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The Employer Information page allows you to add the beneficiary or claimant's employer information to a case.
Fields marked with a superscript 1 (1) on the application are required.
Employer Information Data Elements
| Element | Description |
| Employer Name | Enter the employer's name. |
| Address Line 1 | Enter the first line of the employer's mailing address. |
| Address Line 2 | Enter the second line of the employer's mailing address. Optional. |
| City | Enter the city where the beneficiary/claimant lives. |
| State | Select the state where the beneficiary/claimant lives from the dropdown list. |
| Zip Code | Enter the beneficiary/claimant's 5-digit zip code. The ZIP+4 is optional. |
| Phone | Enter the beneficiary/claimant's telephone number. The extension field is optional. |
| Tax ID Number (TIN) | Enter the employer's 9-digit Tax Identification Number. Optional.
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Click the Previous button to return to the previous page.
Click the Next button to save all information and proceed to the next page.
Click the Case Summary button to view a synopsis of the case information entered.
For new cases and cases in Work-In-Progress (WIP) status:
- Click the Save Work-In-Progress button to save all information entered up to this point. You can return to the WCMSAP at a later time to complete the case creation process.
- Click the Cancel Case Creation button to delete all information entered and cancel out of the case creation process.
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