SAIF.Business.View.Claim operations and processes

This page is the operation catalog and cross-operation hub for this library. Each operation's detailed, step-by-step logic lives in its own page under operations/. The library is a read-only claim-view surface: it exposes claim header, financial, contact, medical, legal, investigation, and reference-code data through a mix of REST API calls (CCClaimDataApi, EaipApi, InvestigationApi, LegalApi) and inline Oracle SQL / stored procedures.

Operation catalog

Operation	Intent	Trigger	Inputs	Outputs	Rules	Tables	SQL
Claim summary and detail retrieval	Load a claim's full read-only header, or a worker's/policy's claim history.	Caller requests a claim by ID/number, or a claim history search.	Claim ID/number; worker ID or policy number	Populated clsClaimData or clsClaimDataCollection	BR-002	cl_claim_support_order, MCO_PLAN	SQL-001, SQL-002, SQL-003, SQL-029, SQL-030, SQL-031
Claim reserves and payments retrieval	Load claim reserve amounts by cost category and payment/line-item history.	Caller reads Reserves/AllReserves/PaymentsData on a claim.	Claim ID; optional valuation date; combine-death-and-burial flag	clsClaimReservesCollection; PaymentsData	BR-005, BR-006	Not documented in database-tables.md**	API-backed; no cataloged SQL-ID
Financial transaction retrieval	Load individual financial transaction and payment-remark rows for a claim.	Caller retrieves clsFinancialTransactionCollection.	Claim ID, policy number, or reimbursement issue date	clsFinancialTransactionCollection of clsFinancialTransaction	BR-001	Stored procedure-owned tables not available	SQL-004, SQL-005, SQL-007, SQL-008, SQL-009
Claim notes retrieval	Load note rows for a claim.	Caller reads clsClaimData.ClaimNotes.	Claim ID; internal-user flag	clsClaimNoteList of clsClaimNoteData	N/A	Stored procedure-owned tables not available	SQL-006 (legacy path)
Claim contacts and beneficiaries retrieval	Load claim role contacts and map beneficiary contacts into person-view objects.	Caller reads clsClaimData.Beneficiaries, or requests raw claim contacts.	Claim number or claim ID; contact type	ClaimContacts; clsClaimPersonViewCollection	BR-007	Not documented in database-tables.md**	API-backed; no cataloged SQL-ID
Claim responsibility retrieval	Resolve claim responsibility assignment and supervisor metadata.	Caller retrieves clsClaimResponsibilityData.	ClaimRespCode	Responsibility user, supervisor, and section metadata	N/A	CL_CLAIM_RESPONSIBILITY, CLAIM_SUPERVISOR	SQL-013
Medical condition retrieval	Load medical-condition detail with the latest compensability decision and denial metadata.	Caller reads clsClaimData.MedicalConditions, or retrieves a single condition by ID.	Claim ID; optional medical condition ID	clsMedicalConditionList or single clsMedicalConditionData	BR-004	cl_medical_condition, cl_cond_compensability_decisn, condition_type_code, claim_decision_code, claim_denial_final_reas_cd, claim_denial_reason_code, claim_denial_status_code	SQL-022
Prison code retrieval	Expose prison-code lookup values plus a synthetic blank option.	Caller retrieves clsPrisonCode/clsPrisonCodeCollection.	Optional prison code	One prison row or the full prison-code list	BR-003	CL_PRISON_CODE	SQL-010, SQL-011
Reference code retrieval	Expose read-only claim reference code lookups (closure, order, MCO status, work status/release, vocational responsibility, cost category, activity type).	Caller retrieves a specific lookup object or its collection.	Optional code filters	Reference code rows	N/A	CL_CLAIM_COST_CATEGORY_CODE, CL_CLOSURE_LOCATION_TYPE_CODE, CL_CLOSURE_TYPE_OF_ORDER_CODE, CL_MCO_STATUS_REASON_CODE, CL_ORDER_TYPE_CODE, CL_WORK_STATUS_CODE, CL_WORK_RELEASE_CODE, VOCATIONAL_RESP_CODE, CLAIM_ACTIVITY_CAT_TYPE_CODE	SQL-012, SQL-014, SQL-015, SQL-016, SQL-017, SQL-018, SQL-019, SQL-020, SQL-021, SQL-023, SQL-024, SQL-025, SQL-026, SQL-027, SQL-028
Claim award and closure order retrieval	Load claim award/benefit-payment history and claim closure/order header records.	Caller reads clsClaimData.AwardInfo, or calls clsClosureOrder.GetClosureOrders.	Claim ID; optional closure ID and order ID	clsAwardInfo; clsClosureOrder / enumerable	BR-011	Not documented in database-tables.md**	Not cataloged as SQL-ID**
EAIP service period retrieval	Load EAIP service period header data and resolve the EAIP specialist/policy RTW consultant contacts.	Caller reads clsClaimData.EAIPData.	Claim ID; optional period sequence number	Service period status/dates; resolved employee contacts	BR-008, BR-009	N/A	API-backed; no cataloged SQL-ID
Investigation case retrieval	Retrieve a single investigation case, active fraud cases, or cross-system case search results.	Caller retrieves clsInvestigationInfo by sequence number, or calls fraud/search collection methods.	Investigation sequence number; or identifier plus OFAC/in-progress flags	clsInvestigationInfo; clsInvestigationInfoCollection; InvestigationHeader	BR-010	Not documented in database-tables.md**	Not cataloged as SQL-ID**
Legal case retrieval	Load legal case header data (case number, attorney, status, hearing date).	Caller constructs clsLegalData.	Claim ID; legal case sequence number	CaseNumber, AttorneyName, CaseStatus, HearingDate	N/A	N/A	API-backed; no cataloged SQL-ID

Process flow diagram

The following diagram visualizes the primary claim-view retrieval flow.

flowchart TD
    Start([Start]) --> Choose[Select claim view object]
    Choose --> ApiPath[API-backed BOF view]
    Choose --> SqlPath[Oracle-backed BOF view or code table]
    ApiPath --> ApiFramework[Framework API transport†]
    SqlPath --> SqlExec[Inline SQL or stored procedure]
    ApiFramework --> Result[Populate business object]
    SqlExec --> Result
    Result --> End([Return read-only data])

Inherited operations and processes

Operations in this section originate from base classes or services provided by dependency framework libraries. They are inherited or delegated, not implemented in this library.

From clsBusinessApiBase (saif-framework-core)

Operation	Intent	Provided by	Origin	Embedded in
API-backed BOF retrieval	Resolve named API clients, format routes, and dispatch API requests for single-object retrieval†	clsBusinessApiBase	saif-framework-core	Claim summary and detail retrieval, Claim notes retrieval, Medical condition retrieval, Claim contacts and beneficiaries retrieval, EAIP service period retrieval
API-backed edit lifecycle	Provide BOF edit-state methods such as BeginEdit, CancelEdit, and ApplyEdit for API-backed objects†	clsBusinessApiBase	saif-framework-core	Claim notes retrieval

Origin: These operations are defined in saif-framework-core / clsBusinessApiBase and inherited or delegated by this component.

From clsBusinessCollectionApiBase (saif-framework-core)

Operation	Intent	Provided by	Origin	Embedded in
API-backed collection retrieval	Populate collection-based view types through framework collection transport and hydration services†	clsBusinessCollectionApiBase	saif-framework-core	Claim summary and detail retrieval, Claim reserves and payments retrieval, Claim contacts and beneficiaries retrieval

Origin: This flow is defined in saif-framework-core / clsBusinessCollectionApiBase and inherited by this component.

From clsBusinessBase (saif-framework-core)

Operation	Intent	Provided by	Origin	Embedded in
SQL-backed BOF retrieval and validation lifecycle	Provide inline-SQL retrieval plumbing plus Rules, IsValid, and related messaging surfaces for non-API-backed business objects†	clsBusinessBase	saif-framework-core	Claim responsibility retrieval, Reference code retrieval, Claim award and closure order retrieval, Investigation case retrieval

Origin: This behavior is defined in saif-framework-core / clsBusinessBase and inherited by this component.

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 summary and detail retrieval	SQL-001, SQL-030	cl_claim_support_order	Read
Claim summary and detail retrieval	SQL-002, SQL-031	MCO_PLAN	Read
Claim summary and detail retrieval	SQL-003, SQL-029	Stored procedure-owned tables not available	Read
Financial transaction retrieval	SQL-004, SQL-005, SQL-007, SQL-008, SQL-009	Stored procedure-owned tables not available	Read
Claim notes retrieval	SQL-006	Stored procedure-owned tables not available	Read
Claim responsibility retrieval	SQL-013	CL_CLAIM_RESPONSIBILITY	Read
Medical condition retrieval	SQL-022	cl_medical_condition, cl_cond_compensability_decisn, condition_type_code, claim_decision_code, claim_denial_final_reas_cd, claim_denial_reason_code, claim_denial_status_code	Read
Prison code retrieval	SQL-010, SQL-011	CL_PRISON_CODE	Read
Reference code retrieval	SQL-012	CL_CLAIM_COST_CATEGORY_CODE	Read
Reference code retrieval	SQL-014, SQL-015	CL_CLOSURE_LOCATION_TYPE_CODE	Read
Reference code retrieval	SQL-016, SQL-017	CL_CLOSURE_TYPE_OF_ORDER_CODE	Read
Reference code retrieval	SQL-018, SQL-019	CL_MCO_STATUS_REASON_CODE	Read
Reference code retrieval	SQL-020, SQL-021	CL_ORDER_TYPE_CODE	Read
Reference code retrieval	SQL-023, SQL-024	CL_WORK_STATUS_CODE	Read
Reference code retrieval	SQL-025, SQL-026	CL_WORK_RELEASE_CODE	Read
Reference code retrieval	SQL-027	VOCATIONAL_RESP_CODE	Read
Reference code retrieval	SQL-028	CLAIM_ACTIVITY_CAT_TYPE_CODE	Read
Claim reserves and payments retrieval	Not cataloged as SQL-ID**	Not documented in database-tables.md**	Read
Claim contacts and beneficiaries retrieval	Not cataloged as SQL-ID**	Not documented in database-tables.md**	Read
Claim award and closure order retrieval	Not cataloged as SQL-ID**	CL_AWARD, CL_BENEFIT_PAYMENT, cl_state_award_monthly_payee, cl_benefit_payee, cl_claim_closure_order, cl_order_type_code (not yet in database-tables.md)**	Read
EAIP service period retrieval	Not cataloged as SQL-ID**	Not documented in database-tables.md**	Read (API)
Investigation case retrieval	Not cataloged as SQL-ID**	INVESTIGATION, INVESTIGATION_NOTE, INVESTIGATION_STATUS_HIST, investigation_type_code, investigation_status_code, subject_type_code, identifier_type_code (not yet in database-tables.md)**	Read
Legal case retrieval	Not cataloged as SQL-ID**	Not documented in database-tables.md**	Read (API)

Failure and edge-case behavior

• Note and financial-transaction read paths that rely on Oracle stored procedures were referenced from code, but the Oracle source was not found during source review, so those callers may represent dead or environment-specific code paths.**
• Many reference-data queries use unqualified table names, so schema ownership is unknown from source alone.**
• The prison-code collection injects a synthetic blank row that does not correspond to a persisted database record.
• Several API-backed operations (contacts, EAIP, legal, investigation search) swallow API failures into an empty/default result plus, in some cases, an added error message, rather than propagating exceptions — see each operation's own failure section for specifics.
• Newly traced tables referenced by award, closure-order, and investigation retrieval (CL_AWARD, CL_BENEFIT_PAYMENT, cl_state_award_monthly_payee, cl_benefit_payee, cl_claim_closure_order, cl_order_type_code, INVESTIGATION, INVESTIGATION_NOTE, INVESTIGATION_STATUS_HIST, investigation_type_code, investigation_status_code, subject_type_code, identifier_type_code) are not yet cataloged in database-tables.md or sql/; they are described in prose on the relevant operation pages pending a future database/SQL cataloging pass.**

Stored procedure operations

Operations implemented in Oracle stored procedures referenced by this library.

Operation	Description	Source	Link
Claim note retrieval (legacy)	Stored-procedure selector for claim notes; Oracle package not found, so implementation details remain unavailable.	pk82281_claim_note.select_by_claimnum	Details
Financial transaction retrieval	Stored-procedure selectors for claim-id, policy-number, reimbursement, and payment-remarks retrieval; Oracle package not found, so implementation details remain unavailable.	pk83407_payment_hist_trans.*	Details

Related documentation

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

Note: Statements marked with † are derived from dependency library documentation via the Legends CLI. They describe inherited behavior from the indicated origin library and should be verified if the dependency version changes. Statements marked with ** could not be confirmed; treat as unknown until verified.

Sources

• Business\SAIF.Business.View.Claim\clsClaimData.vb
• Business\SAIF.Business.View.Claim\ClaimData.vb
• Business\SAIF.Business.View.Claim\clsClaimDataCollection.vb
• Business\SAIF.Business.View.Claim\clsClaimReserves.vb
• Business\SAIF.Business.View.Claim\clsClaimReservesCollection.vb
• Business\SAIF.Business.View.Claim\clsFinancialTransaction.vb
• Business\SAIF.Business.View.Claim\clsFinancialTransactionCollection.vb
• Business\SAIF.Business.View.Claim\clsClaimNoteData.vb
• Business\SAIF.Business.View.Claim\clsClaimNoteList.vb
• Business\SAIF.Business.View.Claim\clsClaimPersonView.vb
• Business\SAIF.Business.View.Claim\clsClaimPersonViewCollection.vb
• Business\SAIF.Business.View.Claim\clsClaimResponsibilityData.vb
• Business\SAIF.Business.View.Claim\clsMedicalConditionData.vb
• Business\SAIF.Business.View.Claim\clsMedicalConditionList.vb
• Business\SAIF.Business.View.Claim\clsPrisonCode.vb
• Business\SAIF.Business.View.Claim\clsPrisonCodeCollection.vb
• Business\SAIF.Business.View.Claim\clsClosureLocationTypeCode.vb
• Business\SAIF.Business.View.Claim\clsClosureLocationTypeCodeCollection.vb
• Business\SAIF.Business.View.Claim\clsClosureTypeOfOrderCodeCollection.vb
• Business\SAIF.Business.View.Claim\clsClosureTypeofOrderCode.vb
• Business\SAIF.Business.View.Claim\clsMcoStatusReasonCode.vb
• Business\SAIF.Business.View.Claim\clsMcoStatusReasonCodeTable.vb
• Business\SAIF.Business.View.Claim\clsOrderTypeCode.vb
• Business\SAIF.Business.View.Claim\clsOrderTypeCodeCollection.vb
• Business\SAIF.Business.View.Claim\clsVocResponsibilityData.vb
• Business\SAIF.Business.View.Claim\clsWorkReleaseCode.vb
• Business\SAIF.Business.View.Claim\clsWorkReleaseCodeTable.vb
• Business\SAIF.Business.View.Claim\clsWorkStatusCode.vb
• Business\SAIF.Business.View.Claim\clsWorkStatusCodeTable.vb
• Business\SAIF.Business.View.Claim\clsClaimActivityTypeCodeCollection.vb
• Business\SAIF.Business.View.Claim\clsClaimCostCategoryCodeCollection.vb
• Business\SAIF.Business.View.Claim\clsAwardInfo.vb
• Business\SAIF.Business.View.Claim\clsClosureOrder.vb
• Business\SAIF.Business.View.Claim\clsMcoData.vb
• Business\SAIF.Business.View.Claim\clsEAIPData.vb
• Business\SAIF.Business.View.Claim\EaipApi\EaipHeader.vb
• Business\SAIF.Business.View.Claim\clsInvestigationInfo.vb
• Business\SAIF.Business.View.Claim\InvestigationApi\InvestigationFindCases.vb
• Business\SAIF.Business.View.Claim\InvestigationApi\InvestigationHeader.vb
• Business\SAIF.Business.View.Claim\InvestigationCodemaps.vb
• Business\SAIF.Business.View.Claim\clsLegalData.vb
• Business\SAIF.Business.View.Claim\LegalApi\LegalData.vb
• Business\SAIF.Business.View.Claim\CCClaimDataApi\Claim\ClaimApiClient.vb
• Business\SAIF.Business.View.Claim\CCClaimDataApi\Contact\ClaimContactsCollection.vb
• Business\SAIF.Business.View.Claim\CCClaimDataApi\Financial\FinancialData.vb