Title
Approval of Case #20-2 Dental Request
Report
Issue:
Whether to approve payment for dental expenses for LEOFF 1 member.
Staff Contact:
Debbi Hufana, HR Analyst, Human Resources, 360.753.8149
Background:
The board must decide whether or not to approve the request for dental work for a bridge, buildups and filings in the amount of $7,635.00.
The member is requesting dental work to include a bridge to replace missing teeth and fillings.
This request is in accordance with LEOFF 1 Disability Board Policies & Procedures.
Attachments:
Application for Payment of Services
Letter of Current Condition and Recommended Treatment
Treatment Plan
Photo of Tooth Wear
Reference:
Section H. Dental Benefits