Medical Criteria and
Disease Levels for Asbestos Litigation
Non-malignant Conditions--For
non-malignant conditions (Levels I to V), the medical
criteria generally require a diagnosis of bilateral pleural
plaques or thickening, bilateral pleural calcification,
diffuse pleural thickening, bilateral pleural disease of
grade B2, or asbestosis based on x-ray readings or
pathology. Level II includes claimants with mixed
obstructive and restrictive disease based on pulmonary
function testing and supporting medical documentation, such
as a written opinion by the examining or diagnosing
physician according to diagnostic guidelines establishing
that asbestos exposure was a contributing factor to the
disease. Mild, moderate and severe impairment is required
for Levels III, IV, and V, respectively, based on pulmonary
function test results and supporting medical documentation,
such as a written opinion by the examining or diagnosing
physician according to diagnostic guidelines establishing
that the claimant's asbestos exposure is a substantial
contributing factor in causing the pulmonary condition in
question. Level I requires five years cumulative
occupational exposure, while levels II through V require
five years substantial occupational exposure weighted based
on time and industry (“weighted years”).
Malignant Conditions--For malignant
conditions (Levels VI to IX), the medical criteria require
a diagnosis of mesothelioma, primary lung cancer, or other
cancer.
Level VI (other cancers) claims include (i) a diagnosis of
primary colorectal, laryngeal, esophageal, pharyngeal, or
stomach cancer; (ii) evidence of a bilateral
asbestos-related nonmalignant disease; (iii) fifteen
weighted years of exposure to asbestos; and (iv) supporting
medical documentation, such as a written opinion by the
examining or diagnosing physician according to diagnostic
guidelines establishing that the claimant's exposure to
asbestos was a substantial contributing factor in causing
the claimant's other cancer. Level VII claims must include:
(i) a diagnosis of primary lung cancer; (ii) evidence of
bilateral pleural plaques, thickening, or calcification as
established by chest x-ray or any such diagnostic
methodology supported by the findings of the Institute of
Medicine; (iii) evidence of twelve or more weighted years
of substantial occupational exposure; and (iv) medical
documentation, such as a written opinion by the examining
or diagnosing physician according to diagnostic guidelines,
establishing asbestos exposure as a substantial
contributing factor in causing the cancer. Level VIII
claims must include: (i) a diagnosis of a primary lung
cancer disease; (ii) evidence of asbestosis based on a
chest x-ray showing irregular opacities and the relevant
weighted years of exposure; and (iii) supporting medical
documentation, such as a written opinion by the examining
or diagnosing physician according to diagnostic guidelines
establishing that the claimants exposure to asbestos for
ten or more weighted years was a substantial contributing
factor in causing the claimant's cancer. Level IX claims
shall include: (i) a diagnosis of malignant mesothelioma;
and (ii) credible evidence resulting from occupational,
take home, or other identifiable exposure to asbestos.
Diagnosis of all of the malignant disease levels must be
made by a board certified pathologist.
Exceptional Medical Claims: This allows a
claimant to have a claim designated an exceptional medical
claim if the claim does not meet the medical criteria
requirements of the bill or has been found ineligible for
compensation based on the failure to meet the medical
criteria only. The claimant must provide a report from a
physician meeting the requirements of this section which
includes (i) a complete review of the claimant's medical
history and current condition, (ii) additional material as
required by the Administrator, and (iii) a detailed
explanation as to why the claim meets the standard for
designating exceptional medical claims.
A Physicians Panel shall review all applications for
designation as an exceptional medical claim. For the claim
to receive treatment as an exceptional medical claim, a
Physicians Panel must find that the claimant cannot meet
the requirements for reasons beyond the individual's
control, but can through comparably reliable evidence
establish a condition similar to one that would satisfy the
requirements. In reaching its determination, a Physicians
Panel may request additional reasonable testing. Further,
the claimant may submit CT scans in addition to an x-ray.
If a Physicians Panel certifies a claim as an exceptional
medical claim, it must designate the disease category for
which the claimant may seek compensation and refer the
claim to the Administrator for a determination on
eligibility on the remaining diagnostic, latency and
exposure requirements. In making this determination, the
Administrator shall give due consideration to the
recommendation of the Physicians Panel. If a Physicians
Panel denies claimant's application for designation as an
exceptional medical claim, then the claimant may resubmit
application based on new evidence, specifying the new
evidence that serves as the basis of the resubmission.
Naturally Occurring Asbestos--Claimants
exposed to naturally occurring asbestos may file and seek
designation as an exceptional medical claim.--Claimants
exposed to naturally occurring asbestos may file and seek
designation as an exceptional medical claim.
(excerpted from the US Senate's Hearings on the FAIR Act, and Modified by AntiHubris.com)
BREAKING NEWS!
Mesothelioma Pleads
Guilty!
Unexpected plea indites White House, Asbestos, & Vioxx
Washington, D.C. In a shocking turn of events, Mesothelioma
today pleaded guilty on all charges... read more.