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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.  AWI exposure prior to December 31, 1982.

Note:  Individual Review Process may not be elected for Level I claims unless the PI Trust deems that it has failed to meet the presumptive Medical/Exposure criteria.

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

Exposure Criteria

1.  Six months AWI 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 AWI 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.  AWI 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 AWI 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 AWI 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.

1For claims 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 AWI will accept a chest x-ray report (read by a Qualified Physician) 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).