To communicate employing carrier response to a sickness or unemployment claim
| Position | Element | Name | Type | Min/Max | Repeat | |
|---|---|---|---|---|---|---|
| 1 | 373 | Date | Mandatory | Date | 8/8 | 1 |
| 2 | 585 | Payroll Status Code | Rel | ID | 2/2 | 1 |
| 3 | 590 | Wages Paid Code | Rel | ID | 1/1 | 1 |
| 4 | 585 | Payroll Status Code | Rel | ID | 2/2 | 1 |
| 5 | 590 | Wages Paid Code | Rel | ID | 1/1 | 1 |
| 6 | 585 | Payroll Status Code | Rel | ID | 2/2 | 1 |
| 7 | 590 | Wages Paid Code | Rel | ID | 1/1 | 1 |
| 8 | 585 | Payroll Status Code | Rel | ID | 2/2 | 1 |
| 9 | 590 | Wages Paid Code | Rel | ID | 1/1 | 1 |
| 10 | 585 | Payroll Status Code | Rel | ID | 2/2 | 1 |
| 11 | 590 | Wages Paid Code | Rel | ID | 1/1 | 1 |
| 12 | 585 | Payroll Status Code | Rel | ID | 2/2 | 1 |
| 13 | 590 | Wages Paid Code | Rel | ID | 1/1 | 1 |
| 14 | 585 | Payroll Status Code | Rel | ID | 2/2 | 1 |
| 15 | 590 | Wages Paid Code | Rel | ID | 1/1 | 1 |
| 16 | 585 | Payroll Status Code | Rel | ID | 2/2 | 1 |
| 17 | 590 | Wages Paid Code | Rel | ID | 1/1 | 1 |
| 18 | 585 | Payroll Status Code | Rel | ID | 2/2 | 1 |
| 19 | 590 | Wages Paid Code | Rel | ID | 1/1 | 1 |
| 20 | 585 | Payroll Status Code | Rel | ID | 2/2 | 1 |
| 21 | 590 | Wages Paid Code | Rel | ID | 1/1 | 1 |
| 22 | 585 | Payroll Status Code | Rel | ID | 2/2 | 1 |
| 23 | 590 | Wages Paid Code | Rel | ID | 1/1 | 1 |
| 24 | 585 | Payroll Status Code | Rel | ID | 2/2 | 1 |
| 25 | 590 | Wages Paid Code | Rel | ID | 1/1 | 1 |
| 26 | 585 | Payroll Status Code | Rel | ID | 2/2 | 1 |
| 27 | 590 | Wages Paid Code | Rel | ID | 1/1 | 1 |
| 28 | 585 | Payroll Status Code | Rel | ID | 2/2 | 1 |
| 29 | 590 | Wages Paid Code | Rel | ID | 1/1 | 1 |