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This form allows the injured worker to elect a lump sum payment of the permanent partial disability award. AN ACT relating to workers' compensation; revising provisions governing the payment in a lump sum for certain.Permanent partial disability in a lump sum under certain circumstances. Download Reaffirmation - Retraction of Lump Sum Request – Business and Industry (Nevada) form. 2. Complete the Debtor's Statement in Support of Reaffirmation Agreement (Part II above). 505, is entitled to a lump sum equal to the present value of the deceased claimant s undisbursed award for a permanent partial disability. Agreeing to repay the excess loan amount in accordance with the terms of the promissory note is called "reaffirmation. Agreeing to repay the excess loan amount in accordance with the terms of the promissory note is called "reaffirmation. Owed for past support turns the entire amount owed into arrears. Htm) to determine the amount of the.