Obligation Record

Back to Accountability Chain · WC-2026-1502
#04

File Statutory Injury Report with State Board

Break · +5d

Identity

What was supposed to happen

File Statutory Injury Report with State Board

Claims administrator files the initial injury report with the state workers' compensation board within the statutory deadline (3 business days from the incident report).

Sequence

#04

Owner

Rachel NomuraClaims Administrator

Assigned by

Lifecycle Facts

The dates the employer recorded. These are editable facts — the Engine derives everything below from them.

Assigned

August 12, 2026

Accepted

August 12, 2026

Due

August 15, 2026

Completed

August 21, 2026

Verified

August 21, 2026

Evidence Summary

1 linked

Completion recorded without evidence

A completion date is on record but no evidence supporting the completion claim has been linked to substantiate that the work was actually done.

Verification recorded without evidence

A verification date is on record but no evidence supporting the verification claim documents who verified the obligation or how.

Accountability break has no supporting evidence

This obligation completed after its deadline, but no evidence supporting the delay/break claim has been linked to explain it.

State Board Filing Confirmation

Document
Supports: Other

State workers' compensation board electronic filing confirmation, time-stamped Aug 20, showing the initial injury report was accepted 3 business days after the statutory deadline.

Recorded by Rachel Nomura · logged August 20, 2026

Derived State

Engine output — read-only

Derived status

Break · +5d

Delay

+5 business days late

Accountability break

Present

Depends on

No upstream dependency

Blocks (downstream)

Nothing depends on this

Notes

Operational context only. Notes never override evidence and never change any derived conclusion above.