Haw. Code R. § 12-11-41 - Denial of claim
(a) If an
employee's claim for benefits is denied in whole or in part by the employer or
employer's disability benefits carrier, a copy of the notice of denial, in the
form prescribed by the director, shall be sent to the department. The
department shall review the denial within ten days of receipt and request the
employer or insurer to reconsider the denial if it considers it to be
erroneous, without proper legal basis, or without sufficient evidence. If the
employer or insurer still decides to deny disability benefits, the employee and
the department shall be so notified.
(b) If an employee desires a review of any
action of the claim for benefits, the employee shall file with the director two
copies of the notice of denial, the employee's request for appeal, and a
statement in duplicate giving specific reasons for the request. The request for
appeal shall be filed within twenty days from the date denial was mailed to the
claimant. The appeal shall be filed at the office of the department in the
county in which the claimant resides or in the county in which the claimant was
employed prior to the disability. The director shall forthwith notify the
employer or the employer's disability benefits carrier or the special fund for
disability benefits, as the case may be, of the claimant's request for appeal,
enclosing a copy of the claimant's statement of reasons therefor. Determination
of the appeal shall be made in accordance with the provisions of Part V of
chapter 392, Hawaii Revised Statutes.
Notes
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