The only document type currently supported by the Massachusetts Department of Industrial Accidents for Electronic Data Interchange (EDI) transactions is the First Report Of Injury (FROI), which consists of the EDI 148 document and companion R21 document.

The following variable segments are also supported for the R21:

  • Accident/Injury Description Narratives
  • Witness Names and Contact Numbers

EDI File Layout for First Report Of Injury transactions

HD1 record xls format of hd1.xls

Repeating transactions

.

.

.

148 record xls format of 148_record.xls
R21 record xls format of r21_record.xls
. . .( optional R21 injury narrative variable segments xls format of r21_injury.xls
)( optional R21 witness variable segments xls format of r21_witness.xls
)
TR2 record xls format of tr2_record.xls



 

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