Schema GoldenRodLien.xsd


attribute form default:  unqualified
element form default:  qualified
targetNamespace:  http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
 
Elements  Groups  Complex types  Simple types 
GoldenRodLien  AmendedLienGroup  AmendedLien  lienTypeCode 
LienInformationSectionGroup  AmendedLienDomain  proofOfServiceText 
UnemploymentCompensationGroup  HeaderSection 
InjuryType 
LienClaimant 
LienClaimantAttorneyOrRep 
LienInformation 
NameGroup 
ProofOfServiceAndSignature 
UnemploymentCompensation 


attribute form default:  unqualified
element form default:  qualified
targetNamespace:  http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
 
Simple types 
addressLine 
amount 
attorneyorAuthRepTypeCode 
bodyPart 
city 
claimNumber 
employerName 
employerRoleTypeCode 
fileOnBehalfTypeCode 
filerRoleTypeCode 
firstName 
fullAddress 
fullLongName 
fullName 
hearingTypeCode 
initialCheckBox 
injuryTypeCode 
laborAdjustmentTypeCode 
lastName 
lawFirmNumber 
lienUnemploymentCompensationType 
middleInitial 
occupationText 
organizationName 
phoneNumber 
prefix 
sftField 
signature 
socialSecurityNumber 
state 
venueLocationTypeCode 
venueOfficeCode 
zip4Code 
zip5Code 


attribute form default:  unqualified
element form default:  qualified
targetNamespace:  http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
 
Groups  Complex types 
AddressGroup  Address 
DeclarantSignatureGroup  AttorneyorRep 
EarningAmountGroup  AttorneyorRepWithoutNumber 
EmployerRoleTypeGroup  CheckBox 
InjuryInformationGroup  DateRangeMandatory 
InjuryTypeAndDates  DoctorInformation 
PersonNameGroup  EmployerName 
RoleTypeGroup  InjuryInformation 
SignatureAddressGroup  OrganizationInformation 
VenueInformationGroup  PersonInformation 
PersonName 
SelectionType126 
SelectionType129 
SelectionType84 
SelectionType85 
Signature 
Signatures 
StartAndEndDate 
VenueInformation 


attribute form default:  unqualified
element form default:  qualified
targetNamespace:  http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/CommonFields
 
Simple types 
caseNumber 
checkBox 
ptsDate 
typeCode1 
typeCode3 
versionNumber 


element GoldenRodLien
diagram GoldenRodLien_p1.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
properties
content complex
children HeaderSection InjuryTypeSection LienInformationSection InjuredWorkerSection LienClaimantSection LienClaimantAttorneyOrRepSection EmployerSection InsuranceCarrierOrClaimsAdministratorSection EmployerOrClaimsAdminAttorneySection OpeningLien AdditionalLien AmendedLien ProofOfServiceAndSignature
annotation
documentation
Golden Rod Lien Form
source <xs:element name="GoldenRodLien">
 
<xs:annotation>
   
<xs:documentation>Golden Rod Lien Form</xs:documentation>
 
</xs:annotation>
 
<xs:complexType>
   
<xs:sequence>
     
<xs:element name="HeaderSection" type="HeaderSection"/>
     
<xs:element name="InjuryTypeSection" type="InjuryType"/>
     
<xs:element name="LienInformationSection" type="LienInformation"/>
     
<xs:element name="InjuredWorkerSection" type="CD:PersonInformation"/>
     
<xs:element name="LienClaimantSection" type="LienClaimant"/>
     
<xs:element name="LienClaimantAttorneyOrRepSection" type="CD:AttorneyorRepWithoutNumber" minOccurs="0"/>
     
<xs:element name="EmployerSection" type="CD:OrganizationInformation" minOccurs="0"/>
     
<xs:element name="InsuranceCarrierOrClaimsAdministratorSection" type="CD:OrganizationInformation" minOccurs="0"/>
     
<xs:element name="EmployerOrClaimsAdminAttorneySection" type="CD:OrganizationInformation" minOccurs="0"/>
     
<xs:element name="OpeningLien" type="UnemploymentCompensation" minOccurs="0"/>
     
<xs:element name="AdditionalLien" type="UnemploymentCompensation" minOccurs="0"/>
     
<xs:element name="AmendedLien" type="AmendedLien" minOccurs="0"/>
     
<xs:element name="ProofOfServiceAndSignature" type="ProofOfServiceAndSignature"/>
   
</xs:sequence>
 
</xs:complexType>
</xs:element>

element GoldenRodLien/HeaderSection
diagram GoldenRodLien_p2.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type HeaderSection
properties
isRef 0
content complex
children VersionNumber
source <xs:element name="HeaderSection" type="HeaderSection"/>

element GoldenRodLien/InjuryTypeSection
diagram GoldenRodLien_p3.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type InjuryType
properties
isRef 0
content complex
children InjuryType DateOfInjuryStart DateOfInjuryEnd
source <xs:element name="InjuryTypeSection" type="InjuryType"/>

element GoldenRodLien/LienInformationSection
diagram GoldenRodLien_p4.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type LienInformation
properties
isRef 0
content complex
children DateOfOriginalLien LienType SocialSecurityNumber DateOfBirth
source <xs:element name="LienInformationSection" type="LienInformation"/>

element GoldenRodLien/InjuredWorkerSection
diagram GoldenRodLien_p5.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type PersonInformation
properties
isRef 0
content complex
children Name Address
source <xs:element name="InjuredWorkerSection" type="CD:PersonInformation"/>

element GoldenRodLien/LienClaimantSection
diagram GoldenRodLien_p6.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type LienClaimant
properties
isRef 0
content complex
children EmployerName Address PhoneNumber
source <xs:element name="LienClaimantSection" type="LienClaimant"/>

element GoldenRodLien/LienClaimantAttorneyOrRepSection
diagram GoldenRodLien_p7.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type AttorneyorRepWithoutNumber
properties
isRef 0
minOcc 0
maxOcc 1
content complex
children AttorneyorAuthRepTypeCode EmployerName Name Address PhoneNumber
source <xs:element name="LienClaimantAttorneyOrRepSection" type="CD:AttorneyorRepWithoutNumber" minOccurs="0"/>

element GoldenRodLien/EmployerSection
diagram GoldenRodLien_p8.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type OrganizationInformation
properties
isRef 0
minOcc 0
maxOcc 1
content complex
children EmployerName Address
source <xs:element name="EmployerSection" type="CD:OrganizationInformation" minOccurs="0"/>

element GoldenRodLien/InsuranceCarrierOrClaimsAdministratorSection
diagram GoldenRodLien_p9.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type OrganizationInformation
properties
isRef 0
minOcc 0
maxOcc 1
content complex
children EmployerName Address
source <xs:element name="InsuranceCarrierOrClaimsAdministratorSection" type="CD:OrganizationInformation" minOccurs="0"/>

element GoldenRodLien/EmployerOrClaimsAdminAttorneySection
diagram GoldenRodLien_p10.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type OrganizationInformation
properties
isRef 0
minOcc 0
maxOcc 1
content complex
children EmployerName Address
source <xs:element name="EmployerOrClaimsAdminAttorneySection" type="CD:OrganizationInformation" minOccurs="0"/>

element GoldenRodLien/OpeningLien
diagram GoldenRodLien_p11.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type UnemploymentCompensation
properties
isRef 0
minOcc 0
maxOcc 1
content complex
children UnemploymentCompensationType LienWeeklyRate DateOfBenefitsCommencing LienTotalBenefitsNotToExceed
source <xs:element name="OpeningLien" type="UnemploymentCompensation" minOccurs="0"/>

element GoldenRodLien/AdditionalLien
diagram GoldenRodLien_p12.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type UnemploymentCompensation
properties
isRef 0
minOcc 0
maxOcc 1
content complex
children UnemploymentCompensationType LienWeeklyRate DateOfBenefitsCommencing LienTotalBenefitsNotToExceed
source <xs:element name="AdditionalLien" type="UnemploymentCompensation" minOccurs="0"/>

element GoldenRodLien/AmendedLien
diagram GoldenRodLien_p13.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type AmendedLien
properties
isRef 0
minOcc 0
maxOcc 1
content complex
children AmendedLienSDIWeeklyRate AmendedLienPFLWeeklyRate AmendedLienTotal AmendedLienGroup
source <xs:element name="AmendedLien" type="AmendedLien" minOccurs="0"/>

element GoldenRodLien/ProofOfServiceAndSignature
diagram GoldenRodLien_p14.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type ProofOfServiceAndSignature
properties
isRef 0
content complex
children DateOfProofOfService ProofOfServiceText SignatureOfLienClaimant
source <xs:element name="ProofOfServiceAndSignature" type="ProofOfServiceAndSignature"/>

group AmendedLienGroup
diagram GoldenRodLien_p15.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
source <xs:group name="AmendedLienGroup">
 
<xs:sequence/>
</xs:group>

group LienInformationSectionGroup
diagram GoldenRodLien_p16.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
children DateOfOriginalLien LienType SocialSecurityNumber DateOfBirth
used by
complexType LienInformation
source <xs:group name="LienInformationSectionGroup">
 
<xs:sequence>
   
<xs:element name="DateOfOriginalLien" type="CF:ptsDate"/>
   
<xs:element name="LienType" type="lienTypeCode" fixed="O"/>
   
<xs:element name="SocialSecurityNumber" type="FF:socialSecurityNumber" minOccurs="0"/>
   
<xs:element name="DateOfBirth" type="CF:ptsDate" minOccurs="0">
     
<xs:annotation>
       
<xs:documentation>DOB of injured worker</xs:documentation>
     
</xs:annotation>
   
</xs:element>
 
</xs:sequence>
</xs:group>

element LienInformationSectionGroup/DateOfOriginalLien
diagram GoldenRodLien_p17.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type ptsDate
properties
isRef 0
content simple
facets
Kind Value annotation 
pattern [0-1][0-9]/[0-3][0-9]/[1-2][0-9][0-9][0-9] 
source <xs:element name="DateOfOriginalLien" type="CF:ptsDate"/>

element LienInformationSectionGroup/LienType
diagram GoldenRodLien_p18.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type lienTypeCode
properties
isRef 0
content simple
fixed O
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
source <xs:element name="LienType" type="lienTypeCode" fixed="O"/>

element LienInformationSectionGroup/SocialSecurityNumber
diagram GoldenRodLien_p19.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type socialSecurityNumber
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
length 
whiteSpace collapse 
pattern ([0-9])* 
source <xs:element name="SocialSecurityNumber" type="FF:socialSecurityNumber" minOccurs="0"/>

element LienInformationSectionGroup/DateOfBirth
diagram GoldenRodLien_p20.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type ptsDate
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
pattern [0-1][0-9]/[0-3][0-9]/[1-2][0-9][0-9][0-9] 
annotation
documentation
DOB of injured worker
source <xs:element name="DateOfBirth" type="CF:ptsDate" minOccurs="0">
 
<xs:annotation>
   
<xs:documentation>DOB of injured worker</xs:documentation>
 
</xs:annotation>
</xs:element>

group UnemploymentCompensationGroup
diagram GoldenRodLien_p21.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
children UnemploymentCompensationType LienWeeklyRate DateOfBenefitsCommencing LienTotalBenefitsNotToExceed
used by
complexType UnemploymentCompensation
source <xs:group name="UnemploymentCompensationGroup">
 
<xs:sequence>
   
<xs:element name="UnemploymentCompensationType" type="FF:lienUnemploymentCompensationType"/>
   
<xs:element name="LienWeeklyRate">
     
<xs:simpleType>
       
<xs:restriction base="FF:amount">
         
<xs:maxInclusive value="99999999999.99"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
   
<xs:element name="DateOfBenefitsCommencing" type="CF:ptsDate"/>
   
<xs:element name="LienTotalBenefitsNotToExceed">
     
<xs:simpleType>
       
<xs:restriction base="FF:amount">
         
<xs:maxInclusive value="99999999999.99"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
 
</xs:sequence>
</xs:group>

element UnemploymentCompensationGroup/UnemploymentCompensationType
diagram GoldenRodLien_p22.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type lienUnemploymentCompensationType
properties
isRef 0
content simple
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration PFL 
enumeration SDI 
source <xs:element name="UnemploymentCompensationType" type="FF:lienUnemploymentCompensationType"/>

element UnemploymentCompensationGroup/LienWeeklyRate
diagram GoldenRodLien_p23.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type restriction of amount
properties
isRef 0
content simple
facets
Kind Value annotation 
minInclusive 0.00 
maxInclusive 99999999999.99 
source <xs:element name="LienWeeklyRate">
 
<xs:simpleType>
   
<xs:restriction base="FF:amount">
     
<xs:maxInclusive value="99999999999.99"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

element UnemploymentCompensationGroup/DateOfBenefitsCommencing
diagram GoldenRodLien_p24.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type ptsDate
properties
isRef 0
content simple
facets
Kind Value annotation 
pattern [0-1][0-9]/[0-3][0-9]/[1-2][0-9][0-9][0-9] 
source <xs:element name="DateOfBenefitsCommencing" type="CF:ptsDate"/>

element UnemploymentCompensationGroup/LienTotalBenefitsNotToExceed
diagram GoldenRodLien_p25.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type restriction of amount
properties
isRef 0
content simple
facets
Kind Value annotation 
minInclusive 0.00 
maxInclusive 99999999999.99 
source <xs:element name="LienTotalBenefitsNotToExceed">
 
<xs:simpleType>
   
<xs:restriction base="FF:amount">
     
<xs:maxInclusive value="99999999999.99"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

complexType AmendedLien
diagram GoldenRodLien_p26.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
children AmendedLienSDIWeeklyRate AmendedLienPFLWeeklyRate AmendedLienTotal AmendedLienGroup
used by
element GoldenRodLien/AmendedLien
source <xs:complexType name="AmendedLien">
 
<xs:sequence>
   
<xs:element name="AmendedLienSDIWeeklyRate" minOccurs="0">
     
<xs:simpleType>
       
<xs:restriction base="FF:amount">
         
<xs:maxInclusive value="99999999999.99"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
   
<xs:element name="AmendedLienPFLWeeklyRate" minOccurs="0">
     
<xs:simpleType>
       
<xs:restriction base="FF:amount">
         
<xs:maxInclusive value="99999999999.99"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
   
<xs:element name="AmendedLienTotal" minOccurs="0">
     
<xs:simpleType>
       
<xs:restriction base="FF:amount">
         
<xs:maxInclusive value="9999999.99"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
   
<xs:element name="AmendedLienGroup" type="AmendedLienDomain" minOccurs="0" maxOccurs="5"/>
 
</xs:sequence>
</xs:complexType>

element AmendedLien/AmendedLienSDIWeeklyRate
diagram GoldenRodLien_p27.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type restriction of amount
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
minInclusive 0.00 
maxInclusive 99999999999.99 
source <xs:element name="AmendedLienSDIWeeklyRate" minOccurs="0">
 
<xs:simpleType>
   
<xs:restriction base="FF:amount">
     
<xs:maxInclusive value="99999999999.99"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

element AmendedLien/AmendedLienPFLWeeklyRate
diagram GoldenRodLien_p28.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type restriction of amount
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
minInclusive 0.00 
maxInclusive 99999999999.99 
source <xs:element name="AmendedLienPFLWeeklyRate" minOccurs="0">
 
<xs:simpleType>
   
<xs:restriction base="FF:amount">
     
<xs:maxInclusive value="99999999999.99"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

element AmendedLien/AmendedLienTotal
diagram GoldenRodLien_p29.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type restriction of amount
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
minInclusive 0.00 
maxInclusive 9999999.99 
source <xs:element name="AmendedLienTotal" minOccurs="0">
 
<xs:simpleType>
   
<xs:restriction base="FF:amount">
     
<xs:maxInclusive value="9999999.99"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

element AmendedLien/AmendedLienGroup
diagram GoldenRodLien_p30.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type AmendedLienDomain
properties
isRef 0
minOcc 0
maxOcc 5
content complex
children NumberOfDays AmendedLienDailyBenefitRate Dates UnemploymentCompensationType
source <xs:element name="AmendedLienGroup" type="AmendedLienDomain" minOccurs="0" maxOccurs="5"/>

complexType AmendedLienDomain
diagram GoldenRodLien_p31.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
children NumberOfDays AmendedLienDailyBenefitRate Dates UnemploymentCompensationType
used by
element AmendedLien/AmendedLienGroup
source <xs:complexType name="AmendedLienDomain">
 
<xs:sequence>
   
<xs:element name="NumberOfDays">
     
<xs:simpleType>
       
<xs:restriction base="xs:int">
         
<xs:minInclusive value="0"/>
         
<xs:maxInclusive value="999"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
   
<xs:element name="AmendedLienDailyBenefitRate">
     
<xs:simpleType>
       
<xs:restriction base="FF:amount">
         
<xs:maxInclusive value="99999.99"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
   
<xs:element name="Dates" type="CD:DateRangeMandatory"/>
   
<xs:element name="UnemploymentCompensationType" type="FF:lienUnemploymentCompensationType"/>
 
</xs:sequence>
</xs:complexType>

element AmendedLienDomain/NumberOfDays
diagram GoldenRodLien_p32.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type restriction of xs:int
properties
isRef 0
content simple
facets
Kind Value annotation 
minInclusive 
maxInclusive 999 
source <xs:element name="NumberOfDays">
 
<xs:simpleType>
   
<xs:restriction base="xs:int">
     
<xs:minInclusive value="0"/>
     
<xs:maxInclusive value="999"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

element AmendedLienDomain/AmendedLienDailyBenefitRate
diagram GoldenRodLien_p33.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type restriction of amount
properties
isRef 0
content simple
facets
Kind Value annotation 
minInclusive 0.00 
maxInclusive 99999.99 
source <xs:element name="AmendedLienDailyBenefitRate">
 
<xs:simpleType>
   
<xs:restriction base="FF:amount">
     
<xs:maxInclusive value="99999.99"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

element AmendedLienDomain/Dates
diagram GoldenRodLien_p34.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type DateRangeMandatory
properties
isRef 0
content complex
children DateFrom DateTo
source <xs:element name="Dates" type="CD:DateRangeMandatory"/>

element AmendedLienDomain/UnemploymentCompensationType
diagram GoldenRodLien_p35.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type lienUnemploymentCompensationType
properties
isRef 0
content simple
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration PFL 
enumeration SDI 
source <xs:element name="UnemploymentCompensationType" type="FF:lienUnemploymentCompensationType"/>

complexType HeaderSection
diagram GoldenRodLien_p36.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
children VersionNumber
used by
element GoldenRodLien/HeaderSection
source <xs:complexType name="HeaderSection">
 
<xs:sequence>
   
<xs:element name="VersionNumber" type="CF:versionNumber" fixed="0.1"/>
 
</xs:sequence>
</xs:complexType>

element HeaderSection/VersionNumber
diagram GoldenRodLien_p37.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type versionNumber
properties
isRef 0
content simple
fixed 0.1
source <xs:element name="VersionNumber" type="CF:versionNumber" fixed="0.1"/>

complexType InjuryType
diagram GoldenRodLien_p38.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
children InjuryType DateOfInjuryStart DateOfInjuryEnd
used by
element GoldenRodLien/InjuryTypeSection
source <xs:complexType name="InjuryType">
 
<xs:group ref="CD:InjuryTypeAndDates"/>
</xs:complexType>

complexType LienClaimant
diagram GoldenRodLien_p39.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
children EmployerName Address PhoneNumber
used by
element GoldenRodLien/LienClaimantSection
source <xs:complexType name="LienClaimant">
 
<xs:sequence>
   
<xs:element name="EmployerName" type="FF:employerName"/>
   
<xs:element name="Address" type="CD:Address"/>
   
<xs:element name="PhoneNumber" type="FF:phoneNumber"/>
 
</xs:sequence>
</xs:complexType>

element LienClaimant/EmployerName
diagram GoldenRodLien_p40.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type employerName
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 56 
pattern ([A-Z0-9 ])* 
source <xs:element name="EmployerName" type="FF:employerName"/>

element LienClaimant/Address
diagram GoldenRodLien_p41.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type Address
properties
isRef 0
content complex
children AddressLine1 City State Zip5Code
source <xs:element name="Address" type="CD:Address"/>

element LienClaimant/PhoneNumber
diagram GoldenRodLien_p42.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type phoneNumber
properties
isRef 0
content simple
facets
Kind Value annotation 
maxLength 10 
pattern \d\d\d\d\d\d\d\d\d\d 
source <xs:element name="PhoneNumber" type="FF:phoneNumber"/>

complexType LienClaimantAttorneyOrRep
diagram GoldenRodLien_p43.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
children LienClaimantNotRepresented AttorneyOrRepWithoutNumber
source <xs:complexType name="LienClaimantAttorneyOrRep">
 
<xs:sequence>
   
<xs:element name="LienClaimantNotRepresented" type="CD:CheckBox"/>
   
<xs:element name="AttorneyOrRepWithoutNumber" minOccurs="0">
     
<xs:complexType>
       
<xs:sequence>
         
<xs:element name="AttorneyorAuthRepTypeCode" type="FF:attorneyorAuthRepTypeCode"/>
         
<xs:element name="EmployerName" type="FF:employerName" minOccurs="0"/>
         
<xs:element name="Name" type="CD:PersonName"/>
         
<xs:element name="Address" type="CD:Address"/>
         
<xs:element name="PhoneNumber" type="FF:phoneNumber" minOccurs="0"/>
       
</xs:sequence>
     
</xs:complexType>
   
</xs:element>
 
</xs:sequence>
</xs:complexType>

element LienClaimantAttorneyOrRep/LienClaimantNotRepresented
diagram GoldenRodLien_p44.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type CheckBox
properties
isRef 0
content complex
children Checkbox
source <xs:element name="LienClaimantNotRepresented" type="CD:CheckBox"/>

element LienClaimantAttorneyOrRep/AttorneyOrRepWithoutNumber
diagram GoldenRodLien_p45.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
properties
isRef 0
minOcc 0
maxOcc 1
content complex
children AttorneyorAuthRepTypeCode EmployerName Name Address PhoneNumber
source <xs:element name="AttorneyOrRepWithoutNumber" minOccurs="0">
 
<xs:complexType>
   
<xs:sequence>
     
<xs:element name="AttorneyorAuthRepTypeCode" type="FF:attorneyorAuthRepTypeCode"/>
     
<xs:element name="EmployerName" type="FF:employerName" minOccurs="0"/>
     
<xs:element name="Name" type="CD:PersonName"/>
     
<xs:element name="Address" type="CD:Address"/>
     
<xs:element name="PhoneNumber" type="FF:phoneNumber" minOccurs="0"/>
   
</xs:sequence>
 
</xs:complexType>
</xs:element>

element LienClaimantAttorneyOrRep/AttorneyOrRepWithoutNumber/AttorneyorAuthRepTypeCode
diagram GoldenRodLien_p46.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type attorneyorAuthRepTypeCode
properties
isRef 0
content simple
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
enumeration 
source <xs:element name="AttorneyorAuthRepTypeCode" type="FF:attorneyorAuthRepTypeCode"/>

element LienClaimantAttorneyOrRep/AttorneyOrRepWithoutNumber/EmployerName
diagram GoldenRodLien_p47.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type employerName
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
minLength 
maxLength 56 
pattern ([A-Z0-9 ])* 
source <xs:element name="EmployerName" type="FF:employerName" minOccurs="0"/>

element LienClaimantAttorneyOrRep/AttorneyOrRepWithoutNumber/Name
diagram GoldenRodLien_p48.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type PersonName
properties
isRef 0
content complex
children FirstName MiddleInitial LastName
source <xs:element name="Name" type="CD:PersonName"/>

element LienClaimantAttorneyOrRep/AttorneyOrRepWithoutNumber/Address
diagram GoldenRodLien_p49.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type Address
properties
isRef 0
content complex
children AddressLine1 City State Zip5Code
source <xs:element name="Address" type="CD:Address"/>

element LienClaimantAttorneyOrRep/AttorneyOrRepWithoutNumber/PhoneNumber
diagram GoldenRodLien_p50.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type phoneNumber
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
maxLength 10 
pattern \d\d\d\d\d\d\d\d\d\d 
source <xs:element name="PhoneNumber" type="FF:phoneNumber" minOccurs="0"/>

complexType LienInformation
diagram GoldenRodLien_p51.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
children DateOfOriginalLien LienType SocialSecurityNumber DateOfBirth
used by
element GoldenRodLien/LienInformationSection
source <xs:complexType name="LienInformation">
 
<xs:group ref="LienInformationSectionGroup"/>
</xs:complexType>

complexType NameGroup
diagram GoldenRodLien_p52.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
children FirstName MiddleInitial LastName EmployerName
source <xs:complexType name="NameGroup">
 
<xs:sequence>
   
<xs:group ref="CD:PersonNameGroup" minOccurs="0"/>
   
<xs:element name="EmployerName" type="FF:fullName" minOccurs="0"/>
 
</xs:sequence>
</xs:complexType>

element NameGroup/EmployerName
diagram GoldenRodLien_p53.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type fullName
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
minLength 
maxLength 56 
pattern ([A-Z 0-9])* 
source <xs:element name="EmployerName" type="FF:fullName" minOccurs="0"/>

complexType ProofOfServiceAndSignature
diagram GoldenRodLien_p54.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
children DateOfProofOfService ProofOfServiceText SignatureOfLienClaimant
used by
element GoldenRodLien/ProofOfServiceAndSignature
source <xs:complexType name="ProofOfServiceAndSignature">
 
<xs:sequence>
   
<xs:element name="DateOfProofOfService" type="CF:ptsDate"/>
   
<xs:element name="ProofOfServiceText" minOccurs="0">
     
<xs:simpleType>
       
<xs:restriction base="xs:string">
         
<xs:maxLength value="1323"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
   
<xs:element name="SignatureOfLienClaimant">
     
<xs:simpleType>
       
<xs:restriction base="FF:signature">
         
<xs:minLength value="1"/>
         
<xs:maxLength value="40"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
 
</xs:sequence>
</xs:complexType>

element ProofOfServiceAndSignature/DateOfProofOfService
diagram GoldenRodLien_p55.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type ptsDate
properties
isRef 0
content simple
facets
Kind Value annotation 
pattern [0-1][0-9]/[0-3][0-9]/[1-2][0-9][0-9][0-9] 
source <xs:element name="DateOfProofOfService" type="CF:ptsDate"/>

element ProofOfServiceAndSignature/ProofOfServiceText
diagram GoldenRodLien_p56.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type restriction of xs:string
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
maxLength 1323 
source <xs:element name="ProofOfServiceText" minOccurs="0">
 
<xs:simpleType>
   
<xs:restriction base="xs:string">
     
<xs:maxLength value="1323"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

element ProofOfServiceAndSignature/SignatureOfLienClaimant
diagram GoldenRodLien_p57.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type restriction of signature
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 40 
whiteSpace preserve 
source <xs:element name="SignatureOfLienClaimant">
 
<xs:simpleType>
   
<xs:restriction base="FF:signature">
     
<xs:minLength value="1"/>
     
<xs:maxLength value="40"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

complexType UnemploymentCompensation
diagram GoldenRodLien_p58.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
children UnemploymentCompensationType LienWeeklyRate DateOfBenefitsCommencing LienTotalBenefitsNotToExceed
used by
elements GoldenRodLien/AdditionalLien GoldenRodLien/OpeningLien
source <xs:complexType name="UnemploymentCompensation">
 
<xs:group ref="UnemploymentCompensationGroup"/>
</xs:complexType>

simpleType lienTypeCode
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type restriction of typeCode1
properties
base CF:typeCode1
used by
element LienInformationSectionGroup/LienType
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
annotation
documentation
Lien Type
Valid Values
'O' - Original Lien
source <xs:simpleType name="lienTypeCode">
 
<xs:annotation>
   
<xs:documentation>Lien Type
Valid Values
'O' - Original Lien
</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:typeCode1">
   
<xs:enumeration value="O"/>
 
</xs:restriction>
</xs:simpleType>

simpleType proofOfServiceText
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/GoldenRodLien
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
minLength 
maxLength 1323 
whiteSpace preserve 
source <xs:simpleType name="proofOfServiceText">
 
<xs:restriction base="xs:string">
   
<xs:minLength value="0"/>
   
<xs:maxLength value="1323"/>
   
<xs:whiteSpace value="preserve"/>
 
</xs:restriction>
</xs:simpleType>

simpleType addressLine
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
used by
element AddressGroup/AddressLine1
facets
Kind Value annotation 
minLength 
maxLength 40 
whiteSpace preserve 
pattern ([A-Z0-9 ])* 
source <xs:simpleType name="addressLine">
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="40"/>
   
<xs:minLength value="1"/>
   
<xs:whiteSpace value="preserve"/>
   
<xs:pattern value="([A-Z0-9 ])*"/>
 
</xs:restriction>
</xs:simpleType>

simpleType amount
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:double
properties
base xs:double
used by
elements AmendedLienDomain/AmendedLienDailyBenefitRate AmendedLien/AmendedLienPFLWeeklyRate AmendedLien/AmendedLienSDIWeeklyRate AmendedLien/AmendedLienTotal EarningAmountGroup/EarningsAmount UnemploymentCompensationGroup/LienTotalBenefitsNotToExceed UnemploymentCompensationGroup/LienWeeklyRate
facets
Kind Value annotation 
minInclusive 0.00 
maxInclusive 9999999999999.99 
source <xs:simpleType name="amount">
 
<xs:restriction base="xs:double">
   
<xs:maxInclusive value="9999999999999.99"/>
   
<xs:minInclusive value="0.00"/>
 
</xs:restriction>
</xs:simpleType>

simpleType attorneyorAuthRepTypeCode
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of typeCode1
properties
base CF:typeCode1
used by
elements LienClaimantAttorneyOrRep/AttorneyOrRepWithoutNumber/AttorneyorAuthRepTypeCode AttorneyorRep/AttorneyorAuthRepTypeCode AttorneyorRepWithoutNumber/AttorneyorAuthRepTypeCode
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
enumeration 
annotation
documentation
Attorney or Authorized Representative
Valid Values
'A' - Attorney
'R' - AuthorizedRepresentative
source <xs:simpleType name="attorneyorAuthRepTypeCode">
 
<xs:annotation>
   
<xs:documentation> Attorney or Authorized Representative
Valid Values
'A' - Attorney
'R' - AuthorizedRepresentative
</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:typeCode1">
   
<xs:enumeration value="A"/>
   
<xs:enumeration value="R"/>
 
</xs:restriction>
</xs:simpleType>

simpleType bodyPart
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of typeCode3
properties
base CF:typeCode3
used by
element InjuryInformationGroup/BodyPartInformation/BodyPart
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 100 
enumeration 110 
enumeration 120 
enumeration 121 
enumeration 124 
enumeration 130 
enumeration 140 
enumeration 141 
enumeration 144 
enumeration 145 
enumeration 146 
enumeration 148 
enumeration 149 
enumeration 150 
enumeration 160 
enumeration 198 
enumeration 200 
enumeration 300 
enumeration 310 
enumeration 311 
enumeration 313 
enumeration 315 
enumeration 318 
enumeration 319 
enumeration 320 
enumeration 330 
enumeration 340 
enumeration 398 
enumeration 400 
enumeration 410 
enumeration 411 
enumeration 420 
enumeration 430 
enumeration 440 
enumeration 450 
enumeration 498 
enumeration 500 
enumeration 510 
enumeration 511 
enumeration 513 
enumeration 515 
enumeration 518 
enumeration 519 
enumeration 520 
enumeration 530 
enumeration 540 
enumeration 598 
enumeration 700 
enumeration 800 
enumeration 801 
enumeration 802 
enumeration 810 
enumeration 820 
enumeration 830 
enumeration 840 
enumeration 841 
enumeration 842 
enumeration 850 
enumeration 860 
enumeration 870 
enumeration 880 
enumeration 999 
annotation
documentation
Body Parts
Valid Values
'100' - 100 HEAD - not specified
'110' - 110 BRAIN
'120' - 120 EAR - not specified
'121' - 121 EAR - external
'124' - 124 EAR - internal (including hearing)
'130' - 130 EYE - (including optic nerves and vision)
'140' - 140 FACE - not specified
'141' - 141 JAW - (including chin and mandible)
'144' - 144 MOUTH - (including lips, tongue, throat and taste)
'145' - 145 TEETH
'146' - 146 NOSE - (including nasal passages, sinus and smell)
'148' - 148 FACE - multiple parts (any combination of above parts)
'149' - 149 FACE - forehead, cheeks, eyelids
'150' - 150 SCALP
'160' - 160 SKULL
'198' - 198 HEAD - multiple injury (any combination of above parts)
'200' - 200 NECK
'300' - 300 UPPER EXTREMITIES - not specified
'310' - 310 ARM - above wrist (not specified)
'311' - 311 ARM - upper arm (humerus)
'313' - 313 ARM - elbow (head of radius)
'315' - 315 ARM - forearm (radius and ulna)
'318' - 318 ARM - multiple parts (any combination of above parts)
'319' - 319 ARM - not specified
'320' - 320 WRIST
'330' - 330 HAND - (not wrist or fingers)
'340' - 340 FINGER(s)
'398' - 398 UPPER EXTREMITIES - multiple parts (any combination of above parts)
'400' - 400 TRUNK - not specified'
'410' - 410 ABDOMEN - including internal organs and groin
'411' - 411 HERNIA
'420' - 420 BACK - including back muscles, spine and spinal cord
'430' - 430 CHEST - including ribs, breast bone and internal organs of the chest
'440' - 440 HIP(s) - including pelvis, pelvic organs, tailbone, coccyx and buttocks
'450' - 450 SHOULDER(s) - (scapula and clavicle)
'498' - 498 TRUNK - use for side; multiple parts (any combination of above parts)
'500' - 500 LOWER EXTREMITIES - not specified
'510' - 510 LEGS - above ankles, not specified
'511' - 511 THIGH (femur)
'513' - 513 KNEE (Patella)
'515' - 515 LOWER LEG (tibia and fibula)
'518' - 518 LEG - multiple parts (any combination of above parts)
'519' - 519 LEG - not specified
'520' - 520 ANKLE (malleolus)
'530' - 530 FOOT (not ankle or toe)
'540' - 540 TOE(s)
'598' - 598 LOWER EXTREMITIES - multiple parts (any combination of above parts)
'700' - 700 MULITPLE PARTS (more than five major parts) (use only in fifth position of listing of body parts)
'800' - 800 BODY SYSTEM - not specific
'801' - 801 CIRCULATORY SYSTEM - (heart - other than heart attack, blood, arteries, veins, etc.)
'802' - 802 CIRCULATORY SYTEM - Heart attack
'810' - 810 DIGESTIVE SYSTEM - (stomach)
'820' - 820 EXCRETORY SYSTEM - (kidneys, bladder, intestines, etc.)
'830' - 830 MUSCULO-SKELETAL SYSTEM - (bones, joints, tendons, muscles, etc.)
'840' - 840 NERVOUS SYSTEM - not specified
'841' - 841 NERVOUS SYSTEM - Stress
'842' - 842 NERVOUS SYSTEM - Psychiatric/psych
'850' - 850 RESPIRATORY SYSTEM - (lungs, trachea, etc.)
'860' - 860 SKIN (dermititis, etc.)
'870' - 870 REPRODUCTIVE SYSTEMS
'880' - 880 OTHER BODY SYSTEMS
'999' - 999 UNCLASSIFIED - insufficient information to identify body parts
source <xs:simpleType name="bodyPart">
 
<xs:annotation>
   
<xs:documentation> Body Parts
Valid Values
'100' - 100 HEAD - not specified
'110' - 110 BRAIN
'120' - 120 EAR - not specified
'121' - 121 EAR - external
'124' - 124 EAR - internal (including hearing)
'130' - 130 EYE - (including optic nerves and vision)
'140' - 140 FACE - not specified
'141' - 141 JAW - (including chin and mandible)
'144' - 144 MOUTH - (including lips, tongue, throat and taste)
'145' - 145 TEETH
'146' - 146 NOSE - (including nasal passages, sinus and smell)
'148' - 148 FACE - multiple parts (any combination of above parts)
'149' - 149 FACE - forehead, cheeks, eyelids
'150' - 150 SCALP
'160' - 160 SKULL
'198' - 198 HEAD - multiple injury (any combination of above parts)
'200' - 200 NECK
'300' - 300 UPPER EXTREMITIES - not specified
'310' - 310 ARM - above wrist (not specified)
'311' - 311 ARM - upper arm (humerus)
'313' - 313 ARM - elbow (head of radius)
'315' - 315 ARM - forearm (radius and ulna)
'318' - 318 ARM - multiple parts (any combination of above parts)
'319' - 319 ARM - not specified
'320' - 320 WRIST
'330' - 330 HAND - (not wrist or fingers)
'340' - 340 FINGER(s)
'398' - 398 UPPER EXTREMITIES - multiple parts (any combination of above parts)
'400' - 400 TRUNK - not specified'
'410' - 410 ABDOMEN - including internal organs and groin
'411' - 411 HERNIA
'420' - 420 BACK - including back muscles, spine and spinal cord
'430' - 430 CHEST - including ribs, breast bone and internal organs of the chest
'440' - 440 HIP(s) - including pelvis, pelvic organs, tailbone, coccyx and buttocks
'450' - 450 SHOULDER(s) - (scapula and clavicle)
'498' - 498 TRUNK - use for side; multiple parts (any combination of above parts)
'500' - 500 LOWER EXTREMITIES - not specified
'510' - 510 LEGS - above ankles, not specified
'511' - 511 THIGH (femur)
'513' - 513 KNEE (Patella)
'515' - 515 LOWER LEG (tibia and fibula)
'518' - 518 LEG - multiple parts (any combination of above parts)
'519' - 519 LEG - not specified
'520' - 520 ANKLE (malleolus)
'530' - 530 FOOT (not ankle or toe)
'540' - 540 TOE(s)
'598' - 598 LOWER EXTREMITIES - multiple parts (any combination of above parts)
'700' - 700 MULITPLE PARTS (more than five major parts) (use only in fifth position of listing of body parts)
'800' - 800 BODY SYSTEM - not specific
'801' - 801 CIRCULATORY SYSTEM - (heart - other than heart attack, blood, arteries, veins, etc.)
'802' - 802 CIRCULATORY SYTEM - Heart attack
'810' - 810 DIGESTIVE SYSTEM - (stomach)
'820' - 820 EXCRETORY SYSTEM - (kidneys, bladder, intestines, etc.)
'830' - 830 MUSCULO-SKELETAL SYSTEM - (bones, joints, tendons, muscles, etc.)
'840' - 840 NERVOUS SYSTEM - not specified
'841' - 841 NERVOUS SYSTEM - Stress
'842' - 842 NERVOUS SYSTEM - Psychiatric/psych
'850' - 850 RESPIRATORY SYSTEM - (lungs, trachea, etc.)
'860' - 860 SKIN (dermititis, etc.)
'870' - 870 REPRODUCTIVE SYSTEMS
'880' - 880 OTHER BODY SYSTEMS
'999' - 999 UNCLASSIFIED - insufficient information to identify body parts
</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:typeCode3">
   
<xs:enumeration value="100"/>
   
<xs:enumeration value="110"/>
   
<xs:enumeration value="120"/>
   
<xs:enumeration value="121"/>
   
<xs:enumeration value="124"/>
   
<xs:enumeration value="130"/>
   
<xs:enumeration value="140"/>
   
<xs:enumeration value="141"/>
   
<xs:enumeration value="144"/>
   
<xs:enumeration value="145"/>
   
<xs:enumeration value="146"/>
   
<xs:enumeration value="148"/>
   
<xs:enumeration value="149"/>
   
<xs:enumeration value="150"/>
   
<xs:enumeration value="160"/>
   
<xs:enumeration value="198"/>
   
<xs:enumeration value="200"/>
   
<xs:enumeration value="300"/>
   
<xs:enumeration value="310"/>
   
<xs:enumeration value="311"/>
   
<xs:enumeration value="313"/>
   
<xs:enumeration value="315"/>
   
<xs:enumeration value="318"/>
   
<xs:enumeration value="319"/>
   
<xs:enumeration value="320"/>
   
<xs:enumeration value="330"/>
   
<xs:enumeration value="340"/>
   
<xs:enumeration value="398"/>
   
<xs:enumeration value="400"/>
   
<xs:enumeration value="410"/>
   
<xs:enumeration value="411"/>
   
<xs:enumeration value="420"/>
   
<xs:enumeration value="430"/>
   
<xs:enumeration value="440"/>
   
<xs:enumeration value="450"/>
   
<xs:enumeration value="498"/>
   
<xs:enumeration value="500"/>
   
<xs:enumeration value="510"/>
   
<xs:enumeration value="511"/>
   
<xs:enumeration value="513"/>
   
<xs:enumeration value="515"/>
   
<xs:enumeration value="518"/>
   
<xs:enumeration value="519"/>
   
<xs:enumeration value="520"/>
   
<xs:enumeration value="530"/>
   
<xs:enumeration value="540"/>
   
<xs:enumeration value="598"/>
   
<xs:enumeration value="700"/>
   
<xs:enumeration value="800"/>
   
<xs:enumeration value="801"/>
   
<xs:enumeration value="802"/>
   
<xs:enumeration value="810"/>
   
<xs:enumeration value="820"/>
   
<xs:enumeration value="830"/>
   
<xs:enumeration value="840"/>
   
<xs:enumeration value="841"/>
   
<xs:enumeration value="842"/>
   
<xs:enumeration value="850"/>
   
<xs:enumeration value="860"/>
   
<xs:enumeration value="870"/>
   
<xs:enumeration value="880"/>
   
<xs:enumeration value="999"/>
 
</xs:restriction>
</xs:simpleType>

simpleType city
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
used by
element AddressGroup/City
facets
Kind Value annotation 
minLength 
maxLength 25 
whiteSpace preserve 
pattern ([A-Z' ])* 
source <xs:simpleType name="city">
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="25"/>
   
<xs:minLength value="1"/>
   
<xs:whiteSpace value="preserve"/>
   
<xs:pattern value="([A-Z' ])*"/>
 
</xs:restriction>
</xs:simpleType>

simpleType claimNumber
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
minLength 
maxLength 20 
pattern ([A-Z0-9 ])* 
source <xs:simpleType name="claimNumber">
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="20"/>
   
<xs:minLength value="0"/>
   
<xs:pattern value="([A-Z0-9 ])*"/>
 
</xs:restriction>
</xs:simpleType>

simpleType employerName
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of fullName
properties
base fullName
used by
elements LienClaimant/EmployerName LienClaimantAttorneyOrRep/AttorneyOrRepWithoutNumber/EmployerName AttorneyorRep/EmployerName AttorneyorRepWithoutNumber/EmployerName
facets
Kind Value annotation 
minLength 
maxLength 56 
pattern ([A-Z0-9 ])* 
source <xs:simpleType name="employerName">
 
<xs:restriction base="fullName">
   
<xs:pattern value="([A-Z0-9 ])*"/>
 
</xs:restriction>
</xs:simpleType>

simpleType employerRoleTypeCode
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of typeCode1
properties
base CF:typeCode1
used by
element EmployerRoleTypeGroup/EmployerRoleTypeCode
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
enumeration 
enumeration 
enumeration 
annotation
documentation
Employer Role Type
Valid Values
'I' - Insured
'S' - Self Insured
'L' - Legally Uninsured
'U' - Uninsured
source <xs:simpleType name="employerRoleTypeCode">
 
<xs:annotation>
   
<xs:documentation> Employer Role Type
Valid Values
'I' - Insured
'S' - Self Insured
'L' - Legally Uninsured
'U' - Uninsured
</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:typeCode1">
   
<xs:enumeration value="I"/>
   
<xs:enumeration value="S"/>
   
<xs:enumeration value="L"/>
   
<xs:enumeration value="U"/>
 
</xs:restriction>
</xs:simpleType>

simpleType fileOnBehalfTypeCode
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of typeCode1
properties
base CF:typeCode1
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
enumeration 
enumeration 
annotation
documentation
File On Behalf Type
Valid Values
'E' - Employer
'I' - Insurance Carrier
'B' - Both

source <xs:simpleType name="fileOnBehalfTypeCode">
 
<xs:annotation>
   
<xs:documentation> File On Behalf Type
Valid Values
'E' - Employer
'I' - Insurance Carrier
'B' - Both

</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:typeCode1">
   
<xs:enumeration value="E"/>
   
<xs:enumeration value="I"/>
   
<xs:enumeration value="B"/>
 
</xs:restriction>
</xs:simpleType>

simpleType filerRoleTypeCode
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of typeCode1
properties
base CF:typeCode1
used by
element RoleTypeGroup/RoleTypeCode
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
enumeration 
enumeration 
enumeration 
annotation
documentation
Filer Role Type
Valid Values
'E' - Employee
'A' - Applicant
'D' - Defendant
'L' - LienClaimnt
source <xs:simpleType name="filerRoleTypeCode">
 
<xs:annotation>
   
<xs:documentation> Filer Role Type
Valid Values
'E' - Employee
'A' - Applicant
'D' - Defendant
'L' - LienClaimnt
</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:typeCode1">
   
<xs:enumeration value="E"/>
   
<xs:enumeration value="A"/>
   
<xs:enumeration value="D"/>
   
<xs:enumeration value="L"/>
 
</xs:restriction>
</xs:simpleType>

simpleType firstName
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
used by
element PersonNameGroup/FirstName
facets
Kind Value annotation 
minLength 
maxLength 25 
whiteSpace preserve 
pattern ([A-Z ])* 
source <xs:simpleType name="firstName">
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="25"/>
   
<xs:whiteSpace value="preserve"/>
   
<xs:minLength value="1"/>
   
<xs:pattern value="([A-Z ])*"/>
 
</xs:restriction>
</xs:simpleType>

simpleType fullAddress
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
used by
element DeclarantSignatureGroup/DeclarantOrLawFirmAddress
facets
Kind Value annotation 
minLength 
maxLength 56 
whiteSpace preserve 
pattern ([A-Z0-9 ])* 
source <xs:simpleType name="fullAddress">
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="56"/>
   
<xs:minLength value="1"/>
   
<xs:whiteSpace value="preserve"/>
   
<xs:pattern value="([A-Z0-9 ])*"/>
 
</xs:restriction>
</xs:simpleType>

simpleType fullLongName
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
minLength 
maxLength 80 
pattern ([A-Z ])* 
source <xs:simpleType name="fullLongName">
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="80"/>
   
<xs:minLength value="1"/>
   
<xs:pattern value="([A-Z ])*"/>
 
</xs:restriction>
</xs:simpleType>

simpleType fullName
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
used by
elements DeclarantSignatureGroup/DeclarantOrLawFirmName NameGroup/EmployerName
simpleType employerName
facets
Kind Value annotation 
minLength 
maxLength 56 
pattern ([A-Z 0-9])* 
source <xs:simpleType name="fullName">
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="56"/>
   
<xs:minLength value="2"/>
   
<xs:pattern value="([A-Z 0-9])*"/>
 
</xs:restriction>
</xs:simpleType>

simpleType hearingTypeCode
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of typeCode1
properties
base CF:typeCode1
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
enumeration 
enumeration 
enumeration 
enumeration 
annotation
documentation
Hearing Type
Valid Values
'M' - Mandatory Settlement Conference
'S' - Status Conference
'R' - Rating MSC
'P' - Priority Conference
'L' -  Lien Conference
source <xs:simpleType name="hearingTypeCode">
 
<xs:annotation>
   
<xs:documentation> Hearing Type
Valid Values
'M' - Mandatory Settlement Conference
'S' - Status Conference
'R' - Rating MSC
'P' - Priority Conference
'L' -  Lien Conference
</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:typeCode1">
   
<xs:enumeration value="M"/>
   
<xs:enumeration value="S"/>
   
<xs:enumeration value="R"/>
   
<xs:enumeration value="P"/>
   
<xs:enumeration value="L"/>
 
</xs:restriction>
</xs:simpleType>

simpleType initialCheckBox
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type checkBox
properties
base CF:checkBox
facets
Kind Value annotation 
whiteSpace collapse 
source <xs:simpleType name="initialCheckBox">
 
<xs:restriction base="CF:checkBox"/>
</xs:simpleType>

simpleType injuryTypeCode
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of typeCode1
properties
base CF:typeCode1
used by
element InjuryTypeAndDates/InjuryType
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
enumeration 
annotation
documentation
Injury Type
Valid Values
'I' - Specific Injury Date
'C' - Cumulative Injury
source <xs:simpleType name="injuryTypeCode">
 
<xs:annotation>
   
<xs:documentation> Injury Type
Valid Values
'I' - Specific Injury Date
'C' - Cumulative Injury
</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:typeCode1">
   
<xs:enumeration value="I"/>
   
<xs:enumeration value="C"/>
 
</xs:restriction>
</xs:simpleType>

simpleType laborAdjustmentTypeCode
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of typeCode1
properties
base CF:typeCode1
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
enumeration 
annotation
documentation
Labor Adjustment Code
Valid Values
'I' - Increase rate
'D' - Decrease rate
source <xs:simpleType name="laborAdjustmentTypeCode">
 
<xs:annotation>
   
<xs:documentation> Labor Adjustment Code
Valid Values
'I' - Increase rate
'D' - Decrease rate
</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:typeCode1">
   
<xs:enumeration value="I"/>
   
<xs:enumeration value="D"/>
 
</xs:restriction>
</xs:simpleType>

simpleType lastName
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
used by
element PersonNameGroup/LastName
facets
Kind Value annotation 
minLength 
maxLength 25 
whiteSpace preserve 
pattern ([A-Z ])* 
source <xs:simpleType name="lastName">
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="25"/>
   
<xs:minLength value="1"/>
   
<xs:whiteSpace value="preserve"/>
   
<xs:pattern value="([A-Z ])*"/>
 
</xs:restriction>
</xs:simpleType>

simpleType lawFirmNumber
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
used by
element AttorneyorRep/LawFirmNumber
facets
Kind Value annotation 
minLength 
maxLength 10 
whiteSpace collapse 
source <xs:simpleType name="lawFirmNumber">
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="10"/>
   
<xs:minLength value="1"/>
   
<xs:whiteSpace value="collapse"/>
 
</xs:restriction>
</xs:simpleType>

simpleType lienUnemploymentCompensationType
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of typeCode3
properties
base CF:typeCode3
used by
elements AmendedLienDomain/UnemploymentCompensationType UnemploymentCompensationGroup/UnemploymentCompensationType
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration PFL 
enumeration SDI 
annotation
documentation
Lien Unemployment Compensation Type 
Valid Values
'PFL' - Paid Family Leave
'SDI' - State Disability Insurance
source <xs:simpleType name="lienUnemploymentCompensationType">
 
<xs:annotation>
   
<xs:documentation>Lien Unemployment Compensation Type 
Valid Values
'PFL' - Paid Family Leave
'SDI' - State Disability Insurance
</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:typeCode3">
   
<xs:enumeration value="PFL"/>
   
<xs:enumeration value="SDI"/>
 
</xs:restriction>
</xs:simpleType>

simpleType middleInitial
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
final <empty>
base xs:string
used by
element PersonNameGroup/MiddleInitial
facets
Kind Value annotation 
minLength 
maxLength 
whiteSpace collapse 
pattern [A-Z] 
source <xs:simpleType name="middleInitial" final="">
 
<xs:restriction base="xs:string">
   
<xs:whiteSpace value="collapse"/>
   
<xs:maxLength value="1"/>
   
<xs:minLength value="1"/>
   
<xs:pattern value="[A-Z]"/>
 
</xs:restriction>
</xs:simpleType>

simpleType occupationText
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
minLength 
maxLength 56 
whiteSpace preserve 
annotation
documentation
Occupation of injured worker at time of injury
source <xs:simpleType name="occupationText">
 
<xs:annotation>
   
<xs:documentation>Occupation of injured worker at time of injury</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="56"/>
   
<xs:minLength value="1"/>
   
<xs:whiteSpace value="preserve"/>
 
</xs:restriction>
</xs:simpleType>

simpleType organizationName
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
minLength 
maxLength 56 
pattern ([A-Z ])* 
source <xs:simpleType name="organizationName">
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="56"/>
   
<xs:minLength value="1"/>
   
<xs:pattern value="([A-Z ])*"/>
 
</xs:restriction>
</xs:simpleType>

simpleType phoneNumber
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
used by
elements DeclarantSignatureGroup/DeclarantOrLawFirmPhoneNumber LienClaimant/PhoneNumber LienClaimantAttorneyOrRep/AttorneyOrRepWithoutNumber/PhoneNumber AttorneyorRepWithoutNumber/PhoneNumber
facets
Kind Value annotation 
maxLength 10 
pattern \d\d\d\d\d\d\d\d\d\d 
annotation
documentation
10 digits (0 - 9)
source <xs:simpleType name="phoneNumber">
 
<xs:annotation>
   
<xs:documentation>10 digits (0 - 9)</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="10"/>
   
<xs:pattern value="\d\d\d\d\d\d\d\d\d\d"/>
 
</xs:restriction>
</xs:simpleType>

simpleType prefix
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
enumeration Mr 
enumeration Ms 
enumeration Mrs 
annotation
documentation
Employee Name Prefix
Valid Values
'Mr.' 'Ms.' 'Mrs'
source <xs:simpleType name="prefix">
 
<xs:annotation>
   
<xs:documentation> Employee Name Prefix
Valid Values
'Mr.' 'Ms.' 'Mrs'
</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:string">
   
<xs:enumeration value="Mr"/>
   
<xs:enumeration value="Ms"/>
   
<xs:enumeration value="Mrs"/>
 
</xs:restriction>
</xs:simpleType>

simpleType sftField
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
used by
element EmployerName/EmployerName
facets
Kind Value annotation 
pattern ([A-Z0-9 ])* 
source <xs:simpleType name="sftField">
 
<xs:restriction base="xs:string">
   
<xs:pattern value="([A-Z0-9 ])*"/>
 
</xs:restriction>
</xs:simpleType>

simpleType signature
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
used by
elements Signature/DeclarantSignature SignatureAddressGroup/DeclarantSignature DeclarantSignatureGroup/DeclarantSignature ProofOfServiceAndSignature/SignatureOfLienClaimant
facets
Kind Value annotation 
maxLength 82 
whiteSpace preserve 
source <xs:simpleType name="signature">
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="82"/>
   
<xs:whiteSpace value="preserve"/>
 
</xs:restriction>
</xs:simpleType>

simpleType socialSecurityNumber
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
used by
element LienInformationSectionGroup/SocialSecurityNumber
facets
Kind Value annotation 
length 
whiteSpace collapse 
pattern ([0-9])* 
source <xs:simpleType name="socialSecurityNumber">
 
<xs:restriction base="xs:string">
   
<xs:length value="9"/>
   
<xs:whiteSpace value="collapse"/>
   
<xs:pattern value="([0-9])*"/>
 
</xs:restriction>
</xs:simpleType>

simpleType state
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
used by
element AddressGroup/State
facets
Kind Value annotation 
minLength 
maxLength 
whiteSpace preserve 
pattern ([A-Z])* 
source <xs:simpleType name="state">
 
<xs:restriction base="xs:string">
   
<xs:whiteSpace value="preserve"/>
   
<xs:minLength value="2"/>
   
<xs:maxLength value="2"/>
   
<xs:pattern value="([A-Z])*"/>
 
</xs:restriction>
</xs:simpleType>

simpleType venueLocationTypeCode
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of typeCode1
properties
base CF:typeCode1
used by
element VenueInformationGroup/VenueLocationCode
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
enumeration 
enumeration 
annotation
documentation
'R' - Residence Location, 'I' - Injury Location, 'B' - Business Location 
source <xs:simpleType name="venueLocationTypeCode">
 
<xs:annotation>
   
<xs:documentation>'R' - Residence Location, 'I' - Injury Location, 'B' - Business Location 
</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:typeCode1">
   
<xs:whiteSpace value="collapse"/>
   
<xs:enumeration value="R"/>
   
<xs:enumeration value="I"/>
   
<xs:enumeration value="B"/>
 
</xs:restriction>
</xs:simpleType>

simpleType venueOfficeCode
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of typeCode3
properties
base CF:typeCode3
used by
element VenueInformationGroup/VenueOfficeCode
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration STK 
enumeration SFO 
enumeration SAC 
enumeration LBO 
enumeration VNO 
enumeration SAL 
enumeration OAK 
enumeration SDO 
enumeration MDR 
enumeration OXN 
enumeration EUR 
enumeration SRO 
enumeration SBR 
enumeration AHM 
enumeration RIV 
enumeration FRE 
enumeration LAO 
enumeration POM 
enumeration SJO 
enumeration ANA 
enumeration BAK 
enumeration GRO 
enumeration RDG 
enumeration SLO 
enumeration SBA 
annotation
documentation
Venue Office Code
'STK'  - Stockton       
'SFO'  - San Francisco  
'SAC'  - Sacramento     
'GOL'  - Goleta (Closed since Jan. 2014)
'LBO'  - Long Beach     
'VNO'  - Van Nuys       
'SAL'  -  Salinas        
'OAK'  - Oakland        
'SDO'  - San Diego      
'MDR'  - Marina Del Rey 
'OXN'  -  Oxnard         
'EUR'  -  Eureka         
'SRO'  - Santa Rosa     
'SBR'  -  San Bernardino 
'AHM' -  Anaheim        
'RIV'   -  Riverside      
'FRE'  -  Fresno         
'LAO'  -  Los Angeles    
'POM' -  Pomona         
'SJO'  -  San Jose       
'ANA'  -  Santa Ana      
'BAK'  -  Bakersfield    
'GRO'  - Grover Beach   
'RDG'  - Redding 
'SLO' - San Luis Obispo
'SBA' - Santa Barbara (Added since Sept. 2014)
 
source <xs:simpleType name="venueOfficeCode">
 
<xs:annotation>
   
<xs:documentation> Venue Office Code
'STK'  - Stockton       
'SFO'  - San Francisco  
'SAC'  - Sacramento     
'GOL'  - Goleta (Closed since Jan. 2014)
'LBO'  - Long Beach     
'VNO'  - Van Nuys       
'SAL'  -  Salinas        
'OAK'  - Oakland        
'SDO'  - San Diego      
'MDR'  - Marina Del Rey 
'OXN'  -  Oxnard         
'EUR'  -  Eureka         
'SRO'  - Santa Rosa     
'SBR'  -  San Bernardino 
'AHM' -  Anaheim        
'RIV'   -  Riverside      
'FRE'  -  Fresno         
'LAO'  -  Los Angeles    
'POM' -  Pomona         
'SJO'  -  San Jose       
'ANA'  -  Santa Ana      
'BAK'  -  Bakersfield    
'GRO'  - Grover Beach   
'RDG'  - Redding 
'SLO' - San Luis Obispo
'SBA' - Santa Barbara (Added since Sept. 2014)
 
</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:typeCode3">
   
<xs:whiteSpace value="collapse"/>
   
<xs:enumeration value="STK"/>
   
<xs:enumeration value="SFO"/>
   
<xs:enumeration value="SAC"/>
   
<xs:enumeration value="LBO"/>
   
<xs:enumeration value="VNO"/>
   
<xs:enumeration value="SAL"/>
   
<xs:enumeration value="OAK"/>
   
<xs:enumeration value="SDO"/>
   
<xs:enumeration value="MDR"/>
   
<xs:enumeration value="OXN"/>
   
<xs:enumeration value="EUR"/>
   
<xs:enumeration value="SRO"/>
   
<xs:enumeration value="SBR"/>
   
<xs:enumeration value="AHM"/>
   
<xs:enumeration value="RIV"/>
   
<xs:enumeration value="FRE"/>
   
<xs:enumeration value="LAO"/>
   
<xs:enumeration value="POM"/>
   
<xs:enumeration value="SJO"/>
   
<xs:enumeration value="ANA"/>
   
<xs:enumeration value="BAK"/>
   
<xs:enumeration value="GRO"/>
   
<xs:enumeration value="RDG"/>
   
<xs:enumeration value="SLO"/>
   
<xs:enumeration value="SBA"/>
   
<!--  xs:enumeration value="GOL"/ -->
 
</xs:restriction>
</xs:simpleType>

simpleType zip4Code
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
length 
whiteSpace collapse 
pattern \d\d\d\d 
source <xs:simpleType name="zip4Code">
 
<xs:restriction base="xs:string">
   
<xs:length value="4" fixed="true"/>
   
<xs:whiteSpace value="collapse"/>
   
<xs:pattern value="\d\d\d\d"/>
 
</xs:restriction>
</xs:simpleType>

simpleType zip5Code
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/FormFields
type restriction of xs:string
properties
base xs:string
used by
element AddressGroup/Zip5Code
facets
Kind Value annotation 
length 
whiteSpace collapse 
pattern \d\d\d\d\d 
source <xs:simpleType name="zip5Code">
 
<xs:restriction base="xs:string">
   
<xs:whiteSpace value="collapse"/>
   
<xs:length value="5"/>
   
<xs:pattern value="\d\d\d\d\d"/>
 
</xs:restriction>
</xs:simpleType>

group AddressGroup
diagram GoldenRodLien_p59.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children AddressLine1 City State Zip5Code
used by
complexType Address
source <xs:group name="AddressGroup">
 
<xs:sequence>
   
<xs:element name="AddressLine1" type="FF:addressLine"/>
   
<xs:element name="City" type="FF:city"/>
   
<xs:element name="State">
     
<xs:simpleType>
       
<xs:restriction base="FF:state"/>
     
</xs:simpleType>
   
</xs:element>
   
<xs:element name="Zip5Code">
     
<xs:simpleType>
       
<xs:restriction base="FF:zip5Code">
         
<xs:whiteSpace value="collapse"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
 
</xs:sequence>
</xs:group>

element AddressGroup/AddressLine1
diagram GoldenRodLien_p60.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type addressLine
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 40 
whiteSpace preserve 
pattern ([A-Z0-9 ])* 
source <xs:element name="AddressLine1" type="FF:addressLine"/>

element AddressGroup/City
diagram GoldenRodLien_p61.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type city
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 25 
whiteSpace preserve 
pattern ([A-Z' ])* 
source <xs:element name="City" type="FF:city"/>

element AddressGroup/State
diagram GoldenRodLien_p62.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type restriction of state
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 
whiteSpace preserve 
pattern ([A-Z])* 
source <xs:element name="State">
 
<xs:simpleType>
   
<xs:restriction base="FF:state"/>
 
</xs:simpleType>
</xs:element>

element AddressGroup/Zip5Code
diagram GoldenRodLien_p63.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type restriction of zip5Code
properties
isRef 0
content simple
facets
Kind Value annotation 
length 
whiteSpace collapse 
pattern \d\d\d\d\d 
source <xs:element name="Zip5Code">
 
<xs:simpleType>
   
<xs:restriction base="FF:zip5Code">
     
<xs:whiteSpace value="collapse"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

group DeclarantSignatureGroup
diagram GoldenRodLien_p64.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children DeclarantSignature DeclarantOrLawFirmName DeclarantOrLawFirmAddress DeclarantOrLawFirmPhoneNumber DateOfSignature
source <xs:group name="DeclarantSignatureGroup">
 
<xs:sequence>
   
<xs:element name="DeclarantSignature">
     
<xs:simpleType>
       
<xs:restriction base="FF:signature">
         
<xs:minLength value="1"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
   
<xs:element name="DeclarantOrLawFirmName">
     
<xs:simpleType>
       
<xs:restriction base="FF:fullName">
         
<xs:minLength value="2"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
   
<xs:element name="DeclarantOrLawFirmAddress">
     
<xs:simpleType>
       
<xs:restriction base="FF:fullAddress">
         
<xs:whiteSpace value="preserve"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
   
<xs:element name="DeclarantOrLawFirmPhoneNumber" minOccurs="0">
     
<xs:simpleType>
       
<xs:restriction base="FF:phoneNumber"/>
     
</xs:simpleType>
   
</xs:element>
   
<xs:element name="DateOfSignature" type="CF:ptsDate"/>
 
</xs:sequence>
</xs:group>

element DeclarantSignatureGroup/DeclarantSignature
diagram GoldenRodLien_p65.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type restriction of signature
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 82 
whiteSpace preserve 
source <xs:element name="DeclarantSignature">
 
<xs:simpleType>
   
<xs:restriction base="FF:signature">
     
<xs:minLength value="1"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

element DeclarantSignatureGroup/DeclarantOrLawFirmName
diagram GoldenRodLien_p66.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type restriction of fullName
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 56 
pattern ([A-Z 0-9])* 
source <xs:element name="DeclarantOrLawFirmName">
 
<xs:simpleType>
   
<xs:restriction base="FF:fullName">
     
<xs:minLength value="2"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

element DeclarantSignatureGroup/DeclarantOrLawFirmAddress
diagram GoldenRodLien_p67.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type restriction of fullAddress
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 56 
whiteSpace preserve 
pattern ([A-Z0-9 ])* 
source <xs:element name="DeclarantOrLawFirmAddress">
 
<xs:simpleType>
   
<xs:restriction base="FF:fullAddress">
     
<xs:whiteSpace value="preserve"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

element DeclarantSignatureGroup/DeclarantOrLawFirmPhoneNumber
diagram GoldenRodLien_p68.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type restriction of phoneNumber
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
maxLength 10 
pattern \d\d\d\d\d\d\d\d\d\d 
source <xs:element name="DeclarantOrLawFirmPhoneNumber" minOccurs="0">
 
<xs:simpleType>
   
<xs:restriction base="FF:phoneNumber"/>
 
</xs:simpleType>
</xs:element>

element DeclarantSignatureGroup/DateOfSignature
diagram GoldenRodLien_p69.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type ptsDate
properties
isRef 0
content simple
facets
Kind Value annotation 
pattern [0-1][0-9]/[0-3][0-9]/[1-2][0-9][0-9][0-9] 
source <xs:element name="DateOfSignature" type="CF:ptsDate"/>

group EarningAmountGroup
diagram GoldenRodLien_p70.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children EarningsAmount
source <xs:group name="EarningAmountGroup">
 
<xs:sequence>
   
<xs:element name="EarningsAmount" type="FF:amount" minOccurs="0"/>
 
</xs:sequence>
</xs:group>

element EarningAmountGroup/EarningsAmount
diagram GoldenRodLien_p71.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type amount
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
minInclusive 0.00 
maxInclusive 9999999999999.99 
source <xs:element name="EarningsAmount" type="FF:amount" minOccurs="0"/>

group EmployerRoleTypeGroup
diagram GoldenRodLien_p72.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children EmployerRoleTypeCode
source <xs:group name="EmployerRoleTypeGroup">
 
<xs:sequence>
   
<xs:element name="EmployerRoleTypeCode">
     
<xs:simpleType>
       
<xs:restriction base="FF:employerRoleTypeCode"/>
     
</xs:simpleType>
   
</xs:element>
 
</xs:sequence>
</xs:group>

element EmployerRoleTypeGroup/EmployerRoleTypeCode
diagram GoldenRodLien_p73.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type restriction of employerRoleTypeCode
properties
isRef 0
content simple
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
enumeration 
enumeration 
enumeration 
source <xs:element name="EmployerRoleTypeCode">
 
<xs:simpleType>
   
<xs:restriction base="FF:employerRoleTypeCode"/>
 
</xs:simpleType>
</xs:element>

group InjuryInformationGroup
diagram GoldenRodLien_p74.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children InjuryType DateOfInjuryStart DateOfInjuryEnd BodyPartInformation
used by
complexType InjuryInformation
source <xs:group name="InjuryInformationGroup">
 
<xs:sequence>
   
<xs:group ref="InjuryTypeAndDates"/>
   
<xs:element name="BodyPartInformation">
     
<xs:complexType>
       
<xs:sequence>
         
<xs:element name="BodyPart" maxOccurs="5">
           
<xs:simpleType>
             
<xs:restriction base="FF:bodyPart"/>
           
</xs:simpleType>
         
</xs:element>
       
</xs:sequence>
     
</xs:complexType>
   
</xs:element>
 
</xs:sequence>
</xs:group>

element InjuryInformationGroup/BodyPartInformation
diagram GoldenRodLien_p75.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
properties
isRef 0
content complex
children BodyPart
source <xs:element name="BodyPartInformation">
 
<xs:complexType>
   
<xs:sequence>
     
<xs:element name="BodyPart" maxOccurs="5">
       
<xs:simpleType>
         
<xs:restriction base="FF:bodyPart"/>
       
</xs:simpleType>
     
</xs:element>
   
</xs:sequence>
 
</xs:complexType>
</xs:element>

element InjuryInformationGroup/BodyPartInformation/BodyPart
diagram GoldenRodLien_p76.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type restriction of bodyPart
properties
isRef 0
minOcc 1
maxOcc 5
content simple
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 100 
enumeration 110 
enumeration 120 
enumeration 121 
enumeration 124 
enumeration 130 
enumeration 140 
enumeration 141 
enumeration 144 
enumeration 145 
enumeration 146 
enumeration 148 
enumeration 149 
enumeration 150 
enumeration 160 
enumeration 198 
enumeration 200 
enumeration 300 
enumeration 310 
enumeration 311 
enumeration 313 
enumeration 315 
enumeration 318 
enumeration 319 
enumeration 320 
enumeration 330 
enumeration 340 
enumeration 398 
enumeration 400 
enumeration 410 
enumeration 411 
enumeration 420 
enumeration 430 
enumeration 440 
enumeration 450 
enumeration 498 
enumeration 500 
enumeration 510 
enumeration 511 
enumeration 513 
enumeration 515 
enumeration 518 
enumeration 519 
enumeration 520 
enumeration 530 
enumeration 540 
enumeration 598 
enumeration 700 
enumeration 800 
enumeration 801 
enumeration 802 
enumeration 810 
enumeration 820 
enumeration 830 
enumeration 840 
enumeration 841 
enumeration 842 
enumeration 850 
enumeration 860 
enumeration 870 
enumeration 880 
enumeration 999 
source <xs:element name="BodyPart" maxOccurs="5">
 
<xs:simpleType>
   
<xs:restriction base="FF:bodyPart"/>
 
</xs:simpleType>
</xs:element>

group InjuryTypeAndDates
diagram GoldenRodLien_p77.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children InjuryType DateOfInjuryStart DateOfInjuryEnd
used by
complexType InjuryType
group InjuryInformationGroup
source <xs:group name="InjuryTypeAndDates">
 
<xs:sequence>
   
<xs:element name="InjuryType" type="FF:injuryTypeCode"/>
   
<xs:element name="DateOfInjuryStart" type="CF:ptsDate"/>
   
<xs:element name="DateOfInjuryEnd" type="CF:ptsDate" nillable="true" minOccurs="0"/>
 
</xs:sequence>
</xs:group>

element InjuryTypeAndDates/InjuryType
diagram GoldenRodLien_p78.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type injuryTypeCode
properties
isRef 0
content simple
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
enumeration 
source <xs:element name="InjuryType" type="FF:injuryTypeCode"/>

element InjuryTypeAndDates/DateOfInjuryStart
diagram GoldenRodLien_p79.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type ptsDate
properties
isRef 0
content simple
facets
Kind Value annotation 
pattern [0-1][0-9]/[0-3][0-9]/[1-2][0-9][0-9][0-9] 
source <xs:element name="DateOfInjuryStart" type="CF:ptsDate"/>

element InjuryTypeAndDates/DateOfInjuryEnd
diagram GoldenRodLien_p80.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type ptsDate
properties
isRef 0
minOcc 0
maxOcc 1
content simple
nillable true
facets
Kind Value annotation 
pattern [0-1][0-9]/[0-3][0-9]/[1-2][0-9][0-9][0-9] 
source <xs:element name="DateOfInjuryEnd" type="CF:ptsDate" nillable="true" minOccurs="0"/>

group PersonNameGroup
diagram GoldenRodLien_p81.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children FirstName MiddleInitial LastName
used by
complexTypes NameGroup PersonName
source <xs:group name="PersonNameGroup">
 
<xs:sequence>
   
<xs:element name="FirstName" type="FF:firstName"/>
   
<xs:element name="MiddleInitial" type="FF:middleInitial" minOccurs="0"/>
   
<xs:element name="LastName" type="FF:lastName"/>
 
</xs:sequence>
</xs:group>

element PersonNameGroup/FirstName
diagram GoldenRodLien_p82.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type firstName
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 25 
whiteSpace preserve 
pattern ([A-Z ])* 
source <xs:element name="FirstName" type="FF:firstName"/>

element PersonNameGroup/MiddleInitial
diagram GoldenRodLien_p83.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type middleInitial
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
minLength 
maxLength 
whiteSpace collapse 
pattern [A-Z] 
source <xs:element name="MiddleInitial" type="FF:middleInitial" minOccurs="0"/>

element PersonNameGroup/LastName
diagram GoldenRodLien_p84.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type lastName
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 25 
whiteSpace preserve 
pattern ([A-Z ])* 
source <xs:element name="LastName" type="FF:lastName"/>

group RoleTypeGroup
diagram GoldenRodLien_p85.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children RoleTypeCode
source <xs:group name="RoleTypeGroup">
 
<xs:sequence>
   
<xs:element name="RoleTypeCode" type="FF:filerRoleTypeCode"/>
 
</xs:sequence>
</xs:group>

element RoleTypeGroup/RoleTypeCode
diagram GoldenRodLien_p86.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type filerRoleTypeCode
properties
isRef 0
content simple
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
enumeration 
enumeration 
enumeration 
source <xs:element name="RoleTypeCode" type="FF:filerRoleTypeCode"/>

group SignatureAddressGroup
diagram GoldenRodLien_p87.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children DateOfSignature Firm DeclarantSignature
used by
complexType Signatures
source <xs:group name="SignatureAddressGroup">
 
<xs:sequence>
   
<xs:element name="DateOfSignature" type="CF:ptsDate"/>
   
<xs:element name="Firm" type="OrganizationInformation"/>
   
<xs:element name="DeclarantSignature">
     
<xs:simpleType>
       
<xs:restriction base="FF:signature">
         
<xs:minLength value="1"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
 
</xs:sequence>
</xs:group>

element SignatureAddressGroup/DateOfSignature
diagram GoldenRodLien_p88.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type ptsDate
properties
isRef 0
content simple
facets
Kind Value annotation 
pattern [0-1][0-9]/[0-3][0-9]/[1-2][0-9][0-9][0-9] 
source <xs:element name="DateOfSignature" type="CF:ptsDate"/>

element SignatureAddressGroup/Firm
diagram GoldenRodLien_p89.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type OrganizationInformation
properties
isRef 0
content complex
children EmployerName Address
source <xs:element name="Firm" type="OrganizationInformation"/>

element SignatureAddressGroup/DeclarantSignature
diagram GoldenRodLien_p90.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type restriction of signature
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 82 
whiteSpace preserve 
source <xs:element name="DeclarantSignature">
 
<xs:simpleType>
   
<xs:restriction base="FF:signature">
     
<xs:minLength value="1"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

group VenueInformationGroup
diagram GoldenRodLien_p91.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children VenueLocationCode VenueOfficeCode
used by
complexType VenueInformation
source <xs:group name="VenueInformationGroup">
 
<xs:sequence>
   
<xs:element name="VenueLocationCode" type="FF:venueLocationTypeCode"/>
   
<xs:element name="VenueOfficeCode" type="FF:venueOfficeCode"/>
 
</xs:sequence>
</xs:group>

element VenueInformationGroup/VenueLocationCode
diagram GoldenRodLien_p92.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type venueLocationTypeCode
properties
isRef 0
content simple
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
enumeration 
enumeration 
source <xs:element name="VenueLocationCode" type="FF:venueLocationTypeCode"/>

element VenueInformationGroup/VenueOfficeCode
diagram GoldenRodLien_p93.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type venueOfficeCode
properties
isRef 0
content simple
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration STK 
enumeration SFO 
enumeration SAC 
enumeration LBO 
enumeration VNO 
enumeration SAL 
enumeration OAK 
enumeration SDO 
enumeration MDR 
enumeration OXN 
enumeration EUR 
enumeration SRO 
enumeration SBR 
enumeration AHM 
enumeration RIV 
enumeration FRE 
enumeration LAO 
enumeration POM 
enumeration SJO 
enumeration ANA 
enumeration BAK 
enumeration GRO 
enumeration RDG 
enumeration SLO 
enumeration SBA 
source <xs:element name="VenueOfficeCode" type="FF:venueOfficeCode"/>

complexType Address
diagram GoldenRodLien_p94.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children AddressLine1 City State Zip5Code
used by
elements LienClaimant/Address LienClaimantAttorneyOrRep/AttorneyOrRepWithoutNumber/Address AttorneyorRep/Address AttorneyorRepWithoutNumber/Address OrganizationInformation/Address PersonInformation/Address
source <xs:complexType name="Address">
 
<xs:group ref="AddressGroup"/>
</xs:complexType>

complexType AttorneyorRep
diagram GoldenRodLien_p95.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children AttorneyorAuthRepTypeCode EmployerName LawFirmNumber Name Address
source <xs:complexType name="AttorneyorRep">
 
<xs:sequence>
   
<xs:element name="AttorneyorAuthRepTypeCode" type="FF:attorneyorAuthRepTypeCode"/>
   
<xs:element name="EmployerName" type="FF:employerName"/>
   
<xs:element name="LawFirmNumber" type="FF:lawFirmNumber" minOccurs="0"/>
   
<xs:element name="Name" type="PersonName" minOccurs="0"/>
   
<xs:element name="Address" type="Address"/>
 
</xs:sequence>
</xs:complexType>

element AttorneyorRep/AttorneyorAuthRepTypeCode
diagram GoldenRodLien_p96.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type attorneyorAuthRepTypeCode
properties
isRef 0
content simple
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
enumeration 
source <xs:element name="AttorneyorAuthRepTypeCode" type="FF:attorneyorAuthRepTypeCode"/>

element AttorneyorRep/EmployerName
diagram GoldenRodLien_p97.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type employerName
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 56 
pattern ([A-Z0-9 ])* 
source <xs:element name="EmployerName" type="FF:employerName"/>

element AttorneyorRep/LawFirmNumber
diagram GoldenRodLien_p98.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type lawFirmNumber
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
minLength 
maxLength 10 
whiteSpace collapse 
source <xs:element name="LawFirmNumber" type="FF:lawFirmNumber" minOccurs="0"/>

element AttorneyorRep/Name
diagram GoldenRodLien_p99.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type PersonName
properties
isRef 0
minOcc 0
maxOcc 1
content complex
children FirstName MiddleInitial LastName
source <xs:element name="Name" type="PersonName" minOccurs="0"/>

element AttorneyorRep/Address
diagram GoldenRodLien_p100.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type Address
properties
isRef 0
content complex
children AddressLine1 City State Zip5Code
source <xs:element name="Address" type="Address"/>

complexType AttorneyorRepWithoutNumber
diagram GoldenRodLien_p101.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children AttorneyorAuthRepTypeCode EmployerName Name Address PhoneNumber
used by
element GoldenRodLien/LienClaimantAttorneyOrRepSection
source <xs:complexType name="AttorneyorRepWithoutNumber">
 
<xs:sequence>
   
<xs:element name="AttorneyorAuthRepTypeCode" type="FF:attorneyorAuthRepTypeCode"/>
   
<xs:element name="EmployerName" type="FF:employerName"/>
   
<xs:element name="Name" type="PersonName" minOccurs="0"/>
   
<xs:element name="Address" type="Address"/>
   
<xs:element name="PhoneNumber" type="FF:phoneNumber" minOccurs="0"/>
 
</xs:sequence>
</xs:complexType>

element AttorneyorRepWithoutNumber/AttorneyorAuthRepTypeCode
diagram GoldenRodLien_p102.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type attorneyorAuthRepTypeCode
properties
isRef 0
content simple
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
enumeration 
source <xs:element name="AttorneyorAuthRepTypeCode" type="FF:attorneyorAuthRepTypeCode"/>

element AttorneyorRepWithoutNumber/EmployerName
diagram GoldenRodLien_p103.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type employerName
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 56 
pattern ([A-Z0-9 ])* 
source <xs:element name="EmployerName" type="FF:employerName"/>

element AttorneyorRepWithoutNumber/Name
diagram GoldenRodLien_p104.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type PersonName
properties
isRef 0
minOcc 0
maxOcc 1
content complex
children FirstName MiddleInitial LastName
source <xs:element name="Name" type="PersonName" minOccurs="0"/>

element AttorneyorRepWithoutNumber/Address
diagram GoldenRodLien_p105.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type Address
properties
isRef 0
content complex
children AddressLine1 City State Zip5Code
source <xs:element name="Address" type="Address"/>

element AttorneyorRepWithoutNumber/PhoneNumber
diagram GoldenRodLien_p106.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type phoneNumber
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
maxLength 10 
pattern \d\d\d\d\d\d\d\d\d\d 
source <xs:element name="PhoneNumber" type="FF:phoneNumber" minOccurs="0"/>

complexType CheckBox
diagram GoldenRodLien_p107.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children Checkbox
used by
element LienClaimantAttorneyOrRep/LienClaimantNotRepresented
source <xs:complexType name="CheckBox">
 
<xs:sequence>
   
<xs:element name="Checkbox" type="CF:checkBox" default="false"/>
 
</xs:sequence>
</xs:complexType>

element CheckBox/Checkbox
diagram GoldenRodLien_p108.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type checkBox
properties
isRef 0
content simple
default false
facets
Kind Value annotation 
whiteSpace collapse 
source <xs:element name="Checkbox" type="CF:checkBox" default="false"/>

complexType DateRangeMandatory
diagram GoldenRodLien_p109.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children DateFrom DateTo
used by
element AmendedLienDomain/Dates
source <xs:complexType name="DateRangeMandatory">
 
<xs:sequence>
   
<xs:element name="DateFrom" type="CF:ptsDate"/>
   
<xs:element name="DateTo" type="CF:ptsDate"/>
 
</xs:sequence>
</xs:complexType>

element DateRangeMandatory/DateFrom
diagram GoldenRodLien_p110.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type ptsDate
properties
isRef 0
content simple
facets
Kind Value annotation 
pattern [0-1][0-9]/[0-3][0-9]/[1-2][0-9][0-9][0-9] 
source <xs:element name="DateFrom" type="CF:ptsDate"/>

element DateRangeMandatory/DateTo
diagram GoldenRodLien_p111.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type ptsDate
properties
isRef 0
content simple
facets
Kind Value annotation 
pattern [0-1][0-9]/[0-3][0-9]/[1-2][0-9][0-9][0-9] 
source <xs:element name="DateTo" type="CF:ptsDate"/>

complexType DoctorInformation
diagram GoldenRodLien_p112.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children Doctor DateOfDoctorReport
source <xs:complexType name="DoctorInformation">
 
<xs:sequence>
   
<xs:element name="Doctor">
     
<xs:simpleType>
       
<xs:restriction base="xs:string">
         
<xs:maxLength value="56"/>
         
<xs:minLength value="1"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
   
<xs:element name="DateOfDoctorReport" type="CF:ptsDate"/>
 
</xs:sequence>
</xs:complexType>

element DoctorInformation/Doctor
diagram GoldenRodLien_p113.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type restriction of xs:string
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 56 
source <xs:element name="Doctor">
 
<xs:simpleType>
   
<xs:restriction base="xs:string">
     
<xs:maxLength value="56"/>
     
<xs:minLength value="1"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

element DoctorInformation/DateOfDoctorReport
diagram GoldenRodLien_p114.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type ptsDate
properties
isRef 0
content simple
facets
Kind Value annotation 
pattern [0-1][0-9]/[0-3][0-9]/[1-2][0-9][0-9][0-9] 
source <xs:element name="DateOfDoctorReport" type="CF:ptsDate"/>

complexType EmployerName
diagram GoldenRodLien_p115.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children EmployerName
used by
complexType OrganizationInformation
source <xs:complexType name="EmployerName">
 
<xs:sequence>
   
<xs:element name="EmployerName">
     
<xs:simpleType>
       
<xs:restriction base="FF:sftField">
         
<xs:maxLength value="40"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
 
</xs:sequence>
</xs:complexType>

element EmployerName/EmployerName
diagram GoldenRodLien_p116.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type restriction of sftField
properties
isRef 0
content simple
facets
Kind Value annotation 
maxLength 40 
pattern ([A-Z0-9 ])* 
source <xs:element name="EmployerName">
 
<xs:simpleType>
   
<xs:restriction base="FF:sftField">
     
<xs:maxLength value="40"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

complexType InjuryInformation
diagram GoldenRodLien_p117.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children InjuryType DateOfInjuryStart DateOfInjuryEnd BodyPartInformation
source <xs:complexType name="InjuryInformation">
 
<xs:group ref="InjuryInformationGroup"/>
</xs:complexType>

complexType OrganizationInformation
diagram GoldenRodLien_p118.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type extension of EmployerName
properties
base EmployerName
children EmployerName Address
used by
elements GoldenRodLien/EmployerOrClaimsAdminAttorneySection GoldenRodLien/EmployerSection Signature/Firm SignatureAddressGroup/Firm GoldenRodLien/InsuranceCarrierOrClaimsAdministratorSection
source <xs:complexType name="OrganizationInformation">
 
<xs:complexContent>
   
<xs:extension base="EmployerName">
     
<xs:sequence>
       
<xs:element name="Address" type="Address"/>
     
</xs:sequence>
   
</xs:extension>
 
</xs:complexContent>
</xs:complexType>

element OrganizationInformation/Address
diagram GoldenRodLien_p119.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type Address
properties
isRef 0
content complex
children AddressLine1 City State Zip5Code
source <xs:element name="Address" type="Address"/>

complexType PersonInformation
diagram GoldenRodLien_p120.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children Name Address
used by
element GoldenRodLien/InjuredWorkerSection
source <xs:complexType name="PersonInformation">
 
<xs:sequence>
   
<xs:element name="Name" type="PersonName"/>
   
<xs:element name="Address" type="Address"/>
 
</xs:sequence>
</xs:complexType>

element PersonInformation/Name
diagram GoldenRodLien_p121.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type PersonName
properties
isRef 0
content complex
children FirstName MiddleInitial LastName
source <xs:element name="Name" type="PersonName"/>

element PersonInformation/Address
diagram GoldenRodLien_p122.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type Address
properties
isRef 0
content complex
children AddressLine1 City State Zip5Code
source <xs:element name="Address" type="Address"/>

complexType PersonName
diagram GoldenRodLien_p123.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children FirstName MiddleInitial LastName
used by
elements LienClaimantAttorneyOrRep/AttorneyOrRepWithoutNumber/Name AttorneyorRep/Name AttorneyorRepWithoutNumber/Name PersonInformation/Name
source <xs:complexType name="PersonName">
 
<xs:group ref="PersonNameGroup"/>
</xs:complexType>

complexType SelectionType126
diagram GoldenRodLien_p124.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children SelectionCheckbox Explanation
source <xs:complexType name="SelectionType126">
 
<xs:sequence>
   
<xs:element name="SelectionCheckbox" type="CF:checkBox" minOccurs="0"/>
   
<xs:element name="Explanation" minOccurs="0">
     
<xs:simpleType>
       
<xs:restriction base="xs:string">
         
<xs:maxLength value="126"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
 
</xs:sequence>
</xs:complexType>

element SelectionType126/SelectionCheckbox
diagram GoldenRodLien_p125.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type checkBox
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
whiteSpace collapse 
source <xs:element name="SelectionCheckbox" type="CF:checkBox" minOccurs="0"/>

element SelectionType126/Explanation
diagram GoldenRodLien_p126.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type restriction of xs:string
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
maxLength 126 
source <xs:element name="Explanation" minOccurs="0">
 
<xs:simpleType>
   
<xs:restriction base="xs:string">
     
<xs:maxLength value="126"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

complexType SelectionType129
diagram GoldenRodLien_p127.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children SelectionCheckbox Explanation
source <xs:complexType name="SelectionType129">
 
<xs:sequence>
   
<xs:element name="SelectionCheckbox" type="CF:checkBox" minOccurs="0"/>
   
<xs:element name="Explanation" minOccurs="0">
     
<xs:simpleType>
       
<xs:restriction base="xs:string">
         
<xs:maxLength value="129"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
 
</xs:sequence>
</xs:complexType>

element SelectionType129/SelectionCheckbox
diagram GoldenRodLien_p128.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type checkBox
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
whiteSpace collapse 
source <xs:element name="SelectionCheckbox" type="CF:checkBox" minOccurs="0"/>

element SelectionType129/Explanation
diagram GoldenRodLien_p129.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type restriction of xs:string
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
maxLength 129 
source <xs:element name="Explanation" minOccurs="0">
 
<xs:simpleType>
   
<xs:restriction base="xs:string">
     
<xs:maxLength value="129"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

complexType SelectionType84
diagram GoldenRodLien_p130.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children SelectionCheckbox Explanation
source <xs:complexType name="SelectionType84">
 
<xs:sequence>
   
<xs:element name="SelectionCheckbox" type="CF:checkBox" minOccurs="0"/>
   
<xs:element name="Explanation" minOccurs="0">
     
<xs:simpleType>
       
<xs:restriction base="xs:string">
         
<xs:maxLength value="84"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
 
</xs:sequence>
</xs:complexType>

element SelectionType84/SelectionCheckbox
diagram GoldenRodLien_p131.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type checkBox
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
whiteSpace collapse 
source <xs:element name="SelectionCheckbox" type="CF:checkBox" minOccurs="0"/>

element SelectionType84/Explanation
diagram GoldenRodLien_p132.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type restriction of xs:string
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
maxLength 84 
source <xs:element name="Explanation" minOccurs="0">
 
<xs:simpleType>
   
<xs:restriction base="xs:string">
     
<xs:maxLength value="84"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

complexType SelectionType85
diagram GoldenRodLien_p133.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children SelectionCheckbox Explanation
source <xs:complexType name="SelectionType85">
 
<xs:sequence>
   
<xs:element name="SelectionCheckbox" type="CF:checkBox" minOccurs="0"/>
   
<xs:element name="Explanation" minOccurs="0">
     
<xs:simpleType>
       
<xs:restriction base="xs:string">
         
<xs:maxLength value="85"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
 
</xs:sequence>
</xs:complexType>

element SelectionType85/SelectionCheckbox
diagram GoldenRodLien_p134.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type checkBox
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
whiteSpace collapse 
source <xs:element name="SelectionCheckbox" type="CF:checkBox" minOccurs="0"/>

element SelectionType85/Explanation
diagram GoldenRodLien_p135.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type restriction of xs:string
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
maxLength 85 
source <xs:element name="Explanation" minOccurs="0">
 
<xs:simpleType>
   
<xs:restriction base="xs:string">
     
<xs:maxLength value="85"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

complexType Signature
diagram GoldenRodLien_p136.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children DateOfSignature Firm DeclarantSignature
source <xs:complexType name="Signature">
 
<xs:sequence>
   
<xs:element name="DateOfSignature" type="CF:ptsDate"/>
   
<xs:element name="Firm" type="OrganizationInformation"/>
   
<xs:element name="DeclarantSignature">
     
<xs:simpleType>
       
<xs:restriction base="FF:signature">
         
<xs:minLength value="1"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
 
</xs:sequence>
</xs:complexType>

element Signature/DateOfSignature
diagram GoldenRodLien_p137.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
type ptsDate
properties
isRef 0
content simple
facets
Kind Value annotation 
pattern [0-1][0-9]/[0-3][0-9]/[1-2][0-9][0-9][0-9] 
source <