OCFB Medical Requirements and Evidence Required to Establish an Asbestos-Related for Individual Review Claimants
Level I: Other Asbestos Disease
Medical Criteria
1. Diagnosis of a bilateral asbestos-related non-malignant disease or an asbestos-related malignancy other than mesothelioma based upon either:
- A physical exam of the claimant by the physician providing the diagnosis, or
- If the claimant is deceased at the time the claim was filed, pathological evidence of the non-malignant asbestos-related disease.
2. Evidence of a bilateral asbestos-related non-malignant disease based upon
- A chest x-ray read by a certified B-reader of 1/0 or higher1; or
- A chest x-ray read by a certified B-reader or read by a qualified physician2, or
- A CAT scan read by a qualified physician2, or
- A pathology report, in each case, showing bilateral interstitial fibrosis, bilateral pleural plaques, bilateral pleural thickening, or bilateral pleural calcification.
3. 10 year latency.
Exposure Criteria
1. OCF exposure prior to December 31, 1982.
Level II: Asbestosis/Pleural Disease
Medical Criteria
1. Diagnosis of an asbestos-related non-malignant disease based upon either:
- A physical exam of the claimant by the physician providing the diagnosis, or
- If the claimant is deceased at the time the claim was filed, pathological evidence of the non-malignant asbestos-related disease.
2. Evidence of a bilateral asbestos-related non-malignant disease based upon:
- A chest x-ray read by a certified B-reader of 1/0 or higher1; or
- A chest x-ray read by a certified B-reader or read by a qualified physician2, or
- A CAT scan read by a qualified physician2, or
- A pathology report, in each case, showing bilateral interstitial fibrosis, bilateral pleural plaques, bilateral pleural thickening, or bilateral pleural calcification.
3. 10 year latency.
Exposure Criteria
1. Six months OCF exposure prior to December 31, 1982, and
2. Five years cumulative occupational exposure to asbestos.
Level III: Asbestosis/Pleural Disease
Medical Criteria
1. Diagnosis of an asbestos-related non-malignant disease based upon either:
- A physical exam of the claimant by the physician providing the diagnosis, or
- If the claimant is deceased at the time the claim was filed, pathological evidence of the non-malignant asbestos-related disease.
2. Evidence of a bilateral asbestos-related non-malignant disease based upon:
- A chest x-ray read by a certified B-reader of 1/0 or higher1 , or
- A chest x-ray read by a certified B-reader or read by a qualified physician2, or
- A CAT scan read by a qualified physician2, or
- A pathology report, in each case, showing bilateral interstitial fibrosis, bilateral pleural plaques, bilateral pleural thickening, or bilateral pleural calcification.
3. Pulmonary Function Testing with either:
- A TLC less than 80%, or
- FVC less than 80% and FEV1/FVC ratio greater than or equal to 65%, or
- Pulmonary Function Test must be in compliance with the quality criteria established by the ATS3.
4. 10 year latency.
5. Supporting medical documentation establishing asbestos exposure as a contributing factor in causing the pulmonary disease.
Exposure Criteria
1. Six months OCF exposure prior to December 31, 1982, plus
2. Significant Occupational Exposure4 to asbestos.
Level IV: Severe Asbestosis
Medical Criteria
1. Diagnosis of asbestosis based upon either:
- A physical exam of the claimant by the physician providing the diagnosis, or
- If the claimant is deceased at the time the claim was filed, pathological evidence of the non-malignant asbestos-related disease.
2. An ILO of 2/1 or greater, or
- Pathological evidence of asbestosis.
3. Pulmonary Function Testing with either:
- TLC less than 65%, or
- FVC less than 65% and FEV1/FVC ratio greater than 65%, or
- Pulmonary Function Test must be in compliance with the quality criteria established by the ATS3.
4. Supporting medical documentation establishing asbestos exposure as a contributing factor in causing the pulmonary disease.
Exposure Criteria
1. Six months OCF exposure prior to December 31, 1982, plus
2. Significant Occupational Exposure4 to asbestos.
Level V: Other Cancer
Medical Criteria
1. A diagnosis of a primary colo-rectal, laryngeal, esophageal, pharyngeal, or stomach cancer based upon either:
- A physical exam of the claimant by the physician providing the diagnosis, or
- A diagnosis of such a malignant disease by a board-certified pathologist.
2. Evidence of an underlying bilateral asbestos-related non-malignant disease based upon:
- A chest x-ray read by a certified B-reader of 1/0 or higher1 , or
- A chest x-ray read by a certified B-reader or read by a qualified physician2, or
- A CAT scan read by a qualified physician2, or
- A pathology report, in each case, showing bilateral interstitial fibrosis, bilateral pleural plaques, bilateral pleural thickening, or bilateral pleural calcification.
3. A causal statement from a medical doctor linking the other cancer to asbestos exposure.
4. 10 year latency.
Exposure Criteria
1. Six months OCF exposure prior to December 31, 1982, plus
2. Significant Occupational Exposure4 to asbestos.
Level VI: Lung Cancer 2*
Medical Criteria
1. A diagnosis of a primary lung cancer based upon either:
- A physical exam of the claimant by the physician providing the diagnosis, or
- A diagnosis of such a malignant disease by a board certified pathologist.
2. A causal statement from a medical doctor linking the lung cancer to asbestos exposure.
3. 10 year latency.
Exposure Criteria
1. OC/FB exposure prior to December 31,1982.
* Lung Cancer 2 (Level VI) claims are claims that do not meet the more stringent medical and/or exposure requirements of Lung Cancer (Level VII) claims. All claims in this Disease Level will be individually evaluated.
There is no distinction between non-smokers and smokers for either Lung Cancer 1 (Level VII) or Lung Cancer 2 (Level VI). A claimant who meets the requirements of Lung Cancer 1, and is a non-smoker may wish to have his or her claim individually evaluated by the Trust.
Level VI claims that show no evidence of either an underlying Bilateral Asbestos-Related Non-malignant Disease or Significant Occupational Exposure may be individually evaluated, although it is not expected that such claims will be treated as having any significant value, especially if the claimant is also a smoker. In any event, no presumption of validity will be available for any claims in this category.
Level VII: Lung Cancer 1
Medical Criteria
1. A diagnosis of a primary lung cancer based upon either:
- A physical exam of the claimant by the physician providing the diagnosis, or
- A diagnosis of such a malignant disease by a board-certified pathologist.
2. Evidence of an underlying bilateral asbestos-related non-malignant disease based upon:
- A chest x-ray read by a certified B-reader of 1/0 or higher1, or
- A chest x-ray read by a certified B-reader or other qualified physician2, or
- A CAT scan read by a qualified physician2, or
- A pathology report, in each case showing bilateral interstitial fibrosis, bilateral pleural plaques, bilateral pleural thickening, or bilateral pleural calcification.
3. A causal statement from a medical doctor linking the lung cancer to asbestos exposure.
4. 10 year latency.
Exposure Criteria
1. Six months OCF exposure prior to December 31, 1982, plus
2. Significant Occupational Exposure4 to asbestos.
Level VIII: Mesothelioma
Medical Criteria
1. A diagnosis of mesothelioma based upon either:
- A physical exam of the claimant by the physician providing the diagnosis, or
- A diagnosis of such a malignant disease by a board-certified pathologist.
2. 10 year latency.
Exposure Criteria
1. Credible evidence of OCF exposure.
Note: A finding by a physician after the Effective Date that a claimant’s disease is “consistent with” or “compatible with” asbestosis will not alone be treated by the Trust as a diagnosis.
1For claims filed before the petition date, if an ILO reading is not available, then OCFB will accept a chest x-ray report (read by a Qualified Physician) regardless of whether it was read by a qualified B-reader.
2Qualified Physician – Physician board-certified in a specialized field of medicine, such as pulmonology, radiology, internal medicine, or occupational medicine.
3ATS – American Thoracic Society.
4Significant Occupational Exposure – Employment for a cumulative period of at least five years with a minimum of two years prior to December 31, 1982 in an industry and an occupation in which the claimant:
A. handled raw asbestos fibers on a regular basis; or
B. fabricated asbestos-containing products so that the claimant in the fabrication process was exposed on a regular basis to raw asbestos fibers; or
C. altered, repaired or otherwise worked with asbestos-containing products such that the claimant was exposed on a regular basis to asbestos fibers; or
D. was employed in an industry and occupation such that the claimant worked on a regular basis in close proximity to workers engaged in the activities described in (a), (b) and/or (c).