Source: http://www.bwasbestostrust.com/resources/understanding-claim-deficiencies/
Timestamp: 2018-05-27 15:17:00
Document Index: 371603437

Matched Legal Cases: ['art 2', 'art 3', 'art 3', 'art 5', 'art 3', 'art 4', 'art 3', 'art 5']

BW Asbestos Trust » Understanding Claim Deficiencies
001 Death Certificate not Provided You have indicated that the Injured Party is deceased. However, no death certificate has been provided. Please provide an official death certificate regarding the injured party. Both
007 Date of Alleged Diagnosis and/or Alleged Injury not Provided You failed to designate an alleged asbestos-related injury and/or the date of diagnosis for the injury. Please provide the alleged injury and at least the month and year in which a physician first diagnosed the injury on Part 2 of the claim. Both
009 First and Last Dates of Exposure Not Provided Your submission regarding the Injured Party's exposure to asbestos does not include complete information. Please provide the dates on which exposure began and ended for each work site where exposure is being alleged on Part 3 of the claim form. Both
010 Industry and Occupation not Provided Your Claim Form failed to provide the industry and occupation of the Injured party. Please provide the industry and occupation in which the Injured Party worked for each work site where exposure is being alleged on Part 3 of the claim form. Both
014 Attachments Missing In your Claim Form, you referenced additional information included as an attachment and/or affidavit, but no such information was found with the claim, or you failed to provide any medical records to support your claim as required by the Trust. In your Claim Form, you referenced additional information included as an attachment and/or affidavit, but no such information was found with the claim, or you failed to provide any medical records to support your claim as required by the Trust. Both
019 Litigation Page Failure to Elect Jurisdiction You failed to provide the jurisdiction in which you would have elected to file a lawsuit. On Part 5 of your Claim Form, you checked 'No' to question 5.1a; however, you failed to answer question 5.2. Please provide the state/jurisdiction in which you would have elected to file suit against this entity. IR
023 Failure to Choose Description for Significant Occuptional Exposure Your submission regarding the Injured Party's circumstances of asbestos exposure was incomplete. Please select the description which best illustrates the Injured Party's exposure to asbestos or asbestos-containing products. Both
103 No Causation or Causation From an Unacceptable Physician The medical reports submitted in support of your claim fail to indicate a correlation between the injury alleged and asbestos exposure or was not by a qualified physician. A qualified physician's report expressly stating that the injury was caused by such exposure is required by the Trust. Please submit any additional or amended reports relating to this issue. The medical reports provided in support of your claim either (1) fail to indicate a correlation between the injury alleged and asbestos exposure or (2) are not authored by a qualified physician. A qualified physician's report expressly stating that the injury was caused by such exposure is required by the Trust. Please provide any additional or amended reports. Both
104 Latency Period does not Qualify Based upon the medical and exposure documentation provided, the latency period between the injured party's first exposure to asbestos and the diagnosis of the disease alleged does not meet Trust requirements. The Trust requires a 10-year latency period which is supported by the medical documents and exposure dates on the claim. Please provide any additional reports which indicate the claim meets the Trust's requirements for latency. In addition, please ensure that any applicable dates entered on the claim form are accurate. i.e. DOD/DOB/start and end dates of occupational exposure, etc. Both
119 Medical Report Language is Unacceptable The provided medical report contains language in the diagnosis which includes the terms 'consistent with' or 'compatible with.' A diagnosis with this language, standing alone, is not acceptable as a diagnosis after the effective date for the Trust. Please submit a medical report with a definitive diagnosis from a qualified physician. Both
123 UK Foreign Claims - Injury Not Recognized United Kingdom ('UK') Foreign Claims -Injury Alleged Not Recognized as an Asbestos-Related Disease. The Claim Form submitted alleges and/or supports a claim for an injury not recognized as asbestos-related by the Trust for foreign claims originating in the UK. UK foreign claims of other non-respiratory cancers and pleural plaques are not compensable by the Trust. Both
130 Physical Exam Report not Provided No physical exam report has been provided. The Trust requires a physical examination, pathology, or autopsy report, authored by the physician performing the examination, which provides a diagnosis for the disease alleged. Please provide a report from a qualified physician which documents the diagnosis for the injury alleged and which is based upon a physical exam. If the injured party is deceased, a pathology report or autopsy report is acceptable if it provides the appropriate diagnosis. The report must be dated and signed by a qualified physician. Both
133 Medical Report for Wrong Party Information contained in the physical examination or pathology report submitted indicates that the report is not for the injured party referenced on the claim form. The information referred to is inconsistent with the name, date of birth, Social Security Number, or other demographic information provided on the claim form. Please provide a medical report for the injured party which documents the diagnosis of the injury alleged and which matches the demographic information provided on the claim form. The Trust will also accept an amended, signed and dated report from either the physician or the facility where the medical procedure was performed or the medical report was written. This amended report should reference the demographic information that was incorrect and provide updated information. Both
137 Medical Report is from an Unacceptable Physician The physical exam submitted with the claim was performed by or relies upon a physical exam from a physician who has been deemed unacceptable by the Trust. Please submit a physical exam which documents the diagnosis of the injury alleged and was performed by an acceptable physician. Both
142 Chest X-Ray Report Disputes or Conflicts with Earlier Reports The most recent chest x-ray, CT scan, or B-reader report contains findings which dispute an earlier report and does not provide an acceptable diagnosis for a bilateral asbestos-related non-malignant disease. Please submit a more recent chest x-ray, CT scan or B-read report which documents a Bilateral Asbestos-Related Non-malignant Disease. The chest x-ray or CT scan must be read by a Qualified Physician . Both
143 Chest X-Ray Report is for the Wrong Party Information contained in the chest x-ray, CT scan, or B-reader report submitted indicates that the report is not for the injured party referenced on the claim form. The information referred to may include the name, date of birth, Social Security number, or any other demographic information which is not consistent with that provided on the claim form. Please submit a chest x-ray, CT scan, or B-read report for the injured party which documents a Bilateral Asbestos-Related Nonmalignant Disease and which matches the demographic information provided on the claim form. The Trust will also accept an amended, signed and dated report from either the physician or the facility where the chest x-ray or CT scan was read. This amended report should reference the demographic information that was incorrect and provide updated information. Both
156 Failure to Choose Description for Significant Occupational Exposure (Disease levels III, IV, V & VII On the exposure page of the claim form, your submission regarding the injured party's circumstances of asbestos exposure was incomplete or you selected Box 5, "None", and failed to provide any description of exposure. The Trust requires completion of the questions on the claim form regarding the circumstances of the injured party's exposure at the site(s). Please check 'yes' or 'no' to each question under section 3.6 on each exposure page of the claim form. If "None of the above" is selected, please provide a detailed description of the claimant's job duties, the performance of which brought him into contact with asbestos-containing products. It is not sufficient to state that he worked with/around, in close proximity to, or in the vicinity of others who were using these products. Specfic details should be provided. Both
163 Pathology Report for Wrong Party The PFT you provided is for the wrong party. The claimant's social security number, date of birth or date of death on the Pathology report differs with what is on the claim form. Please provide a pathology report for the injured party which provides an acceptable diagnosis for the disease alleged and which matches the demographic information provided on the claim form. The Trust will also accept an amended, signed and dated report from either the physician or the facility where the pathology report was performed. This amended report should reference the demographic information that was incorrect and provide updated information. Both
168 Smoking History does not Match Medicals The information you provided in the Claim Form regarding the Injured Party's smoking history is inconsistent with the smoking history in the medical reports. Please provide an explanation with evidence that the information stated in the Claim Form is correct, or amend the Smoking History section of the Claim Form so that it is consistent with the smoking history in the medical reports. IR
171 The Physical Exam Diagnosis Disputes Chest X-Ray Findings The diagnosis in the physical exam report disputes the disease provided in the chest x-ray report, CT scan or B-read report. Please provide a more recent physical exam report which provides a diagnosis for the same disease as provided in the chest x-ray , CT scan or B-read report. Conversely, a more recent chest x-ray, CT scan or B-read report which supports the diagnosis provided in the physical exam may also cure the deficiency. Both
172 For Deceased Claimants/Chest X-Ray was not Read by a Qualified Physician For the deceased claimant, the chest x-ray or CT scan was not read by a qualified physician. Please provide a chest x-ray or CT scan that was read by a qualified physician. The report must provide evidence of bilateral asbestos-related non-malignant disease. Both
177 Affidavit Signed by POA/ Need POA An affidavit has been submitted for proof of exposure to Company products which has been signed by a Power of Attorney. The provided affidavit is unacceptable because no documentation has been submitted confirming the appointintment of the Power of Attorney. Please provide documentation confirming the appointment of the Power of Attorney for the affiant. Both
202 Name of Ship/Plant/Site not Provided. The name of the Ship, Plant, or Site (including city, state, and country) where the Injured Party's exposure occurred is incomplete. Please provide the name of the Ship, Plant, or Site of Exposure (including city, state, and country) where the Injured Party's exposure occurred. Both
204 Company Exposure Insufficient The information that you have provided regarding the Injured Party's exposure to Company products is insufficient to satisfy the Trust's 6-month requirement of working with the Trust product. Please update the claim form and send supporting documentation that includes beginning and ending dates to support additional Company exposure. Both
209 Need Information for Occupationally Exposed Person You have filed a claim alleging an asbestos-related injury resulting from contact with an Occupationally Exposed Person (OEP). As listed, the information submitted about the occupationally exposed person's exposure is incomplete or insufficient to meet the Trust's eligibility criteria for compensation. Please completely fill out Part 3 of the Claim Form pertaining to the OEP's Company and SOE or cumulative exposure, as well as the OEP's name. Both
212 Description for SOE may not meet Criteria (Disease levels III,IV, V & VII Only) This claim requires 5 years of significant occupational exposure (SOE) to asbestos. Based on the information provided, the industry/occupation pairing does not appear on the Master SOE rating list and/or the current description regarding SOE was found to be unacceptable. Please provide a detailed description of the injured party's job duties, the performance of which brought him into contact with asbestos-containing products. Supporting documentation may be required. Please be specific. It is not sufficient to state the injured party worked with/around, in close proximity to, or in the vicinity of others who were using these products. Specific job duties should be provided. This information should be provided as a written response to SOE on the exposure page of the claim form. Both
213 Failure to Provide Description of Cumulative Exposure A Level II claim requires 5 years of cumulative exposure to asbestos-containing products. When the industry/occupation pairing(s) provided on the sites for cumulative exposure do not appear on the Master SOE Rating list, a description as to how the injured party was exposed to asbestos is required. If a description has been provided, it has been deemed unacceptable. Please provide a detailed description of the injured party's job duties, the performance of which brought him into contact with asbestos-containing products. Supporting documentation may be required. Please be specific. It is not sufficient to state the injured party worked with/around, in close proximity to, or in the vicinity of others who were using these products. Specific job duties should be provided. This information should be provided as a written response to SOE on the exposure page of the claim form. Both
218 Exposure to Occupationally Exposed Person is Inadequate Your submission regarding the Injured Party's exposure to an Occupationally Exposed Person (OEP) is incomplete. Either you failed to describe how the Injured Party was exposed to the occupationally exposed person, or you failed to provide the Injured Party's beginning and/or ending dates of exposure to the occupationally exposed person. Please complete Part 4 of the claim form providing detail as to how the injured party was exposed to asbestos thru the OEP. Both
224 Exposure Dates not Provided On Part 3 of the Claim Form, you submitted insufficient exposure information. You have either provided no beginning/ending dates of exposure or you have indicated exposure that was intermittent. Please provide the dates on which exposure began and ended for each employer, occupation, and/or work site. Please submit a separate line of exposure for each employer and/or work site. Both
225 Separate the Years of Exposure at Each Site The Trust requires the injured party have at least 6 months of exposure to a Company product prior to 12/31/82. Although the injured party was at a known or documented site for at least 6 months, this site is completely overlapped by an unknown site. Therefore, it is not possible to determine if the injured party was exposed for the required time period. Please separate the years of exposure at each site. If this is not possible, please indicate that the injured party worked at the known site for at least 6 months prior to 12/31/82. Supporting documentation may be required. You may indicate this as the answer in the circumstances of exposure section on the exposure page of the claim form for known or documented sites, or as part of an exposure affidavit for unknown sites. Both
230 Pre-1983 Exposure is Insufficient The exposure information for pre-December 31, 1982 company exposure does not satisfy the minimum exposure criteria as required under the TDP. Please update the exposure section of the claim to indicate sufficient exposure to company product prior to December 31, 1982. Please provide supporting documentation for any exposure updates that are made. Both
232 Exposure Dates Outside Recognized Range The injured party's exposure at the known or documented site occurred prior to the time the site has been approved for Company products. Please provide an affidavit, invoices of sale, contemporaneous records or other sworn statement which places an asbestos-containing company product at the site listed on the claim form before or during the time the injured party worked there. Both
233 Occupationally Exposed Person's Name and/or Social Security Number The Trust requires both the name and Social Security number of the Occupationally Exposed Person to whom the injured party is alleging exposure. One or both of these requirements have not been met. Please provide the name and/or Social Security number of the Occupationally Exposed person to whom the injured party was exposed. IR
237 A company product was not specified, is generic, or is not recognized by the Trust. The product indicated in the affidavit provided for product identification is generic, is not referred to as asbestos-containing, or is not recognized by the Trust. Please provide an affidavit, deposition, invoices of sale, contemporaneous records or other sworn statement which places an asbestos-containing company product at the site listed on the claim form before or during the time the injured party worked there. Both
238 Affidavit contains multiple company products and/or multiple sites. The deficiency has been assigned because the affidavit provided is insufficient for one of the following reasons: 1) the affidavit lists multiple sites and products, but is not specific as to which products were used at each site, or 2) based on a review of the affidavits provided from your firm, many affidavits contain the same product from individuals working in various industries and occupations. Please provide an affidavit, deposition, invoices of sale, contemporaneous records or other sworn statement which places an asbestos-containing company product at the site listed on the claim form before or during the time the injured party worked there. If an affidavit is provided, please indicate the specific products used at each specific site. Both
250 No Verified Company Exposure Provided The exposure site(s) on the claim form are not known for Company products, nor has documentation which places a Company product at the site been provided. Please provide an affidavit, deposition, invoices of sale, contemporaneous records or other sworn statement which places an acceptable company product at the site on the claim form. Supporting documentation may be required. Both
251 Verified Company Exposure is Insufficient The affidavit provided in support of the claimant's proof of asbestos exposure is insufficient because it fails to properly identify one of the following: 1) missing site, city and/or state of exposure; 2) is undated, unsigned or is otherwise incomplete; 3) a Co-worker affidavit was submitted and the exposure years of the Co-worker do not match claimant's exposure years at the worksite; or 4) a Co-worker affidavit was submitted for a site that does not match the claimant's site of exposure. Please provide a complete affidavit, deposition, invoices of sale, contemporaneous records or other sworn statement which places an acceptable Company product at the site on the claim form. Both
257 Change of Occupation The occupation on the claim form has recently been updated/changed. Please provide documentation which supports the occupation currently reflected on the claim form. Both
267 Secondary Exposure/Foreign Claim Process We are unable to process Secondary Exposure Claims or Foreign Claims through Expedited Review. You must resubmit your claim choosing the Individual Review Process. Please change the process option from Expedited Review to Individual Review. ER
271 Company Exposure Insufficient (Maritime) The claim does not provide a sufficient number of days on board ships to satisfy the Trust's criteria for compensation. Please provide additional documentation regarding the on-board time the injured party spent on each ship for which you have alleged exposure to asbestos. Please provide the number of years the injured party was employed, as well as the specific number of days the injured party was aboard each particular ship each year. Both
273 Intermittent or On and Off Exposure You have indicated exposure that was either "intermittent" or "on and off." The Trust does not accept exposure time that is not specific to that site or product. Please provide the dates on which exposure began and ended for each employer, occupation, and/or work site claimed, or an explanation as to why more specific dates cannot be provided. Both
281 Improper Jurisdiction Selected The jurisdiciton elected in 5.2 on the Claim Form does not meet the Trust's Jurisdiction criteria. Please review section 5.3(b)(2) of the Trust Distribution Procedures to determine the Claimant's Jurisdiction you must or may elect and amend or supplement your claim as necessary. Section 5.3(b)(2) requires a claimant who filed a lawsuit against this Entity in the tort system before this Entity's Petition Date, to elect the state in which the lawsuit was filed as the Claimant's Jurisdiction. If you intent to rely on litigation information to cure this deficiency, you must provide the Trust with a date-stampled copy of your complaint or petition showing that the Entity was sued. Merely updating your claim form with litigation information is not sufficient to cure this deficiency. If no lawsuit was filed or this Entity was not named in the lawsuit, then the jurisdiciton chosen must be one of the following: 1) the state in which the injured party was exposed to Company asbestos products, 2) the state in which the injured party lived when he was diagnosed with the disease alleged, or 3) the state in which the injured party resided when the claim was filed with the Trust. Please provide documentation which supports the jurisdiction if you are using either the 2nd or 3rd criteria above. Examples of acceptable documentation to support the jurisdiction election would be discovery responses, affidavits or medical bills that show the address of the injured party. Both
284 Affidavit for Company Exposure is not acceptable. An affidavit from a family member of the deceased claimant has been provided to place a company product at the site on the claim form, or the affiant does not indicate first-hand knowledge as to the products in use at the site. The Trust requires that the affiant who places a company product at the site on the claim form have first-hand knowledge as to the products used there. Therefore, the Trust will not accept an affidavit from a family member or an individual who does not have first-hand knowledge of products to which he is attesting. Please provide credible evidence of company exposure from a person with first-hand knowledge. This may be an affidavit from a co-worker, discovery responses, deposition testimony, invoices of sale, construction or similar records. Both
285 The Site(s) of Exposure Listed on Claim Form/Does not Match the Site Code selected. The known or documented site selected does not match the exposure site on the claim form. Please amend the exposure page of the claim form to rectify the conflict between the known site code and the site indicated on the claim form. Both
296 Failure to Specify Length of Company Exposure Prior to 12/31/1982. The legal verified document provided for proof of exposure to Company products does not specifically state the injured party had at least 6 months of exposure at the site where the product was in use prior to December 31, 1982. Simply indicating the injured party worked at the site for longer than the required 6 month period is not sufficient. Please provide an affidavit which specifically states the injured party had at least 6 months of exposure to the Company asbestos-containing product prior to 12/31/1982. Both
1201 Incomplete Exposure Information The Exposure information that you provided in the claim form is either incomplete or inconsistent based on the other information provided.
1220 Documentation to Support ATS Standards Based on the medical documentation provided, the Trust requires additional verification from both the individual who administered the PFT and from the physician who performed the physical examination confirming ATS standards were met. Please provide claimant specific documentation, from both the individual who administered the PFT as well as the physician who performed the physical exam or oversaw the administration of the PFT, attesting that all practices and procedures such as technical quality and calibration met ATS standards. Documentation from an individual who did not administer the PFT test or was not present during the testing is not acceptable. Documentation from a physician who did not perform the physical exam and or was not present at time of PFT testing is not acceptable. Both
1221 Edited Lines of Exposure Since the last review of the claim, exposure information was revised, added or deleted. 1. Legal Verified Document from IP that supports the exposure changes. 2. Affidavit or letter from attorney that all exposure information in the claim as currently provided is accurate. Both
2204 Industry Not Provided At one or more of the jobsites identified, you have not provided the industry where the Injured Party's exposure to asbestos occurred. For each line of exposure provided, please indicate the industry which most accurately describes the nature of the industry in which the Injured Party worked. If you select 'Other', please specify the type of industry. Both
2205 Occupation of Injured Party not Provided At one or more of the jobsites identified, you have not provided an occupation for the Injured Party. Please indicate the occupation which most accurately describes the nature of the Injured Party's work. Both
2208 Insufficient documentation for elected jurisdiction You have failed to indicate the jurisdiction in which you would have elected to file a lawsuit or the jurisdiction that you have selected is improper based on the information on the Claim Form. In order to cure this deficiency, please complete Part 5 of the Claim Form. If the answer to Question 1(a) is 'no', then you must answer Question 5.2. If you have answered Question 5.2, please be sure it meets one of the following TDP criteria: (1) the state in which the Injured Party was exposed to Company products; (2) the state in which the Injured Party lived when diagnosed with the disease alleged; or (3) the state in which the Injured Party lived when the claim was filed with the Trust. If you are using (2) or (3) above, you must provide documentation to support that election. Both
2214 Revisions to Verified Documents Revisions to one or more legal verified documents in the claim have been made. The Trust will not accept revisions or alterations to legal verified documents. Please provide a legal verified document which does not contain any revisions. Both
2224 Deposition Provided is not Highlighted or Relevant Pages Identified The deposition testimony submitted in support of the claim is not highlighted or does not indicate the relevant pages or specific issue for which the deposition testimony has been provided. Please highlight the relevant pages of the deposition or provide specific page numbers for the evidence that is relevant to the issue for which it is submitted. Both
R01 Certificate of Official Capacity No Certificate of Official Capacity was provided. Please provide the Certificate of Official Capacity. Both
R03 New Personal Representative Information Needed The Claim Form and release do not have the new Personal Representative's information. Please provide the Personal Representative's full name. Please provide the new Personal Representative's name. Both
R04 Missing Two Witness Signatures The release has not been witnessed by two people. Please resubmit the release with two witness signatures. Both
R05 No Death Certificate No Death Certificate has been provided. Please provide the Death Certificate for the Injured Party. Both
R06 No Notary Stamp/Embossed The notary stamp/embossment on the release is not legible. Please resend/upload the release that contains the Notary Stamp/Embossment. Please ensure that any embossment is viewable. Both
R07 Incomplete Release Uploaded The release received is incomplete. Please resend or upload the completed and signed release. Please make sure the release is properly signed and dated. Both
R08 Corrected SSN The Social Security Number on the release for the claimant does not match the SSN provided on the claim form. The release was returned to the Trust with a Social Security number other than what appears on the Claim Form or the Death Certificate submitted for the claimant. Please verify and provide the correct Social Security number for the claimant. Both
R11 POA Paper The release was signed by someone other than the claimant and there is no information that the claimant is deceased. If the claimant is now deceased, please provide the death certificate and COC documentation. If the claimant is living, please provide Power of Attorney papers appointing the representative to act on behalf of the Injured Party. Both
R14 Incorrect Release Uploaded The release that was uploaded or mailed contains information that does not match the Trust's current claim data. This may include the wrong claimant name on the release, the wrong trust release was uploaded or sent, and/or the Liquidated Value reflected on the release is incorrect. Please upload or resend the correct release for this claim. Both
R17 Signature dates do not match on the release The date the release was signed by the claimant and the date the notary signed the release, do not match. Please provide a new release with matching signature dates for the claimant and the notary. You may also choose to have two witnesses sign the new release in place of a notary. Both
R18 No claimant signature The release is missing the claimant's signature. Please resubmit the release containing the signature of the claimant. Both
R19 Missing signature page of release The signature page of the release is missing. Please send/re-upload the complete release including the completed signature page. Both
R20 Notary stamp/seal not legible The notary stamp/seal is illegible. Please provide a new copy of the release with a legible notary seal or submit a new release with a notary stamp/seal that is legible. You may also choose to have two witnesses sign a new release in place of a notary. Both
R21 New release with new PR information needed The name of the Personal Representative has not been provided. Please provide the PR information and if necessary, COC documetnation if required in your state. Both
R22 Personal representative is deceased Information submitted indicates that the original personal representative on the claim form is now deceased. Please provide a copy of the deceased personal representative's death certificate, as well as the new personal representative's full name and a court document assigning him/her as the new legal representative for the injured party's estate. Both
R24 Incomplete Release Executed Date The Trust has received the signed release but the executed date by the claimant, notary or both is either missing or incomplete. The executed date on the release must include the day, month and year. If there is a notary on the release, the executed date for both the claimant and notary must match. Both