Covered/Non-Covered Employee Designation Dispute Form

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Every reasonable effort shall be made by the parties to resolve the issue at the lowest possible level in a timely manner before initiating the Director’s Coverage Designation Dispute process.

Email *

Filer's Name and Title *

Position Number - One position number per filing *

The Filer is *

Department / Institute of Higher Education *

Departments Division / Unit *

Current Designation *

Reason and/or Exception Cited for Disputing Non-Covered Designation

Job Classification Code for Disputed Position *

Job Classification Title for Disputed Position *

Working Title, if different

Please provide justification to support your request to change the position's designation. *

Please acknowledge with checkmarks below, and send all supporting documentation to DPA_LaborRelations@state.co.us *

The original issue involving the application of the department’s decision to designate an individual as covered or non-covered is disputable at this stage.

Current position description with job duties.

Department's issued final decision OR failure to issue a final decision within the prescribed timeframe.

The Director or designee shall issue a written decision within ninety (90) days from receipt of the email filing and this form whichever is later.

NOTE: Receipt of filing includes this form being submitted and documentation sent to the Labor Relations Unit for review.

Required

The Director’s Coverage Designation Dispute Decision. The Director’s authority regarding final decisions on Director’s Coverage Designation Disputes is limited to reviewing the facts surrounding the department’s final decision, within the limits of the employee’s position description and job duties and how it is applied to a covered or non-covered designation as defined in § 24-50-1102 (3)(a) through (3)(f), C.R.S. *

I understand this is an external review by the State Personnel Director or Designee.

Required

A copy of your responses will be emailed to the address you provided.

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