AGENCY: Labor Commission. Adjudication Division

SERIES: 14567
TITLE: Compensation agreements and lump sum working files
DATES: 1920-
ARRANGEMENT: Alphabetical by surname

DESCRIPTION: This series provides support documentation for the compensation agreements for workers' compensation claims. The series consist of the Compensation Agreement - Form 019 and the Lump-sum application - Form 134. The compensation agreement is used to enter into an agreement for a permanent partial award. The lump-sum form is used by an employee when applying for a lump sum or advance payment for a permanent partial award. Information includes the name and address of the employee, financial information, marital status, medical information, salary information, social security number and telephone number. The original Compensation agreement, series 21924 is retained for 75 years.

RETENTION

Retain for 75 year(s)

DISPOSITION

Destroy.

RETENTION AND DISPOSITION AUTHORIZATION

Retention and disposition for this series were specifically approved by the State Records Committee.

APPROVED: 10/1999

FORMAT MANAGEMENT

Paper: Retain in Office for 1 year and then transfer to State Records Center. Retain in State Records Center for 74 years and then destroy.

APPRAISAL

Administrative Legal

The Agency requested an increase in the retention period to make the retention period consistent with the retention period for similar working files. The original approved retention period had been 10 years.

PRIMARY DESIGNATION

Private. UCA 63G-2-302 (2008)