O-I Medical Requirements and Evidence Required to Establish an Asbestos- Related Disease for Expedited 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, then pathological evidence of the non-malignant asbestos-related disease.
2. Evidence of an underlying bilateral asbestos-related non-malignant disease based upon either:
- 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
- Pathology, in each case showing either bilateral interstitial fibrosis, bilateral pleural plaques, bilateral pleural thickening, or bilateral pleural calcification.
3. 10 year latency.
Exposure Criteria
1. Credible evidence of exposure prior to December 31, 1958 to asbestos or asbestos products for which Debtor has legal responsibility.
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, then pathological evidence of the non-malignant asbestos-related disease.
2. Evidence of an underlying bilateral asbestos-related non-malignant disease based upon either:
- 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
- Pathology, in each case showing either bilateral interstitial fibrosis, bilateral pleural plaques, bilateral pleural thickening, or bilateral pleural calcification.
3. 10 year latency.
Exposure Criteria
1. Six months Debtor exposure prior to December 31, 1958, plus
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, then pathological evidence of the non-malignant asbestos-related disease.
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
- Pathology, in each case showing either 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. Supporting medical documentation establishing asbestos exposure as a contributing factor in causing the pulmonary disease.
5. 10 year latency.
Exposure Criteria
1. Six months Debtor exposure prior to December 31, 1958, plus
2. Five years Significant Occupational Exposure (“SOE”)4 to asbestos.
Level IV: Severe Asbestosis
Medical Criteria
1. A living claimant at the time the claim was filed, a diagnosis of Severe Asbestosis based upon:
- A physical exam of the claimant by the physician providing the diagnosis,
- An ILO of 2/1 or greater, or pathological evidence of asbestosis, and
- Pulmonary function testing* with either
- TLC less than 65%, or
- FVC less than 65% and FEV1/FVC ration greater than 65%.
- Pulmonary function test must be in compliance with the quality criteria established by the ATS3
2. A deceased claimant at the time the claim was filed, a diagnosis of Severe Asbestosis shall be based upon either
- A physical exam of the claimant by the physician providing the diagnosis along with an ILO of 2/1 or greater,
- Pathological evidence of asbestosis, or
- The medical documentation required for an Asbestosis Death.
- An Asbestosis Death, which is defined to mean a death where
- Asbestosis is listed as the cause or a significant contributing cause of death on the death certificate, or
- A report from a Qualified Physician who is a pathologist, a pulmonologist or an occupational medicine physician states that asbestosis was a significant contributing cause of death.
3. Supporting medical documentation establishing asbestos exposure as a contributing factor in causing the pulmonary disease.
4. 10 year latency.
Exposure Criteria
1. Six months Debtor exposure prior to December 31, 1958, plus
2. Five years Significant Occupational Exposure (“SOE”)4 to asbestos.
*In the case of a Severe Asbestosis diagnosis, the claimant must also provide Pulmonary Function Testing unless the claimant is able to meet the requirements in 1(c) of the Medical/Exposure Criteria for Severe Asbestosis in Section 5.3(a)(3):
- 1(c): A diagnosis of asbestosis with ILO of 2/1 or greater, or asbestosis determined by pathological evidence of asbestosis, plus
- a Qualified Physician who is a pulmonologist or an occupational medicine physician prescribes oxygen to the injured party.
- the treating Qualified Physician states that the predominant cause of the need for oxygen is asbestosis, and
- the oxygen is needed by the injured party to perform activities of daily life (e.g., not oxygen that is prescribed only for comfort care, at night, for surgery, or on occasion)
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 either:
- 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
- Pathology, in each case showing either bilateral interstitial fibrosis, bilateral pleural plaques, bilateral pleural thickening, or bilateral pleural calcification.
3. Supporting medical documentation establishing asbestos exposure as a contributing factor in causing the other cancer in question.
4. 10 year latency.
Exposure Criteria
1. Six months Debtor exposure prior to December 31, 1958, plus
2. Five years Significant Occupational Exposure (“SOE”)4 to asbestos.
Level VII: Lung Cancer 1
Medical Criteria
1. A diagnosis of a primary lung cancer based upon:
- 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 level 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
- Pathology, in each case showing either bilateral interstitial fibrosis, bilateral pleural plaques, bilateral pleural thickening, or bilateral pleural calcification.
3. Supporting medical documentation establishing asbestos exposure as a contributing factor in causing the lung cancer in question.
4. 10 year latency.
Exposure Criteria
1. Six months Debtor exposure prior to December 31, 1958, plus
2. Five years Significant Occupational Exposure (“SOE”)4 to asbestos.
Level VIII: Mesothelioma
Medical Criteria
1. A diagnosis of mesothelioma based upon either:
- A physical exam of the claimant by a 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 exposure prior to December 31, 1958 to asbestos or asbestos products for which Debtor has legal responsibility.
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, if an ILO reading is not available, then the Trust 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).