---
title: Claim status and compensability
summary: Resolve claim status, compensability, original acceptance decision, and legacy MCO enrollment date; reject retired WCIS activity queries.
status: draft
owner: SAIF.Core documentation team
last_reviewed: 2026-09-24
library: SAIF.Data
reference_type: package
operation_id: OP-SD-14
trigger: Caller requests claim status/compensability/acceptance data.
---

# Claim status and compensability

Resolve claim status, compensability, original acceptance decision, and legacy MCO enrollment date; reject retired WCIS activity queries.

| Field | Value |
| --- | --- |
| **Operation ID** | OP-SD-14 |
| **Trigger** | Caller requests claim status/compensability/acceptance data. |
| **Inputs** | Claim id |
| **Outputs** | Status/code data, or `NotImplementedException` |
| **Primary components** | `ClaimQueryProvider` |
| **Entry point** | `Data/SAIF.Data/Queries/Claims/ClaimQueryProvider.cs` |

## Steps

1. `GetLatestClaimStatus`: when there is no history, fall back to the WCD status; otherwise use the latest non-removed history entry ([SD-BR-041](../business-rules.md#sd-br-041-latest-claim-status-falls-back-to-wcd-status-when-no-history), [SQL-056](../sql/SQL-056-claim-query-provider-get-claim-from-injury-claim-cross-reference.md), [SQL-058](../sql/SQL-058-claim-query-provider-get-claim-status-date.md), [SQL-059](../sql/SQL-059-claim-query-provider-get-claim-person-addresses.md), [SQL-061](../sql/SQL-061-claim-query-provider-get-claim-status-activity.md), [SQL-062](../sql/SQL-062-claim-query-provider-get-claim-request-decisions.md)).
2. `GetCompensabilityStatus`: "Claim Denied" maps to "D"; otherwise use the first letter, upper-cased ([SD-BR-042](../business-rules.md#sd-br-042-compensability-status-mapping)).
3. `GetOriginalAcceptance`: `RequestType = "I"` and decision "A" ([SD-BR-043](../business-rules.md#sd-br-043-original-acceptance-requires-request-type-i-with-decision-a)). Data: `ClaimRequestDecision` (`CL_CLAIM_REQUEST_DECISION`).
4. `GetMcoEnrollmentDate` (obsolete): returns a date only when the eligibility status is "Y" ([SD-BR-044](../business-rules.md#sd-br-044-mco-enrollment-date-only-when-eligibility-is-y)).
5. The following throw `NotImplementedException`: `GetWorkReleaseStatus`, `GetLatestClaimTypeActivity`, `GetClaimTypeActivity` ("data retired"), `GetClaimStatusActivity`, `GetClaimRequestDecisions` ([SD-BR-045](../business-rules.md#sd-br-045-retired-wcis-claim-activity-queries-are-unsupported)).

## Process flow

The following diagram visualizes this operation's control flow.

```mermaid
flowchart TD
	Start([Caller requests claim status/compensability/acceptance data.]) --> S1["`ClaimQueryProvider`"]
	S1 --> S2{"Rules satisfied?"}
	S2 -->|Yes| EndOk([Result returned])
	S2 -->|No| EndErr([Exception / empty result])
```

## Failure and edge-case behavior
- Retired WCIS activity queries: always throw `NotImplementedException`, never partially execute.

## Related documentation
- [Operations and processes](../operations-processes.md)
- [Business rules](../business-rules.md)
- [SQL catalog](../sql/index.md)
- [Database tables](../database-tables.md)


## Sources
- `Data/SAIF.Data/Queries/Claims/ClaimQueryProvider.cs`
- `Data/SAIF.Data/Queries/Claims/ClaimQueryProvider.cs:100`
- `Data/SAIF.Data/Queries/Claims/ClaimQueryProvider.cs:182`
- `Data/SAIF.Data/Queries/Claims/ClaimQueryProvider.cs:223`