Position
Element
Name
Type
Requirement
Min
Max
Repeat
DSB01
Disability Type Code
Identifier (ID)
Mandatory
1
1
1
Code identifying the disability status of the individual
DSB02
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
DSB02 is scheduled work days before the disability.
DSB03
Occupation Code
Identifier (ID)
Optional
4
6
1
Code identifying the occupation of an individual
DSB04
Work Intensity Code
Identifier (ID)
Optional
1
1
1
Code identifying the level of intensity of work
DSB05
Product Option Code
Identifier (ID)
Optional
1
2
1
Code indicating an option chosen for the product
DSB06
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
DSB06 is the maximum amount of disability coverage to which the insured is entitled.
DSB07
Product/Service ID Qualifier
Identifier (ID)
Conditional
2
2
1
Code identifying the type/source of the descriptive number used in Product/Service ID (234)
P0708: If either DSB-07 or DSB-08 is present, then the other is required
DSB08
Medical Code Value
String (AN)
Conditional
1
15
1
Code value for describing a medical condition or procedure
DSB08 is the functional status code for the disability.