fice of Asbestos Disease Compensation and the As-
bestos Insurers Commission. 
(2) CONFIDENTIALITY.—Any person may des-
ignate any record submitted under this section as a 
confidential commercial or financial record for pur-
poses of section 552 of title 5, United States Code. 
The Administrator and the Chairman of the Asbes-
tos Insurers Commission shall adopt procedures for 
designating such records as confidential. Information 
on reserves and asbestos-related liabilities submitted 
by any participant for the purpose of the allocation 
of payments under subtitles A and B of title II shall 
be deemed to be confidential financial records. 
SEC. 102. ADVISORY COMMITTEE ON ASBESTOS DISEASE 
COMPENSATION. 
(a) ESTABLISHMENT.—
(1) IN
GENERAL.—Not later than 120 days 
after the date of enactment of this Act, the Adminis-
trator shall establish an Advisory Committee on As-
bestos Disease Compensation (hereinafter the ‘‘Advi-
sory Committee’’). 
(2) COMPOSITION
AND
APPOINTMENT.—The 
Advisory Committee shall be composed of 24 mem-
bers, appointed as follows—
(A) The Majority and Minority Leaders of 
the Senate, the Speaker of the House, and the 
Minority Leader of the House shall each ap-
point 4 members. Of the 4—
(i) 2 shall be selected to represent the 
interests of claimants, at least 1 of whom 
shall be selected from among individuals 
recommended by recognized national labor 
federations; and 
(ii) 2 shall be selected to represent the 
interests of participants, 1 of whom shall 
be selected to represent the interests of the 
insurer participants and 1 of whom shall 
be selected to represent the interests of the 
defendant participants. 
(B) The Administrator shall appoint 8 
members, who shall be individuals with quali-
fications and expertise in occupational or pul-
monary medicine, occupational health, workers 
compensation programs, financial administra-
tion, investment of funds, program auditing, or 
other relevant fields. 
(3) QUALIFICATIONS.—All of the members de-
scribed in paragraph (2) shall have expertise or ex-
perience relevant to the asbestos compensation pro-
gram, including experience or expertise in diagnosing 
asbestos-related diseases and conditions, assessing 
asbestos exposure and health risks, filing asbestos 
claims, or administering a compensation or insur-
ance program. None of the members described in 
paragraph (2)(B) shall be individuals who, for each 
of the 5 years before their appointments, earned 
more than 25 percent of their income by serving in 
matters related to asbestos litigation as consultants 
or expert witnesses. 
(b) DUTIES.—The Advisory Committee shall advise 
the Administrator on—
(1) claims filing and claims processing proce-
dures; 
(2) claimant assistance programs; 
(3) audit procedures and programs to ensure 
the quality and integrity of the compensation pro-
gram; 
(4) the development of a list of industries, occu-
pations and time periods for which there is a pre-
sumption of substantial occupational exposure to as-
bestos; 
(5) recommended analyses or research that 
should be conducted to evaluate past claims and to 
project future claims under the program;
(6) the annual report required to be submitted 
to Congress under section 405; and 
(7) such other matters related to the implemen-
tation of this Act as the Administrator considers ap-
propriate. 
(c) OPERATION OF THE COMMITTEE.—
(1) Each member of the Advisory Committee 
shall be appointed for a term of 3 years, except that, 
of the members first appointed—
(A) 8 shall be appointed for a term of 1 
year; 
(B) 8 shall be appointed for a term of 2 
years; and 
(C) 8 shall be appointed for a term of 3 
years, 
as determined by the Administrator at the time of 
appointment. 
(2) Any member appointed to fill a vacancy oc-
curring before the expiration of the term shall be ap-
pointed only for the remainder of such term. 
(3) The Administrator shall designate a Chair-
person and Vice Chairperson from among members 
of the Advisory Committee appointed under sub-
section (a)(2)(B).
(4) The Advisory Committee shall meet at the 
call of the Chairperson or the majority of its mem-
bers, and at a minimum shall meet at least 4 times 
per year during the first 5 years of the asbestos 
compensation program, and at least 2 times per year 
thereafter. 
(5) The Administrator shall provide to the 
Committee such information as is necessary and ap-
propriate for the Committee to carry out its respon-
sibilities under this section. The Administrator may, 
upon request of the Advisory Committee, secure di-
rectly from any Federal department or agency such 
information as may be necessary and appropriate to 
enable the Advisory Committee to carry out its du-
ties under this section. Upon request of the Admin-
istrator, the head of such department or agency 
shall furnish such information to the Advisory Com-
mittee. 
(6) The Administrator shall provide the Advi-
sory Committee with such administrative support as 
is reasonably necessary to enable it to perform its 
functions. 
(d) EXPENSES.—Members of the Advisory Com-
mittee, other than full-time employees of the United 
States, while attending meetings of the Advisory Com-
mittee or while otherwise serving at the request of the Ad-
ministrator, and while serving away from their homes or 
regular places of business, shall be allowed travel and meal 
expenses, including per diem in lieu of subsistence, as au-
thorized by section 5703 of title 5, United States Code, 
for individuals in the Government serving without pay. 
SEC. 103. MEDICAL ADVISORY COMMITTEE. 
(a) IN GENERAL.—The Administrator may establish 
a Medical Advisory Committee to provide expert advice re-
garding medical issues arising under the statute. 
(b) QUALIFICATIONS.—None of the members of the 
Medical Advisory Committee shall be individuals who, for 
each of the 5 years before their appointments, earned 
more than 25 percent of their income by serving in mat-
ters related to asbestos litigation as consultants or expert 
witnesses. 
SEC. 104. CLAIMANT ASSISTANCE. 
(a) ESTABLISHMENT.—Not later than 180 days after 
the enactment of this Act, the Administrator shall estab-
lish a comprehensive asbestos claimant assistance program 
to—
(1) publicize and provide information to poten-
tial claimants about the availability of benefits for 
eligible claimants under this Act, and the procedures
for filing claims and for obtaining assistance in fil-
ing claims; 
(2) provide assistance to potential claimants in 
preparing and submitting claims, including assist-
ance in obtaining the documentation necessary to 
support a claim; 
(3) respond to inquiries from claimants and po-
tential claimants; and 
(4) provide training with respect to the applica-
ble procedures for the preparation and filing of 
claims to persons who provide assistance or rep-
resentation to claimants. 
(b) RESOURCE CENTERS.—The claimant assistance 
program shall provide for the establishment of resource 
centers in areas where there are determined to be large 
concentrations of potential claimants. These centers shall 
be located, to the extent feasible, in facilities of the De-
partment of Labor or other Federal agencies. 
(c) CONTRACTS.—The claimant assistance program 
may be carried out in part through contracts with labor 
organizations, community-based organizations, and other 
entities which represent or provide services to potential 
claimants, except that such organizations may not have 
a financial interest in the outcome of claims filed with the 
Office.
(d) LEGAL ASSISTANCE.—
(1) IN GENERAL.—As part of the program es-
tablished under subsection (a), the Administrator 
shall establish a legal assistance program to provide 
assistance to asbestos claimants concerning legal 
representation issues. 
(2) LIST OF QUALIFIED ATTORNEYS.—As part 
of the program, the Administrator shall maintain a 
roster of qualified attorneys who have agreed to pro-
vide pro bono services to asbestos claimants under 
rules established by the Administrator. The claim-
ants shall not be required to use the attorneys listed 
on such roster. 
(3) NOTICE.—
(A) NOTICE
BY
ADMINISTRATOR.—The 
Administrator shall provide asbestos claimants 
with notice of, and information relating to—
(i) pro bono services for legal assist-
ance available to those claimants; and 
(ii) any limitations on attorneys fees 
for claims filed under this title. 
(B) NOTICE
BY
ATTORNEYS.—Before a 
person becomes a client of an attorney with re-
spect to an asbestos claim that attorney shall
provide notice to that person of pro bono serv-
ices for legal assistance available for that claim. 
(e) ATTORNEY’S FEES.—
(1) IN
GENERAL.—Notwithstanding any con-
tract, the representative of an individual may not re-
ceive, for services rendered in connection with the 
claim of an individual under this Act, more than 
that percentage specified in paragraph (2) of an 
award made under this Act on such claim. 
(2) APPLICABLE PERCENTAGE LIMITATIONS.—
(A) IN GENERAL.—The percentage limita-
tion under paragraph (1) shall be—
(i) 2 percent for the filing of an initial 
claim; and 
(ii) 10 percent with respect to any 
claim under appellate review. 
(B) EXCEPTION.—The Administrator may 
by rule adopt a lower percentage limitation for 
particular classes of cases if the Administrator 
finds that—
(i) the percentage limitation otherwise 
applicable under this paragraph would re-
sult in unreasonably high compensation to 
claimants’ representatives in such cases; 
and
(ii) such lower percentage limitation 
would be reasonable and would not unduly 
limit the availability of representatives to 
claimants. 
(3) PENALTY.—Any representative of an asbes-
tos claimant who violates this subsection shall be 
fined not more than $5,000. 
SEC. 105. PHYSICIANS PANELS. 
(a) APPOINTMENT.—The Administrator shall, in ac-
cordance with section 3109 of title 5, United States Code, 
appoint physicians with experience and competency in di-
agnosing asbestos-related diseases to be available to serve 
on Physicians Panels as necessary to carry out this Act. 
(b) FORMATION OF PANELS.—
(1) IN GENERAL.—The Administrator shall pe-
riodically determine—
(A) the number of Physicians Panels nec-
essary for the efficient conduct of the medical 
review process under section 121; 
(B) the number of Physicians Panels nec-
essary for the efficient conduct of the excep-
tional medical claims process under section 121; 
and 
(C) the particular expertise necessary for 
each panel.
(2) EXPERTISE.—Each panel shall be composed 
of members having the particular expertise deter-
mined necessary by the Administrator, randomly se-
lected from among the physicians appointed under 
subsection (a) having such expertise. 
(3) PANEL MEMBERS.—Each panel shall consist 
of 3 physicians, 2 of whom shall be designated to 
participate in each case submitted to the panel, and 
the third of whom shall be consulted in the event of 
disagreement. 
(c) QUALIFICATIONS.—To be eligible to serve on a 
Physicians Panel under subsection (a), a person shall be—
(1) a physician licensed in any State; 
(2) board-certified in pulmonary medicine, occu-
pational medicine, internal medicine, oncology, or 
pathology; and 
(3) an individual who, for each of the 5 years 
before and during his or her appointment to a Phy-
sicians Panel, has earned no more than 25 percent 
of his or her income as an employee of a partici-
pating defendant or insurer or a law firm rep-
resenting any party in asbestos litigation or as a 
consultant or expert witness in matters related to 
asbestos litigation.
(d) DUTIES.—Members of the Physicians Panel 
shall—
(1) make such medical determinations as are 
required to be made by Physicians Panels under sec-
tion 121; and 
(2) perform such other functions as required 
under this Act. 
(e) COMPENSATION.—Notwithstanding any limitation 
otherwise established under section 3109 of title 5, United 
States Code, the Administrator shall be authorized to pay 
members of the Physician Panel such compensation as is 
reasonably necessary to obtain their services. 
(f) FEDERAL ADVISORY COMMITTEE ACT.—A panel 
established under this section shall not be subject to the 
Federal Advisory Committee Act (5 U.S.C. App. 2). 
SEC. 106. PROGRAM STARTUP. 
(a) INTERIM REGULATIONS.—Not later than 90 days 
after the enactment of this Act, the Administrator shall 
promulgate interim regulations and procedures for the 
processing of claims under title I and the operation of the 
Fund under title II, including procedures for the expe-
diting of exigent claims. 
(b) INTERIM PERSONNEL.—The Secretary of Labor 
and the Assistant Secretary of Labor for the Employment 
Standards Administration may make available to the Ad-
ministrator on a temporary basis such personnel and other 
resources as may be necessary to facilitate the expeditious 
startup of the program. The Administrator may in addi-
tion contract with individuals or entities having relevant 
experience to assist in the expeditious startup of the pro-
gram. Such relevant experience shall include, but not be 
limited to, experience with the review of workers’ com-
pensation, occupational disease, or similar claims and with 
financial matters relevant to the operation of the program. 
(c) EXIGENT HEALTH CLAIMS.—
(1) IN GENERAL.—The Administrator shall de-
velop procedures to provide for an expedited process 
to categorize, evaluate, and pay exigent health 
claims. Such procedures shall include, pending pro-
mulgation of final regulations, adoption of interim 
regulations as needed for processing of exigent 
claims. 
(2) ELIGIBLE
EXIGENT
HEALTH
CLAIMS.—A 
claim shall qualify for treatment as an exigent 
health claim if the claimant is living and the claim-
ant provides—
(A) documentation that a physician has di-
agnosed the claimant as having mesothelioma; 
or
(B) a declaration or affidavit, from a phy-
sician who has examined the claimant within 
120 days before the date of such declaration or 
affidavit, that the physician has diagnosed the 
claimant as being terminally ill from an asbes-
tos-related illness and having a life expectancy 
of less than 1 year. 
(3) ADDITIONAL EXIGENT HEALTH CLAIMS.—
The Administrator may, in final regulations promul-
gated under section 101(c), designate additional cat-
egories of claims that qualify as exigent health 
claims under this subsection. 
(d) EXTREME FINANCIAL HARDSHIP CLAIMS.—The 
Administrator may, in final regulations promulgated 
under section 101(c), designate categories of claims to be 
handled on an expedited basis as a result of extreme finan-
cial hardship. 
(e) INTERIM ADMINISTRATOR.—Until an Adminis-
trator is appointed and confirmed under section 101(b), 
the responsibilities of the Administrator under this Act 
shall be performed by the Assistant Secretary of Labor 
for the Employment Standards Administration, who shall 
have all the authority conferred by this Act on the Admin-
istrator and who shall be deemed to be the Administrator 
for purposes of this Act. Before final regulations being
promulgated relating to claims processing, the Interim Ad-
ministrator may prioritize claims processing, without re-
gard to the time requirements prescribed in subtitle B of 
this title, based on severity of illness and likelihood that 
the illness in question was caused by exposure to asbestos. 
SEC. 107. AUTHORITY OF THE ADMINISTRATOR. 
The Administrator, on any matter within the jurisdic-
tion of the Administrator under this Act, may—
(1) issue subpoenas for and compel the attend-
ance of witnesses within a radius of 100 miles; 
(2) administer oaths; 
(3) examine witnesses; and 
(4) require the production of books, papers, 
documents, and other evidence. 
Subtitle B—Asbestos Disease 
Compensation Procedures 
SEC. 111. ESSENTIAL ELEMENTS OF ELIGIBLE CLAIM. 
To be eligible for an award under this Act for an as-
bestos-related disease or injury, an individual shall—
(1) file a claim in a timely manner in accord-
ance with section 113; and 
(2) prove, by a preponderance of the evidence, 
that the claimant suffers from an eligible disease or 
condition, as demonstrated by evidence that meets 
the requirements established under subtitle C.
SEC. 112. GENERAL RULE CONCERNING NO-FAULT COM-
PENSATION. 
An asbestos claimant shall not be required to dem-
onstrate that the asbestos-related injury for which the 
claim is being made resulted from the negligence or other 
fault of any other person. 
SEC. 113. FILING OF CLAIMS. 
(a) WHO MAY SUBMIT.—
(1) IN GENERAL.—Any individual who has suf-
fered from a disease or condition that is believed to 
meet the requirements established under subtitle C 
(or the personal representative of the individual, if 
the individual is deceased) may file a claim with the 
Office for an award with respect to such injury. 
(2) DEFINITION.—In this Act, the term ‘‘per-
sonal representative’’ shall have the same meaning 
as that term is defined in section 104.4 of title 28 
of the Code of Federal Regulations, as in effect De-
cember 31, 2003. 
(3) LIMITATION.—A claim may not be filed by 
any person seeking contribution or indemnity. 
(b) STATUTE OF LIMITATIONS.—
(1) IN GENERAL.—Except as provided in para-
graphs (2) and (3), if an individual fails to file a 
claim with the Office under this section within 4 
years after the date on which the individual first—
(A) received a medical diagnosis of an eli-
gible disease or condition as provided for under 
this subtitle and subtitle C; or 
(B) discovered facts that would have led a 
reasonable person to obtain a medical diagnosis 
with respect to an eligible disease or condition, 
any claim relating to that injury, and any other as-
bestos claim related to that injury, shall be extin-
guished, and any recovery thereon shall be prohib-
ited. 
(2) EFFECT ON PENDING CLAIMS.—If an asbes-
tos claimant has any timely filed asbestos claim that 
is pending in a Federal or State court or with a 
trust established under title 11, United States Code, 
on the date of enactment of this Act, such claimant 
shall file a claim under this section within 4 years 
after such date of enactment or be barred from re-
ceiving any award under this title. For purposes of 
this paragraph, a claim shall not be treated as pend-
ing with a trust established under title 11, United 
States Code, solely because a claimant whose claim 
was previously compensated by the trust has or al-
leges—
(A) a non-contingent right to the payment 
of future installments of a fixed award; or
(B) a contingent right to recover some ad-
ditional amount from the trust on the occur-
rence of a future event, such as the reevaluation 
of the trust’s funding adequacy or projected 
claims experience. 
(3) EFFECT OF MULTIPLE INJURIES.—
(A) IN GENERAL.—An asbestos claimant 
who receives an award under this title for an el-
igible disease or condition, and who subse-
quently develops another such injury, shall be 
eligible for additional awards under this title 
(subject to appropriate setoffs for such prior re-
covery of any award under this title and from 
any other collateral source) and the statute of 
limitations under paragraph (1) shall not begin 
to run with respect to such subsequent injury 
until such claimant obtains a medical diagnosis 
of such other injury or discovers facts that 
would have led a reasonable person to obtain 
such a diagnosis. 
(B) SETOFFS.—Except as provided in sub-
paragraph (C), any amounts paid or to be paid 
for a prior award under this Act shall be de-
ducted as a setoff against amounts payable for 
the second injury claim.
(C) EXCEPTION.—Any amounts paid or to 
be paid for a prior claim for a non-malignant 
disease (Levels I through V) filed against the 
Fund shall not be deducted as a setoff against 
amounts payable for the second injury claim for 
a malignant disease (Levels VI through X), un-
less the malignancy was diagnosed, or the as-
bestos claimant had discovered facts that would 
have led a reasonable person to obtain such a 
diagnosis, before the date on which the non-ma-
lignancy claim was compensated. 
(c) REQUIRED INFORMATION.—A claim filed under 
subsection (a) shall be in such form, and contain such in-
formation in such detail, as the Administrator shall by 
regulation prescribe. At a minimum, a claim shall in-
clude—
(1) the name, social security number, gender, 
date of birth, and, if applicable, date of death of the 
claimant; 
(2) information relating to the identity of de-
pendents and beneficiaries of the claimant; 
(3) a complete employment history of the claim-
ant, accompanied by social security records or a 
signed release permitting access to such records;
(4) a description of the asbestos exposure of the 
claimant, including, to the extent known, informa-
tion on the site, or location of exposure, and dura-
tion and intensity of exposure; 
(5) a description of the tobacco product use his-
tory of the claimant, including frequency and dura-
tion; 
(6) an identification and description of the as-
bestos-related diseases or conditions of the claimant, 
accompanied by a written report by the claimant’s 
physician with medical diagnoses and x-ray films, 
and other test results necessary to establish eligi-
bility for an award under this Act; 
(7) a description of any prior or pending civil 
action or other claim brought by the claimant for as-
bestos-related injury or any other pulmonary, paren-
chymal or pleural injury, including an identification 
of any recovery of compensation or damages through 
settlement, judgment, or otherwise; and 
(8) for any claimant who asserts that he or she 
is a nonsmoker or an ex-smoker, as defined in sec-
tion 131, for purposes of an award under Malignant 
Level VI, Malignant Level VII, Malignant Level 
VIII, or Malignant Level IX, evidence to support the
assertion of nonsmoking or ex-smoking, including 
relevant medical records. 
(d) DATE OF FILING.—A claim shall be considered 
to be filed on the date that the claimant mails the claim 
to the Office, as determined by postmark, or on the date 
that the claim is received by the Office, whichever is the 
earliest determinable date. 
(e) INCOMPLETE CLAIMS.—If a claim filed under 
subsection (a) is incomplete, the Administrator shall notify 
the claimant of the information necessary to complete the 
claim and inform the claimant of such services as may 
be available through the Claimant Assistance Program es-
tablished under section 104 to assist the claimant in com-
pleting the claim. Any time periods for the processing of 
the claim shall be suspended until such time as the claim-
ant submits the information necessary to complete the 
claim. If such information is not received within 1 year 
after the date of such notification, the claim shall be dis-
missed. 
SEC. 
114. 
ELIGIBILITY 
DETERMINATIONS 
AND 
CLAIM 
AWARDS. 
(a) IN GENERAL.—
(1) REVIEW
OF
CLAIMS.—The Administrator 
shall, in accordance with this section, determine 
whether each claim filed under this Act satisfies the
requirements for eligibility for an award under this 
Act and, if so, the value of the award. In making 
such determinations, the Administrator shall con-
sider the claim presented by the claimant, the fac-
tual and medical evidence submitted by the claimant 
in support of the claim, the medical determinations 
of any Physicians Panel to which a claim is referred 
under section 121, and the results of such investiga-
tion as the Administrator may deem necessary to de-
termine whether the claim satisfies the criteria for 
eligibility established by this Act. 
(2) ADDITIONAL
EVIDENCE.—The Adminis-
trator may request the submission of medical evi-
dence in addition to the minimum requirements of 
section 113(c) if necessary or appropriate to make 
a determination of eligibility for an award, in which 
case the cost of obtaining such additional informa-
tion or testing shall be borne by the Office. 
(b) PROPOSED DECISIONS.—Not later than 90 days 
after the filing of a claim, the Administrator shall provide 
to the claimant (and the claimant’s representative) a pro-
posed decision accepting or rejecting the claim in whole 
or in part and specifying the amount of the proposed 
award, if any. The proposed decision shall be in writing, 
shall contain findings of fact and conclusions of law, and
shall contain an explanation of the procedure for obtaining 
review of the proposed decision. 
(c) REVIEW OF PROPOSED DECISIONS.—
(1) RIGHT TO HEARING.—
(A) IN GENERAL.—Any claimant not satis-
fied with a proposed decision of the Adminis-
trator under subsection (b) shall be entitled, on 
written request made within 90 days after the 
date of the issuance of the decision, to a hear-
ing on the claim of that claimant before a rep-
resentative of the Administrator. At the hear-
ing, the claimant shall be entitled to present 
oral evidence and written testimony in further 
support of that claim. 
(B) CONDUCT OF HEARING.—When prac-
ticable, the hearing will be set at a time and 
place convenient for the claimant. In conducting 
the hearing, the representative of the Adminis-
trator shall not be bound by common law or 
statutory rules of evidence, by technical or for-
mal rules of procedure, or by section 554 of 
title 5, United States Code, except as provided 
by this Act, but shall conduct the hearing in 
such manner as to best ascertain the rights of 
the claimant. For this purpose, the representa-
tive shall receive such relevant evidence as the 
claimant adduces and such other evidence as 
the representative determines necessary or use-
ful in evaluating the claim. 
(C) REQUEST FOR SUBPOENAS.—
(i) IN GENERAL.—A claimant may re-
quest a subpoena but the decision to grant 
or deny such a request is within the discre-
tion of the representative of the Adminis-
trator. The representative may issue sub-
poenas for the attendance and testimony of 
witnesses, and for the production of books, 
records, correspondence, papers or other 
relevant documents. Subpoenas are issued 
for documents only if they are relevant and 
cannot be obtained by other means, and 
for witnesses only where oral testimony is 
the best way to ascertain the facts. 
(ii) REQUEST.—A claimant may re-
quest a subpoena only as part of the hear-
ing process. To request a subpoena, the re-
quester shall—
(I) submit the request in writing 
and send it to the representative as 
early as possible, but no later than 30
days after the date of the original 
hearing request; and 
(II) explain why the testimony or 
evidence is directly relevant to the 
issues at hand, and a subpoena is the 
best method or opportunity to obtain 
such evidence because there are no 
other means by which the documents 
or testimony could have been ob-
tained. 
(iii) FEES AND MILEAGE.—Any per-
son required by such subpoena to attend as 
a witness shall be allowed and paid the 
same fees and mileage as are paid wit-
nesses in the district courts of the United 
States. 
(2) REVIEW OF WRITTEN RECORD.—In lieu of 
a hearing under paragraph (1), any claimant not 
satisfied with a proposed decision of the Adminis-
trator shall have the option, on written request made 
within 90 days after the date of the issuance of the 
decision, of obtaining a review of the written record 
by a representative of the Administrator. If such re-
view is requested, the claimant shall be afforded an
opportunity to submit any written evidence or argu-
ment which he or she believes relevant. 
(d) FINAL DECISIONS.—
(1) IN GENERAL.—If the period of time for re-
questing review of the proposed decision expires and 
no request has been filed, or if the claimant waives 
any objections to the proposed decision, the Admin-
istrator shall issue a final decision. If such decision 
materially differs from the proposed decision, the 
claimant shall be entitled to review of the decision 
under subsection (c). 
(2) TIME AND CONTENT.—If the claimant re-
quests review of all or part of the proposed decision 
the Administrator shall issue a final decision on the 
claim not later than 180 days after the request for 
review is received, if the claimant requests a hearing, 
or not later than 90 days after the request for re-
view is received, if the claimant requests review of 
the written record. Such decision shall be in writing 
and contain findings of fact and conclusions of law. 
(e) REPRESENTATION.—A claimant may authorize 
an attorney or other individual to represent him or her 
in any proceeding under this Act. 
SEC. 115. MEDICAL EVIDENCE AUDITING PROCEDURES. 
(a) IN GENERAL.—
(1) DEVELOPMENT.—The Administrator shall 
develop methods for auditing and evaluating the 
medical evidence submitted as part of a claim. The 
Administrator may develop additional methods for 
auditing and evaluating other types of evidence or 
information received by the Administrator. 
(2) REFUSAL
TO
CONSIDER
CERTAIN
EVI-
DENCE.—
(A) IN
GENERAL.—If the Administrator 
determines that an audit conducted in accord-
ance with the methods developed under para-
graph (1) demonstrates that the medical evi-
dence submitted by a specific physician or med-
ical facility is not consistent with prevailing 
medical practices or the applicable requirements 
of this Act, any medical evidence from such 
physician or facility shall be unacceptable for 
purposes of establishing eligibility for an award 
under this Act. 
(B) NOTIFICATION.—Upon a determina-
tion by the Administrator under subparagraph 
(A), the Administrator shall notify the physi-
cian or medical facility involved of the results of 
the audit. Such physician or facility shall have
a right to appeal such determination under pro-
cedures issued by the Administrator. 
(b) REVIEW OF CERTIFIED B-READERS.—
(1) IN GENERAL.—At a minimum, the Adminis-
trator shall prescribe procedures to randomly assign 
claims for evaluation by an independent certified B-
reader of x-rays submitted in support of a claim, the 
cost of which shall be borne by the Office. 
(2) DISAGREEMENT.—If an independent cer-
tified B-reader assigned under paragraph (1) dis-
agrees with the quality grading or ILO level as-
signed to an x-ray submitted in support of a claim, 
the Administrator shall require a review of such x-
rays by a second independent certified B-reader. 
(3) EFFECT ON CLAIM.—If neither certified B-
reader under paragraph (2) agrees with the quality 
grading and the ILO grade level assigned to an x-
ray as part of the claim, the Administrator shall 
take into account the findings of the 2 independent 
B readers in making the determination on such 
claim. 
(4) CERTIFIED
B-READERS.—The Adminis-
trator shall maintain a list of a minimum of 50 cer-
tified B-readers eligible to participate in the inde-
pendent reviews, chosen from all certified B-readers.
When an x-ray is sent for independent review, the 
Administrator shall choose the certified B-reader at 
random from that list. 
(c) SMOKING ASSESSMENT.—
(1) IN GENERAL.—
(A) RECORDS AND DOCUMENTS.—To aid 
in the assessment of the accuracy of claimant 
representations as to their smoking status for 
purposes of determining eligibility and amount 
of award under Malignant Level VI, Malignant 
Level VII, Malignant Level VIII, Malignant 
Level IX, and exceptional medical claims, the 
Administrator shall have the authority to obtain 
relevant records and documents, including—
(i) records of past medical treatment 
and evaluation; 
(ii) affidavits of appropriate individ-
uals; 
(iii) applications for insurance and 
supporting materials; and 
(iv) employer records of medical ex-
aminations. 
(B) CONSENT.—The claimant shall provide 
consent for the Administrator to obtain such 
records and documents where required.
(2) REVIEW.—The frequency of review of 
records and documents submitted under paragraph 
(1)(A) shall be at the discretion of the Adminis-
trator, but shall address at least 5 percent of the 
claimants asserting status as nonsmokers or ex-
smokers. 
(3) CONSENT.—The Administrator may require 
the performance of blood tests or any other appro-
priate medical test where claimants assert they are 
nonsmokers or ex-smokers for purposes of an award 
under Malignant Level VI, Malignant Level VII, 
Malignant Level VIII, Malignant Level IX, or as an 
exceptional medical claim, the cost of which shall be 
borne by the Office. 
(4) PENALTY FOR FALSE STATEMENTS.—Any 
false information submitted under this subsection 
shall be subject to criminal prosecution or civil pen-
alties as provided under section 1348 of title 18, 
United States Code (as added by this Act) and sec-
tion 101(c)(2). 
Subtitle C—Medical Criteria 
SEC. 121. MEDICAL CRITERIA REQUIREMENTS. 
(a) DEFINITIONS.—In this section, the following defi-
nitions shall apply:
(1) ASBESTOSIS
DETERMINED
BY
PATHOL-
OGY.—The term ‘‘asbestosis determined by pathol-
ogy’’ means indications of asbestosis based on the 
pathological grading system for asbestosis described 
in the Special Issues of the Archives of Pathology 
and Laboratory Medicine, ‘‘Asbestos-associated Dis-
eases’’, Vol. 106, No. 11, App. 3 (October 8, 1982). 
(2) BILATERAL ASBESTOS-RELATED NONMALIG-
NANT
DISEASE.—The term ‘‘bilateral asbestos-re-
lated nonmalignant disease’’ means a diagnosis of 
bilateral 
asbestos-related 
nonmalignant 
disease 
based on—
(A) an x-ray reading of 1/0 or higher 
based on the ILO grade scale; 
(B) bilateral pleural plaques; 
(C) bilateral pleural thickening; or 
(D) bilateral pleural calcification. 
(3) BILATERAL PLEURAL DISEASE OF B2.—The 
term ‘‘bilateral pleural disease of B2’’ means a chest 
wall pleural thickening or plaque with a maximum 
width of at least 5 millimeters and a total length of 
at least 1⁄4 of the projection of the lateral chest wall. 
(4) CERTIFIED
B-READER.—The term ‘‘cer-
tified B-reader’’ means an individual who is certified 
by the National Institute of Occupational Safety and
Health and whose certification by the National Insti-
tute of Occupational Safety and Health is up to 
date. 
(5) DIFFUSE
PLEURAL
THICKENING.—The 
term ‘‘diffuse pleural thickening’’ means blunting of 
either costophrenic angle and bilateral pleural plaque 
or bilateral pleural thickening. 
(6) DLCO.—The term ‘‘DLCO’’ means the sin-
gle-breath diffusing capacity of the lung (carbon 
monoxide) technique used to measure the volume of 
carbon monoxide transferred from the alveoli to 
blood in the pulmonary capillaries for each unit of 
driving pressure of the carbon monoxide. 
(7) FEV1.—The term ‘‘FEV1’’ means forced 
expiratory volume (1 second), which is the maximal 
volume of air expelled in 1 second during perform-
ance of the spirometric test for forced vital capacity. 
(8) FVC.—The term ‘‘FVC’’ means forced vital 
capacity, which is the maximal volume of air expired 
with a maximally forced effort from a position of 
maximal inspiration. 
(9) ILO 
GRADE.—The term ‘‘ILO grade’’ 
means the radiological ratings for the presence of 
lung changes as determined from a chest x-ray, all
as established from time to time by the International 
Labor Organization. 
(10) LOWER
LIMITS
OF
NORMAL.—The term 
‘‘lower limits of normal’’ means the fifth percentile 
of healthy populations as defined in the American 
Thoracic Society statement on lung function testing 
(Amer. Rev. Resp. Disease 1991, 144:1202–1218) 
and any future revision of the same statement. 
(11) NONSMOKER.—The term ‘‘nonsmoker’’ 
means that the claimant never smoked. 
(12) PO2.—The term ‘‘PO2’’ means the partial 
pressure (tension) of oxygen, which measures the 
amount of dissolved oxygen in the blood. 
(13) PULMONARY
FUNCTION
TESTING.—The 
term 
‘‘pulmonary 
function 
testing’’ 
means 
spirometry testing that is in material compliance 
with the quality criteria established by the American 
Thoracic Society and is performed on equipment 
which is in material compliance with the standards 
of the American Thoracic Society for technical qual-
ity and calibration. 
(14) SUBSTANTIAL
OCCUPATIONAL
EXPOSURE 
TO ASBESTOS.—
(A) IN GENERAL.—The term ‘‘substantial 
occupational exposure’’ means employment in
an industry and an occupation where for a sub-
stantial portion of a normal work year for that 
occupation, the claimant—
(i) handled raw asbestos fibers; 
(ii) 
fabricated 
asbestos-containing 
products so that the claimant in the fab-
rication process was exposed to raw asbes-
tos fibers; 
(iii) altered, repaired, or otherwise 
worked with an asbestos-containing prod-
uct such that the claimant was exposed on 
a regular basis to asbestos fibers; or 
(iv) worked in close proximity to other 
workers engaged in the activities described 
under clause (i), (ii), or (iii) such that the 
claimant was exposed on a regular basis to 
asbestos fibers. 
(B) REGULAR BASIS.—In this paragraph, 
the term ‘‘on a regular basis’’ means on a fre-
quent or recurring basis. 
(15) TLC.—The term ‘‘TLC’’ means total lung 
capacity, which is the total volume of air in the lung 
after maximal inspiration. 
(16) WEIGHTED OCCUPATIONAL EXPOSURE.—
(A) IN GENERAL.—The term ‘‘weighted oc-
cupational exposure’’ means exposure for a pe-
riod of years calculated according to the expo-
sure weighting formula under subparagraphs 
(B) through (E). 
(B) MODERATE
EXPOSURE.—Subject to 
subparagraph (E), each year that a claimant’s 
primary occupation, during a substantial por-
tion of a normal work year for that occupation, 
involved working in areas immediate to where 
asbestos-containing products were being in-
stalled, 
repaired, 
or 
removed 
under 
cir-
cumstances that involved regular airborne emis-
sions of asbestos fibers, shall count as 1 year 
of substantial occupational exposure. 
(C) HEAVY
EXPOSURE.—Subject to sub-
paragraph (E), each year that a claimant’s pri-
mary occupation, during a substantial portion 
of a normal work year for that occupation, in-
volved the direct installation, repair, or removal 
of asbestos-containing products such that the 
person was exposed on a regular basis to asbes-
tos fibers, shall count as 2 years of substantial 
occupational exposure.
(D) VERY HEAVY EXPOSURE.—Subject to 
subparagraph (E), each year that a claimant’s 
primary occupation, during a substantial por-
tion of a normal work year for that occupation, 
was in primary asbestos manufacturing, a 
World War II shipyard, or the asbestos insula-
tion trades, such that the person was exposed 
on a regular basis to asbestos fibers, shall count 
as 4 years of substantial occupational exposure. 
(E) DATES OF EXPOSURE.—Each year of 
exposure calculated under subparagraphs (B), 
(C), and (D) that occurred before 1976 shall be 
counted at its full value. Each year from 1976 
to 1986 shall be counted as 1⁄2 its value. Each 
year after 1986 shall be counted as 1⁄10 its 
value. 
(F) OTHER CLAIMS.—Individuals who do 
not meet the provisions of subparagraphs (A) 
through (E) and believe their post-1976 or 
post-1986 exposures exceeded the Occupational 
Safety and Health Administration standard 
may submit evidence, documentation, work his-
tory or other information to substantiate non-
compliance with the Occupational Safety and 
Health Administration standard (such as lack
of engineering or work practice controls, or pro-
tective equipment) such that exposures would 
be equivalent to exposures before 1976 or 1986 
or to documented exposures in similar jobs or 
occupations where control measures had not 
been implemented. Claims under this subpara-
graph shall be evaluated on an individual basis 
by a Physicians Panel. 
(b) MEDICAL EVIDENCE.—
(1) LATENCY.—Unless otherwise specified, all 
diagnoses of an asbestos-related disease for a level 
under this section shall be accompanied by—
(A) a statement by the physician providing 
the diagnosis that at least 10 years have 
elapsed between the date of first exposure to as-
bestos or asbestos-containing products and the 
diagnosis; or 
(B) a history of the claimant’s exposure 
that is sufficient to establish a 10-year latency 
period between the date of first exposure to as-
bestos or asbestos-containing products and the 
diagnosis. 
(2) DIAGNOSTIC GUIDELINES.—All diagnoses of 
asbestos-related diseases shall be based upon—
(A) for disease Levels I through V, in the 
case of a claimant who was living at the time 
the claim was filed—
(i) a physical examination of the 
claimant by the physician providing the di-
agnosis; 
(ii) an evaluation of smoking history 
and exposure history before making a diag-
nosis; 
(iii) an x-ray reading by a certified B-
reader; and 
(iv) pulmonary function testing in the 
case of disease Levels III, IV, and V; 
(B) for disease Levels I through V, in the 
case of a claimant who was deceased at the 
time the claim was filed, a report from a physi-
cian based upon a review of the claimant’s med-
ical records which shall include—
(i) pathological evidence of the non-
malignant asbestos-related disease; or 
(ii) an x-ray reading by a certified B-
reader; 
(C) for disease Levels VI through X, in the 
case of a claimant who was living at the time 
the claim was filed—
(i) a physical examination by the 
claimant’s physician providing the diag-
nosis; or 
(ii) a diagnosis of such a malignant 
asbestos-related disease, as described in 
this section, by a board-certified patholo-
gist; and 
(D) for disease Levels VI through X, in 
the case of a claimant who was deceased at the 
time the claim was filed—
(i) a diagnosis of such a malignant as-
bestos-related disease, as described in this 
section, by a board-certified pathologist; 
and 
(ii) a report from a physician based 
upon a review of the claimant’s medical 
records. 
(3) CREDIBILITY OF MEDICAL EVIDENCE.—To 
ensure the medical evidence provided in support of 
a claim is credible and consistent with recognized 
medical standards, a claimant under this title may 
be required to submit—
(A) x-rays or computerized tomography; 
(B) detailed results of pulmonary function 
tests;
(C) laboratory tests; 
(D) tissue samples; 
(E) results of medical examinations; 
(F) reviews of other medical evidence; and 
(G) medical evidence that complies with 
recognized medical standards regarding equip-
ment, testing methods, and procedure to ensure 
the reliability of such evidence as may be sub-
mitted. 
(c) EXPOSURE EVIDENCE.—
(1) IN GENERAL.—To qualify for any disease 
level, the claimant shall demonstrate—
(A) a minimum exposure to asbestos or as-
bestos-containing products; 
(B) the exposure occurred in the United 
States, its territories or possessions, or while a 
United States citizen while an employee of an 
entity organized under any Federal or State law 
regardless of location, or while a United States 
citizen while serving on any United States 
flagged or owned ship, provided the exposure 
results from such employment or service; and 
(C) any additional asbestos exposure re-
quirement under this section.
(2) GENERAL EXPOSURE REQUIREMENTS.—In 
order to establish exposure to asbestos, a claimant 
shall present meaningful and credible evidence—
(A) by an affidavit of the claimant; 
(B) by an affidavit of a coworker or family 
member, if the claimant is deceased and such 
evidence is found in proceedings under this title 
to be reasonably reliable; 
(C) by invoices, construction, or similar 
records; or 
(D) any other credible evidence. 
(3) TAKE-HOME EXPOSURE.—
(A) IN GENERAL.—A claimant may alter-
natively satisfy the medical criteria require-
ments of this section where a claim is filed by 
a person who alleges their exposure to asbestos 
was the result of living with a person who, if 
the claim had been filed by that person, would 
have met the exposure criteria for the given dis-
ease level, and the claimant lived with such per-
son for the time period necessary to satisfy the 
exposure requirement, for the claimed disease 
level. 
(B) REVIEW.—Except for claims for dis-
ease Level X (mesothelioma), all claims alleging
take-home exposure shall be submitted as an 
exceptional medical claim under section 121(f) 
for review by a Physicians Panel. 
(4) WAIVER FOR WORKERS AND RESIDENTS OF 
LIBBY, MONTANA.—Because of the unique nature of 
the asbestos exposure related to the vermiculite min-
ing and milling operations in Libby, Montana, the 
Administrator shall waive the exposure requirements 
under this subtitle for individuals who worked at the 
vermiculite mining and milling facility in Libby, 
Montana, or lived or worked within a 20-mile radius 
of Libby, Montana, for at least 12 consecutive 
months before December 31, 2003. Claimants under 
this section shall provide such supporting docu-
mentation as the Administrator shall require. 
(5) EXPOSURE PRESUMPTIONS.—The Adminis-
trator shall prescribe rules identifying specific indus-
tries, occupations within those industries, and time 
periods for which substantial occupational exposure 
(as defined under section 121(a)) shall be a rebut-
table presumption for asbestos claimants who pro-
vide meaningful and credible evidence that the 
claimant worked in that industry and occupation 
during such time periods. The Administrator may 
provide evidence to rebut this presumption.
(d) ASBESTOS DISEASE LEVELS.—
(1) NONMALIGNANT LEVEL I.—To receive Level 
I compensation, a claimant shall provide—
(A) a diagnosis of bilateral asbestos-related 
nonmalignant disease; and 
(B) evidence of 5 years cumulative occupa-
tional exposure to asbestos. 
(2) NONMALIGNANT
LEVEL
II.—To receive 
Level II compensation, a claimant shall provide—
(A) a diagnosis of bilateral asbestos-related 
nonmalignant disease with ILO grade of 1/1 or 
greater, and showing small irregular opacities 
of shape or size either ss, st, or tt and present 
in both lower lung zones, or asbestosis deter-
mined by pathology, or blunting of either 
costophrenic angle and bilateral pleural plaque 
or bilateral pleural thickening of at least grade 
B2 or greater, or bilateral pleural disease of 
grade B2 or greater; 
(B) evidence of TLC less than 80 percent 
or FVC less than the lower limits of normal, 
and FEV1/FVC ratio less than 65 percent; 
(C) evidence of 5 or more weighted years 
of substantial occupational exposure to asbes-
tos; and
(D) supporting medical documentation es-
tablishing asbestos exposure as a contributing 
factor in causing the pulmonary condition in 
question. 
(3) NONMALIGNANT
LEVEL
III.—To receive 
Level III compensation a claimant shall provide—
(A) a diagnosis of bilateral asbestos-related 
nonmalignant disease with ILO grade of 1/0 or 
greater and showing small irregular opacities of 
shape or size either ss, st, or tt and present in 
both lower lung zones, or asbestosis determined 
by pathology, or diffuse pleural thickening, or 
bilateral pleural disease of B2 or greater; 
(B) evidence of TLC less than 80 percent; 
FVC less than the lower limits of normal and 
FEV1/FVC ratio greater than or equal to 65 
percent; or evidence of a decline in FVC of 20 
percent or greater, after allowing for the ex-
pected decrease due to aging, and an FEV1/
FVC ratio greater than or equal to 65 percent 
documented with a second spirometry; 
(C) evidence of 5 or more weighted years 
of substantial occupational exposure to asbes-
tos; and 
(D) supporting medical documentation—
(i) establishing asbestos exposure as a 
contributing factor in causing the pul-
monary condition in question; and 
(ii) excluding other more likely causes 
of that pulmonary condition. 
(4) NONMALIGNANT
LEVEL
IV.—To receive 
Level IV compensation a claimant shall provide—
(A) diagnosis of bilateral asbestos-related 
nonmalignant disease with ILO grade of 1/1 or 
greater and showing small irregular opacities of 
shape or size either ss, st, or tt and present in 
both lower lung zones, or asbestosis determined 
by pathology, or diffuse pleural thickening, or 
bilateral pleural disease of B2 or greater; 
(B) evidence of TLC less than 60 percent 
or FVC less than 60 percent, and FEV1/FVC 
ratio greater than or equal to 65 percent; 
(C) evidence of 5 or more weighted years 
of substantial occupational exposure to asbestos 
before diagnosis; and 
(D) supporting medical documentation—
(i) establishing asbestos exposure as a 
contributing factor in causing the pul-
monary condition in question; and
(ii) excluding other more likely causes 
of that pulmonary condition. 
(5) NONMALIGNANT
LEVEL
V.—To receive 
Level V compensation a claimant shall provide—
(A) diagnosis of bilateral asbestos-related 
nonmalignant disease with ILO grade of 1/1 or 
greater and showing small irregular opacities of 
shape or size either ss, st, or tt and present in 
both lower lung zones, or asbestosis determined 
by pathology, or diffuse pleural thickening, or 
bilateral pleural disease of B2 or greater; 
(B)(i) evidence of TLC less than 50 per-
cent or FVC less than 50 percent, and FEV1/
FVC ratio greater than or equal to 65 percent; 
(ii) DLCO less than 40 percent of pre-
dicted, plus a FEV1/FVC ratio not less than 65 
percent; or 
(iii) PO2 less than 55 mm/Hg, plus a 
FEV1/FVC ratio not less than 65 percent; 
(C) evidence of 5 or more weighted years 
of substantial occupational exposure to asbes-
tos; and 
(D) supporting medical documentation—
(i) establishing asbestos exposure as a 
contributing factor in causing the pul-
monary condition in question; and 
(ii) excluding other more likely causes 
of that pulmonary condition. 
(6) MALIGNANT LEVEL VI.—
(A) IN
GENERAL.—To receive Level VI 
compensation a claimant shall provide—
(i) a diagnosis of a primary colorectal, 
laryngeal, esophageal, pharyngeal, or stom-
ach cancer on the basis of findings by a 
board certified pathologist; 
(ii) evidence of a bilateral asbestos-re-
lated nonmalignant disease; 
(iii) evidence of 15 or more weighted 
years of substantial occupational exposure 
to asbestos; and 
(iv) supporting medical documentation 
establishing asbestos exposure as a contrib-
uting factor in causing the cancer in ques-
tion. 
(B) REFERRAL TO PHYSICIANS PANEL.—
All claims filed with respect to Level VI under 
this paragraph shall be referred to a Physicians 
Panel for a determination that it is more prob-
able than not that asbestos exposure was a sub-
stantial contributing factor in causing the other 
cancer in question. If the claimant meets the 
requirements of subparagraph (A), there shall 
be a presumption of eligibility for the scheduled 
value of compensation unless there is evidence 
determined by the Physicians Panel that rebuts 
that presumption. 
(C) REQUEST FOR REFERRAL TO PHYSI-
CIANS PANEL.—A claimant filing a claim with 
respect to Level VI under this paragraph may 
request that the claim be referred to a Physi-
cians Panel for a determination on amount of 
award. In making its determination under this 
subparagraph, the Physicians Panel shall con-
sider the intensity and duration of exposure, 
smoking history, and the quality of evidence re-
lating to exposure and smoking. Claimants shall 
bear the burden of producing meaningful and 
credible evidence of their smoking history as 
part of their claim submission. 
(7) MALIGNANT LEVEL VII.—
(A) IN GENERAL.—To receive Level VII 
compensation a claimant shall provide—
(i) a diagnosis of a primary lung can-
cer disease on the basis of findings by a 
board certified pathologist; 
(ii) evidence of 15 or more weighted 
years of substantial occupational exposure 
to asbestos; and 
(iii) supporting medical documenta-
tion establishing asbestos exposure as a 
contributing factor in causing the lung 
cancer in question. 
(B) PHYSICIANS PANEL.—All claims filed 
relating to Level VII under this paragraph shall 
be referred to a Physicians Panel for a deter-
mination on the amount of award. In making 
its determination under this subparagraph, the 
Physicians Panel shall consider the intensity 
and duration of exposure, smoking history, and 
the quality of evidence relating to exposure and 
smoking. Claimants shall bear the burden of 
producing meaningful and credible evidence of 
their smoking history as part of their claim 
submission. 
(8) MALIGNANT LEVEL VIII.—
(A) IN GENERAL.—To receive Level VIII 
compensation, a claimant shall provide—
(i) a diagnosis of a primary lung can-
cer disease on the basis of findings by a 
board certified pathologist; 
(ii) 
evidence 
of 
bilateral 
pleural 
plaques or bilateral pleural thickening or 
bilateral pleural calcification; 
(iii) evidence of 12 or more weighted 
years of substantial occupational exposure 
to asbestos; and 
(iv) supporting medical documentation 
establishing asbestos exposure as a contrib-
uting factor in causing the lung cancer in 
question. 
(B) PHYSICIANS PANEL.—A claimant filing 
a claim relating to Level VIII under this para-
graph may request that the claim be referred to 
a Physicians Panel for a determination on 
amount of award. In making its determination 
under this subparagraph, the Physicians Panel 
shall consider the intensity and duration of ex-
posure, smoking history, and the quality of evi-
dence relating to exposure and smoking. Claim-
ants shall bear the burden of producing mean-
ingful and credible evidence of their smoking 
history as part of their claim submission.
(9) MALIGNANT LEVEL IX.—
(A) IN
GENERAL.—To receive Level IX 
compensation, a claimant shall provide—
(i) a diagnosis of a primary lung can-
cer disease on the basis of findings by a 
board certified pathologist; 
(ii)(I) evidence of—
(aa) asbestosis based on a chest 
x-ray of at least 1/0 on the ILO scale 
and showing small irregular opacities 
of shape or size either ss, st, or tt and 
present in both lower lung zones; and 
(bb) 10 or more weighted years 
of substantial occupational exposure 
to asbestos; 
(II) evidence of—
(aa) asbestosis based on a chest 
x-ray of at least 1/1 on the ILO scale 
and showing small irregular opacities 
of shape or size either ss, st, or tt and 
present in both lower lung zones; and 
(bb) 8 or more weighted years of 
substantial occupational exposure to 
asbestos; or
(III) asbestosis determined by pathol-
ogy and 10 or more weighted years of sub-
stantial occupational exposure to asbestos; 
and 
(iii) supporting medical documenta-
tion establishing asbestos exposure as a 
contributing factor in causing the lung 
cancer in question. 
(B) PHYSICIANS PANEL.—A claimant filing 
a claim with respect to Level IX under this 
paragraph may request that the claim be re-
ferred to a Physicians Panel for a determina-
tion on amount of award. In making its deter-
mination under this subparagraph, the Physi-
cians Panel shall consider the intensity and du-
ration of exposure, smoking history, and the 
quality of evidence relating to exposure and 
smoking. Claimants shall bear the burden of 
producing meaningful and credible evidence of 
their smoking history as part of their claim 
submission. 
(10) MALIGNANT LEVEL X.—To receive Level 
X compensation, a claimant shall provide—
(A) a diagnosis of malignant mesothelioma 
disease on the basis of findings by a board cer-
tified pathologist; and 
(B) credible evidence of identifiable expo-
sure to asbestos resulting from—
(i) occupational exposure to asbestos; 
(ii) 
exposure 
to 
asbestos 
fibers 
brought into the home of the claimant by 
a worker occupationally exposed to asbes-
tos; 
(iii) exposure to asbestos fibers result-
ing from living or working in the proxi-
mate vicinity of a factory, shipyard, build-
ing demolition site, or other operation that 
regularly released asbestos fibers into the 
air due to operations involving asbestos at 
that site; or 
(iv) other identifiable exposure to as-
bestos fibers, in which case the claim shall 
be reviewed by a Physicians Panel under 
section 121(f) for a determination of eligi-
bility. 
(e) INSTITUTE OF MEDICINE STUDY.—
(1) IN GENERAL.—Not later than 2 years after 
date of enactment of this Act, the Institute of Medi-
cine of the National Academy of Sciences shall com-
plete a study of the causal link between asbestos ex-
posure and other cancers, including colorectal, laryn-
geal, esophageal, pharyngeal, and stomach cancers, 
except for mesothelioma and lung cancers. The In-
stitute of Medicine shall issue a report on its find-
ings on causation, which shall be transmitted to 
Congress, the Administrator, the Advisory Com-
mittee on Asbestos Disease Compensation or the 
Medical Advisory Committee, and the Physicians 
Panels. The Administrator and the Physicians Pan-
els may consider the results of the report for pur-
poses of determining whether asbestos exposure is a 
substantial 
contributing 
factor 
under 
section 
121(d)(6)(B). 
(2) SUBSEQUENT
STUDIES.—If the Adminis-
trator has evidence that there have been advance-
ments in science that would require additional study, 
the Administrator may request that the Institute of 
Medicine conduct a subsequent study to determine if 
asbestos exposure is a cause of other cancers. 
(f) EXCEPTIONAL MEDICAL CLAIMS.—
(1) IN
GENERAL.—A claimant who does not 
meet the medical criteria requirements under this
section may apply for designation of the claim as an 
exceptional medical claim. 
(2) APPLICATION.—When submitting an appli-
cation for review of an exceptional medical claim, the 
claimant shall—
(A) state that the claim does not meet the 
medical criteria requirements under this sec-
tion; or 
(B) seek designation as an exceptional 
medical claim within 60 days after a determina-
tion that the claim is ineligible solely for failure 
to meet the medical criteria requirements under 
subsection (d). 
(3) REPORT OF PHYSICIAN.—
(A) IN GENERAL.—Any claimant applying 
for designation of a claim as an exceptional 
medical claim shall support an application filed 
under paragraph (1) with a report from a phy-
sician meeting the requirements of this section. 
(B) CONTENTS.—A report filed under sub-
paragraph (A) shall include—
(i) a complete review of the claimant’s 
medical history and current condition; 
(ii) such additional material by way of 
analysis and documentation as shall be
prescribed by rule of the Administrator; 
and 
(iii) a detailed explanation as to why 
the claim meets the requirements of para-
graph (4)(B). 
(4) REVIEW.—
(A) IN
GENERAL.—The Administrator 
shall refer all applications and supporting docu-
mentation submitted under paragraph (2) to a 
Physicians Panel for review for eligibility as an 
exceptional medical claim. 
(B) STANDARD.—A claim shall be des-
ignated as an exceptional medical claim if the 
claimant, for reasons beyond the control of the 
claimant, cannot satisfy the requirements under 
this section, but is able, through comparably re-
liable evidence that meets the standards under 
this section, to show that the claimant has an 
asbestos-related condition that is substantially 
comparable to that of a medical condition that 
would satisfy the requirements of a category 
under this section. 
(C) ADDITIONAL INFORMATION.—A Physi-
cians Panel may request additional reasonable 
testing to support the claimant’s application.
(D) CT SCAN.—A claimant may submit a 
CT Scan in addition to an x-ray. 
(5) APPROVAL.—
(A) IN GENERAL.—If the Physicians Panel 
determines that the medical evidence is suffi-
cient to show a comparable asbestos-related 
condition, it shall issue a certificate of medical 
eligibility designating the category of asbestos-
related injury under this section for which the 
claimant may be eligible to seek compensation. 
(B) REFERRAL.—Upon the issuance of a 
certificate under subparagraph (A), the Physi-
cians Panel shall submit the claim to the Ad-
ministrator, who shall proceed to determine 
whether the claimant meets the requirements 
for compensation under this Act. 
(6) RESUBMISSION.—Any claimant whose appli-
cation for designation as an exceptional medical 
claim is rejected may resubmit an application if new 
evidence becomes available. The application shall 
identify any prior applications and state the new evi-
dence that forms the basis of the resubmission. 
(7) RULES.—The Administrator shall promul-
gate rules governing the procedures for seeking des-
ignation of a claim as an exceptional medical claim.
(8) LIBBY, MONTANA.—All claims filed by 
Libby, Montana claimants shall be designated as ex-
ceptional medical claims and referred to a Physi-
cians Panel for review. In reviewing the medical evi-
dence submitted by a Libby, Montana claimant in 
support of that claim, and before making an eligi-
bility determination for a Libby, Montana claimant, 
the Physicians Panel shall review the current med-
ical and scientific literature relating to the study, di-
agnosis, and treatment of asbestos-related diseases 
resulting from exposure to asbestos and other fibers 
found in and around Libby, Montana, including pub-
lic health assessments prepared by the Agency for 
Toxic Substances and Disease Registry for the 
Libby Asbestos Site. The Physicians Panel shall 
take into consideration the unique and serious na-
ture of asbestos exposure in Libby, Montana, includ-
ing the nature of the pleural disease related to as-
bestos exposure in Libby, when making a determina-
tion of eligibility and designating the disease cat-
egory. 
Subtitle D—Awards 
SEC. 131. AMOUNT. 
(a) IN GENERAL.—An asbestos claimant who meets 
the requirements of section 111 shall be entitled to an
award in an amount determined by reference to the benefit 
table contained in subsection (b). 
(b) BENEFIT TABLE.—
(1) IN GENERAL.—An asbestos claimant with 
an eligible disease or condition established in accord-
ance with section 121, shall be eligible for an award 
according to the following schedule:
Level 
Scheduled Condition 
or Disease 
Scheduled Value 
I
Asbestosis/Pleural Disease 
Medical Monitoring 
II 
Mixed Disease With Impair-
ment 
$35,000
III 
Asbestosis/Pleural Disease B 
$100,000
IV 
Severe Asbestosis 
$400,000
V
Disabling Asbestosis 
$850,000
VI 
Other Cancer 
$200,000
VII 
Lung Cancer One 
individual evaluation; smokers re-
ceive $50,000; ex-smokers re-
ceive $150,000; non-smokers 
receive $625,000
VIII 
Lung Cancer With Pleural 
Disease 
smokers receive $275,000; ex-
smokers $700,000; non-smok-
ers receive $800,000
IX 
Lung Cancer With Asbestosis 
smokers receive $575,000; ex-
smokers receive $950,000; non-
smokers receive $1,050,000
X
Mesothelioma 
$1,050,000
(2) DEFINITIONS.—In this section—
(A) the term ‘‘nonsmoker’’ means a claim-
ant who never smoked; and 
(B) the term ‘‘ex-smoker’’ means a claim-
ant who has not smoked during any portion of 
the 12-year period preceding the diagnosis of 
lung cancer. 
(3) VALUES
WITHIN
LEVELS
RELATING
TO 
LUNG CANCER.—
(A) IN
GENERAL.—In setting values for 
levels relating to lung cancer, the Administrator 
shall develop a matrix of classes for each of 
Levels VII, VIII, and IX based on—
(i) the smoking history of the claim-
ant, including whether the claimant cur-
rently or in the past smoked tobacco prod-
ucts, the duration of smoking, pack years, 
and whether the claimant has quit smoking 
and for how long; 
(ii) the age of the claimant at diag-
nosis with claim values increased propor-
tionately for claimants who are younger 
than the average life span and reduced for 
those who are older; and 
(iii) the level and duration of asbestos 
exposure with those receiving the highest 
total dose (level x duration) receiving 
greater values. 
(B) DETERMINATION OF EXPOSURE.—Lev-
els of exposure shall be based on research in the 
fields of epidemiology and industrial hygiene. 
(4) MEDICAL MONITORING.—An asbestos claim-
ant with asymptomatic exposure, based on the cri-
teria under section 121(d)(1), shall only be eligible
for medical monitoring reimbursement as provided 
under section 132. 
(5) COST-OF-LIVING ADJUSTMENT.—
(A) IN GENERAL.—Beginning January 1, 
2006, award amounts under paragraph (1) 
shall be annually increased by an amount equal 
to such dollar amount multiplied by the cost-of-
living adjustment, rounded to the nearest 
$1,000 increment. 
(B) CALCULATION OF COST-OF-LIVING AD-
JUSTMENT.—For the purposes of subparagraph 
(A), the cost-of-living adjustment for any cal-
endar year shall be the percentage, if any, by 
which the consumer price index for the suc-
ceeding calendar year exceeds the consumer 
price index for calendar year 2004. 
(C) CONSUMER PRICE INDEX.—
(i) IN GENERAL.—For the purposes of 
subparagraph (B), the consumer price 
index for any calendar year is the average 
of the consumer price index as of the close 
of the 12-month period ending on August 
31 of such calendar year. 
(ii) DEFINITION.—For purposes of 
clause (i), the term ‘‘consumer price
index’’ means the consumer price index 
published by the Department of Labor. 
The consumer price index series to be used 
for award escalations shall include the con-
sumer price index used for all-urban con-
sumers, with an area coverage of the 
United States city average, for all items, 
based on the 1982–1984 index based pe-
riod, as published by the Department of 
Labor. 
SEC. 132. MEDICAL MONITORING. 
(a) RELATION TO STATUTE OF LIMITATIONS.—The 
filing of a claim under this Act that seeks reimbursement 
for medical monitoring shall not be considered as evidence 
that the claimant has discovered facts that would other-
wise commence the period applicable for purposes of the 
statute of limitations under section 113(b). 
(b) COSTS.—Reimbursable medical monitoring costs 
shall include the costs of a claimant not covered by health 
insurance for an examination by the claimant’s physician, 
x-ray tests, and pulmonary function tests every 3 years. 
(c) REGULATIONS.—The Administrator shall promul-
gate regulations that establish—
(1) the reasonable costs for medical monitoring 
that is reimbursable; and
(2) the procedures applicable to asbestos claim-
ants. 
SEC. 133. PAYMENT. 
(a) STRUCTURED PAYMENTS.—
(1) IN GENERAL.—An asbestos claimant who is 
entitled to an award should receive the amount of 
the award through structured payments from the 
Fund, made over a period of 3 years, and in no 
event more than 4 years after the date of final adju-
dication of the claim. 
(2) PAYMENT
PERIOD
AND
AMOUNT.—There 
shall be a presumption that any award paid under 
this subsection shall provide for payment of—
(A) 40 percent of the total amount in year 
1; 
(B) 30 percent of the total amount in year 
2; and 
(C) 30 percent of the total amount in year 
3. 
(3) EXTENSION OF PAYMENT PERIOD.—
(A) IN
GENERAL.—The Administrator 
shall develop guidelines to provide for the pay-
ment period of an award under subsection (a) 
to be extended to a 4-year period if such action 
is warranted in order to preserve the overall sol-
vency of the Fund. Such guidelines shall include 
reference to the number of claims made to the 
Fund and the awards made and scheduled to be 
paid from the Fund as provided under section 
405. 
(B) LIMITATIONS.—In no event shall less 
than 50 percent of an award be paid in the first 
2 years of the payment period under this sub-
section. 
(4) ACCELERATED PAYMENTS.—The Adminis-
trator shall develop guidelines to provide for acceler-
ated payments to asbestos claimants who are meso-
thelioma victims and who are alive on the date on 
which the Administrator receives notice of the eligi-
bility of the claimant. Such payments shall be cred-
ited against the first regular payment under the 
structured payment plan for the claimant. 
(5) EXPEDITED
PAYMENTS.—The Adminis-
trator shall develop guidelines to provide for expe-
dited payments to asbestos claimants in cases of exi-
gent circumstances or extreme hardship caused by 
asbestos-related injury. 
(6) ANNUITY.—An asbestos claimant may elect 
to receive any payments to which they are entitled 
under this title in the form of an annuity.
(b) LIMITATION
ON TRANSFERABILITY.—A claim 
filed under this Act shall not be assignable or otherwise 
transferable under this Act. 
(c) CREDITORS.—An award under this title shall be 
exempt from all claims of creditors and from levy, execu-
tion, and attachment or other remedy for recovery or col-
lection of a debt, and such exemption may not be waived. 
(d) MEDICARE AS SECONDARY PAYER.—No award 
under this title shall be deemed a payment for purposes 
of section 1862 of the Social Security Act (42 U.S.C. 
1395y). 
(e) EXEMPT PROPERTY IN ASBESTOS CLAIMANT’S 
BANKRUPTCY CASE.—If an asbestos claimant files a peti-
tion for relief under section 301 of title 11, United States 
Code, no award granted under this Act shall be treated 
as property of the bankruptcy estate of the asbestos claim-
ant in accordance with section 541(b)(6) of title 11, 
United States Code. 
SEC. 134. REDUCTION IN BENEFIT PAYMENTS FOR COLLAT-
ERAL SOURCES. 
(a) IN GENERAL.—The amount of an award other-
wise available to an asbestos claimant under this title shall 
be reduced by the amount of collateral source compensa-
tion.
(b) EXCLUSIONS.—In no case shall statutory benefits 
under workers’ compensation laws and veterans’ benefits 
programs be deemed as collateral source compensation for 
purposes of this section. 
TITLE II—ASBESTOS INJURY 
CLAIMS RESOLUTION FUND 
Subtitle A—Asbestos Defendants 
Funding Allocation 
SEC. 201. DEFINITIONS. 
In this subtitle, the following definitions shall apply: 
(1) AFFILIATED GROUP.—The term ‘‘affiliated 
group’’—
(A) means a defendant participant that is 
an ultimate parent and any person whose entire 
beneficial interest is directly or indirectly owned 
by that ultimate parent on the date of enact-
ment of this Act; and 
(B) shall not include any person that is a 
debtor or any direct or indirect majority-owned 
subsidiary of a debtor. 
(2) CLASS ACTION TRUST.—The term ‘‘class ac-
tion trust’’ means a trust or similar entity estab-
lished to hold assets for the payment of asbestos 
claims asserted against a debtor or participating de-
fendant, under a settlement that—
(A) is a settlement of class action claims 
under rule 23 of the Federal Rules of Civil Pro-
cedure; and 
(B) has been approved by a final judgment 
of a United States district court before the date 
of enactment of this Act. 
(3) DEBTOR.—The term ‘‘debtor’’—
(A) means—
(i) a person that is subject to a case 
pending under a chapter of title 11, United 
States Code, on the date of enactment of 
this Act or at any time during the 1-year 
period immediately preceding that date, ir-
respective of whether the debtor’s case 
under that title has been dismissed; and 
(ii) all of the direct or indirect major-
ity-owned subsidiaries of a person de-
scribed under clause (i), regardless of 
whether any such majority-owned sub-
sidiary has a case pending under title 11, 
United States Code; and 
(B) shall not include an entity—
(i) subject to chapter 7 of title 11, 
United States Code, if a final decree clos-
ing the estate shall have been entered be-
fore the date of enactment of this Act; or 
(ii) subject to chapter 11 of title 11, 
United States Code, if a plan of reorga-
nization for such entity shall have been 
confirmed by a duly entered order or judg-
ment of a court that is no longer subject 
to any appeal or judicial review, and the 
substantial consummation, as such term is 
defined in section 1101(2) of title 11, 
United States Code, of such plan of reor-
ganization has occurred. 
(4) 
INDEMNIFIABLE
COST.—The 
term 
‘‘indemnifiable cost’’ means a cost, expense, debt, 
judgment, or settlement incurred with respect to an 
asbestos claim that, at any time before December 
31, 2002, was or could have been subject to indem-
nification, contribution, surety, or guaranty. 
(5) INDEMNITEE.—The term ‘‘indemnitee’’ 
means a person against whom any asbestos claim 
has been asserted before December 31, 2002, who 
has received from any other person, or on whose be-
half a sum has been paid by such other person to 
any third person, in settlement, judgment, defense, 
or indemnity in connection with an alleged duty with
respect to the defense or indemnification of such 
person concerning that asbestos claim, other than 
under a policy of insurance or reinsurance. 
(6) INDEMNITOR.—The term ‘‘indemnitor’’ 
means a person who has paid under a written agree-
ment at any time before December 31, 2002, a sum 
in settlement, judgment, defense, or indemnity to or 
on behalf of any person defending against an asbes-
tos claim, in connection with an alleged duty with 
respect to the defense or indemnification of such 
person concerning that asbestos claim, except that 
payments by an insurer or reinsurer under a con-
tract of insurance or reinsurance shall not make the 
insurer or reinsurer an indemnitor for purposes of 
this subtitle. 
(7) PRIOR
ASBESTOS
EXPENDITURES.—The 
term ‘‘prior asbestos expenditures’’—
(A) means the gross total amount paid by 
or on behalf of a person at any time before De-
cember 31, 2002, in settlement, judgment, de-
fense, or indemnity costs related to all asbestos 
claims against that person; 
(B) includes payments made by insurance 
carriers to or for the benefit of such person or 
on such person’s behalf with respect to such as-
bestos claims, except as provided in section 
204(g); 
(C) shall not include any payment made by 
a person in connection with or as a result of 
changes in insurance reserves required by con-
tract or any activity or dispute related to insur-
ance coverage matters for asbestos-related li-
abilities; and 
(D) shall not include any payment made by 
or on behalf of persons who are or were com-
mon carriers by railroad for asbestos claims 
brought under the Act of April 22, 1908 (45 
U.S.C. 51 et seq.), commonly known as the 
Federal Employers’ Liability Act, as a result of 
operations as a common carrier by railroad, in-
cluding settlement, judgment, defense, or in-
demnity costs associated with these claims. 
(8) TRUST.—The term ‘‘trust’’ means any 
trust, as described in sections 524(g)(2)(B)(i) or 
524(h) of title 11, United States Code, or estab-
lished in conjunction with an order issued under sec-
tion 105 of title 11, United States Code, established 
or formed under the terms of a chapter 11 plan of 
reorganization, which in whole or in part provides 
compensation for asbestos claims.