First Report Of Injury

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Sort By: Claimant Name | MWCC #

{{item.claimant}}MWCC : {{item.mwcc}}

Employer:{{item.employerName}}

Injury Date: {{item.dateOfInjury}}

Claimant : {{getFROIData[selectedClaimant].claimant}}

MWCC#
{{getFROIData[selectedClaimant].mwcc}}

DKT#
{{getFROIData[selectedClaimant].docket}}

Employer
{{getFROIData[selectedClaimant].employerName}}

City / State / Zip
{{getInjuryDetailsData.city}} {{getInjuryDetailsData.state}} {{getInjuryDetailsData.zip}}

Injury Details

Judges Details

Judge:
{{getInjuryDetailsData.judgeName}}

Legal Assistant:
{{getInjuryDetailsData.legalAssistantName}}
Ph:{{getInjuryDetailsData.legalAssistantPhone}}

Hearing Date:
{{getInjuryDetailsData.lastHearingDate}}

Attorney Details

Attorney for Claimant:
{{getInjuryDetailsData.claimantAttorneyName1}}
Ph:{{getInjuryDetailsData.claimantAttorneyPhone1}}

Attorney for Employer/Carrier:
{{getInjuryDetailsData.defenseAttorneyName1}}
Ph:{{getInjuryDetailsData.defenseAttorneyPhone1}}

Basic Details

Gender:
{{getInjuryDetailsData.gender}}

Date of Birth:
{{getInjuryDetailsData.dob}}

Employer:
{{getInjuryDetailsData.employer}}

{{getInjuryDetailsData.employerAdd1.trim()}}
{{getInjuryDetailsData.employerAdd2.trim()}}
{{getInjuryDetailsData.employerCity}} {{getInjuryDetailsData.employerState}} {{getInjuryDetailsData.employerZip}}
{{getInjuryDetailsData.employerPhone}}

Service Co:
{{getInjuryDetailsData.serviceCompany}}

{{getInjuryDetailsData.serviceCompanyAdd1.trim()}}
{{getInjuryDetailsData.serviceCompanyAdd2.trim()}}
{{getInjuryDetailsData.serviceCompanyCity}} {{getInjuryDetailsData.serviceCompanyState}} {{getInjuryDetailsData.serviceCompanyZip}}
{{getInjuryDetailsData.serviceCompanyPhone}}

Carrier:
{{getInjuryDetailsData.carrier}}

{{getInjuryDetailsData.carrierAdd1.trim()}}
{{getInjuryDetailsData.carrierAdd2.trim()}}
{{getInjuryDetailsData.carrierCity}} {{getInjuryDetailsData.carrierState}} {{getInjuryDetailsData.carrierZip}}
{{getInjuryDetailsData.carrierPhone}}

County of Injury:
{{getInjuryDetailsData.countyOfInjury}}

Nature of Injury:
{{getInjuryDetailsData.natureOfInjury}}

Part of Body:
{{getInjuryDetailsData.partOfBody}}

Cause of Injury:
{{getInjuryDetailsData.causeOfInjury}}

Report Date:
{{getInjuryDetailsData.reportDate}}

Wage:
{{TrimDollarValue(getInjuryDetailsData.wage)}}

Hire Date:
{{getInjuryDetailsData.hireDate}}

Employer Aware:
{{getInjuryDetailsData.employerAwareDate}}

Death Date:
{{getInjuryDetailsData.deathDate}}

Carrier File #:
{{getInjuryDetailsData.carrierFileNumber}}

Returned to Work:
{{getInjuryDetailsData.returnToWorkDate}}

B-31's Rcvd Date:
{{getInjuryDetailsData.b31sReceiveDate}}

# B-31's Rcvd:
{{getInjuryDetailsData.numberB31sReceived}}

Activity History

Activity Details

Curr. Status
{{getInjuryDetailsData.currentStatus}}

Curr. Status Date
{{getInjuryDetailsData.currentStatusDate}}

Deadline Date
{{getInjuryDetailsData.deadlineDate}}

Judges Details

Judge:
{{getInjuryDetailsData.judgeName}}

Legal Assistant
{{getInjuryDetailsData.legalAssistantName}}
Ph:{{getInjuryDetailsData.legalAssistantPhone}}

Hearing Date
{{getInjuryDetailsData.lastHearingDate}}

Attorney Details

Attorney for Claimant:
{{getInjuryDetailsData.claimantAttorneyName1}}
Ph:{{getInjuryDetailsData.claimantAttorneyPhone1}}

Attorney for Employer/Carrier:
{{getInjuryDetailsData.claimantAttorneyName2}}
Ph:{{getInjuryDetailsData.claimantAttorneyName2}}

Activity History Details

{{item.activityDescription}}
B-31 Filed
Activity Date:{{item.activityDate}}
Activity Reason:{{item.activityReason}}

Curr. Status
{{getInjuryDetailsData.currentStatus}}

Curr. Status Date
{{getInjuryDetailsData.currentStatusDate}}

Deadline Date
{{getInjuryDetailsData.deadlineDate}}

Activity Date	Activity Description	Activity Reason
{{item.activityDate}}	{{item.activityDescription}}	{{item.activityReason}}

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