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Segment
in
X12 Release 005040

ESI Employment Status Information

To specify status of employment
Sequence
Element
Name
Type
Requirement
Min
Max
Repeat
01
1073
Yes/No Condition or Response Code
Identifier (ID)
Mandatory
1
1
1
Code indicating a Yes or No condition or response
ESI01 designates if the segment contains post-injury employment information. A "Y" designates that the segment contains post-injury employment information; an "N" designates that the segment contains pre-injury employment information.
Codes (4)
02
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
1
1
Code indicating a Yes or No condition or response
ESI02 designates if the person returned to the same job. A "Y" indicates the person returned to same job; an "N" indicates the person did not return to the same job.
Codes (4)
03
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
1
1
Code indicating a Yes or No condition or response
ESI03 designates if this is a permanent return to work. A "Y" indicates this is a permanent return to work; an "N" indicates this is not a permanent return to work.
Codes (4)
04
Time
Time (TM)
Optional
4
8
1
Time expressed in 24-hour clock time as follows: HHMM, or HHMMSS, or HHMMSSD, or HHMMSSDD, where H = hours (00-23), M = minutes (00-59), S = integer seconds (00-59) and DD = decimal seconds; decimal seconds are expressed as follows: D = tenths (0-9) and DD = hundredths (00-99)
ESI04 is the start time on the day of injury.
05
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
ESI05 is the number of hours worked on the last day worked.
06
Employment Status Code
Identifier (ID)
Conditional
2
2
1
Code showing the general employment status of an employee/claimant
Codes (91)
07
Work Intensity Code
Identifier (ID)
Optional
1
1
1
Code identifying the level of intensity of work
Codes (4)
08
Reason Stopped Work Code
Identifier (ID)
Optional
2
2
1
Code identifying reason claimant stopped working
Codes (37)
09
Status Reason Code
Identifier (ID)
Optional
3
3
1
Code indicating the status reason
C0906
ESI09 designates the reason for the status indicated in ESI06.
Codes (438)
Stedi is a registered trademark of Stedi, Inc. Stedi's EDI Reference and Mapping Guides are provided for marketing purposes and are free of charge. All names, logos, and brands of third parties listed on our site are trademarks of their respective owners (including “X12”, which is a trademark of X12 Incorporated). Stedi, Inc. and its products and services are not endorsed by, sponsored by, or affiliated with these third parties. Our use of these names, logos, and brands is for identification purposes only, and does not imply any such endorsement, sponsorship, or affiliation.
Stedi is a registered trademark of Stedi, Inc. Stedi's EDI Reference and Mapping Guides are provided for marketing purposes and are free of charge. All names, logos, and brands of third parties listed on our site are trademarks of their respective owners (including “X12”, which is a trademark of X12 Incorporated). Stedi, Inc. and its products and services are not endorsed by, sponsored by, or affiliated with these third parties. Our use of these names, logos, and brands is for identification purposes only, and does not imply any such endorsement, sponsorship, or affiliation.