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Motion for Telephonic Appearance

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Motion for Telephonic Appearance Powered By Docstoc
					 1
     Lien Claimant’s information
 2   Address
 3   Phone :
     Fax:
 4
     (insert your name)
 5   Hearing Representative for the Lien Claimant
 6

 7                   BEFORE THE WORKERS COMPENSATION APPEALS BOARD
 8                                  OF THE STATE OF CALIFORNIA
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10    (injured workers name),                         )   WCAB NO.:
                                                      )
11                    Applicant ,                     )   MOTION FOR TELEPHONIC APPERANCE
                                                      )
12             vs.                                    )   Hearing Date:
                                                      )   Time:
13    (Employers name) and (Insurer or adjusting      )   Presiding Judge:
                                                      )
14    agency) Defendant.                              )
                                                      )
15

16             NOW COMES, (insert lien claimants) through and by their Hearing/Lien representative,
17   ( insert Hearing reps name) files this Petition for a telephonic appearance. Tulare Occupational
18   Medicine has been served with a Notice of Expedited Hearing for (insert date) .
19          On this date I have a ( reason for non-appearance)
20          My health is important and I am also a qualified injured worker. Therefore, I am
21   requesting that I be allowed to participate via telephonic appearance. Ms Galicia states that she
22   can attend but I cannot physically be there. I submitted a joint letter and faxed it to Ms. Logoluso
23   but she did not sign it and I have heard nothing in regards to my request. Since I do not want this
24   matter to be continued I respectfully request that I be allowed to attend telephonically. The
25   matter is set to determine whether Ms _______ should be placed into an MPN. There is also an

                                    MOTION FOR TELEPHONIC APPERANCE
 1   outstanding balance with regards to (insert lien claimant) , but the most important thing is the
 2   injured worker and her treatment at the moment. I can be contacted at (must put the number
 3   where you can be reached).
 4

 5   DATED:                                             _______________________________
 6                                                      (insert your name) Hearing Representative
                                                        For (insert lien claimants name)
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                                  MOTION FOR TELEPHONIC APPERANCE

				
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posted:4/15/2010
language:English
pages:2