*2026-04-13 Disclosure Claim Data Report

Claim Number:42647461 Worker Name:MARK HOLAND Date Created:13-4-2026 1:05 PM

: MARK HOLAND - 42647

Workers Age

Current age: 47 years Age at overall claim date: 47 years

Mechanism of Injury

W is claiming for acoustic trauma he attributes to a server fan noise.

Description of Injury

Worker statement:
Employer statement:

Effective Date ICD 9 Code Area of Body Side of Body Eligiblity Status Status
2026/01/12 3882-SUDDEN NERVOUS Both Right & Left Denied Temporary
HEARING LOSS, SYSTM(FOR
UNSPECIFIED NERVOUS

SHOCK,BRKDOWN)
2026/01/12 A04-AGGRAVATION OTHER BODY __ Not Applicable Denied Temporary
OF A PRE-EXISTINGPARTS, N.E.C.

OTHER CONDITION

Latest Diagnosis
Date: 2026/03/12 Consult with WorkSafe BC?: No

HEADACHE

Previous Pain or Disablility Details

Worker statement:
Employer statement:
Provider statement:

Plateau Dates

Date Comments

ODS Occupation Details
Employer Job Title NOC Code Group Title

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