Appeal Procedure. The Appeal will be deemed an appeal of the entire Arbitration Award. In conducting the Appeal, the Appeal Panel shall conduct a de novo review of all Claims described or otherwise set forth in the Arbitration Notice. Subject to the foregoing and all other provisions of this Paragraph 5, the Appeal Panel shall conduct the Appeal in a manner the Appeal Panel considers appropriate for a fair and expeditious disposition of the Appeal, may hold one or more hearings and permit oral argument, and may review all previous evidence and discovery, together with all briefs, pleadings and other documents filed with the Original Arbitrator (as well as any documents filed with the Appeal Panel pursuant to Paragraph 5.4(a) below). Notwithstanding the foregoing, in connection with the Appeal, the Appeal Panel shall not permit the parties to conduct any additional discovery or raise any new Claims to be arbitrated, shall not permit new witnesses or affidavits, and shall not base any of its findings or determinations on the Original Arbitrator’s findings or the Arbitration Award.
Appeal Procedure. The definition of an appeal is action taken by you with respect to your disagreement with our non-coverage of or non-payment for a service, denials, reductions or termination of services, denial of enrollment, or your involuntary disenrollment from the program. You will be notified in writing if your LIFE Provider: • will not cover or pay for a service that you are requesting. • denies, reduces, or terminates a service. • is denying enrollment into LIFE. • is initiating an involuntary disenrollment from LIFE. The notice will instruct you on how to appeal the decision if you do not agree with the decision. You must request an appeal within 30 calendar days of the date the notice was sent to you. An involuntary disenrollment for non-compliance with your care plan or conditions of participation, engaging in disruptive or threatening behavior, failing to pay or make satisfactory arrangements to pay, or being out of the service area for more than 30 calendar days without prior approved arrangements, will automatically be considered an appeal. • Confirmation of receipt of your request for appeal will be sent to you within 24 hours of receipt of your request. • Your LIFE Provider will continue to furnish disputed services until a final determination is made if you appeal within 30 calendar days of the notice to you. o If your LIFE Provider is proposing to terminate or reduce services that you are currently receiving; and o If you agree that you will be liable for the costs of the disputed services if the appeal is not resolved in your favor. • An independent review entity will review your appeal and you will be notified in writing of the date and time of that review to have an opportunity to present evidence related to your dispute. • You will receive a written report of the independent review entity’s review within 30 calendar days of receipt of your appeal. That report will describe the appeal, actions taken, and outcome of the review. • If your appeal is resolved in your favor, your LIFE Provider will provide or pay for the disputed service right away. • If the decision is not in your favor, a copy of the written report from the independent review entity will be forwarded immediately to CMS and the Department. You will also be notified in writing of your additional appeal rights under Medicare, or Medical Assistance through the State Fair Hearing Process. Your LIFE Provider will assist you with your appeal. • If you believe that your life, health, or ability t...
Appeal Procedure. Any grievance concerning the interpretation, application, or alleged breach of any provision of this agreement that has been properly processed through the grievance procedure as set forth above and has not been settled, may be appealed to arbitration by the Association by serving written notice on the Board within fifteen (15) calendar days after the Superintendent’s answer at Step 3 of the said grievance procedure. If the Association fails to serve such notice of its intention to arbitrate within this time limitation, it shall be deemed to have waived the arbitration and the grievance shall be considered settled. No individual employee shall have the right to invoke this arbitration procedure.
Appeal Procedure. Upon request of the Local Union, an Appointing Authority shall develop an internal appeal system to review the denial of a training request. A copy of the appeal and the determination shall be sent to the Local Union. Such determination shall not be grievable.
Appeal Procedure. If the claimant’s claim is denied, the claimant (or his or her authorized representative) may apply in writing to the Administrator for a review of the decision denying the claim. Review must be requested within 60 days following the date the claimant received the written notice of their claim denial or else the claimant loses the right to review. The claimant (or representative) then has the right to review and obtain copies of all documents and other information relevant to the claim, upon request and at no charge, and to submit issues and comments in writing. The Administrator will provide written notice of its decision on review within 60 days after it receives a review request. If additional time (up to 60 days) is needed to review the request, the claimant (or representative) will be given written notice of the reason for the delay. This notice of extension will indicate the special circumstances requiring the extension of time and the date by which the Administrator expects to render its decision. If the claim is denied (in full or in part), the claimant will be provided a written notice explaining the specific reasons for the denial and referring to the provisions of the Plan on which the denial is based. The notice also will include a statement that the claimant will be provided, upon request and free of charge, reasonable access to, and copies of, all documents and other information relevant to the claim and a statement regarding the claimant’s right to bring an action under Section 502(a) of ERISA.
Appeal Procedure. If not satisfied with the above referenced decision, the UAW may file a written appeal of the decision within five (5) business days after service of the decision. The appeal must specify the unresolved issues, all relevant facts and the remedy requested. The appeal shall be submitted to Campus Labor Relations. Campus Labor Relations will immediately notify the parties of the need to appoint panel members. The dispute will be submitted to a Dispute Resolution Panel, as defined herein. The Dispute Resolution Panel will be comprised of two campus specific members of the Academic Senate. The UAW and the Chancellor or designee each will name a member to the Panel within five (5) business days of the receipt of the appeal by the Campus Labor Relations Office. The Dispute Resolution Panel will hold a hearing no later than twenty (20) business days following the filing of the appeal. The Dispute Resolution Panel shall issue a written decision within five (5) business days following said hearing. In the event the Dispute Resolution Panel is deadlocked and cannot issue a decision, they will select a third person to join the Panel. This third panel member shall be selected from a list set forth in Appendix D on the date the decision is due. The three-member panel will then review the appeal. The three member Dispute Resolution Panel will issue its decision within five (5) business days of the appointment of the third panel member. Said decision will be final and binding and not subject to Grievance and Arbitration, Article 11 of this Agreement. The list set forth in Appendix D will be comprised of ten (10) names designated by the UAW and ten names designated by the Office of the President. Each individual to be included on Appendix D must be a member of the Academic Senate on any of the University of California campuses, have expertise as a neutral in labor-management dispute resolution, and have expertise in matters of faculty governance. The parties reserve the right to annually amend the names each has respectively designated on Appendix D by September 1 of each year, and when a vacancy occurs. The Dispute Resolution Panel shall apply the terms of the contract and fashion a remedy where appropriate in a fair and neutral manner. Disputes regarding the designation of names to Appendix D may be challenged by either party within 30 days of designation and shall be submitted to an arbitrator for resolution.
Appeal Procedure. 1. Either disputing party may appeal before the Appeal Tribunal a provisional award, within 90 days of its issuance. The grounds for appeal are:
Appeal Procedure. Where an employee feels they have been aggrieved by the decision of the selection panel, the President or the President's designate may appeal the decision in accordance with Clause 8.4 within fourteen (14) days of the employee receiving the Employer's written reply to their request for the reasons why they were unsuccessful.
Appeal Procedure. An employee directly affected by the operation of this policy may, within five (5) working days after a notice of layoff is received, request a meeting with a department head or the department head’s designated representative to review the application of this policy as it affects the employee’s status. The employee may be accompanied by a representative of the Union. The Union, and only the Union, after making an attempt to resolve the matter informally, may with seven (7) days of the date of an alleged violation of this policy file a grievance for final consideration and determination at the department head level in accordance with the provisions of the grievance procedure in effect between the County and the Union. A grievance filed in accordance with this paragraph shall not be subject to the Arbitration provision of the Grievance procedure section of this Agreement.
Appeal Procedure. Any “appeal” from the Board’s decision on layoff or recall, pursuant to this Article, shall be by means of expedited Arbitration, as follows:
