AGENCY: Salt Lake City (Utah). Mayor. Division of Risk Management
SERIES: 6866
TITLE: Industrial injury files
DATES: 1948-
ARRANGEMENT: Chronological
DESCRIPTION: These files contain forms required by the Utah State Industrial Commisson and other pertinent information concerning industrial injuries or illness incurred by city employees. They are used for reference purposes. These files include employee's name, insurance number, mailing address, location (if different than mailing address); insurance carrier, name and position of person report of injury was made to, date reported; employee's name; date of birth; home address; social security number; marital status; age, sex, occupation; length of time employed by city; time in same position, department, hours worked per day, days worked per week, wage per hour, day, week, or month,or average earnings; and name and birthdate of spouse and other minor dependents; date of injury or diagnosis of illness; whether accident or exposure on employer's premises; whether injury fatal; place of accident or exposure, what employee was doing when injured, how accident occurred, name of object or substance that directly injured the employee; part of body affected and description of injury or illness; name and address of attending physician; name of hospital; signature and title of person making report; date report made; billing information; report of injury; doctor's report; payments made; copies of check stubs; and other information pertaining to the injury.
RETENTION
Retain for 25 year(s)
DISPOSITION
Destroy.
RETENTION AND DISPOSITION AUTHORIZATION
Retention and disposition for this series were specifically approved by the State Records Committee.
APPROVED: 11/1986
FORMAT MANAGEMENT
Paper: Retain in Office for 5 years and then microfilm and destroy provided microfilm has passed inspection.
Microfilm master: Retain in Office for 25 years and then destroy.
APPRAISAL
The Industrial Commission's copy of the form is maintained permanently, but the city's file contains other information necessary for litigation purposes. The city attorney has determined it should be kept for at least twenty-five years.