Appeals


Section 8.03 of the Annex A To The Settlement Facility and Fund Distribution Agreement states that claimants may appeal their claims review decision to the Claims Administrator.  Before a claimant can appeal to the Claims Administrator, she must first submit any additional documentation she wishes to have considered to the Settlement Facility. 

If a final claims decision has been reached by the Settlement Facility and the claimant disagrees with it, then a claimant may submit a written appeal to the Claims Administrator.  An appeal is not automatic; a claimant or her attorney of record must request the appeal.  All records that a claimant wishes to have considered for the appeal - absent a request for additional information by the Claims Administrator - must be submitted for review by the SF-DCT prior to filing an appeal.

Section 8.04 of Annex A states that the Claims Administrator review shall be de novo - or new.  The Claims Administrator may request further submissions from the claimant or may seek further information from the claimants' physician in deciding the appeal.

The claimant has the right to appeal any determination by the Claims Administrator to the Appeals Judge in the same manner and under the same procedure.

Claimants who disagree with the ruling of the Claims Administrator may appeal to the Appeals Judge.  An appeal is not automatic; a claimant or her attorney of record must request the appeal.

The appeal must be in writing and must outline the claimant's position and statement as to why the Settlement Facility and the Claims Adminstrator have erred.  The Appeals Judge will review the appeal record and the claim file in deciding the appeal and will issue a written ruling.  The decision of the Appeals Judge is final and binding on the claimant.  No further appeals are permitted.  The Plan does not permit an appeal to the District Court of an individual claimant decision from the Settlement Facility, Claims Administrator or Appeals Judge.