site": "Test near MissSample_String",
"Location Code": "Testing LocationSample_String",
"Location": "Testing LocationSample_String",
"Incident Date": "2019-12-02T00:00:00.000ZSample_String",
"Time of Incident": "9:00Sample_String",
"Time Undetermined": "NoSample_String",
"Day Of Week": "MondaySample_String",
"Reported By": "Sample _String",
"Work Shift": "MorningSample_String",
"Operating UnitDepartment": "Sample _String",
"Was this an HPE (Potential life altering injury or fatality)? ((IF YES - The incident investigation is mandatory))": "YesSample_String",
"Describe what occurred to create the Near Miss/Hazard Recognition?": "Sample _String",
"Is Contractor Involved?": "YesSample_String",
"Please provide Contractor Name, Company": "Sample _String",
"Is this a stop work?": "YesSample_String",
"Employee/Individual Details": {
"Was an Employee / Individual involved in the incident?": "YesSample_String",
"Personnel Type": "EmployeeSample_String",
"First Name": "Sample _String",
"Middle Name": "Sample _String",
"Last Name": "Sample _String",
"Salutation": "Sample _String",
"Employee Id": "Sample _String",
"Gender": "MaleSample_String",
"Occupation/Job Title": "Sample _String",
"Hire Date": "2003-05-01T00:00:00.000ZSample_String",
"Employee / Individual Department": "Sample _String",
"Supervisor First Name": "Sample _String",
"Supervisor Last Name": "Sample _String",
"Supervisor Middle Name": "Sample _String",
"Supervisor's Email": "Sample _String"
},
"Are there any Witnesses identified?": "YesSample_String",
"Number of Witnesses": 1"Sample_String",
"Witness Information": [
{
"First Name": "Sample _String",
"Middle Name": "Sample _String",
"Last Name": "Sample _String",
"Phone Number": "Sample _String",
"Notes": "Sample _String"
}
],
"Incident Status": "Investigation Report CompletedSample_String",
"Created By EmployeeID": "Sample_String",
"Created By": "Sample _String",
"Created Date": "2019-12-02T07:38:26.087ZSample_String",
"Modified Date": "2019-10-14T11:47:29.440ZSample_String",
"Modified By": "Sample _String",
"Investigation Responsibility": {
"Responsible Team": [
{
"Salutation": "Sample_String",
"First Name": "Sample_String",
"Last Name": "Sample_String"
},
{
"Salutation": "Sample_String",
"First Name": "Sample _String",
"Last Name": "Sample _String"
}
],
"Target Completion Date": "2019-12-24T00:00:00.000ZSample_String",
"Note/Comments": "Sample _String",
"Notify Immediate Supervisor": "YSample_String"
},
"Investigation Details": [
{
"Date Reported to Management": "12/02/2019Sample_String"
},
{
"Time Reported to Management": "10:00Sample_String"
},
{
"Is this an HPE?": "YesSample_String",
"Please select Non-HPE Type": " Sample_String",
"HPE Type": "Hoisted LoadsSample_String"
},
{
"Is this a Near Miss or a Hazard Recognition?": "Hazard RecognitionSample_String"
},
{
"Did this result in Stop Work?": "YesSample_String",
"Who performed the Stop Work?": "Sample _String"
},
{
"EHS Category": "Sample _String"
},
{
"Did this incident involve a Procedural Breakdown?": "YesSample_String"
},
{
"Are new procedures or special training needed to prevent recurrence?": "YesSample_String",
"If yes, provide the details": "Sample _String"
},
{
"Was incident reviewed with the involved employee?": "YesSample_String",
"Employee Comments (If yes to answer above)": "Sample _String"
},
{
"Could this incident have resulted in a life-altering injury?": "YesSample_String",
"What type of injury could have occurred?": {
"What type of injury could have occurred?": "Sample _String",
"Please specify": "Sample _String"
},
"How severe could the injury have been?": "Sample _String"
},
{
"Length of Normal Workday": "Sample _String"
},
{
"What tool, machine, equipment, object or substance was involved in the near-miss. If this question does not apply, enter ?not applicable?.": "Sample _String"
},
{
"Time Work Day Began": "15:10Sample_String"
},
{
"Specific Work Activity when the incident occurred": "Sample _String",
"Please specify :": " Sample_String"
},
{
"Area where near miss/hazard recognition occurred": "Sample _String",
"Please specify:": " Sample_String"
},
{
"Investigation Conducted By": "Sample _String"
},
{
"Investigation Conducted Date": "12/02/2019Sample_String"
}
],
"Contributing Factor/Immediate Cause": [
{
"Contributing Factor Type (Parent)": "Sample _String",
"Contributing Factor/Immediate Cause": [
"Sample _String"
],
"Comments": "Sample _String"
},
{
"Contributing Factor Type (Parent)": "Sample _String",
"Contributing Factor/Immediate Cause": [
"Sample _String"
],
"Comments": "Sample _String"
}
],
"5 Why? Methodology": [
{
"Select Action or Condition that may have directly caused incident": [
"Sample _String",
"Sample_String"
],
"Whys": [
{
"Why or what created the scenario above to affect the action or condition": "Sample _String"
},
{
"Final Root Cause/Basic Cause Checked": "YesSample_String"
}
]
}
],
{
"SelectRoot ActionCause/Basic or Condition that may have directly caused incident": [
"Sample String"
],
"Whys"Cause Analysis": [
{
"WhyRoot orcause what created the scenario above to affect the action or conditionType (Parent)": "Sample _String"
},
{
"Final Root Cause/Basic Cause Checked": [
"Sample _String"
}
]
}
],
"Root Cause/Basic Cause AnalysisComments": [
{
"Root cause Type (Parent)": "Sample String"Sample_String"
}
],
"Root Cause/Basic Cause AnalysisLessons Learned": [
"Sample String",{
"Sample String"
],
"CommentsLessons Learned": "Sample_String"
}
],
"Action Items": [
{
"Source ID": "Sample _String",
"Source Title": "Sample _String",
"Action Item Title": "Sample _String",
"Action Item Category": "Sample _String",
"Action Item Type": "Corrective ActionSample_String",
"Action Item Description": "Sample _String",
"Action Item Priority": "LowSample_String",
"Action Item Due Date": "2020-01-02T00:00:00.000Z""Sample_String",
"Owners": [
"Sample _String"
],
"ResponsibleAssigned DepartmentBy": "Sample _String",
"ApplicableVerification to ExpansionRequired": "Sample _String",
"Description of Actions to be ExpandedVerify User": [
"Sample _String"
],
"ApplicableAction to EEM/EPM InfoItem Status": "Sample _String",
"EEMAction / EPMTaken": "Sample _String",
"EEM/EPM Info SubmittedAction Item Completed By": "Sample _String",
"DocumentCompleted NumberDate": "Sample _String",
"AssignedDue Date ByExtension": "Sample _String",
"Verification RequiredRequested Due Date Extension": "YesSample_String",
"Verify UserReason for Due Date Extension": [
"Sample _String"
],
"Action Item StatusDue Date Extension Request Approved?": "OpenSample_String",
"Action TakenReason for not extending the Due Date": "Sample _String",
"CompletedVerification ByStatus": "Sample _String",
"Action Item Completed DateVerification Performed": "Sample _String",
"DueVerified Date ExtensionBy": [
"Sample _String",
"Sample_String"
],
"RequestedVerification Due Date Extension": "Sample _String",
"Reason for Due Date ExtensionComments": "Sample _String",
"Due Date Extension Request Approved": "Sample String",
"Reason for not extending the Due Date": "Sample String",
"Verification Status": "Open",
"Verification Performed": "Onsite",
"Verified By": [
"Sample String"
],
"Verification Date": "Sample String",
"Comments": "Sample String"
}
]
}
]

Near Miss Field List

...

NVARCHAR(200)

...

Injury/Illness

Incident Details

Request

GET papi/v1/imsoutbound/injuryincidents?locationCode={locationCode}&dateFrom={dateFrom}&dateTo={dateTo}&lastSyncedDate={lastSyncedDate}

Ex: papi/v1/imsoutbound/injuryincidents?locationCode=westlake&dateFrom=2019-07-01&dateTo=2019-07-30&lastSyncedDate=2019-01-01

URI Parameters

Location Code, DateFrom, DateTo and LastSyncedDate are to be passed as parameters.

DateFrom and DateTo are required when LastSyncedDate is not provided.

When DateFrom, DateTo and LastSyncedDate are provided, data will be returned based on LastSyncedDate only.

...

Represents the unique code of location for which Incident records to return.

...

Required

...

Represents the starting date of Incident records to return.

...

Required but value optional

...

Represents the ending date of Incident records to return.

...

Required but value optional

...

Headers

...

Response

Sample:

{
    "Incident ID (System Generated)": "sample string 1",
    "Incident Internal Id (System Generated)": "sample string 2",
    "Incident Title (No Personal data to be entered)": "sample string 3",
    "Incident Type": "sample string 4",
    "Were multiple people injured as part of this incident?": "sample string 5",
    "Date of Incident": "2019-08-14T12:39:46.403Z",
    "Time of Incident": "sample string 6",
    "Time undetermined": "sample string 7",
    "Day Of Week": "sample string 8",
    "Work Shift": "sample string 9",
    "Time Work Day Began": "sample string 10",
    "Description of Incident": "sample string 11",
    "Incident Occurred on Employer's Premises": "sample string 12",
    "Address of Incident Location": "sample string 13",
    "City of Incident Location": "sample string 14",
    "County of Incident Location": "sample string 15",
    "Country of Incident Location": "sample string 16",
    "State/Province of Incident Location": "sample string 17",
    "Postal Code/Zip Code of Incident Location": "sample string 18",
    "Department": "sample string 19",
    "Location of Injury Scene": "sample string 20",
    "Would you like to submit a Workers Compensation claim?": "sample string 21",
    "Personnel Type": "sample string 22",
    "Employee / Individual Involved (Prefix, First, M.I., Last)": "sample string 23",
    "Employee Id": "sample string 24",
    "Gender": "sample string 25",
    "Occupation/Job Title": "sample string 26",
    "Hire Date": "2019-08-14T12:39:46.404Z",
    "Time in Current job": 1,
    "Time in Current job Unit": "sample string 27",
    "Employee / Individual Department": "sample string 28",
    "Supervisor (First, M.I., Last)": "sample string 29",
    "Supervisor's Email": "sample string 30",
    "Supervisor Phone": "sample string 31",
    "Employee Home Address": "sample string 32",
    "Employee City": "sample string 33",
    "Employee State": "sample string 34",
    "Employee Postal Code/Zip Code": "sample string 35",
    "Employee Home Phone Number": "sample string 36",
    "Marital Status": "sample string 37",
    "Years at Company": 1,
    "Number Of Dependents": 1,
    "Current Weekly Wage": 1.1,
    "Hourly Wage": 1.1,
    "Hours Worked per Week": 1.1,
    "Days worked Per Week": 1,
    "Hours worked Per Day": 1,
    "State Hired": "sample string 38",
    "Employment Status": "sample string 39",
    "Was Employee Paid in Full for Date of Injury?": "sample string 40",
    "Any Prior WC Injuries?": "sample string 41",
    "Name of Contractor": "sample string 42",
    "Name of Sub-Contractor": "sample string 43",
    "Was Employee treated offsite?": "sample string 44",
    "Did this incident involve an in-patient hospitalization, amputation, or a loss of an eye?": "sample string 45",
    "Has OSHA been contacted?": "sample string 46",
    "Please Identify OSHA Contact Details (Name and Phone Number)": "sample string 47",
    "Nature of Injury / Illness": "sample string 48",
    "Cause of Illness/Injury": "sample string 49",
    "Injured Body Part": "sample string 50",
    "What was the employee doing just before the incident occurred?": "sample string 51",
    "Please describe what object or substance directly harmed the employee? If this question does not apply, enter 'not applicable'": "sample string 52",
    "Most Severe Case": "sample string 53",
    "Current Case": "sample string 54",
    "Health & Safety / WC Contact Name": "sample string 55",
    "Employer Telephone Number": "sample string 56",
    "Employer Title": "sample string 57",
    "Employer Mailing Address": "sample string 58",
    "Employer City": "sample string 59",
    "Employer State": "sample string 60",
    "Employer Postal Code/Zip Code": "sample string 61",
    "Employer Location Code": "sample string 62",
    "Employer SIC": "sample string 63",
    "Nature of Business": "sample string 64",
    "Is This Claim Work Related": "sample string 65",
    "Did the incident result in fatality?": "sample string 66",
    "Date fatality occurred": "2019-08-14T12:39:46.406Z",
    "Did the employee lose any time from work?": "sample string 67",
    "What was the first full day out?": "2019-08-14T12:39:46.406Z",
    "Do you know the Date Employee Last Worked?": "sample string 68",
    "Date Returned to Work": "2019-08-14T12:39:46.407Z",
    "Estimated Return to Work Date": "2019-08-14T12:39:46.407Z",
    "Reqs Sharps Inj Log": "sample string 69",
    "Was employee sent to Hospital / Clinic to receive Medical Treatment?": "sample string 70",
    "Initial Medical Treatment": "sample string 71",
    "Hospital / Clinic Name": "sample string 72",
    "Hospital Address": "sample string 73",
    "Hospital City": "sample string 74",
    "Hospital State": "sample string 75",
    "Hospital Postal Code/Zip Code": "sample string 76",
    "Hospital Phone": "sample string 77",
    "Hospital Fax": "sample string 78",
    "Clinic/Doctor Name": "sample string 79",
    "Do you question the Validity of the claim?": "sample string 80",
    "Provide details": "sample string 81",
    "Other Comments": "sample string 82",
    "Is Claim Form Completed?": "sample string 83",
    "Claim Submission Status": "sample string 84",
    "Claim Submitted By": "sample string 85",
    "Claim Submitted Date": "2019-08-14T12:39:46.407Z",
    "Claim Status": "sample string 86",
    "Date Claim Closed": "2019-08-14T12:39:46.407Z",
    "Total Cost Incurred": 1.1,
    "Total Cost Paid": 1.1,
    "Total Outstanding Cost": 1.1,
    "Total Developed Cost": 1.1,
    "Are there any Witnesses identified?": "sample string 87",
    "Witness Information": [
      {
        "LastName": "sample string 2",
        "FirstName": "sample string 3",
        "MiddleName": "sample string 4",
        "PhoneNumber": "sample string 5",
        "Notes": "sample string 6"
      },
      {
        "LastName": "sample string 2",
        "FirstName": "sample string 3",
        "MiddleName": "sample string 4",
        "PhoneNumber": "sample string 5",
        "Notes": "sample string 6"
      }
    ],
    "Name": "sample string 88",
    "Title": "sample string 89",
    "Phone": "sample string 90",
    "Incident Status": "sample string 91",
    "Incident Created By": "sample string 92",
    "Incident Created Date": "2019-08-14T12:39:46.408Z",
    "Incident Last Updated By": "sample string 93",
    "Incident Last Updated Date": "2019-08-14T12:39:46.408Z"
  }

Injury/Illness and Claim Field List

...

Case Management Field List

...

Investigation Sections Field List (Common to All Incident Types)

...

Action Item Field List (Common to All Incident Types)

...


}
]
}
]

Injury/Illness

Incident Details

Request

GET papi/v1/imsoutbound/injuryincidents?locationCode={locationCode}&dateFrom={dateFrom}&dateTo={dateTo}&lastSyncedDate={lastSyncedDate}

Ex: papi/v1/imsoutbound/injuryincidents?locationCode=westlake&dateFrom=2019-07-01&dateTo=2019-07-30&lastSyncedDate=2019-01-01

URI Parameters

Location Code, DateFrom, DateTo and LastSyncedDate are to be passed as parameters.

DateFrom and DateTo are required when LastSyncedDate is not provided.

When DateFrom, DateTo and LastSyncedDate are provided, data will be returned based on LastSyncedDate only.

Name	Description	Type	Additional information
locationCode	Represents the unique code of location for which Incident records to return.	string	Required
dateFrom	Represents the starting date of Incident records to return.	date	Required but value optional
dateTo	Represents the ending date of Incident records to return.	date	Required but value optional
lastSyncedDate	Represents the data from incident created date or incident modified date.	date	Required but value optional

Headers

Name	Description	Sample
Authorization	Represents the value of the authentication token. Allow multiple values: no.	Bearer eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ...
ConsumerId	Represents the value of the consumer id. Allow multiple values: no.	2222

Response

Sample:

[
{
"Injury/Illness Incident Detail": {
"Incident Details": {
"Incident ID": "Sample_String",
"Incident Title/Site": "Sample_String",
"Incident Type": "Sample_String",
"Location Code": "Sample_String",
"Location": "Sample_String",
"Were multiple people injured as part of this incident?": "Sample_String"
},
"General Details": {
"Date of Incident": "Sample_String",
"Time of Incident": "Sample_String",
"Time Undetermined": "Sample_String",
"Day Of Week": "Sample_String",
"Work Shift": "Sample_String",
"Time Work Day Began": "Sample_String",
"Description of Incident": "Sample_String",
"Incident Occurred on Employer's Premises": "Sample_String",
"Department": "Sample_String",
"Location of Injury Scene": "Sample_String"
},
"Employee / Individual Details": [
{
"Personnel Type": "Sample_String",
"Employee": {
"Last Name": "Sample_String",
"First Name": "Sample_String",
"Middle Name": "Sample_String",
"Salutation": "Sample_String"
},
"Employee ID": "Sample_String",
"Gender": "Sample_String",
"Occupation/Job Title": "Sample_String",
"Hire Date": "Sample_String",
"Employee / Individual Department": "Sample_String",
"Supervisor (Last,First,MI)": {
"Last Name": "Sample_String",
"First Name": "Sample_String",
"Middle Name": "Sample_String"
},
"Supervisor's Email": "Sample_String"
}
],
"Injury/Illness Summary": [
{
"Was employee taken offsite for evaluation by a medical professional?": "Sample_String",
"Did this incident involve an in-patient hospitalization, amputation, or a loss of an eye?": "Sample_String",
"Has OSHA been contacted?": "Sample_String",
"Please Identify OSHA Contact Details �Name and Phone Number�": "Sample_String",
"Nature of Injury / Illness": "Sample_String",
"Cause of Injury/Illness": "Sample_String",
"Injured Body Parts": [
"Sample_String"
],
"What was the employee doing just before the incident occurred?": "Sample_String",
"Please describe what object or substance directly harmed the employee?.If this question does not apply, enter �not applicable�?": "Sample_String",
"Machine/Equipment Number": "Sample_String",
"Type": "Sample_String",
"Brand": "Sample_String",
"Model": "Sample_String"
}
],
"Witness Information": {
"Are there any Witnesses identified?": "Sample_String",
"Number of Witnesses": "Sample_String",
"Witness Information": [
{
"First Name": "Sample_String",
"Middle Name": "Sample_String",
"Last Name": "Sample_String",
"Phone Number": "Sample_String",
"Notes": "Sample_String"
}
]
},
"Additional Incident Information": {
"Incident Status": "Sample_String",
"Created By": "Sample_String",
"Created Date": "Sample_String",
"Last Updated By": "Sample_String",
"Last Updated Date": "Sample_String"
}
},
"Case Management": {
"Classification of Case": [
{
"Case Number": "Sample_String",
"Was this case Work-Related?": "Sample_String",
"Describe the reason for the \"Non Work Related\" classification": "Sample_String",
"Did this incident result in a fatality?": "Sample_String",
"Did this incident result in an amputation, fractured/cracked bone(s) (including teeth), or loss of consciousness?": "Sample_String",
"Did the incident result in work restrictions, lost time or job transfer?": "Sample_String",
"Was Treatment Provided beyond First Aid? (Prescription strength medications, Application of wound closing devices, Intravenous Fluids)": "Sample_String",
"Did the injury involve a needlestick and cut(s) from sharp objects that are contaminated with another person's blood or other potentially infectious material?": "Sample_String",
"Was treatment defined as \"First Aid\" provided?": "Sample_String",
"This is a First Aid Case, identify the specific treatment(s) provided": "Sample_String",
"Is This a Bunge (US OSHA) defined Recordable Case ?": "Sample_String",
"Describe the reason for the \"Not Recordable\" classification": "Sample_String",
"Is this Case Recordable According to Local Record keeping Requirements ?": "Sample_String",
"Case Status": "Sample_String",
"Comments": "Sample_String",
"Completed By": "Sample_String",
"Title": "Sample_String",
"Phone": "Sample_String"
}
],
"Case Classification and Progress Tracking": {
"Other Recordable/MAA": [
{
"Employee Name": "Sample_String",
"Classification of Case": "Sample_String",
"Date Other Recordable/MAA Case Occurred": "Sample_String",
"Reason for Classification": "Sample_String",
"Comments": "Sample_String",
"Official Medical Diagnosis (Nature of Injury / Illness)": "Sample_String",
"Was Treatment provided offsite?": "Sample_String",
"Hospital / Clinic Name": "Sample_String",
"Type": "Sample_String",
"Physician/Healthcare Provider": "Sample_String",
"Street": "Sample_String",
"City": "Sample_String",
"Country": "Sample_String",
"State": "Sample_String",
"Postal Code/Zip Code": "Sample_String",
"Phone": "Sample_String",
"Fax": "Sample_String",
"Was the employee treated in an emergency room": "Sample_String",
"Was employee hospitalized overnight as an in-patient": "Sample_String",
"Recording/Revision Date": "Sample_String"
}
]
}
},
"Claim": {
"Claim Information": [
{
"Do you want to file a claim for this incident?": "Sample_String",
"Worker's Comp ID": "Sample_String",
"Workers Comp Claim#": "Sample_String",
"Incident Reported By": "Sample_String",
"Reporter's Email": "Sample_String",
"Reporter's Phone": "Sample_String",
"Injury Date": "Sample_String",
"Injury Day of Week": "Sample_String",
"Time of Injury": "Sample_String",
"Time Workday (Shift) Began": "Sample_String",
"Incident id/Case No": "Sample_String",
"Is this Claim work related?": "Sample_String"
}
],
"Employee/Individual Details": [
{
"Employee Name First": "Sample_String",
"Middle": "Sample_String",
"Last": "Sample_String",
"Home Address:Street": "Sample_String",
"City": "Sample_String",
"State": "Sample_String",
"Zip": "Sample_String",
"Home Phone Number": "Sample_String",
"Gender": "Sample_String",
"Date of Birth": "Sample_String",
"Marital Status": "Sample_String",
"Hire Date": "Sample_String",
"Years at Bunge": "Sample_String",
"Number of Dependants": "Sample_String",
"Type of Employment": "Sample_String",
"Occupation": "Sample_String",
"Department Name": "Sample_String",
"State Hired": "Sample_String",
"Supervisor Name": "Sample_String",
"Supervisor Phone": "Sample_String",
"Current Weekly Wage": "Sample_String",
"Hourly Wage": "Sample_String",
"Hours worked per Week": "Sample_String",
"Days worked Per Week": "Sample_String",
"Hours worked Per Day": "Sample_String",
"Employment Status": "Sample_String",
"Employee ID Number": "Sample_String",
"Was Employee Paid in Full for Date of Injury": "Sample_String",
"Any Prior WC Injuries": "Sample_String",
"OSHA Reference No.": "Sample_String",
"Will employee's salary continue?": "Sample_String"
}
],
"Employer Information": [
{
"Health & Safety / WC Contact Name": "Sample_String",
"Telephone Number": "Sample_String",
"Title": "Sample_String",
"Mailing Address": "Sample_String",
"City": "Sample_String",
"State": "Sample_String",
"Zip": "Sample_String",
"Employer Location Code": "Sample_String",
"Employer SIC": "Sample_String",
"Nature of Business": "Sample_String",
"Employer Name": "Sample_String"
}
],
"Accident Information": [
{
"Did the Accident Occur at the Work Location?": "Sample_String",
"If no , where did the accident occur? Accident Address": "Sample_String",
"City": "Sample_String",
"State": "Sample_String",
"Zip": "Sample_String",
"Give a full Description of the Accident: (Be as Complete as Possible)": "Sample_String",
"What was the employee doing just before the incident occurred?": "Sample_String",
"Please describe what object or substance directly harmed the employee?": "Sample_String",
"Jurisdiction State": "Sample_String",
"Date and Time Reported to Employer": "Sample_String",
"Hours: Minutes": "Sample_String"
}
],
"Injury Information": [
{
"Did incident result in a fatality?": "Sample_String",
"Date fatality occurred": "Sample_String",
"Did the employee lose any time from work?": "Sample_String",
"What was the first full day out": "Sample_String",
"Do you know the Date Employee Last Worked?": "Sample_String",
"Date Employee Last Worked": "Sample_String",
"Has the employee returned to work?": "Sample_String",
"Date Returned to Work": "Sample_String",
"Return to Work Status": "Sample_String",
"Estimated return to work date": "Sample_String",
"Nature of Injury": "Sample_String",
"Cause of Injury/illness": "Sample_String",
"Which Part of the Body was Injured?": [
"Sample_String"
],
"Part of the Body Location?": "Sample_String",
"Needle Stick Injury": "Sample_String",
"Reqs Sharps Inj Log": "Sample_String"
}
],
"Medical Information": [
{
"Was employee sent to Hospital / Clinic to receive Medical Treatement?": "Sample_String",
"Initial Medical Treatment": "Sample_String",
"Hospital / Clinic Name": "Sample_String",
"Address": "Sample_String",
"City": "Sample_String",
"State": "Sample_String",
"Zip": "Sample_String",
"Phone": "Sample_String",
"Fax": "Sample_String",
"Clinic/Doctor Name": "Sample_String"
}
],
"Witness Information": [
{
"Were There Any Witnesses?": "Sample_String",
"If Yes, Name": "Sample_String",
"Contact": "Sample_String"
}
],
"Additional Comments and Information": [
{
"Do you question the validity of the claim": "Sample_String",
"If yes, provide Details": "Sample_String",
"Other Comments": "Sample_String"
}
],
"Report Prepared By": [
{
"Name": "Sample_String",
"Title": "Sample_String",
"Phone": "Sample_String"
}
]
},
"Investigation Report": {
"Investigation Responsibility": {},
"Investigation Details": [
{
"Is this an Ergonomic injury?": "Sample_String"
},
{
"Description of incident (please maintain in local language if other than English)": "Sample_String"
},
{
"Is this an HPE incident?": "Sample_String",
"Please select Non-HPE Type": "Sample_String",
"HPE Type": "Sample_String"
},
{
"Task at time of incident": "Sample_String"
},
{
"Did incident interrupt normal operations?": "Sample_String",
"Length of Downtime": "Sample_String",
"Describe interruption:": "Sample_String"
},
{
"Was it necessary to retain items involved with this incident? (tools, equipment, etc.)": "Sample_String",
"If yes, please list items retained and current location": "Sample_String"
},
{
"Were Local or Government Authorities contacted as a result of this incident?": "Sample_String",
"Which agencies were contacted?": {
"Which agencies were contacted?": "Sample_String",
"Please specify": "Sample_String"
}
},
{
"Post Accident: Drug/Alcohol Screen Conducted": "Sample_String"
},
{
"Date Reported to Management": "Sample_String"
},
{
"Time Reported to Management": "Sample_String"
},
{
"Length of Normal Workday": "Sample_String"
},
{
"length of employment at current position": "Sample_String"
},
{
"length of employment at current position Unit": "Sample_String"
},
{
"Was any Machine / Equipment involved?": "Sample_String",
"Machine/Equipment Number": "Sample_String"
},
{
"Specific Work Activity when the incident occurred": "Sample_String",
"Please specify:": "Sample_String"
}
],
"Ergonomic Analysis": [],
"Contributing Factor/Immediate Cause": [
{
"Contributing Factor Type (Parent)": "Sample_String",
"Contributing Factor/Immediate Cause": [
"Sample_String"
],
"Comments": "Sample_String"
},
{
"Contributing Factor Type (Parent)": "Sample_String",
"Contributing Factor/Immediate Cause": [
"Sample_String"
],
"Comments": "Sample_String"
}
],
"5 Why? Methodology": [
{
"Select Action or Condition that may have directly caused incident": [
"Sample_String"
],
"Whys": [
{
"Why or what created the scenario above to affect the action or condition": "Sample_String"
},
{
"Final Root Cause/Basic Cause Checked": "Sample_String"
}
]
},
{
"Select Action or Condition that may have directly caused incident": [
"Sample_String"
],
"Whys": [
{
"Why or what created the scenario above to affect the action or condition": "Sample_String"
},
{
"Final Root Cause/Basic Cause Checked": "Sample_String"
}
]
}
],
"Root Cause/Basic Cause Analysis": [
{
"Root cause Type (Parent)": "Sample_String",
"Root Cause/Basic Cause": [
"Sample_String"
],
"Comments": ""
}
],
"Lessons Learned": [
{
"Lessons Learned": "Sample_String"
}
]
},
"Action Items": [
{
"Source ID": "Sample_String",
"Source Title": "Sample_String",
"Action Item Title": "Sample_String",
"Action Item Category": "Sample_String",
"Action Item Type": "Sample_String",
"Action Item Description": "Sample_String",
"Action Item Priority": "Sample_String",
"Action Item Due Date": "Sample_String",
"Owners": [
"Sample_String"
],
"Assigned By": "Sample_String",
"Verification Required": "Sample_String",
"Verify User": [
"Sample_String"
],
"Action Item Status": "Sample_String",
"Action Taken": "Sample_String",
"Action Item Completed By": "Sample_String",
"Completed Date": "Sample_String",
"Due Date Extension": "Sample_String",
"Requested Due Date Extension": "Sample_String",
"Reason for Due Date Extension": "Sample_String",
"Due Date Extension Request Approved?": "Sample_String",
"Reason for not extending the Due Date": "Sample_String",
"Verification Status": "Sample_String",
"Verification Performed": "Sample_String",
"Verified By": [
"Sample_String",
"Sample_String"
],
"Verification Date": "Sample_String",
"Comments": "Sample_String"
}
]
}
]

Errors/Validation Messages

...

Version	Old Version 1	New Version Current
Changes made by	Sunil Yalala	Sunil Yalala
Saved on	Dec 02, 2019	Dec 23, 2019

Versions Compared

Key

Background and strategic fit

Assumptions

User Interaction

Near Miss

User Interaction

Near Miss

Incident Details

Request

Near Miss Field List

Injury/Illness

Incident Details

Request

Response

Injury/Illness and Claim Field List

Case Management Field List

Investigation Sections Field List (Common to All Incident Types)

Action Item Field List (Common to All Incident Types)

Injury/Illness

Incident Details

Request

Response

Errors/Validation Messages

Page Comparison

Versions Compared

Key

Background and strategic fit

Assumptions

User Interaction

Near Miss

User Interaction

Near Miss

Incident Details

Request

Near Miss Field List

Injury/Illness

Incident Details

Request

Response

Injury/Illness and Claim Field List

Case Management Field List

Investigation Sections Field List (Common to All Incident Types)

Action Item Field List (Common to All Incident Types)

Injury/Illness

Incident Details

Request

Response

Errors/Validation Messages