IRC Medical Requirements

Celotex Medical Requirements and Evidence Required to Establish an Asbestos Related Disease for Individual Review Claimants

For Non-Malignancy Claims – A medical report documenting the diagnosis of the claimed disease by an internal medicine or pulmonary medicine specialist or other appropriate specialist based on either a physical examination of the claimant by that doctor, a physical examination by another doctor whose physical examination and findings are reliable or a pathologist’s examination for a deceased claimant; and chest x-ray evidence of asbestos-related disease.

For Malignancy Claims – A medical report documenting the diagnosis of the claimed disease by an internal medicine or pulmonary medicine specialist or other appropriate specialist based on either a physical examination of the claimant by that doctor, a physical examination by another doctor whose physical examination and findings are reliable or a pathologist’s examination for a deceased claimant, and

For Other Cancer claims, evidence that the claimant also had a non-malignant disease that qualifies under categories I, II or III below and a medical report that states exposure to asbestos was a substantial cause of the cancer.

For Lung Cancer 2 claims, be a non-smoker for 15 years prior to diagnosis or evidence that the claimant also had a non-malignant disease that qualifies under categories I, II or III below and a medical report that states exposure to asbestos was a substantial cause of the cancer.

For Lung Cancer 1 claims, a medical report that states exposure to asbestos was a substantial cause of the cancer.

The evidence required for each alleged disease category is as follows:

Category I: Bilateral Pleural Disease

1. The claimant must document bilateral pleural disease (plaques or thickening) diagnosed on the basis of x-ray, CT scan, HRCT scan or pathological, evidence; and
2. The proof of claim must establish a 10-year latency period between the date of first exposure to asbestos and the date of diagnosis of bilateral pleural disease.

Category II: Non-disabling Bilateral Interstitial

1. The claimant must document bilateral interstitial lung disease diagnosed on the basis of x-ray, CT scan, HRCT scan or pathological evidence, and submit either:
   • A medical report stating that a causal relationship exists between asbestos exposure and the bilateral interstitial lung disease; or
   • Documentation of the presence of either unilateral or bilateral pleural disease accompanying the bilateral interstitial lung disease; and
2. The proof of claim must establish a 10-year latency period between the date of first exposure to asbestos and the date of diagnosis of bilateral interstitial disease.

Category III: Disabling Bilateral Interstitial Lung Disease

1. The claimant must document bilateral interstitial lung disease diagnosed on the basis of x-ray, CT scan, HRCT scan or pathological evidence; and
2. The claimant must document disability or impairment evidenced by pulmonary function tests (PFTs), total lung capacity (TLC) forced vital capacity (FVC), or diffusing capacity (DLCO) of less than 80%; and
3. The claimant must submit a medical report stating that a causal relationship exists between asbestos exposure and the bilateral interstitial lung disease; and
4. The proof of claim must establish a 10-year latency period between the date of first exposure to asbestos and the date of diagnosis of bilateral interstitial disease.

Category IV: Other Cancers

1. The claimant must demonstrate by medical report the existence of primary asbestos-related cancer of one of the following sites:
   • Colo-rectal;
   • Laryngeal;
   • Esophageal; or
   • Pharyngeal; and
2. The claimant must demonstrate by medical report the existence of one of the following:
   • Bilateral interstitial lung disease;
   • Bilateral pleural disease (thickening or plaques); or
   • Pathological evidence of asbestosis; and
3. The proof of claim must establish occupational exposure to asbestos during an aggregate of three (3) years or twelve (12) quarters of employment and 10-year latency period between the date of first exposure to asbestos and the date of diagnosis of the cancer.

Category V: Lung Cancers (One)

1. The claimant must demonstrate by medical report the existence of primary asbestos-related cancer of the lung; and
2. The claimant must demonstrate at least 15 years of occupational exposure to asbestos-containing materials in employment regularly requiring work in the immediate area of visible asbestos dust; and
3. The proof of claim must establish a 10-year latency period between the date of first exposure to asbestos and the date of diagnosis of the cancer.

Category VI: Lung Cancers (Two)

1. The claimant must demonstrate by medical report the existence of primary asbestos-related cancer of the lung; and
2. The proof of claim must establish a 10-year latency period between the date of first exposure to asbestos and the date of diagnosis of the cancer; and the claimant must:
   • Be a nonsmoker (has not smoked cigarettes for at least 15 years prior to diagnosis) and demonstrate by documentation such as Social Security records or a medical report with claimant’s work history, occupational exposure to asbestos during an aggregate of three years or 12 quarters of employment; or
   • Demonstrate by medical report the existence of one of the following:

Bilateral interstitial lung disease; Bilateral pleural disease (thickening or plaques); or Pathological evidence of asbestosis.

Category VII: Malignant Mesothelioma

1. The claimant must demonstrate by medical report referencing pathological findings of the existence of malignant mesothelioma; and
2. The proof of claim must establish a 10-year latency period between the date of first exposure to asbestos and the date of diagnosis of the cancer