IR Medical Requirements

AWI Medical Requirements and Evidence Required to Establish an Asbestos-Related Disease for Individual Review Claimants

Level I: Other Asbestos Disease

Medical Criteria

1.  Diagnosis of a bilateral asbestos-related non-malignant disease or an asbestos-related malignancy other than mesothelioma based upon either:

• A physical exam of the claimant by the physician providing the diagnosis, or
• If the claimant is deceased at the time the claim was filed, pathological evidence of the non-malignant asbestos-related disease.

2.  Evidence of a bilateral asbestos-related non-malignant disease based upon:

• A chest x-ray read by a certified B-reader of 1/0 or higher¹; or
• A chest x-ray read by a certified B-reader or read by a qualified physician², or
• A CAT scan read by a qualified physician², or
• A pathology report, in each case, showing bilateral interstitial fibrosis, bilateral pleural plaques, bilateral pleural thickening, or bilateral pleural calcification.

3.  10 year latency.

Exposure Criteria

1.  B&W exposure prior to December 31, 1982.

Level II: Asbestosis/Pleural Disease

Medical Criteria

1.  Diagnosis of an asbestos-related non-malignant disease based upon either:

• A physical exam of the claimant by the physician providing the diagnosis, or
• If the claimant is deceased at the time the claim was filed, pathological evidence of the non-malignant asbestos-related disease.

2.  Evidence of a bilateral asbestos-related non-malignant disease based upon:

• A chest x-ray read by a certified B-reader of 1/0 or higher¹; or
• A chest x-ray read by a certified B-reader or read by a qualified physician², or
• A CAT scan read by a qualified physician², or
• A pathology report, in each case, showing bilateral interstitial fibrosis, bilateral pleural plaques, bilateral pleural thickening, or bilateral pleural calcification.

3.  10 year latency.

Exposure Criteria

1.  Six months B&W exposure prior to December 31, 1982, and

2.  Five years cumulative occupational exposure to asbestos.

Level III: Asbestosis/Pleural Disease

Medical Criteria

1.  Diagnosis of an asbestos-related non-malignant disease based upon either:

• A physical exam of the claimant by the physician providing the diagnosis, or
• If the claimant is deceased at the time the claim was filed, pathological evidence of the non-malignant asbestos-related disease.

2.  Evidence of a bilateral asbestos-related non-malignant disease based upon:

• A chest x-ray read by a certified B-reader of 1/0 or higher¹ , or
• A chest x-ray read by a certified B-reader or read by a qualified physician², or
• A CAT scan read by a qualified physician², or
• A pathology report, in each case, showing bilateral interstitial fibrosis, bilateral pleural plaques, bilateral pleural thickening, or bilateral pleural calcification.

3.  Pulmonary Function Testing with either:

• A TLC less than 80%, or
• FVC less than 80% and FEV1/FVC ratio greater than or equal to 65%, or
• Pulmonary Function Test must be in compliance with the quality criteria established by the ATS³.

4.  10 year latency.

5.  Supporting medical documentation establishing asbestos exposure as a contributing factor in causing the pulmonary disease.

Exposure Criteria

1.  Six months B&W exposure prior to December 31, 1982, plus

2.  Significant Occupational Exposure⁴ to asbestos.

Level IV: Severe Asbestosis

Medical Criteria

1.  Diagnosis of asbestosis based upon either:

• A physical exam of the claimant by the physician providing the diagnosis, or
• If the claimant is deceased at the time the claim was filed, pathological evidence of the non-malignant asbestos-related disease.

2.  An ILO of 2/1 or greater, or

• Pathological evidence of asbestosis.

3.  Pulmonary Function Testing with either:

• TLC less that 65%, or
• FVC less than 65% and FEV1/FVC ratio greater than 65%, or
• Pulmonary Function Test must be in compliance with the quality criteria established by the ATS³.

4. 10 Year Latency

5. Supporting medical documentation establishing asbestos exposure as a contributing factor in causing the pulmonary disease.

Exposure Criteria

1.  Six months B&W exposure prior to December 31, 1982, plus

2.  Significant Occupational Exposure⁴ to asbestos.

Level V: Other Cancer

Medical Criteria

1.  A diagnosis of a primary colo-rectal, laryngeal, esophageal, pharyngeal, or stomach cancer based upon either:

• A physical exam of the claimant by the physician providing the diagnosis of the asbestos related disease , or
• A diagnosis of such a malignant disease by a board-certified pathologist or by a pathology report prepared at or on behalf of a JCAHO accredited hospital.

2.  Evidence of an underlying bilateral asbestos-related non-malignant disease based upon:

• A chest x-ray read by a certified B-reader of 1/0 or higher¹ , or
• A chest x-ray read by a certified B-reader or read by a qualified physician², or
• A CAT scan read by a qualified physician², or
• A pathology report, in each case, showing bilateral interstitial fibrosis, bilateral pleural plaques, bilateral pleural thickening, or bilateral pleural calcification.

3.  A causal statement from a medical doctor linking the other cancer to asbestos exposure.

4.  10 year latency.

Exposure Criteria

1.  Six months B&W exposure prior to December 31, 1982, plus

2.  Significant Occupational Exposure⁴ to asbestos.

Level VI: Lung Cancer 2

Medical Criteria

1.  A diagnosis of a primary lung cancer based upon either:

• A physical exam of the claimant by the physician providing the diagnosis of the asbestos related disease , or
• A diagnosis of such a malignant disease by a board certified pathologist, or by a pathology report prepared at or on behalf of a JCAHO accredited hospital..

2.  A causal statement from a medical doctor linking the lung cancer to asbestos exposure.

3.  10 year latency.

Exposure Criteria

1.  B&W exposure prior to December 31, 1982:

* Lung Cancer 2 (Level VI) claims are claims that do not meet the medical and/or exposure criteria of Lung Cancer 1(Level VII).  All claims with this Disease Level will be individually evaluated.

There is no distinction between non-smokers and smokers for either Lung Cancer 1 (Level VII) or Lung Cancer 2 (Level VI).  A claimant who meets the requirements of Lung Cancer 1, and is a non-smoker may wish to have his or her claim individually evaluated by the Trust.

Level VII: Lung Cancer 1

Medical Criteria

1.  A diagnosis of a primary lung cancer based upon either:

• A physical exam of the claimant by the physician providing the diagnosis  of the asbestos related disease, or
• A diagnosis of such a malignant disease by a board-certified pathologist, or by a pathology report prepared at or on behalf of a JCAHO accredited hospital. .

2.  Evidence of an underlying bilateral asbestos-related non-malignant disease based upon:

• A chest x-ray read by a certified B-reader of 1/0 or higher¹, or
• A chest x-ray read by a certified B-reader or other qualified physician², or
• A CAT scan read by a qualified physician², or
• A pathology report, in each case showing bilateral interstitial fibrosis, bilateral pleural plaques, bilateral pleural thickening, or bilateral pleural calcification.

3.  A causal statement from a medical doctor linking the lung cancer to asbestos exposure.

4.  10 year latency.

Exposure Criteria

1.  Six months B&W exposure prior to December 31, 1982, plus

2.  Significant Occupational Exposure⁴ to asbestos.

Level VIII: Mesothelioma

Medical Criteria

1.  A diagnosis of mesothelioma based upon either:

• A physical exam of the claimant by the physician providing the diagnosis of the asbestos related disease , or
• A diagnosis of such a malignant disease by a board-certified pathologist or by a pathology report prepared at or on behalf of a JCAHO accredited hospital. .

2.  10 year latency.

Exposure Criteria

1.  Credible evidence of B&W exposure.

Note:  A finding by a physician after the Effective Date that a claimant’s disease is “consistent with” or “compatible with” asbestosis will not alone be treated by the Trust as a diagnosis.  However, if a claim was filed before the petition date, then a diagnosis of “consistent with” or “compatible with” asbestosis will be accepted by the Trust.

¹For claims filed before the petition date, if an ILO reading is not available, then B&W will accept a chest x-ray report regardless of whether it was read by a qualified B-reader.

²Qualified Physician – Physician board-certified in a specialized field of medicine, such as pulmonology, radiology, internal medicine, or occupational medicine.

³ATS – American Thoracic Society.

⁴Significant Occupational Exposure – Employment for a cumulative period of at least five years with a minimum of two years prior to December 31, 1982 in an industry and an occupation in which the claimant:

a) handled raw asbestos fibers on a regular basis; or
b) fabricated asbestos-containing products so that the claimant in the fabrication process was exposed on a regular basis to raw asbestos fibers; or
c) altered, repaired or otherwise worked with asbestos-containing products such that the claimant was exposed on a regular basis to asbestos fibers; or
d) was employed in an industry and occupation such that the claimant worked on a regular basis in close proximity to workers engaged in the activities described in (a), (b) and/or (c).