*2026-04-13 Disclosure Claim Data Report

Claim Number:42647461 Worker Name:MARK HOLAND Date Created:13-4-2026 1:05 PM

Eligibility Home: MARK HOLAND- 42647461

Claim Eligibility-Details
Process: Assisted Eligibility Eligibilty Status: Disallowed
Date Processed: 2026/03/20 14:45
Reconsideration Days Remaining: 51

Injury Eligibility Details

Date Processed Injury Process Eligibility Status
2026/03/20 14:45 Assisted Eligibility Disallowed
2026/03/20 14:45 SUDDEN HEARING LOSS, UNSPECIFIED Assisted Eligibility Denied

2026/03/20 14:45 AGGRAVATION OF A PRE-EXISTING OTHER CONDITIONAssisted Eligibility Denied
Eligibility History

Date Processed Eligibility Type Injury Process Eligibility Status
2026/03/20 14:45 Injury AGGRAVATION OF __ Assisted Eligibility Denied
A PRE-EXISTING
OTHER CONDITION
2026/03/20 14:45 Injury SUDDEN HEARING Assisted Eligibility Denied
LOSS, UNSPECIFIED
2026/03/20 14:45 Claim Assisted Eligibility Disallowed

2026/02/03 11:27 Claim System-based Eligibility Pending

Page 12