Individual tripped on uneven carpet in the workplace during normal business hours. Fall resulted in broken hip and elbow.
Claim almost immediately denied upon filing. Have not seen denial letter but have been told claim was refused because claimant tripped over their feet.
Is alleged clumsiness justification for denial?
Claimant had visual impairments that require the use of special glasses similar to goggles worn by basketball players. Field of vision is slightly impaired but does not prevent the individual from performing regular duties.
Claimant asked employer for appeal forms and information on the appeal process. Request for forms denied.
Plan is self funded municipal plan.
Claim almost immediately denied upon filing. Have not seen denial letter but have been told claim was refused because claimant tripped over their feet.
Is alleged clumsiness justification for denial?
Claimant had visual impairments that require the use of special glasses similar to goggles worn by basketball players. Field of vision is slightly impaired but does not prevent the individual from performing regular duties.
Claimant asked employer for appeal forms and information on the appeal process. Request for forms denied.
Plan is self funded municipal plan.
