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Deficiency - 136 - Medical Report/Final Request

Explanation: Final request for medical report diagnosing the alleged injury

Instructions: This is our final request for a signed and dated medical report providing evidence of a physical examination by a qualified physician and an acceptable diagnosis of the alleged injury. Without additional information, this claim will not be capable of further review.

Detail Text: This is the final request for a signed and dated medical report providing evidence of a physical examination by a qualified physician, and an acceptable diagnosis of the alleged injury as required by the Trust's Instructions for Filing a Claim. A pathology or autopsy report is acceptable if it provides the appropriate diagnosis. Without additional information, this claim will not be capable of further review.

Option: BOTH

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