SAIF.Business.Claim.Maintenance operations and processes

This page is the operation catalog and cross-operation hub for SAIF.Business.Claim.Maintenance. The library exposes twelve operations covering claim-header maintenance, accident/injury data, claim adjustments executed through Oracle packages, and the ancillary collections (support orders, vocational data, disability activity, work release/status, medical conditions, COVID-19 testing, policy history, attending physicians) that hang off a claim. Each operation's detailed, step-by-step logic lives in its own page under operations/.

Operation catalog

Operation	Intent	Trigger	Inputs	Outputs	Rules	Tables	SQL
Claim detail CRUD	Retrieve and update the core claim header and its dependent child collections	clsClaimDetail.GetClaimDetail(dpi, claimID) followed by property edits and Save()	ClaimID, mutable CL_INJURY_CLAIM header fields, UpdateNum, IDataPortalInfo	Populated claim-detail object; persisted header update; derived pharmacy/legal-rep/policy side effects	BR-CM-001, BR-CM-009, BR-CM-010, BR-CM-011, BR-CM-012, BR-CM-013, BR-CM-014, BR-CM-015, BR-CM-016, BR-CM-017, BR-CM-018, BR-CM-019, BR-CM-020, BR-CM-021, BR-CM-022, BR-CM-023, BR-CM-024, BR-CM-025, BR-CM-026, BR-CM-027, BR-CM-028, BR-CM-029, BR-CM-030, BR-CM-031, BR-CM-032, BR-CM-033, BR-CM-034, BR-CM-035, BR-CM-036, BR-CM-037, BR-CM-038, BR-CM-039	CL_INJURY_CLAIM, CL_MERGED_CLAIM, CL_MEDICAL_CONDITION, CL_CLAIM_LEGAL_REPRESENTATIVE, MCO_GSA_LOCATION, CL_CLAIM_PERSON, CL_BENEFIT_PERIOD	SQL-032, SQL-033, SQL-034, SQL-035, SQL-036, SQL-037, SQL-038, SQL-039, SQL-040, SQL-041, SQL-086, SQL-087
Accident injury management	Maintain injury date, injury circumstances, and injury address on a claim	clsAccidentInjury.GetAccidentInjury(dpi, claimID) followed by property edits and Save()	ClaimID, injury/exposure fields, injury address, supporting claim dates	Updated CL_INJURY_CLAIM row; conditional three-day-wait deletion; federal awards set to pending	BR-CM-001, BR-CM-040, BR-CM-041, BR-CM-042, BR-CM-043, BR-CM-044, BR-CM-045, BR-CM-046, BR-CM-047, BR-CM-048, BR-CM-049, BR-CM-050, BR-CM-051, BR-CM-052, BR-CM-053, BR-CM-054, BR-CM-055, BR-CM-056, BR-CM-057, BR-CM-058	CL_INJURY_CLAIM, CL_CLAIM_PERSON, ZIP_MCO_COUNTY, CL_DISABILITY_AUTH_ACTIVITY, CL_MEDICAL_CONDITION, CL_CLAIM_REQUEST_DECISION, CL_CLAIM_WORK_RELEASE_STATUS, CL_CLAIM_TD_THREE_DAY_WAIT	SQL-021, SQL-022, SQL-023, SQL-024, SQL-025, SQL-026, SQL-027, SQL-081, SQL-106
Claim adjustment	Void, combine, transfer, or restore a claim through PK82140_CLAIM_ADJUSTMENTS	Caller selects an AdjustmentAction, populates the matching context objects, and calls Save()	Adjustment type selector, current claim, combine claim, transfer worker and claim collection, acting user	Stored-function row count per adjustment; broken rules on validation or contention failure	BR-CM-007, BR-PROC-001, BR-PROC-002, BR-PROC-003	CL_INJURY_CLAIM, CL_CLAIM_PERSON	SQL-029, SQL-030, SQL-031, SQL-082, SQL-083, SQL-084, SQL-085
Support order management	Create, update, delete, and connect child-support withholding orders for a worker	Caller invokes the support-order factories or collection retrieve and calls Save()	WorkerID, order fields, selected claim connections, acting user	Persisted support order and connection rows; generated to-do tasks; validation errors and warnings	BR-CM-001, BR-CM-002, BR-CM-003, BR-CM-004, BR-CM-005, BR-CM-006, BR-CM-008	CL_CLAIM_SUPPORT_ORDER_CONN, CL_INJURY_CLAIM, DUAL	SQL-001, SQL-002, SQL-008, SQL-009, SQL-049, SQL-050, SQL-051, SQL-052, SQL-054, SQL-055, SQL-056, SQL-057, SQL-058, SQL-059, SQL-060, SQL-092, SQL-110, SQL-111
Vocational data retrieval	Load and maintain the vocational-detail history for a claim	clsVocationalDetailCollection.GetVocationalDetails(dpi, claimID) and collection Save()	ClaimID, vocational status/date, rehab provider, counselor, responsibility code	Populated vocational-detail collection; inserted/updated/deleted detail rows; synchronized claim responsibility code	BR-CM-001	VOCATIONAL_DETAIL, CL_INJURY_CLAIM	SQL-017, SQL-073, SQL-099, SQL-118
Vocational coordinators	Resolve and cache the vocational reference lists used to validate a vocational detail	Any read of the coordinator, provider, status, or status-detail lists, or rule evaluation during IsValid	IDataPortalInfo only — the lookups are process-wide reference data	Cached coordinator, provider, status, and status-detail lookups; resolved display names; validation errors	None catalogued*	None documented*	None catalogued*
Disability activity tracking	Maintain disability status activity and disability authorization activity history for a claim	Caller retrieves either activity collection, edits or adds items, and calls Save()	ClaimID, disability date, authorization reason code and date, sequence numbers, UpdateNum	Persisted activity rows; latest/current activity items; max disability date used by the claim header	BR-CM-001	CL_CLAIM_DISABILITY_ACTIVITY, CL_DISABILITY_AUTH_ACTIVITY, CL_INJURY_CLAIM	SQL-003, SQL-013, SQL-042, SQL-043, SQL-064, SQL-065, SQL-088, SQL-095, SQL-107, SQL-114
Work release/status management	Maintain work release and work status history under the injury-claim aggregate	Caller retrieves clsWorkStatusInjuryClaim, adds or edits rows, and calls Save()	ClaimID, work release/status codes and dates, sequence numbers, UpdateNum, leave-work date	Persisted work release and work status rows; updated claim header dates; broken-rule collection	BR-CM-001	CL_CLAIM_WORK_RELEASE_STATUS, CL_CLAIM_WORK_STATUS, CL_INJURY_CLAIM	SQL-018, SQL-019, SQL-074, SQL-075, SQL-076, SQL-100, SQL-101, SQL-102, SQL-119, SQL-120
Medical condition management	Maintain medical conditions, omitted conditions, and their compensability decision history	Caller retrieves the condition collections, edits conditions or decisions, and calls Save()	Claim data, condition fields, diagnosis codes, decision and denial fields	Persisted condition, decision, and omitted-condition rows; generated claim tasks; validation messages	BR-CM-001	CL_MEDICAL_CONDITION, CL_COND_COMPENSABILITY_DECISN, CL_OMITTED_COND_DENIED, CBP_DIAGNOSIS	SQL-011, SQL-014, SQL-015, SQL-062, SQL-067, SQL-068, SQL-069, SQL-071, SQL-094, SQL-096, SQL-097, SQL-115, SQL-116
COVID-19 testing history	Append and read the COVID-19 testing history for a claim	NewCovid19TestingHistory or GetCovid19TestingHistoryCollection, followed by Save()	ClaimID, tested-for-COVID-19 flag, test result code, acting user	Inserted testing-history rows; history collection ordered by create date descending	None registered*	CL_COVID19_TESTING_HISTORY	SQL-012, SQL-063
Policy history tracking	Record policy-number changes on a claim as an append-only policy history	Caller sets clsClaimPolicy.PolicyNum and calls Save(); the history page retrieves read-only	ClaimID, new policy number, policy sub-code, acting user	Updated claim header policy fields; inserted policy-history rows; in-memory history collection	BR-CM-001	CL_INJURY_CLAIM, CL_CLAIM_POLICY_HISTORY	SQL-005, SQL-045, SQL-046, SQL-089
Attending physician retrieval	Read attending physicians and alternate care providers for a claim from the claim-contacts API	clsAttendingPhysicianCollection.GetAttendingPhysicians(dpi, claimID)	IDataPortalInfo, ClaimID	Read-only collection of attending physicians with resolved termination reasons	None documented*	ATTENDING_PHYS_EXP_REASON_CODE	SQL-028

Process flow diagram

The following diagram shows how the twelve operations relate across the claim-maintenance lifecycle: a claim is retrieved, its header and injury data are maintained, ancillary collections are edited, adjustments are executed through Oracle packages, and all changes converge on a save that enforces optimistic concurrency.

flowchart TD
    Start([Caller requests claim maintenance]) --> Retrieve[Retrieve claim context<br>by ClaimID or WorkerID]
    Retrieve --> Header[Claim header maintenance]
    Header --> Detail[Claim detail CRUD]
    Header --> Injury[Accident injury management]
    Header --> Policy[Policy history tracking]
    Retrieve --> Ancillary[Ancillary claim collections]
    Ancillary --> Conditions[Medical condition management]
    Ancillary --> Disability[Disability activity tracking]
    Ancillary --> WorkRel[Work release and status management]
    Ancillary --> Voc[Vocational data retrieval]
    Voc --> VocRef[Vocational coordinators<br>cached reference lookups]
    Ancillary --> Covid[COVID-19 testing history]
    Ancillary --> Support[Support order management]
    Retrieve --> External[Attending physician retrieval<br>claim contacts API]
    Retrieve --> Adjust{Claim adjustment<br>requested?}
    Adjust -->|Yes| Proc[Void, combine, transfer,<br>or restore via PK82140]
    Adjust -->|No| Edit[Caller edits properties]
    Detail --> Edit
    Injury --> Edit
    Policy --> Edit
    Conditions --> Edit
    Disability --> Edit
    WorkRel --> Edit
    Voc --> Edit
    Covid --> Edit
    Support --> Edit
    Edit --> Validate{Validation rules pass?}
    Validate -->|No| Errors([Broken rules returned;<br>changes retained in memory])
    Validate -->|Yes| Save[Save cascade:<br>children then header]
    Save --> Concurrency{RowsAffected = 1?}
    Proc --> Concurrency
    Concurrency -->|Yes| Done([Changes persisted;<br>objects marked clean])
    Concurrency -->|No| Contention([DB contention error added;<br>save reported as failed])
    External --> ReadOnly([Read-only projection returned])

Database interactions

The following table summarizes which operations read from or write to the database. Per-step SQL and table citations live in each operation's detail page under operations/.

Operation	SQL	Tables	Type
Claim detail CRUD	SQL-032, SQL-033, SQL-034, SQL-035, SQL-036, SQL-037, SQL-038, SQL-039, SQL-040, SQL-041, SQL-086, SQL-087	CL_INJURY_CLAIM, CL_MERGED_CLAIM, CL_MEDICAL_CONDITION, CL_CLAIM_LEGAL_REPRESENTATIVE, MCO_GSA_LOCATION, CL_CLAIM_PERSON, CL_BENEFIT_PERIOD	Read / Write
Accident injury management	SQL-021, SQL-022, SQL-023, SQL-024, SQL-025, SQL-026, SQL-027, SQL-081, SQL-106	CL_INJURY_CLAIM, ZIP_MCO_COUNTY, CL_CLAIM_TD_THREE_DAY_WAIT	Read / Write
Claim adjustment	SQL-029, SQL-030, SQL-031, SQL-082, SQL-083, SQL-084, SQL-085	CL_INJURY_CLAIM, CL_CLAIM_PERSON	Read / Write (stored procedure)
Support order management	SQL-001, SQL-008, SQL-009, SQL-054, SQL-059, SQL-060, SQL-092, SQL-110, SQL-111	CL_CLAIM_SUPPORT_ORDER_CONN, CL_INJURY_CLAIM, DUAL	Read / Write (stored procedure)
Vocational data retrieval	SQL-017, SQL-073, SQL-099, SQL-118	VOCATIONAL_DETAIL, CL_INJURY_CLAIM	Read / Write
Vocational coordinators	None catalogued*	None documented*	Read (cached reference data)
Disability activity tracking	SQL-003, SQL-013, SQL-042, SQL-043, SQL-064, SQL-065, SQL-088, SQL-095, SQL-107, SQL-114	CL_CLAIM_DISABILITY_ACTIVITY, CL_DISABILITY_AUTH_ACTIVITY, CL_INJURY_CLAIM	Read / Write
Work release/status management	SQL-018, SQL-019, SQL-074, SQL-075, SQL-076, SQL-100, SQL-101, SQL-102, SQL-119, SQL-120	CL_CLAIM_WORK_RELEASE_STATUS, CL_CLAIM_WORK_STATUS, CL_INJURY_CLAIM	Read / Write
Medical condition management	SQL-011, SQL-014, SQL-015, SQL-062, SQL-067, SQL-068, SQL-069, SQL-071, SQL-094, SQL-096, SQL-097, SQL-115, SQL-116	CL_MEDICAL_CONDITION, CL_COND_COMPENSABILITY_DECISN, CL_OMITTED_COND_DENIED, CBP_DIAGNOSIS	Read / Write
COVID-19 testing history	SQL-012, SQL-063	CL_COVID19_TESTING_HISTORY	Read / Insert only
Policy history tracking	SQL-005, SQL-045, SQL-046, SQL-089	CL_INJURY_CLAIM, CL_CLAIM_POLICY_HISTORY	Read / Write (history is insert only)
Attending physician retrieval	SQL-028	ATTENDING_PHYS_EXP_REASON_CODE	Read (plus external REST call)

Stored procedure operations

Operations implemented in Oracle packages referenced by this library.

Operation	Description	Source	Link
Void claim	Voids an active claim and returns a rows-affected count for the contention check.	PK82140_CLAIM_ADJUSTMENTS.VoidClaim	Details
Combine claim	Combines the current claim into another claim for the same worker and policy.	PK82140_CLAIM_ADJUSTMENTS.CombineClaim	Details
Transfer claim	Transfers one claim at a time to a different worker.	PK82140_CLAIM_ADJUSTMENTS.TransferClaim	Details
Restore claim	Restores a voided claim to its own current worker.	PK82140_CLAIM_ADJUSTMENTS.RestoreClaim	Details
Support order persistence and checks	Insert, update, delete, award/payment existence checks, connection reads, and to-do task determination for support orders.*	PK82141_SUPPORT_ORDER.*	Details
Vocational data reads	Vocational-detail retrieval by claim and the coordinator reference list.*	PK82003_VOCDATA.*	Details

Failure and edge-case behavior

• Optimistic concurrency is the dominant failure mode: every persisting operation checks the affected row count and adds a DB contention error instead of throwing (BR-CM-001). Detailed per-operation behavior is documented on each operation page.
• Retrieve paths generally return an empty or unfilled object when no row matches, rather than raising a not-found error; callers must check the populated state themselves.
• Warning-severity rules (nearby-claim, payment-about-to-be-issued, closed-claim medically-stationary date, policy coverage) surface messages without blocking the save.
• Claim transfer is the only adjustment that loops over multiple claims; it stops at the first contention failure and leaves the remaining claims untransferred.
• PK82141_SUPPORT_ORDER and PK82003_VOCDATA could not be located in the Oracle catalog, so the behavior documented for those calls is derived from the VB call sites and parameter shapes rather than verified package bodies.*
• Attending physician retrieval depends on an external REST service and is read-only; its collection save always returns false.

Related documentation

• Index
• Overview
• Architecture
• Dependencies
• Business rules
• Database tables
• SQL catalog
• Procedures
• API reference

Note: Statements marked with * were inferred from code structure, naming conventions, or contextual evidence where direct confirmation was not available in source artifacts.

Sources

• Business\SAIF.Business.Claim.Maintenance\clsClaimDetail.vb
• Business\SAIF.Business.Claim.Maintenance\clsAccidentInjury.vb
• Business\SAIF.Business.Claim.Maintenance\clsClaimAdjustment.vb
• Business\SAIF.Business.Claim.Maintenance\clsClaimSupportOrder.vb
• Business\SAIF.Business.Claim.Maintenance\clsClaimSupportOrderCollection.vb
• Business\SAIF.Business.Claim.Maintenance\clsClaimSupportOrderConn.vb
• Business\SAIF.Business.Claim.Maintenance\clsClaimSupportOrderConnCollection.vb
• Business\SAIF.Business.Claim.Maintenance\clsVocationalDetail.vb
• Business\SAIF.Business.Claim.Maintenance\clsVocationalDetailCollection.vb
• Business\SAIF.Business.Claim.Maintenance\clsVocationalStatusDetail.vb
• Business\SAIF.Business.Claim.Maintenance\clsClaimDisabilityActivity.vb
• Business\SAIF.Business.Claim.Maintenance\clsClaimDisabilityActivityCollection.vb
• Business\SAIF.Business.Claim.Maintenance\clsDisabilityAuthActivity.vb
• Business\SAIF.Business.Claim.Maintenance\clsDisabilityAuthActivityCollection.vb
• Business\SAIF.Business.Claim.Maintenance\clsWorkRelease.vb
• Business\SAIF.Business.Claim.Maintenance\clsWorkReleaseCollection.vb
• Business\SAIF.Business.Claim.Maintenance\clsWorkStatus.vb
• Business\SAIF.Business.Claim.Maintenance\clsWorkStatusCollection.vb
• Business\SAIF.Business.Claim.Maintenance\clsWorkStatusInjuryClaim.vb
• Business\SAIF.Business.Claim.Maintenance\clsMedicalCondition.vb
• Business\SAIF.Business.Claim.Maintenance\clsMedicalConditionCollection.vb
• Business\SAIF.Business.Claim.Maintenance\clsOmittedCondition.vb
• Business\SAIF.Business.Claim.Maintenance\clsOmittedConditionCollection.vb
• Business\SAIF.Business.Claim.Maintenance\clsConditionDecision.vb
• Business\SAIF.Business.Claim.Maintenance\clsConditionDecisionCollection.vb
• Business\SAIF.Business.Claim.Maintenance\clsCovid19TestingHistory.vb
• Business\SAIF.Business.Claim.Maintenance\clsCovid19TestingHistoryCollection.vb
• Business\SAIF.Business.Claim.Maintenance\clsClaimPolicy.vb
• Business\SAIF.Business.Claim.Maintenance\clsClaimPolicyHistory.vb
• Business\SAIF.Business.Claim.Maintenance\clsClaimPolicyHistoryCollection.vb
• Business\SAIF.Business.Claim.Maintenance\clsAttendingPhysician.vb
• Business\SAIF.Business.Claim.Maintenance\clsAttendingPhysicianCollection.vb
• Business\SAIF.Business.Claim.Maintenance\CCClaimDataApi\AttendingPhysicians.vb
• Business\SAIF.Business.Claim.Maintenance\CCClaimDataApi\ClaimContactsResponse.vb
• Business\SAIF.Business.Claim.Maintenance\CCClaimDataApi\Contact.vb
• Business\SAIF.Business.Claim.Maintenance\CCClaimDataApi\ResponseData.vb
• Business\SAIF.Business.Claim.Maintenance\CCClaimDataApi\WorkerRepresentatives.vb