Agency Schedule Detail

Authorization Number : 855-1108

Agency Series No. : MSAD-28

Status : Active

Agency Web Link :

Agency : BWC

Confidential Description : These records contain claim numbers, claimants’ name.

Division : BWCMSAD

Vital Description :

Section : BWCMSAD

Record Title : Complexity Factor Forms

Revision : 0

Record Description : The Complexity Factor Forms are used by the Field Case Managers, Managed Care Organizations (MCO), Disability Management Coordinators (DMC) to record the difficulty, complexity of the vocational rehabilitation cases based on identification factors.

Retention Period	Retention Justification	Media Code	Method of Disposal
Retain the completed form on the H: drive in an Excel spreadsheet and the collaborating information on the I: drive in an Access database for 15 years; then destroy.	Ohio Revised Code 2305.06 states that an action upon a specialty or an agreement, contract, or promise in writing shall be brought within fifteen years after the cause thereof accrued.	Electronic	Delete

Approvals

Status	Name	Title	Date
Approved	Kevin Gartrell	Records Coordinator	5/1/2009 10:26:00 AM
Approved	Melissa Roach	Records Officer	6/17/2009 3:37:00 PM
Approved	Michael Hardenbrook	Record Administrator	6/23/2009 10:00:00 AM
Approved	Martin Meeks	State Auditor	6/23/2009 3:56:00 PM
Approved	Fred Previts	State Archivist	6/30/2009 10:05:00 AM

Notes

Date	Reason	User