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Understanding Claim Deficiencies and Responding to Letters

Letters are generated when a claim is missing required information. This page will allow you to search for:

Letter Text	Letter Explanation
Letter Instructions	Letter Examples

To Search, simply follow the instructions below:

Code	Type	Option	Text
000	Deficiency	BOTH	Failure To Choose Claim Process
001	Deficiency	BOTH	Death Certificate not Provided
002	Deficiency	BOTH	Certificate of Official Capacity
003	Deficiency	BOTH	Injured Party's Social Security Number not Provided
004	Deficiency	BOTH	Injured Party's Date of Birth not Provided
005	Deficiency	BOTH	Original Lawsuit State not Provided
006	Deficiency	BOTH	Original Lawsuit Date not Provided
007	Deficiency	BOTH	Date of Alleged Diagnosis and/or Alleged Injury not Provided
008	Deficiency	BOTH	Signature of Claimant and/or Personal Representative not Provided
009	Deficiency	BOTH	First and Last Dates of Exposure Not Provided
010	Deficiency	BOTH	Industry and Occupation not Provided
011	Deficiency	BOTH	Personal Representative's Name, SSN and/or Relationship not Provided
013	Deficiency	BOTH	SSN, DOB, DOD and/or Name is inconsistent with Claim Form
014	Deficiency	BOTH	Attachments not Provided
015	Deficiency	BOTH	No Date of Death Provided
016	Deficiency	BOTH	Death Certificate for Wrong Party
017	Deficiency	BOTH	Death Certificate is Incomplete
018	Deficiency	BOTH	Alleged Injury is not Recognized by the Trust
019	Deficiency	BOTH	Litigation Page Failure to Elect Jurisdiction
023	Deficiency	BOTH	Failure to Choose Description for Significant Occupational Exposure (Disease levels III, IV, V & VII
026	Deficiency	IR	Duplicate Financial Dependent
103	Deficiency	BOTH	No Causation or Causation From an Unacceptable Physician
104	Deficiency	BOTH	Latency Period does not Qualify
105	Deficiency	BOTH	No Proof of Alleged Asbestos-Related Injury.
110	Deficiency	BOTH	PFT Report not Provided
112	Deficiency	BOTH	Supporting Medical Report
113	Deficiency	BOTH	PFT Disputes or Conflicts with Earlier Report
114	Deficiency	BOTH	Most Recent PFT Scores do not Qualify
116	Deficiency	BOTH	PFT is from an Unacceptable Facility
117	Deficiency	BOTH	PFT does not meet ATS Standards
118	Deficiency	BOTH	Full PFT Report is Required
120	Deficiency	BOTH	Medical Report not by a Qualified Physician
1201	Deficiency	BOTH	Incomplete/Inconsistent Exposure Information
1203	Deficiency	BOTH	Litigation Date is Prior to Alleged Exposure
1206	Deficiency	BOTH	Inconsistent Injured Party Affidavits
121	Deficiency	BOTH	Chest x-ray Report does not Identify the Physician
1210	Deficiency	BOTH	Deficient Description to Floor Tile Exposure
1211	Deficiency	BOTH	Bystander - Deficient Description to Floor Tile Exposure
122	Deficiency	BOTH	Certified Translation of Foreign Document Required
128	Deficiency	BOTH	No Medical Documents Provided
129	Deficiency	BOTH	Medical Report does not qualify as a Physical Exam
130	Deficiency	BOTH	Medical Report not Provided
131	Deficiency	BOTH	Medical Report Unacceptable Diagnosis
132	Deficiency	BOTH	Medical Report Disputes and/or Conflicts with Earlier Reports
133	Deficiency	BOTH	Medical Report for Wrong Party
134	Deficiency	BOTH	Medical Report is Incomplete
135	Deficiency	BOTH	Pathologist not Board-Certified
136	Deficiency	BOTH	Medical Report is Unacceptable, Final Request
137	Deficiency	BOTH	Medical Report is from an Unacceptable Physician
138	Deficiency	BOTH	Medical Report is from an Unacceptable facility
139	Deficiency	BOTH	Chest X-ray was not read by a Qualified Physician
140	Deficiency	BOTH	Chest X-ray Report Not Provided
141	Deficiency	BOTH	Chest X-Ray Report Unacceptable Diagnosis
143	Deficiency	BOTH	Chest X-Ray Report is for the Wrong Party
144	Deficiency	BOTH	CXR Report is Incomplete or the CXR is Not of Acceptable Quality
145	Deficiency	BOTH	Chest X-Ray Report Findings are not Bilateral
146	Deficiency	BOTH	Chest X-Ray Report is Unacceptable, Final Request
147	Deficiency	BOTH	Chest X-Ray Report is from an Unacceptable Physician
148	Deficiency	BOTH	Chest X-Ray Report is from an Unacceptable Facility
149	Deficiency	BOTH	Severe Asbestosis (Disease Level IV)/ILO Score does not Qualify
150	Deficiency	BOTH	Pathology Report not Provided
151	Deficiency	BOTH	Pathology Report for Wrong Injury
152	Deficiency	BOTH	Pathology Report is not for a Primary Site
153	Deficiency	BOTH	Pathology Report is Incomplete
154	Deficiency	BOTH	Pathology Report has an Unacceptable Diagnosis
155	Deficiency	BOTH	Causation statement is not based on a Physical Exam
156	Deficiency	BOTH	Failure to Choose Description for Significant Occupational Exposure (Disease levels III, IV, V & VII
159	Deficiency	BOTH	B-reader/ILO report based on Review of Digital X-ray is Unacceptable.
160	Deficiency	BOTH	PFT for Wrong Party
161	Deficiency	BOTH	PFT is Incomplete
163	Deficiency	BOTH	Pathology Report for Wrong Party
164	Deficiency	IR	Smoking History not Provided
165	Deficiency	BOTH	PFT Facility not Provided
168	Deficiency	IR	Smoking History does not Match Medicals
170	Deficiency	BOTH	Chest X-ray Diagnosis Unacceptable for Asbestosis
171	Deficiency	BOTH	PE diagnosis disputes the chest x-ray findings
172	Deficiency	BOTH	For deceased claimant the chest X-ray or CT scan was not read by a qualified physician
173	Deficiency	BOTH	No Causation Statement Provided
174	Deficiency	BOTH	Causation Statement is Incomplete
175	Deficiency	BOTH	Causation-Doctor not Qualified/Unacceptable Doctor
176	Deficiency	BOTH	Medical Documents Not Available
210	Deficiency	IR	Duplicate Financial Dependent
212	Deficiency	BOTH	Description for SOE may not meet Criteria (Disease levels III,IV, V & VII Only)
228	Deficiency	BOTH	Significant or Cumulative Occupational Exposure is Insufficient
229	Deficiency	BOTH	Exposure is all Post 1982
231	Deficiency	BOTH	Pre-1983 Significant Occupational Exposure is Insufficient
269	Deficiency	BOTH	Check Box for Previously Submitted Physical Examinations
270	Deficiency	BOTH	Incomplete or No Vessel Service History Provided (Maritime)
601	Deficiency	BOTH	Exposure Information does not Match Claim Form
602	Deficiency	BOTH	Name of Ship/Plant/Site not Provided.
604	Deficiency	BOTH	Company Exposure Insufficient
609	Deficiency	BOTH	Need Information for Occupationally Exposed Person
613	Deficiency	BOTH	Failure to Provide Description of Cumulative Exposure
618	Deficiency	BOTH	Exposure to Occupationally Exposed Person is Inadequate
6204	Deficiency	BOTH	Industry Not Provided
6205	Deficiency	BOTH	Occupation of Injured Party not Provided
6208	Deficiency	BOTH	Litigation Page Failure to Elect Jurisdiction
6214	Deficiency	BOTH	Revisions to Verified Documents
624	Deficiency	BOTH	Exposure Dates not Provided
625	Deficiency	BOTH	Separate the Years of Exposure at Each Site
627	Deficiency	BOTH	Verified Company Exposure
630	Deficiency	BOTH	Pre-1983 Exposure is Insufficient
632	Deficiency	BOTH	Exposure Dates Outside Recognized Range
633	Deficiency	IR	Occupationally Exposed Person's Name and/or Social Security Number
636	Deficiency	BOTH	The Industry/Occupation and/or description of exposure is not acceptable.
637	Deficiency	BOTH	A company product was not specified, is generic or is not recognized by the Trust.
638	Deficiency	BOTH	Affidavit contains multiple company products and/or multiple sites.
650	Deficiency	BOTH	No Verified Company Exposure Provided
651	Deficiency	BOTH	Verified Company Exposure is Insufficient
657	Deficiency	BOTH	Change of Occupation
667	Deficiency	ER	Secondary Exposure/Foreign Claim Process
671	Deficiency	BOTH	Company Exposure Insufficient (Maritime)
673	Deficiency	BOTH	Intermittent or On and Off Exposure
677	Deficiency	BOTH	Affidavit Signed by POA/ Need POA
678	Deficiency	BOTH	Product Dates Outside Recognized Manufacture Dates
682	Deficiency	BOTH	Failure to Provide Description of Exposure to Company Products
684	Deficiency	BOTH	Affidavit for Company Exposure is not acceptable.
685	Deficiency	BOTH	The Site(s) of Exposure Listed on Claim Form/Does not Match the Site Code
689	Deficiency	BOTH	Affidavit not Notarized or Does not Otherwise Meet the State Requirements
690	Deficiency	BOTH	Insufficient Description of Exposure to Company Product.
693	Deficiency	BOTH	Medical Report Language is Unacceptable
694	Deficiency	BOTH	Medical Report Disputes and/or Conflicts with Earlier Reports
695	Deficiency	BOTH	Chest X-Ray Report Disputes or Conflicts with Earlier Reports
696	Deficiency	BOTH	Failure to Specify Length of Company Exposure Prior to 12/31/1982.
698	Deficiency	BOTH	Industry and/or Occupation does not match Site/Plant name submitted on the Claim Form.
699	Deficiency	BOTH	Injured Party's Exposure Begins as an Adolescent
C-501	Deficiency	BOTH	Possible Secondary Exposure Claim
C-502	Deficiency	BOTH	Possible Foreign Claim
C-504	Deficiency	BOTH	No Celotex Review of Claim
C-510	Deficiency	BOTH	B&W Exposure
C-511	Deficiency	BOTH	SOE Exposure
C-512	Deficiency	BOTH	Cumulative Exposure
C-520	Deficiency	BOTH	Diagnosis Language
C-530	Deficiency	BOTH	Medical Report and/or Pathology Report/None
Intake Deficient	Status	BOTH	The claim is missing basic information that is required prior to being sent for review.
Offer Issued	Status	BOTH	A settlement offer has been issued.
Paid	Status	BOTH	The claim settlement check is issued.
R01	Deficiency	BOTH	Certificate of Official Capacity
R02	Deficiency	BOTH	Personal Representative's Name Not Provided
R03	Deficiency	BOTH	New Personal Representative Information Needed
R04	Deficiency	BOTH	Missing Two Witness Signatures
R05	Deficiency	BOTH	No Death Certificate
R06	Deficiency	BOTH	No Notary Stamp/Embossed
R07	Deficiency	BOTH	Incomplete Release Received
R08	Deficiency	BOTH	Corrected SSN
R11	Deficiency	BOTH	No Power of Attorney
R14	Deficiency	BOTH	Incorrect Release Received
R16	Deficiency	BOTH	Notary not complete or missing information
R17	Deficiency	BOTH	Signature dates do not match on the release
R18	Deficiency	BOTH	No claimant signature
R19	Deficiency	BOTH	Missing signature page of release
R20	Deficiency	BOTH	Notary stamp/seal not legible
R21	Deficiency	BOTH	New release with new PR information needed
R22	Deficiency	BOTH	Personal representative is deceased
R24	Deficiency	BOTH	Incomplete Release Executed Date
Ready to Re-Review	Status	BOTH	The claim is awaiting medical and exposure re-review of the alleged injury(s).
Ready to Review	Status	BOTH	The claim is awaiting medical and exposure review of the alleged injury(s).
Release Received	Status	BOTH	The release was returned and received by the Trust.
Review	Status	BOTH	The claim is in the review process.
Review Deficient	Status	BOTH	The claim has been reviewed for the alleged injury(s) and is missing information necessary to comple
Withdrawn	Status	BOTH	The claim is withdrawn.