Schema SubmitFormsToEAMS.xsd


attribute form default:  unqualified
element form default:  qualified
targetNamespace:  http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
 
Elements  Complex types 
SubmitFormsToEAMS  FormInformation 
Header 
HeaderSection 


attribute form default:  unqualified
element form default:  qualified
targetNamespace:  http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/CoverSheet
 
Elements 
CoverSheet 


attribute form default:  unqualified
element form default:  qualified
targetNamespace:  http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
 
Complex types  Simple types 
Error  clientUserID 
VersionSection  dateSubmitted 
environment 
errorCode 
errorMessage 
errorSeverity 
errorTimestamp 
formSequenceNumber 
formShortName 
ipAddress 
logicalSystem 
message 
module 
packetID 
packetType 
payloadFormat 
payloadSchema 
resolutionAdvice 
resubmissionID 
resubmissionIND 
securityToken 
serviceNameCode 
serviceVersion 
testMessgeIND 
transactionID 
transportProtocol 


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 


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/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 


element SubmitFormsToEAMS
diagram SubmitFormsToEAMS_p1.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
properties
content complex
children HeaderSection Transactions
annotation
documentation
Comment describing your root element
source <xs:element name="SubmitFormsToEAMS">
 
<xs:annotation>
   
<xs:documentation>Comment describing your root element</xs:documentation>
 
</xs:annotation>
 
<xs:complexType>
   
<xs:sequence>
     
<xs:element name="HeaderSection" type="HeaderSection"/>
     
<xs:element name="Transactions">
       
<xs:complexType>
         
<xs:sequence>
           
<xs:element name="Transaction" maxOccurs="unbounded">
             
<xs:complexType>
               
<xs:sequence>
                 
<xs:element name="Header" type="Header"/>
                 
<xs:element name="Forms">
                   
<xs:complexType>
                     
<xs:sequence>
                       
<xs:element name="Form" type="FormInformation" maxOccurs="unbounded"/>
                     
</xs:sequence>
                   
</xs:complexType>
                 
</xs:element>
               
</xs:sequence>
             
</xs:complexType>
           
</xs:element>
         
</xs:sequence>
       
</xs:complexType>
     
</xs:element>
   
</xs:sequence>
 
</xs:complexType>
</xs:element>

element SubmitFormsToEAMS/HeaderSection
diagram SubmitFormsToEAMS_p2.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
type HeaderSection
properties
isRef 0
content complex
children VersionNumber
source <xs:element name="HeaderSection" type="HeaderSection"/>

element SubmitFormsToEAMS/Transactions
diagram SubmitFormsToEAMS_p3.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
properties
isRef 0
content complex
children Transaction
source <xs:element name="Transactions">
 
<xs:complexType>
   
<xs:sequence>
     
<xs:element name="Transaction" maxOccurs="unbounded">
       
<xs:complexType>
         
<xs:sequence>
           
<xs:element name="Header" type="Header"/>
           
<xs:element name="Forms">
             
<xs:complexType>
               
<xs:sequence>
                 
<xs:element name="Form" type="FormInformation" maxOccurs="unbounded"/>
               
</xs:sequence>
             
</xs:complexType>
           
</xs:element>
         
</xs:sequence>
       
</xs:complexType>
     
</xs:element>
   
</xs:sequence>
 
</xs:complexType>
</xs:element>

element SubmitFormsToEAMS/Transactions/Transaction
diagram SubmitFormsToEAMS_p4.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
properties
isRef 0
minOcc 1
maxOcc unbounded
content complex
children Header Forms
source <xs:element name="Transaction" maxOccurs="unbounded">
 
<xs:complexType>
   
<xs:sequence>
     
<xs:element name="Header" type="Header"/>
     
<xs:element name="Forms">
       
<xs:complexType>
         
<xs:sequence>
           
<xs:element name="Form" type="FormInformation" maxOccurs="unbounded"/>
         
</xs:sequence>
       
</xs:complexType>
     
</xs:element>
   
</xs:sequence>
 
</xs:complexType>
</xs:element>

element SubmitFormsToEAMS/Transactions/Transaction/Header
diagram SubmitFormsToEAMS_p5.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
type Header
properties
isRef 0
content complex
children TransactionID CoverSheet
source <xs:element name="Header" type="Header"/>

element SubmitFormsToEAMS/Transactions/Transaction/Forms
diagram SubmitFormsToEAMS_p6.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
properties
isRef 0
content complex
children Form
source <xs:element name="Forms">
 
<xs:complexType>
   
<xs:sequence>
     
<xs:element name="Form" type="FormInformation" maxOccurs="unbounded"/>
   
</xs:sequence>
 
</xs:complexType>
</xs:element>

element SubmitFormsToEAMS/Transactions/Transaction/Forms/Form
diagram SubmitFormsToEAMS_p7.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
type FormInformation
properties
isRef 0
minOcc 1
maxOcc unbounded
content complex
children FormShortName FormSequenceNumber FormData Attachments ResubmissionIndicator ResubmissionID
source <xs:element name="Form" type="FormInformation" maxOccurs="unbounded"/>

complexType FormInformation
diagram SubmitFormsToEAMS_p8.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
children FormShortName FormSequenceNumber FormData Attachments ResubmissionIndicator ResubmissionID
used by
element SubmitFormsToEAMS/Transactions/Transaction/Forms/Form
source <xs:complexType name="FormInformation">
 
<xs:sequence>
   
<xs:element name="FormShortName">
     
<xs:simpleType>
       
<xs:restriction base="PF:formShortName"/>
     
</xs:simpleType>
   
</xs:element>
   
<xs:element name="FormSequenceNumber" type="PF:formSequenceNumber"/>
   
<xs:element name="FormData" type="xs:anyType"/>
   
<xs:element name="Attachments" minOccurs="0">
     
<xs:complexType>
       
<xs:sequence>
         
<xs:element name="Attachment" maxOccurs="unbounded">
           
<xs:complexType>
             
<xs:sequence>
               
<xs:element name="DocTitle">
                 
<xs:simpleType>
                   
<xs:restriction base="xs:string">
                     
<xs:minLength value="1"/>
                     
<xs:maxLength value="250"/>
                   
</xs:restriction>
                 
</xs:simpleType>
               
</xs:element>
               
<xs:element name="AttachmentName">
                 
<xs:simpleType>
                   
<xs:restriction base="xs:string">
                     
<xs:maxLength value="250"/>
                     
<xs:minLength value="1"/>
                   
</xs:restriction>
                 
</xs:simpleType>
               
</xs:element>
               
<xs:element name="AttachmentBase64" type="xs:base64Binary"/>
               
<xs:element name="DocType">
                 
<xs:simpleType>
                   
<xs:restriction base="xs:string">
                     
<xs:maxLength value="50"/>
                   
</xs:restriction>
                 
</xs:simpleType>
               
</xs:element>
               
<xs:element name="Author">
                 
<xs:simpleType>
                   
<xs:restriction base="xs:string">
                     
<xs:maxLength value="40"/>
                   
</xs:restriction>
                 
</xs:simpleType>
               
</xs:element>
               
<xs:element name="DocDate" type="CF:ptsDate"/>
             
</xs:sequence>
           
</xs:complexType>
         
</xs:element>
       
</xs:sequence>
     
</xs:complexType>
   
</xs:element>
   
<xs:element name="ResubmissionIndicator" type="PF:resubmissionIND"/>
   
<xs:element name="ResubmissionID" type="PF:resubmissionID" minOccurs="0"/>
 
</xs:sequence>
</xs:complexType>

element FormInformation/FormShortName
diagram SubmitFormsToEAMS_p9.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
type restriction of formShortName
properties
isRef 0
content simple
facets
Kind Value annotation 
enumeration WCAB 1 
enumeration 10214(a) 
enumeration 10208.3 
enumeration WCAB 6 
enumeration 10208.2 
enumeration 10214(c) 
enumeration DE2581 
enumeration UFO 
enumeration 4903.05(c) 
source <xs:element name="FormShortName">
 
<xs:simpleType>
   
<xs:restriction base="PF:formShortName"/>
 
</xs:simpleType>
</xs:element>

element FormInformation/FormSequenceNumber
diagram SubmitFormsToEAMS_p10.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
type formSequenceNumber
properties
isRef 0
content simple
facets
Kind Value annotation 
minInclusive 
maxInclusive 9999 
source <xs:element name="FormSequenceNumber" type="PF:formSequenceNumber"/>

element FormInformation/FormData
diagram SubmitFormsToEAMS_p11.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
type xs:anyType
properties
isRef 0
content complex
mixed true
attributes
Name  Type  Use  Default  Fixed  annotation
source <xs:element name="FormData" type="xs:anyType"/>

element FormInformation/Attachments
diagram SubmitFormsToEAMS_p12.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
properties
isRef 0
minOcc 0
maxOcc 1
content complex
children Attachment
source <xs:element name="Attachments" minOccurs="0">
 
<xs:complexType>
   
<xs:sequence>
     
<xs:element name="Attachment" maxOccurs="unbounded">
       
<xs:complexType>
         
<xs:sequence>
           
<xs:element name="DocTitle">
             
<xs:simpleType>
               
<xs:restriction base="xs:string">
                 
<xs:minLength value="1"/>
                 
<xs:maxLength value="250"/>
               
</xs:restriction>
             
</xs:simpleType>
           
</xs:element>
           
<xs:element name="AttachmentName">
             
<xs:simpleType>
               
<xs:restriction base="xs:string">
                 
<xs:maxLength value="250"/>
                 
<xs:minLength value="1"/>
               
</xs:restriction>
             
</xs:simpleType>
           
</xs:element>
           
<xs:element name="AttachmentBase64" type="xs:base64Binary"/>
           
<xs:element name="DocType">
             
<xs:simpleType>
               
<xs:restriction base="xs:string">
                 
<xs:maxLength value="50"/>
               
</xs:restriction>
             
</xs:simpleType>
           
</xs:element>
           
<xs:element name="Author">
             
<xs:simpleType>
               
<xs:restriction base="xs:string">
                 
<xs:maxLength value="40"/>
               
</xs:restriction>
             
</xs:simpleType>
           
</xs:element>
           
<xs:element name="DocDate" type="CF:ptsDate"/>
         
</xs:sequence>
       
</xs:complexType>
     
</xs:element>
   
</xs:sequence>
 
</xs:complexType>
</xs:element>

element FormInformation/Attachments/Attachment
diagram SubmitFormsToEAMS_p13.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
properties
isRef 0
minOcc 1
maxOcc unbounded
content complex
children DocTitle AttachmentName AttachmentBase64 DocType Author DocDate
source <xs:element name="Attachment" maxOccurs="unbounded">
 
<xs:complexType>
   
<xs:sequence>
     
<xs:element name="DocTitle">
       
<xs:simpleType>
         
<xs:restriction base="xs:string">
           
<xs:minLength value="1"/>
           
<xs:maxLength value="250"/>
         
</xs:restriction>
       
</xs:simpleType>
     
</xs:element>
     
<xs:element name="AttachmentName">
       
<xs:simpleType>
         
<xs:restriction base="xs:string">
           
<xs:maxLength value="250"/>
           
<xs:minLength value="1"/>
         
</xs:restriction>
       
</xs:simpleType>
     
</xs:element>
     
<xs:element name="AttachmentBase64" type="xs:base64Binary"/>
     
<xs:element name="DocType">
       
<xs:simpleType>
         
<xs:restriction base="xs:string">
           
<xs:maxLength value="50"/>
         
</xs:restriction>
       
</xs:simpleType>
     
</xs:element>
     
<xs:element name="Author">
       
<xs:simpleType>
         
<xs:restriction base="xs:string">
           
<xs:maxLength value="40"/>
         
</xs:restriction>
       
</xs:simpleType>
     
</xs:element>
     
<xs:element name="DocDate" type="CF:ptsDate"/>
   
</xs:sequence>
 
</xs:complexType>
</xs:element>

element FormInformation/Attachments/Attachment/DocTitle
diagram SubmitFormsToEAMS_p14.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
type restriction of xs:string
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 250 
source <xs:element name="DocTitle">
 
<xs:simpleType>
   
<xs:restriction base="xs:string">
     
<xs:minLength value="1"/>
     
<xs:maxLength value="250"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

element FormInformation/Attachments/Attachment/AttachmentName
diagram SubmitFormsToEAMS_p15.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
type restriction of xs:string
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 250 
source <xs:element name="AttachmentName">
 
<xs:simpleType>
   
<xs:restriction base="xs:string">
     
<xs:maxLength value="250"/>
     
<xs:minLength value="1"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

element FormInformation/Attachments/Attachment/AttachmentBase64
diagram SubmitFormsToEAMS_p16.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
type xs:base64Binary
properties
isRef 0
content simple
source <xs:element name="AttachmentBase64" type="xs:base64Binary"/>

element FormInformation/Attachments/Attachment/DocType
diagram SubmitFormsToEAMS_p17.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
type restriction of xs:string
properties
isRef 0
content simple
facets
Kind Value annotation 
maxLength 50 
source <xs:element name="DocType">
 
<xs:simpleType>
   
<xs:restriction base="xs:string">
     
<xs:maxLength value="50"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

element FormInformation/Attachments/Attachment/Author
diagram SubmitFormsToEAMS_p18.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
type restriction of xs:string
properties
isRef 0
content simple
facets
Kind Value annotation 
maxLength 40 
source <xs:element name="Author">
 
<xs:simpleType>
   
<xs:restriction base="xs:string">
     
<xs:maxLength value="40"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

element FormInformation/Attachments/Attachment/DocDate
diagram SubmitFormsToEAMS_p19.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
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="DocDate" type="CF:ptsDate"/>

element FormInformation/ResubmissionIndicator
diagram SubmitFormsToEAMS_p20.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
type resubmissionIND
properties
isRef 0
content simple
facets
Kind Value annotation 
whiteSpace collapse 
source <xs:element name="ResubmissionIndicator" type="PF:resubmissionIND"/>

element FormInformation/ResubmissionID
diagram SubmitFormsToEAMS_p21.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
type resubmissionID
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
minLength 
maxLength 
source <xs:element name="ResubmissionID" type="PF:resubmissionID" minOccurs="0"/>

complexType Header
diagram SubmitFormsToEAMS_p22.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
children TransactionID CoverSheet
used by
element SubmitFormsToEAMS/Transactions/Transaction/Header
source <xs:complexType name="Header">
 
<xs:sequence>
   
<xs:element name="TransactionID">
     
<xs:simpleType>
       
<xs:restriction base="PF:transactionID">
         
<xs:minLength value="1"/>
         
<xs:maxLength value="23"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
   
<xs:element ref="CoverSheet:CoverSheet"/>
 
</xs:sequence>
</xs:complexType>

element Header/TransactionID
diagram SubmitFormsToEAMS_p23.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
type restriction of transactionID
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 23 
whiteSpace collapse 
source <xs:element name="TransactionID">
 
<xs:simpleType>
   
<xs:restriction base="PF:transactionID">
     
<xs:minLength value="1"/>
     
<xs:maxLength value="23"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

complexType HeaderSection
diagram SubmitFormsToEAMS_p24.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
children VersionNumber
used by
element SubmitFormsToEAMS/HeaderSection
source <xs:complexType name="HeaderSection">
 
<xs:sequence>
   
<xs:element name="VersionNumber" type="CF:versionNumber" fixed="1.2"/>
 
</xs:sequence>
</xs:complexType>

element HeaderSection/VersionNumber
diagram SubmitFormsToEAMS_p25.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Payloads/SubmitFormsToEAMS
type versionNumber
properties
isRef 0
content simple
fixed 1.2
source <xs:element name="VersionNumber" type="CF:versionNumber" fixed="1.2"/>

element CoverSheet
diagram SubmitFormsToEAMS_p26.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/CoverSheet
properties
content complex
children VersionNumber CaseNumber WalkThruIndicator CompanionCases Date
used by
complexType Header
annotation
documentation
Cover Sheet
source <xs:element name="CoverSheet">
 
<xs:annotation>
   
<xs:documentation>Cover Sheet</xs:documentation>
 
</xs:annotation>
 
<xs:complexType>
   
<xs:sequence>
     
<xs:element name="VersionNumber" type="CF:versionNumber" fixed="1.1"/>
     
<xs:element name="CaseNumber" type="CF:caseNumber" minOccurs="0"/>
     
<xs:element name="WalkThruIndicator" type="CF:checkBox"/>
     
<xs:element name="CompanionCases" minOccurs="0">
       
<xs:complexType>
         
<xs:sequence>
           
<xs:element name="CompanionCase" type="CF:caseNumber" maxOccurs="15"/>
         
</xs:sequence>
       
</xs:complexType>
     
</xs:element>
     
<xs:element name="Date" type="CF:ptsDate"/>
   
</xs:sequence>
 
</xs:complexType>
</xs:element>

element CoverSheet/VersionNumber
diagram SubmitFormsToEAMS_p27.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/CoverSheet
type versionNumber
properties
isRef 0
content simple
fixed 1.1
source <xs:element name="VersionNumber" type="CF:versionNumber" fixed="1.1"/>

element CoverSheet/CaseNumber
diagram SubmitFormsToEAMS_p28.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/CoverSheet
type caseNumber
properties
isRef 0
minOcc 0
maxOcc 1
content simple
facets
Kind Value annotation 
minLength 
maxLength 20 
pattern [A-Z][A-Z][A-Z]([0-9])* 
source <xs:element name="CaseNumber" type="CF:caseNumber" minOccurs="0"/>

element CoverSheet/WalkThruIndicator
diagram SubmitFormsToEAMS_p29.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/CoverSheet
type checkBox
properties
isRef 0
content simple
facets
Kind Value annotation 
whiteSpace collapse 
source <xs:element name="WalkThruIndicator" type="CF:checkBox"/>

element CoverSheet/CompanionCases
diagram SubmitFormsToEAMS_p30.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/CoverSheet
properties
isRef 0
minOcc 0
maxOcc 1
content complex
children CompanionCase
source <xs:element name="CompanionCases" minOccurs="0">
 
<xs:complexType>
   
<xs:sequence>
     
<xs:element name="CompanionCase" type="CF:caseNumber" maxOccurs="15"/>
   
</xs:sequence>
 
</xs:complexType>
</xs:element>

element CoverSheet/CompanionCases/CompanionCase
diagram SubmitFormsToEAMS_p31.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/CoverSheet
type caseNumber
properties
isRef 0
minOcc 1
maxOcc 15
content simple
facets
Kind Value annotation 
minLength 
maxLength 20 
pattern [A-Z][A-Z][A-Z]([0-9])* 
source <xs:element name="CompanionCase" type="CF:caseNumber" maxOccurs="15"/>

element CoverSheet/Date
diagram SubmitFormsToEAMS_p32.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Forms/CoverSheet
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="Date" type="CF:ptsDate"/>

complexType Error
diagram SubmitFormsToEAMS_p33.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
children ErrorCode ErrorPrimary ErrorSecondary
source <xs:complexType name="Error">
 
<xs:sequence>
   
<xs:element name="ErrorCode">
     
<xs:simpleType>
       
<xs:restriction base="errorCode">
         
<xs:minInclusive value="10000"/>
       
</xs:restriction>
     
</xs:simpleType>
   
</xs:element>
   
<xs:element name="ErrorPrimary" type="errorMessage"/>
   
<xs:element name="ErrorSecondary" type="errorMessage"/>
 
</xs:sequence>
</xs:complexType>

element Error/ErrorCode
diagram SubmitFormsToEAMS_p34.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of errorCode
properties
isRef 0
content simple
facets
Kind Value annotation 
minInclusive 10000 
maxInclusive 99999 
source <xs:element name="ErrorCode">
 
<xs:simpleType>
   
<xs:restriction base="errorCode">
     
<xs:minInclusive value="10000"/>
   
</xs:restriction>
 
</xs:simpleType>
</xs:element>

element Error/ErrorPrimary
diagram SubmitFormsToEAMS_p35.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type errorMessage
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 1056 
whiteSpace preserve 
source <xs:element name="ErrorPrimary" type="errorMessage"/>

element Error/ErrorSecondary
diagram SubmitFormsToEAMS_p36.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type errorMessage
properties
isRef 0
content simple
facets
Kind Value annotation 
minLength 
maxLength 1056 
whiteSpace preserve 
source <xs:element name="ErrorSecondary" type="errorMessage"/>

complexType VersionSection
diagram SubmitFormsToEAMS_p37.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
children VersionNumber
source <xs:complexType name="VersionSection">
 
<xs:sequence>
   
<xs:element name="VersionNumber" type="xs:float"/>
 
</xs:sequence>
</xs:complexType>

element VersionSection/VersionNumber
diagram SubmitFormsToEAMS_p38.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type xs:float
properties
isRef 0
content simple
source <xs:element name="VersionNumber" type="xs:float"/>

simpleType clientUserID
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
minLength 
maxLength 40 
annotation
documentation
Identifies the client submitting the forms.
source <xs:simpleType name="clientUserID">
 
<xs:annotation>
   
<xs:documentation>Identifies the client submitting the forms.</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="40"/>
   
<xs:minLength value="0"/>
 
</xs:restriction>
</xs:simpleType>

simpleType dateSubmitted
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type xs:date
properties
base xs:date
annotation
documentation
Date the form(s) were sent to PTS
source <xs:simpleType name="dateSubmitted">
 
<xs:annotation>
   
<xs:documentation>Date the form(s) were sent to PTS</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:date"/>
</xs:simpleType>

simpleType environment
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of typeCode3
properties
base CF:typeCode3
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration DEV 
enumeration TST 
enumeration UAT 
enumeration PRD 
annotation
documentation
'DEV' - Development,  'TST - Test, 'UAT' - User Acceptance, 'PRD' - Production
source <xs:simpleType name="environment">
 
<xs:annotation>
   
<xs:documentation> 'DEV' - Development,  'TST - Test, 'UAT' - User Acceptance, 'PRD' - Production
</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:typeCode3">
   
<xs:enumeration value="DEV"/>
   
<xs:enumeration value="TST"/>
   
<xs:enumeration value="UAT"/>
   
<xs:enumeration value="PRD"/>
 
</xs:restriction>
</xs:simpleType>

simpleType errorCode
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of xs:positiveInteger
properties
base xs:positiveInteger
used by
element Error/ErrorCode
facets
Kind Value annotation 
maxInclusive 99999 
annotation
documentation
5 digit code indicating the error.
source <xs:simpleType name="errorCode">
 
<xs:annotation>
   
<xs:documentation>5 digit code indicating the error.</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:positiveInteger">
   
<xs:maxInclusive value="99999"/>
 
</xs:restriction>
</xs:simpleType>

simpleType errorMessage
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of xs:string
properties
base xs:string
used by
elements Error/ErrorPrimary Error/ErrorSecondary
facets
Kind Value annotation 
minLength 
maxLength 1056 
whiteSpace preserve 
source <xs:simpleType name="errorMessage">
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="1056"/>
   
<xs:minLength value="1"/>
   
<xs:whiteSpace value="preserve"/>
 
</xs:restriction>
</xs:simpleType>

simpleType errorSeverity
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of typeCode1
properties
base CF:typeCode1
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration 
enumeration 
annotation
documentation
E - Error, W - Warning
source <xs:simpleType name="errorSeverity">
 
<xs:annotation>
   
<xs:documentation>E - Error, W - Warning</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:typeCode1">
   
<xs:enumeration value="E"/>
   
<xs:enumeration value="W"/>
 
</xs:restriction>
</xs:simpleType>

simpleType errorTimestamp
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type xs:dateTime
properties
base xs:dateTime
annotation
documentation
Date and Time the error occurred
source <xs:simpleType name="errorTimestamp">
 
<xs:annotation>
   
<xs:documentation>Date and Time the error occurred</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:dateTime"/>
</xs:simpleType>

simpleType formSequenceNumber
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of xs:positiveInteger
properties
base xs:positiveInteger
used by
element FormInformation/FormSequenceNumber
facets
Kind Value annotation 
minInclusive 
maxInclusive 9999 
source <xs:simpleType name="formSequenceNumber">
 
<xs:restriction base="xs:positiveInteger">
   
<xs:minInclusive value="1"/>
   
<xs:maxInclusive value="9999"/>
 
</xs:restriction>
</xs:simpleType>

simpleType formShortName
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of xs:string
properties
base xs:string
used by
element FormInformation/FormShortName
facets
Kind Value annotation 
enumeration WCAB 1 
enumeration 10214(a) 
enumeration 10208.3 
enumeration WCAB 6 
enumeration 10208.2 
enumeration 10214(c) 
enumeration DE2581 
enumeration UFO 
enumeration 4903.05(c) 
annotation
documentation
Unique form  ID
source <xs:simpleType name="formShortName">
 
<xs:annotation>
   
<xs:documentation>Unique form  ID</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:string">
   
<xs:enumeration value="WCAB 1"/>
   
<xs:enumeration value="10214(a)"/>
   
<xs:enumeration value="10208.3"/>
   
<xs:enumeration value="WCAB 6"/>
   
<xs:enumeration value="10208.2"/>
   
<xs:enumeration value="10214(c)"/>
   
<xs:enumeration value="DE2581"/>
   
<xs:enumeration value="UFO"/>
   
<xs:enumeration value="4903.05(c)"/>
   
<!-- start CR458 July 30th, 2015 form number changed  -->
   
<!--  xs:enumeration value="10252.1"/ -->
   
<!--  end CR458 July 30th, 2015 form number changed -->
   
<!-- START - Prakash Sankar - CR623 (WC Reform) - introduce the provider declaration form -->
   
<!-- END - Prakash Sankar - CR623 (WC Reform) - introduce the provider declaration form -->
 
</xs:restriction>
</xs:simpleType>

simpleType ipAddress
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
maxLength 80 
annotation
documentation
IP Address of the sender
source <xs:simpleType name="ipAddress">
 
<xs:annotation>
   
<xs:documentation>IP Address of the sender</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="80"/>
 
</xs:restriction>
</xs:simpleType>

simpleType logicalSystem
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
minLength 
maxLength 255 
enumeration EAMS 
annotation
documentation
Submitters System - company system name
source <xs:simpleType name="logicalSystem">
 
<xs:annotation>
   
<xs:documentation>Submitters System - company system name</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="255"/>
   
<xs:minLength value="1"/>
   
<xs:enumeration value="EAMS"/>
 
</xs:restriction>
</xs:simpleType>

simpleType message
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
minLength 
maxLength 255 
annotation
documentation
Mandatory EAMS response message.
source <xs:simpleType name="message">
 
<xs:annotation>
   
<xs:documentation>Mandatory EAMS response message.</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="255"/>
   
<xs:minLength value="0"/>
 
</xs:restriction>
</xs:simpleType>

simpleType module
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
maxLength 20 
annotation
documentation
Submitter, Poller, Validator, EAMS Batch
source <xs:simpleType name="module">
 
<xs:annotation>
   
<xs:documentation>Submitter, Poller, Validator, EAMS Batch</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="20"/>
 
</xs:restriction>
</xs:simpleType>

simpleType packetID
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
maxLength 255 
annotation
documentation
Convention:  XXXX-DATE-YYYY XXXX-SubmitterCode Date-Date(YYYYMMDD) YYYY-RunningSequenceNumber (1..9999)
source <xs:simpleType name="packetID">
 
<xs:annotation>
   
<xs:documentation>Convention:  XXXX-DATE-YYYY XXXX-SubmitterCode Date-Date(YYYYMMDD) YYYY-RunningSequenceNumber (1..9999)</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="255"/>
 
</xs:restriction>
</xs:simpleType>

simpleType packetType
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of typeCode3
properties
base CF:typeCode3
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration REQ 
enumeration REP 
enumeration ERR 
annotation
documentation
REQ- Request, REP- Reply, ERR - Error
source <xs:simpleType name="packetType">
 
<xs:annotation>
   
<xs:documentation>REQ- Request, REP- Reply, ERR - Error</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:typeCode3">
   
<xs:enumeration value="REQ"/>
   
<xs:enumeration value="REP"/>
   
<xs:enumeration value="ERR"/>
 
</xs:restriction>
</xs:simpleType>

simpleType payloadFormat
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of typeCode3
properties
base CF:typeCode3
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration XML 
annotation
documentation
XML
source <xs:simpleType name="payloadFormat">
 
<xs:annotation>
   
<xs:documentation>XML</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:typeCode3">
   
<xs:enumeration value="XML"/>
 
</xs:restriction>
</xs:simpleType>

simpleType payloadSchema
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
minLength 
maxLength 40 
annotation
documentation
the published schema
source <xs:simpleType name="payloadSchema">
 
<xs:annotation>
   
<xs:documentation>the published schema</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="40"/>
   
<xs:minLength value="0"/>
 
</xs:restriction>
</xs:simpleType>

simpleType resolutionAdvice
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
maxLength 255 
whiteSpace collapse 
source <xs:simpleType name="resolutionAdvice">
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="255"/>
   
<xs:whiteSpace value="collapse"/>
 
</xs:restriction>
</xs:simpleType>

simpleType resubmissionID
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of xs:string
properties
base xs:string
used by
element FormInformation/ResubmissionID
facets
Kind Value annotation 
minLength 
maxLength 
annotation
documentation
Resubmission ID Number
source <xs:simpleType name="resubmissionID">
 
<xs:annotation>
   
<xs:documentation>Resubmission ID Number</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="9"/>
   
<xs:minLength value="0"/>
 
</xs:restriction>
</xs:simpleType>

simpleType resubmissionIND
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type checkBox
properties
base CF:checkBox
used by
element FormInformation/ResubmissionIndicator
facets
Kind Value annotation 
whiteSpace collapse 
annotation
documentation
Defaults to 'false'
source <xs:simpleType name="resubmissionIND">
 
<xs:annotation>
   
<xs:documentation>Defaults to 'false'</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:checkBox"/>
</xs:simpleType>

simpleType securityToken
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
minLength 
maxLength 255 
source <xs:simpleType name="securityToken">
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="255"/>
   
<xs:minLength value="0"/>
 
</xs:restriction>
</xs:simpleType>

simpleType serviceNameCode
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of typeCode3
properties
base CF:typeCode3
facets
Kind Value annotation 
length 
whiteSpace collapse 
enumeration IN1 
enumeration OU1 
enumeration OU2 
enumeration OU3 
annotation
documentation

IN1 -SubmitFormsToEAMS,
OU1 -EAMSFilingResponse,
OU2 - EAMSPacketReceiveResponse,
OU3- EAMSPacketValidationResponse
source <xs:simpleType name="serviceNameCode">
 
<xs:annotation>
   
<xs:documentation>
IN1 -SubmitFormsToEAMS,
OU1 -EAMSFilingResponse,
OU2 - EAMSPacketReceiveResponse,
OU3- EAMSPacketValidationResponse
</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:typeCode3">
   
<xs:enumeration value="IN1"/>
   
<xs:enumeration value="OU1"/>
   
<xs:enumeration value="OU2"/>
   
<xs:enumeration value="OU3"/>
 
</xs:restriction>
</xs:simpleType>

simpleType serviceVersion
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
minLength 
maxLength 
annotation
documentation
PTS Version Number
source <xs:simpleType name="serviceVersion">
 
<xs:annotation>
   
<xs:documentation>PTS Version Number</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="5"/>
   
<xs:minLength value="1"/>
 
</xs:restriction>
</xs:simpleType>

simpleType testMessgeIND
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type checkBox
properties
base CF:checkBox
facets
Kind Value annotation 
whiteSpace collapse 
annotation
documentation
true if the message is a test message
source <xs:simpleType name="testMessgeIND">
 
<xs:annotation>
   
<xs:documentation>true if the message is a test message</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="CF:checkBox"/>
</xs:simpleType>

simpleType transactionID
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of xs:string
properties
base xs:string
used by
element Header/TransactionID
facets
Kind Value annotation 
minLength 
maxLength 256 
whiteSpace collapse 
annotation
documentation
Convention:  XXXX-DATE-YYYY-ZZZZZ XXXX-SubmitterCode Date-Date(YYYYMMDD)  YYYY-RunningSequenceNumber (1..9999)
ZZZZZ- RunningSequenceNumber (1...99999)
source <xs:simpleType name="transactionID">
 
<xs:annotation>
   
<xs:documentation>Convention:  XXXX-DATE-YYYY-ZZZZZ XXXX-SubmitterCode Date-Date(YYYYMMDD)  YYYY-RunningSequenceNumber (1..9999)
ZZZZZ- RunningSequenceNumber (1...99999)
</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="256"/>
   
<xs:whiteSpace value="collapse"/>
   
<xs:minLength value="1"/>
 
</xs:restriction>
</xs:simpleType>

simpleType transportProtocol
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/PayloadFields
type restriction of xs:string
properties
base xs:string
facets
Kind Value annotation 
maxLength 40 
annotation
documentation
SFTP
source <xs:simpleType name="transportProtocol">
 
<xs:annotation>
   
<xs:documentation>SFTP</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="40"/>
 
</xs:restriction>
</xs:simpleType>

simpleType caseNumber
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/CommonFields
type restriction of xs:string
properties
base xs:string
used by
elements CoverSheet/CaseNumber CoverSheet/CompanionCases/CompanionCase
facets
Kind Value annotation 
minLength 
maxLength 20 
pattern [A-Z][A-Z][A-Z]([0-9])* 
source <xs:simpleType name="caseNumber">
 
<xs:restriction base="xs:string">
   
<xs:maxLength value="20"/>
   
<xs:minLength value="4"/>
   
<xs:pattern value="[A-Z][A-Z][A-Z]([0-9])*"/>
 
</xs:restriction>
</xs:simpleType>

simpleType checkBox
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/CommonFields
type restriction of xs:boolean
properties
base xs:boolean
used by
elements CheckBox/Checkbox SelectionType129/SelectionCheckbox SelectionType85/SelectionCheckbox SelectionType84/SelectionCheckbox SelectionType126/SelectionCheckbox CoverSheet/WalkThruIndicator
simpleTypes initialCheckBox resubmissionIND testMessgeIND
facets
Kind Value annotation 
whiteSpace collapse 
source <xs:simpleType name="checkBox">
 
<xs:restriction base="xs:boolean">
   
<xs:whiteSpace value="collapse"/>
 
</xs:restriction>
</xs:simpleType>

simpleType ptsDate
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/CommonFields
type restriction of xs:string
properties
base xs:string
used by
elements CoverSheet/Date StartAndEndDate/DateEnds DateRangeMandatory/DateFrom DoctorInformation/DateOfDoctorReport InjuryTypeAndDates/DateOfInjuryEnd InjuryTypeAndDates/DateOfInjuryStart Signature/DateOfSignature SignatureAddressGroup/DateOfSignature DeclarantSignatureGroup/DateOfSignature StartAndEndDate/DateStarts DateRangeMandatory/DateTo FormInformation/Attachments/Attachment/DocDate
facets
Kind Value annotation 
pattern [0-1][0-9]/[0-3][0-9]/[1-2][0-9][0-9][0-9] 
source <xs:simpleType name="ptsDate">
 
<xs:restriction base="xs:string">
   
<xs:pattern value="[0-1][0-9]/[0-3][0-9]/[1-2][0-9][0-9][0-9]"/>
 
</xs:restriction>
</xs:simpleType>

simpleType typeCode1
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/CommonFields
type restriction of xs:string
properties
base xs:string
used by
simpleTypes attorneyorAuthRepTypeCode employerRoleTypeCode errorSeverity fileOnBehalfTypeCode filerRoleTypeCode hearingTypeCode injuryTypeCode laborAdjustmentTypeCode venueLocationTypeCode
facets
Kind Value annotation 
length 
whiteSpace collapse 
source <xs:simpleType name="typeCode1">
 
<xs:restriction base="xs:string">
   
<xs:length value="1" fixed="true"/>
   
<xs:whiteSpace value="collapse"/>
 
</xs:restriction>
</xs:simpleType>

simpleType typeCode3
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/CommonFields
type restriction of xs:string
properties
base xs:string
used by
simpleTypes bodyPart environment lienUnemploymentCompensationType packetType payloadFormat serviceNameCode venueOfficeCode
facets
Kind Value annotation 
length 
whiteSpace collapse 
source <xs:simpleType name="typeCode3">
 
<xs:restriction base="xs:string">
   
<xs:length value="3" fixed="true"/>
   
<xs:whiteSpace value="collapse"/>
 
</xs:restriction>
</xs:simpleType>

simpleType versionNumber
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/CommonFields
type xs:float
properties
base xs:float
used by
elements CoverSheet/VersionNumber HeaderSection/VersionNumber
annotation
documentation
PTS Version Number
source <xs:simpleType name="versionNumber">
 
<xs:annotation>
   
<xs:documentation>PTS Version Number</xs:documentation>
 
</xs:annotation>
 
<xs:restriction base="xs:float"/>
</xs:simpleType>

group AddressGroup
diagram SubmitFormsToEAMS_p39.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 SubmitFormsToEAMS_p40.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 SubmitFormsToEAMS_p41.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 SubmitFormsToEAMS_p42.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 SubmitFormsToEAMS_p43.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 SubmitFormsToEAMS_p44.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 SubmitFormsToEAMS_p45.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 SubmitFormsToEAMS_p46.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 SubmitFormsToEAMS_p47.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 SubmitFormsToEAMS_p48.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 SubmitFormsToEAMS_p49.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 SubmitFormsToEAMS_p50.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 SubmitFormsToEAMS_p51.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 SubmitFormsToEAMS_p52.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 SubmitFormsToEAMS_p53.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 SubmitFormsToEAMS_p54.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 SubmitFormsToEAMS_p55.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 SubmitFormsToEAMS_p56.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 SubmitFormsToEAMS_p57.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children InjuryType DateOfInjuryStart DateOfInjuryEnd
used by
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 SubmitFormsToEAMS_p58.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 SubmitFormsToEAMS_p59.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 SubmitFormsToEAMS_p60.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 SubmitFormsToEAMS_p61.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children FirstName MiddleInitial LastName
used by
complexType 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 SubmitFormsToEAMS_p62.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 SubmitFormsToEAMS_p63.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 SubmitFormsToEAMS_p64.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 SubmitFormsToEAMS_p65.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 SubmitFormsToEAMS_p66.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 SubmitFormsToEAMS_p67.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 SubmitFormsToEAMS_p68.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 SubmitFormsToEAMS_p69.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 SubmitFormsToEAMS_p70.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 SubmitFormsToEAMS_p71.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 SubmitFormsToEAMS_p72.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 SubmitFormsToEAMS_p73.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 SubmitFormsToEAMS_p74.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children AddressLine1 City State Zip5Code
used by
elements AttorneyorRep/Address AttorneyorRepWithoutNumber/Address OrganizationInformation/Address PersonInformation/Address
source <xs:complexType name="Address">
 
<xs:group ref="AddressGroup"/>
</xs:complexType>

complexType AttorneyorRep
diagram SubmitFormsToEAMS_p75.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 SubmitFormsToEAMS_p76.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 SubmitFormsToEAMS_p77.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 SubmitFormsToEAMS_p78.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 SubmitFormsToEAMS_p79.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 SubmitFormsToEAMS_p80.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 SubmitFormsToEAMS_p81.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children AttorneyorAuthRepTypeCode EmployerName Name Address PhoneNumber
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 SubmitFormsToEAMS_p82.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 SubmitFormsToEAMS_p83.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 SubmitFormsToEAMS_p84.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 SubmitFormsToEAMS_p85.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 SubmitFormsToEAMS_p86.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 SubmitFormsToEAMS_p87.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children Checkbox
source <xs:complexType name="CheckBox">
 
<xs:sequence>
   
<xs:element name="Checkbox" type="CF:checkBox" default="false"/>
 
</xs:sequence>
</xs:complexType>

element CheckBox/Checkbox
diagram SubmitFormsToEAMS_p88.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 SubmitFormsToEAMS_p89.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children DateFrom DateTo
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 SubmitFormsToEAMS_p90.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 SubmitFormsToEAMS_p91.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 SubmitFormsToEAMS_p92.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 SubmitFormsToEAMS_p93.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 SubmitFormsToEAMS_p94.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 SubmitFormsToEAMS_p95.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 SubmitFormsToEAMS_p96.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 SubmitFormsToEAMS_p97.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 SubmitFormsToEAMS_p98.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 Signature/Firm SignatureAddressGroup/Firm
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 SubmitFormsToEAMS_p99.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 SubmitFormsToEAMS_p100.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children Name Address
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 SubmitFormsToEAMS_p101.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 SubmitFormsToEAMS_p102.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 SubmitFormsToEAMS_p103.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children FirstName MiddleInitial LastName
used by
elements AttorneyorRep/Name AttorneyorRepWithoutNumber/Name PersonInformation/Name
source <xs:complexType name="PersonName">
 
<xs:group ref="PersonNameGroup"/>
</xs:complexType>

complexType SelectionType126
diagram SubmitFormsToEAMS_p104.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 SubmitFormsToEAMS_p105.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 SubmitFormsToEAMS_p106.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 SubmitFormsToEAMS_p107.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 SubmitFormsToEAMS_p108.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 SubmitFormsToEAMS_p109.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 SubmitFormsToEAMS_p110.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 SubmitFormsToEAMS_p111.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 SubmitFormsToEAMS_p112.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 SubmitFormsToEAMS_p113.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 SubmitFormsToEAMS_p114.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 SubmitFormsToEAMS_p115.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 SubmitFormsToEAMS_p116.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 SubmitFormsToEAMS_p117.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 Signature/Firm
diagram SubmitFormsToEAMS_p118.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 Signature/DeclarantSignature
diagram SubmitFormsToEAMS_p119.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>

complexType Signatures
diagram SubmitFormsToEAMS_p120.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children DateOfSignature Firm DeclarantSignature
source <xs:complexType name="Signatures">
 
<xs:group ref="SignatureAddressGroup"/>
</xs:complexType>

complexType StartAndEndDate
diagram SubmitFormsToEAMS_p121.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children DateStarts DateEnds
source <xs:complexType name="StartAndEndDate">
 
<xs:sequence>
   
<xs:element name="DateStarts" type="CF:ptsDate" minOccurs="0"/>
   
<xs:element name="DateEnds" type="CF:ptsDate" minOccurs="0"/>
 
</xs:sequence>
</xs:complexType>

element StartAndEndDate/DateStarts
diagram SubmitFormsToEAMS_p122.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
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] 
source <xs:element name="DateStarts" type="CF:ptsDate" minOccurs="0"/>

element StartAndEndDate/DateEnds
diagram SubmitFormsToEAMS_p123.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
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] 
source <xs:element name="DateEnds" type="CF:ptsDate" minOccurs="0"/>

complexType VenueInformation
diagram SubmitFormsToEAMS_p124.png
namespace http://www.dir.ca.gov/dwc/EAMS/PresentTermSolution/Schemas/Common/Formdomains
children VenueLocationCode VenueOfficeCode
source <xs:complexType name="VenueInformation">
 
<xs:group ref="VenueInformationGroup"/>
</xs:complexType>

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
element EarningAmountGroup/EarningsAmount
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 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 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' - LienClaimant
source <xs:simpleType name="filerRoleTypeCode">
 
<xs:annotation>
   
<xs:documentation> Filer Role Type
Valid Values
'E' - Employee
'A' - Applicant
'D' - Defendant
'L' - LienClaimant
</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
element DeclarantSignatureGroup/DeclarantOrLawFirmName
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
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 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
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
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>


XML Schema documentation generated by XMLSpy Schema Editor http://www.altova.com/xmlspy