11.01.140 Submission of Claims

All claims made by employees for compensation under this chapter shall be submitted to the Tribal Benefit Specialist who shall review the claim for evaluation of eligibility of payment. The Tribal Benefit Specialist shall evaluate each claim for payment of benefits based on the eligibility criteria and available benefits established in this chapter and the health and disability plan which may be adopted by the Band. The Tribal Benefit Specialist shall promptly evaluate all claims and either pay out health and/or disability benefits to eligible employees or deny such claims. A complete explanation of benefits, or in the case of a denial of benefits statement shall be forwarded to the employee.