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