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Field Name Length of Field Position of Field Contents
Error Title Line #1
Text
41
1-41 “ERROR REPORT FOR EDI OF FIRST REPORTS FOR”
Filler
1
42
Name of Reporter
6
43-48
Error Title Line #2
Filler
14
1-14
Text
10
15-24
“FILE NAME:”
Filler
1
25
Name of File Processed 15
26-40
Error Title Line #3
Text
4
1-4
“WCBN”
Filler
6
5-10
Text
4
11-14
“UIAN”
Filler
7
15-21
Text
4
22-25
“NAME”
Filler
9
26-34
Text
3
35-37
”SSN”
Filler
3
38-40
Text
11
41-51
“INJURY DATE”
Filler
14
52-65
Text
12
66-77
“INSURER FILE”
Error Header Record
WCBN
8
1-8
Filler
1
9
UIAN
10
10-19
Filler
1
20
Employee Name
18
21-38
Filler
1
39
SSN
9
40-48
Filler
1
49
Injury Date
8
50-57
Filler
1
58
Text
12
59-70
“Claim
Create, Modify, or Reject”
Filler
1
71
File Number
16
72-87
Error Message Record
Error Number
4
1-4
Filler
2
5-6
Error Message
72
7-78
If the error message is for a possible claim duplicate, a second error message
line is created :
Error Message Record #2
Filler
6
1-6
Text
13
7-19
“POSSIBLE WCBN”
WCBN
8
20-27
Summary Error Line #1
Filler
19
1-19
# First Report Rcrds Rcvd 2
20-21
Text
43
22-64
“Total First Reports received”
Summary Error Line #2
Filler
19
1-19
# First Report Rcrds Created 2
20-21
Text
43
22-64
“First Reports Created”
Summary Error Line #3
Filler
19
1-19
# First Report Rcrds Updated 2
20-21
Text
43
22-64
“First Reports Updated”
Summary Error Line #4
Filler
19
1-19
# First Report Rcrds Rejected 2
20-21
Text
43
22-64
“First Reports Rejected Mandatory Errors”