| 1 | OOPSSUPB ;WIOFO/LLH-S/E Supervisor Edit for CA1 ;04/25/2000 | 
|---|
| 2 | ;;2.0;ASISTS;;Jun 03, 2002 | 
|---|
| 3 | ;; | 
|---|
| 4 | ; Note:  This routine used to be part of OOPSSUP2, but had to be split | 
|---|
| 5 | ; due to size limitations.  This routine collects the Supervisor | 
|---|
| 6 | ; portion of the CA1. | 
|---|
| 7 | ; | 
|---|
| 8 | CA1 ; CA1 FORM | 
|---|
| 9 | N ITEM,DTINJ,DT110,VWIT | 
|---|
| 10 | S (AIEN,AGN,ADD,CITY,STATE,ZIP)="" | 
|---|
| 11 | S (PNAME,PADD,PCITY,PSTATE,PZIP,PTITLE,STAT,SIEN)="" | 
|---|
| 12 | S MAX1=528 | 
|---|
| 13 | S DR="" | 
|---|
| 14 | W !!," Federal Employee's Notice of Traumatic Injury and Claim" | 
|---|
| 15 | W !," for Continuation of Pay/Compensation (Form CA-1)" | 
|---|
| 16 | W !!,"     Witness" | 
|---|
| 17 | W !,"     -------" | 
|---|
| 18 | ; Patch 8 - DOL project.  Added collection of multiple witnesses | 
|---|
| 19 | ; note: if Witness Statement entry ever allowed, max length = 528 | 
|---|
| 20 | S DR(2,2260.0125)=".01:5" | 
|---|
| 21 | S DR(2,2260.0125,6)="6////SIGNED WITNESS STATEMENT TO FOLLOW." | 
|---|
| 22 | S DR(1,2260,1)="125"         ; call to witness multiple | 
|---|
| 23 | S DR(1,2260,2)="S VWIT=$$WIT^OOPSUTL3" | 
|---|
| 24 | S DR(1,2260,3)="I +VWIT=0!($P(VWIT,U,2)=0) S Y=125" | 
|---|
| 25 | S DR(1,2260,4)="W !!,""     Supervisor's Report""" | 
|---|
| 26 | S DR(1,2260,5)="W !,""     -------------------""" | 
|---|
| 27 | D AGNINFO^OOPSUTL2 | 
|---|
| 28 | S DR(1,2260,10)="130 17. AGENCY NAME...............//^S X=AGN;I X="""" S Y=""@5""" | 
|---|
| 29 | S DR(1,2260,11)="I X'="""",'$$VCHAR^OOPSUTL4(X) D VCHAR^OOPSUTL2 S Y=130" | 
|---|
| 30 | S DR(1,2260,15)="131     STREET ADDRESS............//^S X=ADD" | 
|---|
| 31 | S DR(1,2260,16)="I X'="""",'$$VCHAR^OOPSUTL4(X) D VCHAR^OOPSUTL2 S Y=131" | 
|---|
| 32 | S DR(1,2260,20)="132     CITY......................//^S X=CITY" | 
|---|
| 33 | S DR(1,2260,21)="I X'="""",'$$VCHAR^OOPSUTL4(X) D VCHAR^OOPSUTL2 S Y=132" | 
|---|
| 34 | S DR(1,2260,25)="133     STATE.....................//^S X=STATE" | 
|---|
| 35 | S DR(1,2260,30)="134     ZIP CODE..................//^S X=ZIP" | 
|---|
| 36 | S DR(1,2260,35)="S Y=176" | 
|---|
| 37 | S DR(1,2260,40)="@5" | 
|---|
| 38 | S DR(1,2260,45)="131////@" | 
|---|
| 39 | S DR(1,2260,50)="132////@" | 
|---|
| 40 | S DR(1,2260,55)="133////@" | 
|---|
| 41 | S DR(1,2260,60)="134////@" | 
|---|
| 42 | S DR(1,2260,65)="176 18. EMPLOYEE'S DUTY STATION..." | 
|---|
| 43 | S DR(1,2260,66)="I X'="""",'$$VCHAR^OOPSUTL4(X) D VCHAR^OOPSUTL2 S Y=176" | 
|---|
| 44 | S DR(1,2260,70)="177     STREET ADDRESS............" | 
|---|
| 45 | S DR(1,2260,71)="I X'="""",'$$VCHAR^OOPSUTL4(X) D VCHAR^OOPSUTL2 S Y=177" | 
|---|
| 46 | S DR(1,2260,75)="178     CITY......................" | 
|---|
| 47 | S DR(1,2260,76)="I X'="""",'$$VCHAR^OOPSUTL4(X) D VCHAR^OOPSUTL2 S Y=178" | 
|---|
| 48 | S DR(1,2260,80)="179     STATE....................." | 
|---|
| 49 | S DR(1,2260,85)="180     ZIP CODE.................." | 
|---|
| 50 | S DR(1,2260,90)="60 19. EMPLOYEE'S RETIREMENT.....//^S X=RET;I X<3 S Y=""@6""" | 
|---|
| 51 | S DR(1,2260,95)="61     OTHER RETIREMENT..........." | 
|---|
| 52 | S DR(1,2260,96)="I X'="""",'$$VCHAR^OOPSUTL4(X) D VCHAR^OOPSUTL2 S Y=61" | 
|---|
| 53 | S DR(1,2260,97)="S Y=""@7""" | 
|---|
| 54 | S DR(1,2260,98)="@6" | 
|---|
| 55 | S DR(1,2260,99)="61////@" | 
|---|
| 56 | S DR(1,2260,100)="@7" | 
|---|
| 57 | S DR(1,2260,105)="W !,"" 20. REGULAR WORK HOURS:""" | 
|---|
| 58 | S DR(1,2260,110)="138     FROM......................" | 
|---|
| 59 | S DR(1,2260,115)="139     TO........................" | 
|---|
| 60 | S DR(1,2260,120)="S ITEM=21 W !,"" 21. REGULAR WORK SCHEDULE.....: ""_$$GET1^DIQ(2260,D0,140,""E"")" | 
|---|
| 61 | S DR(1,2260,124)="K DIR S DIR(""A"")=""                                 "",DIR(""B"")=$$GET1^DIQ(2260,D0,140,""I"") D RWS^OOPSUTL2 S:$D(DIRUT) Y=""@2""" | 
|---|
| 62 | ; | 
|---|
| 63 | ; Default from 2162, require time entry but allow edit | 
|---|
| 64 | S DTINJ=$$GET1^DIQ(2260,IEN,4,"E") | 
|---|
| 65 | S DR(1,2260,125)="4 22. DATE/TIME INJURY OCCURRED.......//^S X=DTINJ" | 
|---|
| 66 | S DR(1,2260,130)="I $P(X,""."",2)="""" W !,""Time is REQUIRED in this response."" S Y=4" | 
|---|
| 67 | S DR(1,2260,135)="S DT110=$$GET1^DIQ(2260,IEN,110,""E"")" | 
|---|
| 68 | S DR(1,2260,140)="175 23. DATE OF NOTICE RECEIVED...//^S X=DT110" | 
|---|
| 69 | S DR(1,2260,145)="I X'="""",'$$FUT^OOPSUTL4($P(X,""."")) S Y=175" | 
|---|
| 70 | S DR(1,2260,150)="142 24. DATE/TIME STOPPED WORK...." | 
|---|
| 71 | S DR(1,2260,155)="I X'="""",'$$FUT^OOPSUTL4($P(X,""."")) S Y=142" | 
|---|
| 72 | S DR(1,2260,160)="143 25. DATE PAY STOPPED.........." | 
|---|
| 73 | S DR(1,2260,165)="I X'="""",'$$FUT^OOPSUTL4($P(X,""."")) S Y=143" | 
|---|
| 74 | S DR(1,2260,170)="144 26. DATE 45 DAY PERIOD BEGAN.." | 
|---|
| 75 | S DR(1,2260,175)="I X'="""",'$$FUT^OOPSUTL4($P(X,""."")) S Y=144" | 
|---|
| 76 | S DR(1,2260,180)="145 27. DATE/TIME RETURNED TO WORK" | 
|---|
| 77 | S DR(1,2260,185)="I X'="""",'$$FUT^OOPSUTL4($P(X,""."")) S Y=145" | 
|---|
| 78 | S DR(1,2260,190)="146 28. WAS EMPLOYEE INJURED IN PERFORMANCE OF DUTY;I X=""Y"" S Y=148;" | 
|---|
| 79 | S DR(1,2260,195)="147     EXPLANATION" | 
|---|
| 80 | S DR(1,2260,196)="I X'="""",'$$VCHAR^OOPSUTL4(X) D VCHAR^OOPSUTL2 S Y=147" | 
|---|
| 81 | S DR(1,2260,200)="148 29. WAS INJURY CAUSED BY EMPLOYEE'S WILLFUL MISCONDUCT, INTOXICATION, OR            INTENT TO INJURE SELF OR ANOTHER;I X=""N"" S Y=150;" | 
|---|
| 82 | S DR(1,2260,205)="149     EXPLANATION" | 
|---|
| 83 | S DR(1,2260,206)="I X'="""",'$$VCHAR^OOPSUTL4(X) D VCHAR^OOPSUTL2 S Y=149" | 
|---|
| 84 | S DR(1,2260,210)="150 30. WAS INJURY CAUSED BY 3RD PARTY;I X=""N"" S Y=""@1""" | 
|---|
| 85 | S DR(1,2260,215)="W !,"" 31. NAME AND ADDRESS OF THIRD PARTY:""" | 
|---|
| 86 | S DR(1,2260,220)="151     NAME OF THIRD PARTY.......;I X="""" S Y=""@1""" | 
|---|
| 87 | S DR(1,2260,221)="I X'="""",'$$VCHAR^OOPSUTL4(X) D VCHAR^OOPSUTL2 S Y=151" | 
|---|
| 88 | S DR(1,2260,225)="152     STREET ADDRESS............" | 
|---|
| 89 | S DR(1,2260,226)="I X'="""",'$$VCHAR^OOPSUTL4(X) D VCHAR^OOPSUTL2 S Y=152" | 
|---|
| 90 | S DR(1,2260,230)="153     CITY......................" | 
|---|
| 91 | S DR(1,2260,231)="I X'="""",'$$VCHAR^OOPSUTL4(X) D VCHAR^OOPSUTL2 S Y=153" | 
|---|
| 92 | S DR(1,2260,235)="154     STATE....................." | 
|---|
| 93 | S DR(1,2260,236)="155     ZIP CODE.................." | 
|---|
| 94 | S DR(1,2260,237)="S Y=""@3""" | 
|---|
| 95 | S DR(1,2260,238)="@1" | 
|---|
| 96 | S DR(1,2260,239)="151////@" | 
|---|
| 97 | S DR(1,2260,240)="152////@" | 
|---|
| 98 | S DR(1,2260,241)="153////@" | 
|---|
| 99 | S DR(1,2260,242)="154////@" | 
|---|
| 100 | S DR(1,2260,243)="155////@" | 
|---|
| 101 | S DR(1,2260,244)="@3" | 
|---|
| 102 | S DR(1,2260,250)="W !,"" 32. NAME AND ADDRESS OF PHYSICIAN FIRST PROVIDING MEDICAL CARE:""" | 
|---|
| 103 | ; Patch 7 - default physician info, if name deleted, del other fields | 
|---|
| 104 | D PHINFO^OOPSUTL2 | 
|---|
| 105 | S DR(1,2260,255)="156     NAME OF PHYSICIAN.........//^S X=PNAME;I X="""" S Y=""@4""" | 
|---|
| 106 | S DR(1,2260,256)="I X'="""",'$$NMCHK^OOPSUTL3(X) D NMERR^OOPSUTL3 K X S Y=156" | 
|---|
| 107 | S DR(1,2260,260)="157     STREET ADDRESS............//^S X=PADD" | 
|---|
| 108 | S DR(1,2260,261)="I X'="""",'$$VCHAR^OOPSUTL4(X) D VCHAR^OOPSUTL2 S Y=157" | 
|---|
| 109 | S DR(1,2260,265)="158     CITY......................//^S X=PCITY" | 
|---|
| 110 | S DR(1,2260,266)="I X'="""",'$$VCHAR^OOPSUTL4(X) D VCHAR^OOPSUTL2 S Y=158" | 
|---|
| 111 | S DR(1,2260,270)="159     STATE.....................//^S X=PSTATE" | 
|---|
| 112 | S DR(1,2260,275)="160     ZIP CODE..................//^S X=PZIP" | 
|---|
| 113 | S DR(1,2260,280)="182     TITLE.....................//^S X=PTITLE" | 
|---|
| 114 | S DR(1,2260,285)="S Y=161" | 
|---|
| 115 | S DR(1,2260,290)="@4" | 
|---|
| 116 | S DR(1,2260,295)="157////@" | 
|---|
| 117 | S DR(1,2260,300)="158////@" | 
|---|
| 118 | S DR(1,2260,305)="159////@" | 
|---|
| 119 | S DR(1,2260,310)="160////@" | 
|---|
| 120 | S DR(1,2260,315)="182////@" | 
|---|
| 121 | S DR(1,2260,320)="161 33. 1ST DATE MEDICAL CARE RECEIVED" | 
|---|
| 122 | S DR(1,2260,325)="I X'="""",'$$FUT^OOPSUTL4(X) S Y=161" | 
|---|
| 123 | S DR(1,2260,330)="162 34. DO MEDICAL REPORTS SHOW EMPLOYEE IS DISABLED FOR WORK" | 
|---|
| 124 | S DR(1,2260,335)="163 35. DOES YOUR KNOWLEDGE OF THE FACTS AGREE WITH STATEMENTS OF THE EMPLOYEE;I X=""Y"" S Y=165" | 
|---|
| 125 | S DR(1,2260,340)="164     EXPLANATION~" | 
|---|
| 126 | S DR(1,2260,345)="W !" | 
|---|
| 127 | S DR(1,2260,350)="S MAX=$$WP^OOPSUTL4(164)" | 
|---|
| 128 | S DR(1,2260,351)="I '$P(MAX,U,2) D VCHAR^OOPSUTL2 S Y=164" | 
|---|
| 129 | S DR(1,2260,355)="I +MAX>MAX1 W !!,""Max length for field is "",MAX1,"" characters, you have entered "",+MAX,"".  Please Edit."",! S Y=164" | 
|---|
| 130 | S DR(1,2260,360)="165 36. IF THE EMPLOYING AGENCY CONTROVERTS CONTINUATION OF PAY, STATE THE REASON       IN DETAIL~" | 
|---|
| 131 | S DR(1,2260,365)="S MAX=$$WP^OOPSUTL4(165)" | 
|---|
| 132 | S DR(1,2260,366)="I '$P(MAX,U,2) D VCHAR^OOPSUTL2 S Y=165" | 
|---|
| 133 | S DR(1,2260,370)="I +MAX>MAX1 W !!,""Max length for field is "",MAX1,"" characters, you have entered "",+MAX,"".  Please Edit."",! S Y=165" | 
|---|
| 134 | S DR(1,2260,375)="W !!,"" 37. PAY RATE WHEN EMPLOYEE STOPPED WORK:""" | 
|---|
| 135 | S DR(1,2260,380)="166     $.........................//^S X=SAL" | 
|---|
| 136 | S DR(1,2260,385)="167     PER.......................//^S X=PAY" | 
|---|
| 137 | S DR(1,2260,390)="W !!,""     Signature of Supervisor and Filing Instructions""" | 
|---|
| 138 | S DR(1,2260,395)="W !,""     -----------------------------------------------""" | 
|---|
| 139 | S DR(1,2260,400)="S ITEM=38 D EXCEPT^OOPSUTL2;168     EXCEPTION" | 
|---|
| 140 | S DR(1,2260,401)="I X'="""",'$$VCHAR^OOPSUTL4(X) D VCHAR^OOPSUTL2 S Y=168" | 
|---|
| 141 | S DR(1,2260,405)="W !,""     NAME OF SUPERVISOR:  ""_SUP" | 
|---|
| 142 | S DR(1,2260,410)="172     SUPERVISOR'S TITLE." | 
|---|
| 143 | S DR(1,2260,411)="I X'="""",'$$VCHAR^OOPSUTL4(X) D VCHAR^OOPSUTL2 S Y=172" | 
|---|
| 144 | S DR(1,2260,415)="173     OFFICE PHONE......." | 
|---|
| 145 | ; Patch 8 - add error checking for DOL requirements | 
|---|
| 146 | S DR(1,2260,416)="I $TR(X,""/-*#"","""")'?10N W !?3,""Phone number must include area code and 7 digits only.  Example 703-123-8789"" S Y=173" | 
|---|
| 147 | S DR(1,2260,420)="174 39. FILING INSTRUCTIONS" | 
|---|
| 148 | S DR(1,2260,425)="@2" | 
|---|
| 149 | Q | 
|---|