Workers’ Compensation Data Fields 4 Jurisdiction Claim # The “Jurisdiction Claim #” field is used to add a claim number assigned by the state agency overseeing Workers’ Compensation claims. NOTE: A “Required Fields” prompt may appear. If so, add “N/A” if no state claim number has been assigned. This field can be updated once the state claim number is assigned by the appropriate state agency. Denial If a claim has been denied, check the “Denied” box. Once the box is checked, a box entitled “Deny Claim” will appear. Add the basis for denial in the freeform field. Confidential, Proprietary and Trade Secret Document of NARS and protected by the Florida Uniform Trade Secrets Act, chapter 688, Florida Statutes. No use allowed unless specifically authorized.