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| Deficiency Code | Code Text | Detailed Text | Solution Text | Option |
|---|---|---|---|---|
| 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 |
| 002 | Certificate of Official Capacity is required. | You have indicated that this claim is being made on behalf of the injured party or his/her estate. The Trust requires documentation of the representative's authority to act on behalf of the injured party or the injured party's estate. | Please provide one of the following types of documents to resolve this deficiency: Power of Attorney appointing the representative to act on behalf of the Injured Party in pursuing a claim for asbestos injuries or, where the Injured Party is deceased, Letters Testamentary or Letters of Administration from a court appointing the representative as executor or administrator of the claimant's estate. This does not include birth certificates, marriage certificates, or Last Will and Testament. | Both |
| 003 | Injured Party's Social Security Number not Provided | The SSN of the Injured Party has not been provided. | Please provide the Injured Party's Social Security number. | Both |
| 004 | Injured Party's Date of Birth not Provided | The date of birth of the Injured Party has not been provided. | Please provide the Injured Party's date of birth. | Both |
| 005 | Original Lawsuit State not Provided | The original lawsuit state was not provided. | Please provide the state where the original lawsuit regarding this claim was filed. | Both |
| 006 | Original Lawsuit Date not Provided | The original lawsuit date was not provided. | Please provide the date on which the original lawsuit regarding this claim was filed. | 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 Form. | Both |
| 008 | Signature of Claimant and/or Personal Representative not Provided | Your Claim Form failed to provide the requisite signature, either of the claimant or personal representative, authenticating the claim. | Enclosed is a copy of your claim form with the appropriate space for signature. | 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 (DCP)/Part 4(IRC)of the Claim Form. | Both |
| 010 | Industry and/or Occupation not Provided | The submission of Part 3 (DCP)/Part 4 (IRC) of the Claim Form, regarding the injured party's exposure to Celotex/Carey Canada products, does not include the industry and/or occupation of the injured party. | Please completely fill in the appropriate information for each work ship/plant/site where asbestos exposure is being alleged. | Both |
| 012 | No Injury Alleged | Your Claim form fails to designate an alleged injury. | Please select an injury on Page 3 of the Claim Form and provide the month and year in which the physician first assessed the condition. | Both |
| 013A | SSN is inconsistent with Claim Form | The Social Security Number is inconsistent with what appears in the injured party's documents. | Please submit the correct Social Security Number or provide an explanation as to why there is a discrepancy. | Both |
| 013B | Date of Birth is inconsistent with Claim Form | The Date of Birth is inconsistent with what appears in the injured party's documents. | Please submit the correct Date of Birth or provide an explanation as to why there is a discrepancy. | Both |
| 013C | Date of Death is inconsistent with Claim Form | The Date of Death is inconsistent with what appears in the injured party's documents. | Please submit the correct Date of Death or provide an explanation as to why there is a discrepancy. | Both |
| 013D | Name is inconsistent with Claim Form | The name is inconsistent with what appears in the injured party's documents. | Please submit the correct name or provide an explanation as to why there is a discrepancy. | Both |
| 014 | Attachments Not Provided | Attachments Missing | Please submit any additional information you wish to have evaluated as part of this claim. | Both |
| 015 | No Medical Records | No medical records were provided to support your claim. | Please provide medical records to support your claim as required in the Instructions for Filing a Claim. | Both |
| 016 | Death Certificate for Wrong Party | The death certificate provided is not for the Injured Party of this claim. | Please provide an official death certificate for the Injured Party. | Both |
| 017 | Death Certificate is Incomplete | The death certificate provided is not acceptable because it is illegible, or information such as Injured Party's name, date of birth, date of death and/or SSN was cut-off when photocopied. | Please provide an official death certificate for the Injured Party that is legible and complete. | Both |
| 018 | Alleged Injury Not Recognized | You have not designated a disease that is recognized by the Trust. | On Part 2 of your claim form you have designated an alleged disease other than a disease recognized by the Trust. Please provide an amended page 3 with the appropriate asbestos-related injury and the date on which it was diagnosed. | Both |
| 024 | Original Trial Date has Passed | The trial date provided on the Claim Form has passed without the Trust being notified of the outcome of the trial. Until the Trust receives written notification as to the result of the trial, the above referenced release will be administratively pended. | Please provide written notification as to the result of the trial. | Both |
| 026 | Duplicate Financial Dependent | One or more of the financial dependents as indicated in the dependent section of the Claim Form appears to be a duplicate. | Please review the dependent section of the Caim Form to ensure that no duplicate dependent information is provided. | IRC Only |
| 041 | Incomplete Litigation Information | You have failed to complete all litigation information. | Please complete the litigation section of the Claim Form with all required information. | Both |
| 102 | Failure to Substantiate Alleged Injury | The records provided do not substantiate the injury alleged on the Claim Form. The medical records submitted indicate the Injured Party suffered from a different asbestos-related injury than the injury alleged. | Please provide additional medical records substantiating the injury alleged on the Claim Form, or resubmit an amended Part 2 (Diagnosed Asbestos-Related Injuries) indicating an injury consistent with the medical reports provided. | Both |
| 104 | Latency Period does not Qualify | The proof of claim must establish a 10-year latency period between the date of first exposure to asbestos and the date of the alleged asbestos-related disease. For claims alleging Other Cancer/Lung Cancer One, the claimant must also demonstrate at least 3 years or 12 quarters/15 years of occupational exposure to asbestos-containing materials in employment regularly requiring work in the immediate area of visible asbestos dust. The medical records submitted in support of the claim report a date of diagnosis that does not satisfy the Trust's latency period criteria for the alleged injury category or the claim does not provide the required years of exposure to qualify for the alleged malignancy. | Please provide additional medical records that meet the 10-year latency period or provide additional exposure time that meets the 3-year or 12 quarters/15-year exposure requirement for your Other Cancer/Lung Cancer One claim. | Both |
| 105 | No Proof of Alleged Asbestos-Related Injury. | The medical records submitted allege and/or support a claim for an injury not recognized as asbestos-related by the Trust. The Trust can only compensate injuries that are asbestos-related. | Please refer to the CRP, which can be found on the Trust's website, for a list of diseases compensated by the Trust. Please review and, where applicable, resubmit Part 2 of the Claim Form along with any additional documentation substantiating one of the allowed asbestos-related injuries under the CRP. | Both |
| 110 | PFT Report not Provided | The disease alleged on the claim form is Disabling Bilateral Interstitial Disease. No Pulmonary Function Test (PFT) reports were provided. | In order to fully substantiate your claim for Disabling Bilateral Interstitial Disease, please submit qualifying Pulmonary Function Test (PFT) reports, including at least FVC, TLC, and/or DLCO scores, that meet the criteria established in the Instructions for Filing a Claim. | IRC Only |
| 112 | No Underlying Bilateral Asbestos-Related Disease | Claims alleging Lung Cancer Two or Other Cancer require evidence of an underlying bilateral interstitial lung disease, bilateral pleural disease, or pathological evidence of asbestosis. | In order to fully substantiate your claim for Lung Cancer Two or Other Cancer, please submit evidence of an underlying bilateral interstitial lung disease, bilateral pleural disease, or pathological evidence of asbestosis. There must be evidence that the underlying bilateral disease was caused by asbestos exposure. | IRC Only |
| 114 | Most Recent PFT Scores do not Qualify | The most recent Pulmonary Function Test (PFT) scores that were provided do not qualify, dispute an earlier qualifying report (s), and/or are unacceptable due to poor effort or reproducibility. In order to qualify, the forced vital capacity (FVC), total lung capacity (TLC) and/or diffusion capacity (DLCO) scores must be less than 80%. | In order to fully substantiate the claim for Disabling Bilateral Interstitial Disease, please submit qualifying Pulmonary Function Test (PFT) reports, including at least FVC, TLC, and/or DLCO scores, that meet the criteria established in the Instructions for Filing a Claim. | IRC Only |
| 115 | PFT report is for Wrong Party | The PFT report provided is for the wrong party, illegible, not dated, missing pages or otherwise incomplete. | In order to fully substantiate your claim for Disabling Bilateral Interstitial Disease, please submit complete qualifying Pulmonary Function Test (PFT) reports for the Injured Party, including at least FVC, TLC, and/or DLCO scores, that meet the criteria established in the Instructions for Filing a Claim. | IRC Only |
| 116 | PFT is from an Unacceptable Facility | The PFT report provided with the claim was performed by a facility that has been deemed unacceptable by the Trust. | Please provide a qualifying PFT report from an acceptable facility. Please refer to the Trust's website for additional information regarding facilities which have been deemed unacceptable. | IRC Only |
| 121 | Chest x-ray Report does not Identify the Physician | The medical records provided contain chest x-ray, CT scan or B-reader findings; however, the Trust was unable to determine the identity of the physician who performed the reading of the chest x-ray, CT scan or B-reader. | Please provide a chest x-ray, CT scan or B-reader report in which the physician who read the film is identified. Please provide either a new chest x-ray, CT scan or B-reader report, or the complete original document that identifies the full name of the interpreting physician. | Both |
| 122 | Certified Translation of Foreign Document Required | One or more documents in the claim are in a foreign language. The Trust does not accept documentation written in any language other than English. | The Trust requires a certified translation for each document submitted in a foreign language. The original foreign language document(s), the certified translation and the translator's CV must be provided for each foreign language document in order to cure this deficiency. | Both |
| 130 | Physical Exam Report not Provided | No physical examination, review of a physical examination, pathology, or autopsy report has been provided in the claim. | Please provide a medical report that documents the diagnosis of the injury alleged on the Claim Form. The report must be dated, signed by a qualified physician, and must include a diagnosis based on a physical examination as required by the Trust's Instructions for Filing a Claim. A pathology or autopsy report is acceptable if it provides the appropriate diagnosis. | Both |
| 131 | Medical Report Unacceptable Diagnosis | The most recent physical examination report, review of a physical examination, pathology report or autopsy report does not provide an acceptable diagnosis for the injury alleged. | Please provide a physical examination report or pathology report (if the Injured Party is deceased) which provides the diagnosis of the injury alleged on the claim form. This report must be dated and signed by a qualified physician and must include a diagnosis based upon a physical exam, review of a physical exam by the physician making the diagnosis. A pathology report is acceptable if it provides the appropriate diagnosis. | Both |
| 132 | Medical Report Disputes and/or Conflicts with Earlier Reports | The most recent physical examination report, pathology report, or autopsy report provided disputes an earlier report(s) and does not provide an acceptable diagnosis for the alleged injury. | Please provide a more recent medical report which documents the diagnosis of the injury alleged on the Claim Form. The report must be dated, signed by a qualified physician and must include a diagnosis based upon a physical examination by the physician making the diagnosis. A pathology report is acceptable if it provides the appropriate diagnosis. | 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 the 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 |
| 134 | Medical Report is Incomplete | The physical examination report provided with this claim is not acceptable because it is either missing pages, illegible, is not dated and/or signed by a qualified physician, or is otherwise incomplete. | Please provide the complete or a more legible copy of the medical report that documents the diagnosis of the injury alleged on the Claim Form. | Both |
| 135 | Medical Report is Not a Physical Exam or is Not by a Qualified Physician | The submitted medical report does not qualify as or include evidence of a hands on physical examination by a qualified physician or the Trust was unable to determine the physician's qualifications. | Please provide a hands on physical examination report performed by a qualified physician or provide the qualifications of the physician who performed the previously submitted physical examination. | Both |
| 136 | Final Request for Medical Report Diagnosing the Alleged Injury | This is the final request for the signed and dated medical report providing evidence of a physical examination by a qualified physician and an acceptable diagnosis of the alleged injury. Without additional information, this claim will not be capable of further review. | This is the final request for the signed and dated medical report providing evidence of a physical examination by a qualified physician and an acceptable diagnosis of the alleged injury. Without additional information, this claim will not be capable of further review. | Both |
| 137 | Medical Report is from an Unacceptable Physician | The physical examination report submitted with the claim was performed by or relies upon a physical examination from a physician who has been deemed unacceptable by the Trust. | Please submit a physical examination report which documents the diagnoses of the injury alleged and was performed by an acceptable physician. | Both |
| 138 | Medical Report is from an Unacceptable facility | The physical examination report provided with the claim was performed at a facility that has been deemed unacceptable by the Trust. | Please submit a physical examination report which documents the diagnosis of the alleged injury and is from an acceptable facility . | Both |
| 139 | Chest X-ray was not read by a Qualified Physician | The chest x-ray, CT scan or B-reader report provided does not indicate if it was read by a Qualified Physician. | Please provide a chest x-ray, CT scan or B-reader report, interpreted by a qualified physician, diagnosing the alleged injury. | Both |
| 140 | Chest X-ray Report Not Provided | No chest x-ray, CT scan or B-reader report has been provided. The Trust requires a chest x-ray, CT scan, or B-reader report which provides an acceptable diagnosis for a bilateral asbestos-related non-malignant disease. | Please submit a chest x-ray, CT scan or B-reader 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 |
| 141 | Chest X-Ray Report Unacceptable Diagnosis | The most recent chest x-ray, CT scan, or B-reader report does not provide an acceptable diagnosis for a bilateral asbestos-related non-malignant disease. | Please submit a medical report based upon the review of a chest x-ray, CT scan or B-reading which documents a bilateral asbestos-related non-malignant disease. The chest x-ray , CT scan or B-readering must be read by a Qualified 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, CT scan or B-reading 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-reader report for the Injured Party which documents a bilateral asbestos-related non-malignant disease and which matches the demographic information provided on the Claim Form. The Trust will also accept an amended, signed and dated report from the either the physician or the facility where the chest x-ray, CT scan or B-reader report was read. This amended report should reference the demographic information that was incorrect and provide updated information. | Both |
| 144 | CXR Report is Incomplete or the CXR is Not of Acceptable Quality | The chest x-ray, CT scan, or B-reader report is not acceptable because it is either illegible, incomplete or is based upon a film of unacceptable quality. | Please submit a complete medical report based upon the review of a chest x-ray, CT scan, or a B-reading report which documents a bilateral asbestos-related non-malignant disease. The chest x-ray, CT scan or B-reading must be based upon a film of acceptable quality and read by a Qualified Physician. The report must be dated and signed by the Qualified physician and must include information which identifies the Injured Party. | Both |
| 145 | Chest X-Ray Report Findings are not Bilateral | The chest x-ray, CT scan, or B-reader report does not document bilateral findings for the asbestos-related non-malignant disease. | Please submit a chest x-ray, CT scan, or a B-reader report which documents bilateral findings for the asbestos-related non-malignant disease. This report must be dated and signed by a Qualified Physician and include information which identifies the Injured Party. | Both |
| 146 | Final Request for Chext X-ray Report | Please submit a report based on the review of a chest x-ray, CT scan or a b-reader report. Without additional information, this claim will not be capable of further review. | Please submit a report based on the review of a chest x-ray, CT scan or a b-reader report. Without additional information, this claim will not be capable of further review. | Both |
| 147 | Chest X-Ray Report is from an Unacceptable Physician | The chest x-ray, CT scan, or B-reader report submitted with the claim was evaluated by a physician deemed unacceptable by the Trust. A complete list of unacceptable physicians is available on the Trust's website. | Please submit a chest x-ray, CT scan, or B-reader report for the alleged injury from an acceptable physician. The report must provide evidence of the alleged injury and demonstrate bilateral findings. | Both |
| 148 | Chest X-Ray Report is from an Unacceptable Facility | The chest x-ray, CT scan, or B-reader report submitted with the claim was performed at a facility deemed unacceptable by the Trust. A complete list of unacceptable facilities is available on the Trust's website. | Please submit a chest x-ray, CT scan, or B-reader report that was performed at an acceptable facility, or provide a reading of the chest x-ray, CT scan or B-reading by a qualified physician which includes a statement of the film's acceptable quality. The report must be dated and signed by the radiologist or physician, and must include information which identifies the Injured Party. | Both |
| 150 | Pathology Report not Provided | No pathology report has been provided. A pathology report is required to document the injury alleged on the claim form. | Please provide a pathology report authored by a pathologist which provides an acceptable diagnosis of the alleged disease. If there is no pathological material, please provide the initial diagnosing physical examination or discharge summary along with treating medical documents that confirm the alleged injury. | Both |
| 151 | Pathology Report for Wrong Injury | A pathology report has been provided but it is for an injury other than that alleged on the Claim Form. | Please provide a pathology report which provides an acceptable diagnosis for the disease alleged on the Claim Form. | Both |
| 152 | Pathology Report is not for a Primary Site | The pathology report provided does not indicate the primary site of the malignancy. | Please provide further medical documentation such as treatment records or a physician's report expressly stating that the malignancy was a primary site of the disease alleged. | Both |
| 153 | Pathology Report is Incomplete | The pathology report submitted is not acceptable because it is either missing pages, is illegible, is not dated and/or signed by a qualified physician, or is otherwise incomplete. | Please provide a complete, legible and signed pathology report which contains an acceptable diagnosis for the disease alleged on the Claim Form. | Both |
| 154 | Pathology Report has an Unacceptable Diagnosis | The pathology report submitted does not provide an acceptable diagnosis for the malignancy alleged on the Claim Form. | Please provide a pathology report which provides an acceptable diagnosis for the disease alleged on the Claim Form. | Both |
| 163 | Pathology Report for Wrong Party | The pathology report you provided is for the wrong party. The claimant's social security number, date of birth or date of deathÿon 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 the 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 |
| 164 | Smoking History not Provided | The smoking history on the claim form is incomplete. | Please complete the smoking history on the claim form including whether or not the Injured Party ever smoked cigarettes, the start date, end date and packs smoked per day. | IRC Only |
| 165 | PFT Facility not Provided | The PFT report provided or PFT results referenced within the physical examination/medical records review does not provide the name of the facility that performed the PFTs. | Please submit a complete qualifying PFT report with the full name of the facility that includes the city and state of the facility at which the test was performed or submit a signed PFT Facility Verification affidavit from the Facility, verifying that the PFT's were not performed at a facility deemed unacceptable by the Trust. | IRC Only |
| 166 | Medical Provider Trust Research: PFT Facility | The Trust must have reasonable confidence that medical evidence provided in support of a claim is credible and consistent with recognized medical standards. The Pulmonary Function Testing (“PFT”) report submitted with this claim was evaluated by a facility whose medical evidence is currently being reviewed by the Trust; the Trust cannot pay claims based on PFT reports submitted by this facility unless and until it determines that reports from this facility are credible, reliable and consistent with recognized medical standards. | You may submit a new PFT report for the alleged injury from an acceptable facility (that complies with the requirements of the Trusts’ procedures and rules for the claimed disease level). Alternately, you may wait until the Trust concludes its review of the facility’s evidence; if the review determines the facility’s evidence is credible and consistent with recognized medical standards, the claim processing will move forward, but if the review results in a determination that the facility’s medical evidence may lack credibility or fails to meet recognized medical standards, then the claim will remain deficient unless and until you obtain a new PFT report from an acceptable facility (that complies with the requirements of the Trusts’ procedures and rules for the claimed Disease Level). Alternatively, you may change the claim to a disease level that does not require a PFT report. | IRC Only |
| 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. | IRC Only |
| 170 | Chest X-ray Diagnosis Unacceptable for Asbestosis | The chest x-ray, CT scan, or B-reader report submitted with the claim documents the findings of silicosis including p, q, or r shaped opacities, describes small rounded opacities, or provides a diagnosis of silicosis. | Please submit a more recent chest x-ray, CT scan, or B-reader report which supports an acceptable diagnosis for bilateral asbestos-related non-malignant disease. | Both |
| 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 |
| 178 | Medical Provider Trust Research: X-Ray Report – Dr. Laxminarayana Rao | The report reflecting the reading of a chest X-ray by a B-reader (the “B-read report”) submitted with this claim was prepared by a medical provider who is currently being reviewed by the Trust’s experts. As the review is ongoing, the Trust cannot pay claims relying on this physician at this time. | You may submit a new B-read report from an acceptable physician (that complies with the requirements of the Trust’s procedures and rules for the claimed disease level), or you may submit other evidence permitted by the Trust’s procedures to establish the claimed disease level. Alternatively, you may wait until the Trust’s experts conclude their review of this physician. However, if the review results in a determination that the physician’s B-read reports lack credibility or fail to meet recognized medical standards, then the claim will remain deficient unless and until you submit a new B-read report from an acceptable physician (that complies with the requirements of the Trust’s procedures and rules for the claimed disease level) or you submit other evidence permitted by the Trust’s procedures to establish the claimed disease level. | Both |
| 200 | No Job Duties or Nature of Exposure | The submission of Part 3 (DCP)/Part 4 (IRC) of the Claim Form, regarding the injured party's exposure to Celotex/Carey Canada products, does not provide sufficient detail about the injured party's job duties and nature of exposure. | Please amend and resubmit Part 3 (DCP)/Part 4 (IRC), providing a detailed description of the injured party's job duties for each occupation alleged, and how such duties led the injured party to be exposed to Celotex/Carey Canada asbestos products. | IRC Only |
| 201 | Exposure Information does not Match Claim Form | The information that you have submitted regarding the industry, occupation, work site, employer, and/or the years of exposure of the Injured Party, is inconsistent with information provided in the medical reports, attachments, affidavits, depositions, and/or other supporting documents submitted with the claim. | Please update the Claim Form to match the information that has been provided in the attached documentation or provide an explanation with evidence that the information stated on the Claim Form is correct. | Both |
| 202 | No Employer(s) and/or No Work Site(s) | On Part 3 (DCP)/Part 4 (IRC) of the Claim Form, regarding the injured party's exposure to Celotex/Carey Canada products, the name and address (including city and state) of the employer and/or work site where the injured party's exposure to asbestos products occurred, was not provided. | Please provide the name and address (including city and state) of the employer and/or work site where the Injured Party's exposure to asbestos products occurred. Please remember to submit a separate page for each employer and/or work site claimed. | Both |
| 203 | Industry Not Provided or Not Correct | On Part 3 (DCP)/Part 4 (IRC) of the Claim Form, regarding the Injured Party's exposure to Celotex/Carey Canada products, the industry code that most accurately describes the nature of the industry in which the Injured Party worked was not provided or the industry selected was not correct. | Please provide the industry code that most accurately describes the nature of the industry in which the Injured Party worked. If "Other", please specify the type of industry where indicated. | Both |
| 204 | The Number of Years of Exposure is Insufficient | On Part 3 (DCP)/Part 4 (IRC) of the Claim Form, regarding the injured party's exposure to Celotex/Carey Canada products, the number of years worked in the industry is insufficient to satisfy the Trust's criteria for compensation. | Please provide additional exposure time to meet the criteria for compensation for the alleged asbestos-related disease. | Both |
| 206 | Post-1975 Rip-Out Exposure | You have indicated that the Injured Party's exposure to Celotex/Carey Canada asbestos-containing products began January 1, 1975 or after. If the claimant was first exposed to Celotex/Carey Canada asbestos products after 1975, the claimant must demonstrate employment in an occupation involving maintenance, rip-out, renovation, or repair of equipment or facilities where Celotex or Carey Canada asbestos-containing products were used. | On Part 3(DCP)/Part 4 (IRC) of the Claim Form, please describe whether the injured party's employment and occupation included responsibility for the maintenance, rip-out, renovation, or repair of equipment or facilities where Celotex/Carey Canada asbestos-containing products were used. | Both |
| 208 | Employer is Competitive Manufacturer/ Exposure to raw asbestos fiber | The employer alleged on the Claim Form was an asbestos products manufacturer or the Celotex/Carey Canada product to which the injured party was exposed is Celotex/Carey Canada Raw Asbestos Fiber. The Trust requires more detail as to the Celotex/Carey Canada products to which the injured party was exposed, and how and why those products were used, causing the asbestos exposure. | Please provide more information regarding the Celotex/Carey Canada products to which the injured party was exposed (see Part 3 of the Discounted Cash Payment /Part 4 of the Individualized Review) Claim Form. The Trust requires the additional information in the form of a bill of sale, affidavit and/or deposition(s) verifying the injured person?s exposure to the Celotex/Carey Canada products or raw asbestos fiber. | 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(DCP)/Part 4(IRC) of the Claim Form pertaining to the OEP's exposure. | Both |
| 210 | Duplicate Financial Dependent | One or more of the financial dependents as indicated in the dependent section of the Claim Form appears to be a duplicate. | Please review the dependent section of the claim form to ensure that no duplicate financially dependent information is provided. | IRC Only |
| 212 | Industry and/or Occupation Does Not Meet Criteria | On page 4a (DCP)/5a (IRC) of the Claim Form, the industry and/or occupation listed does not meet the Trust's eligibility criteria. | Please provide further information substantiating asbestos exposure, including job duties and responsibilities involved in the described industry and/or occupation, and how those job duties and responsibilities led the Injured Party to be exposed to asbestos . | Both |
| 213 | Description for Nature of Exposure does not meet Criteria | The Trust needs more information regarding the injured party's nature of exposure to asbestos. | Please provide a completed page 4a (DCP)/page 5a (IRC) of the claim form and provide additional information on how the injured party?s job duties led to exposure to the identified Celotex or Carey Canada asbestos products. | 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(DCP)/Part 5 (IRC) of the Claim Form providing detail as to how the Injured Party was exposed to asbestos thru the OEP. | Both |
| 220 | Job Duties - Duplicate | The information you have submitted regarding the Injured Party's job duties and nature of exposure is a duplicate of previously submitted information. | On Part 3 (DCP)/Part 4 (IRC) of the Claim Form, regarding the Injured Party's exposure to Celotex/Carey Canada products, please submit additional information to elaborate on the injured party's job duties and occupational exposure to asbestos. | Both |
| 221 | Job Duties ? Duplicate/Final Request | The information you have submitted regarding the Injured Party's job duties and nature of exposure is a duplicate of previously submitted information. | On Part 3 (DCP)/Part 4 (IRC) of the Claim Form, regarding the Injured Party's exposure to Celotex/Carey Canada products, please submit additional information to elaborate on the Injured Party's job duties and occupational exposure to asbestos. This request for additional exposure information is the final request that the Trust will send. | Both |
| 222 | Occupation of Injured Party not Provided | On Part 3 (DCP)/Part 4 (IRC) of the Claim Form, regarding the Injured Party's exposure to Celotex/Carey Canada products, you have not included an occupation for the Injured Party. | Please submit an amended Part 3 (DCP)/Part 4 (IRC) indicating the Injured Party's occupation, a description of job duties, and the nature of his/her exposure to asbestos products. | Both |
| 223 | Exposure Information ? Final Request | On Part 3 (DCP)/Part 4 (IRC) of the Claim Form, regarding the Injured Party's exposure to Celotex/Carey Canada products, the number of years worked in the industry are insufficient to satisfy the Trust's criteria for compensation. The proof of claim must establish an aggregate of three years or twelve quarters exposure to asbestos-containing materials. Lung Cancer One claims must demonstrate at least fifteen years of exposure and claims alleging Mesothelioma must demonstrate one year of exposure to asbestos-containing materials. | The exposure information you have provided has been evaluated and does not provide an adequate exposure time period. Please provide additional exposure time to meet the criteria for compensation for the alleged asbestos-related disease. This request for additional exposure information is the final request that the Trust will send. | Both |
| 224 | Exposure Dates not Provided | You have not provided beginning and/or ending dates of exposure or you have indicated that exposure was intermittent. | On Part 3 (DCP)/Part 4 (IRC) of the Claim Form, please provide the dates on which exposure began and ended for each employer, occupation and/or work site claimed. Remember to submit a separate page for each employer and/or work site. | Both |
| 225 | Separate the Years of Exposure at Each Site | Separate exposure years for each employer and/or work site need to be provided as outlined in the instructions for filing a claim. On Part 3 DCP/Part 4 IRC of the claim form regarding the Injured party's exposure to Celotex/Carey Canada Products, you submitted insufficient exposure information. | Please provide the dates on which each exposure began and ended for each employer, occupation and/or work site claimed. Remember to submit a separate page for each employer and/or work site. | Both |
| 226 | Provide Union Work Sites | On Part 3 (DCP)/Part 4 (IRC) of the Claim Form, regarding the Injured Party's exposure to Celotex/Carey Canada products, you have indicated the Injured Party was employed by a union. | Please provide a list of all work sites, including the state where the Injured Party was exposed to Celotex/Carey Canada asbestos products. | 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. | Both |
| 251 | Verified Company Exposure is Insufficient | The affidavit in Support of Celotex/Carey Canada Exposure is Insufficient. | The affidavit provided in support of the claimant's proof of exposure to Celotex/Carey Canada asbestos products is insufficient because it fails to 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 for a site that does not match the claimant's site of exposure or the affidavit lists multiple sites and products, but is not specific as to which products were used at each site; 4) The Claim Form or Injured party affidavit provided for proof of exposure to Celotex/Carey asbestos containing products does not specifically state the injured party had at least 3 years/12 quarters of exposure to the products; 5) Product(s) is Generic or Not Recognized. | Both |
| 252 | 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 unless it can be determined that the testifying party made those changes under oath at the time the document was originally signed. | Please provide a legal verified document which does not contain any revisions, or a letter from the notary or an attorney that confirms the changes/alterations/revisions to the legal verified document were done at the time the document was originally signed and notarized. | Both |
| 260 | No Products Provided | No Celotex/Carey Canada products were included in your claim. | On Part 3 (DCP)/Part 4 (IRC) of the Claim Form, regarding the Injured Party's exposure to Celotex/Carey Canada products, please provide the specific Celotex/Carey Canada asbestos product(s) to which the Injured Party was exposed and how the product(s) was used, causing the Injured Party's asbestos exposure. | Both |
| 261 | Product(s) is Generic or Not Recognized | The product name(s) provided in your claim is generic and could have been produced by any asbestos company, the product(s) listed is not recognized as a Celotex/Carey Canada product, the product(s) does not match the exposure, occupation and/or industry alleged or foreign expsoure is being alleged. The Trust defines foreign expsoure as exposure that occurred outside of the US territories. | Please provide the specific Celotex/Carey Canada asbestos product(s) to which the Injured Party was exposed and how the product(s) was used, causing the Injured Party's asbestos exposure. For foreign exposure(s) the Trust requires the additional information in the form of a bill of sale, affidavit and/or deposition(s) verifying the injured person's exposure to the Celotex/Carey Canada products or raw asbestos fiber. | Both |
| 262 | Product(s) Does Not Coincide with the Manufacture Dates | The alleged Celotex/Carey Canada product (s) was not known to have been manufactured at the time the Injured Party is alleging exposure to the product on the Claim Form. | On Part 3 (DCP)/Part 4 (IRC) of the Claim Form, regarding the Injured Party's exposure to Celotex/Carey Canada products, please provide the specific Celotex/Carey Canada asbestos product(s) to which the Injured Party was exposed and how the product(s) was used, causing the Injured Party's asbestos exposure. | Both |
| 263 | Proof of Exposure/Family Member Affidavit Unacceptable | An affidavit from a family member was submitted for a deceased claimant as proof of exposure to Celotex/Carey Canada asbestos-containing products. The Trust does not accept affidavits from a family member who did not work at the site or have firsthand knowledge of how the deceased claimant was exposed to Celotex/Carey Canada asbestos-containing products. | In order to resolve this deficiency, please provide additional information explaining how the affiant had personal knowledge of the specific Celotex/Carey Canada asbestos-containing product(s) to which the deceased claimant was exposed. | Both |
| 270 | Incomplete or No Vessel Service History Provided (Maritime/Navy) | The claim does not include a Vessel Service History showing the number of days the injured party spent aboard each ship. | Please provide the amount of on-board vessel time the Injured Party spent aboard each ship which you have alleged exposure to. 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 |
| 271 | Company Exposure Insufficient (Maritime/Navy) | 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 |
| 272 | Maritime - Occupation and Job Duties | The claim does not provide enough information about the Injured Party's occupation and work duties aboard ship and how he/she was exposed to asbestos. | Please amend and resubmit Part 3 (DCP)/Part 4 (IRC), providing a detailed description of Injured Party's job duties and how such duties led the Injured Party to be exposed to Celotex/Carey Canada asbestos products. | Both |
| 289 | Affidavit not Notarized or Does not Otherwise Meet the State Requirements | The deficiency has been assigned because the affidavit provided has not been properly notarized accordingly to the notary requirements for the state in which it was executed. | Please provide a new affidavit which meets the notary requirements for the state in which it was executed. | Both |
| 298 | Industry and/or Occupation does not match Site/Plant name submitted on the Claim Form. | The industry and/or occupation provided does not correlate with the site/plant name on the Claim Form. | Please provide documentation supporting the industry/occupation selected, or amend the Claim Form to indicate the proper industry/occupation. | Both |
| 299 | Injured Party's Exposure Begins as an Adolescent | The dates of exposure for the Injured Party indicate that he/she was employed in the stated industry/occupation as an adolescent. | Please provide a legal verified document indicating the circumstances which led to the Injured Party's exposure at the age indicated, including the site at which the Injured Party worked, the Injured Party's occupation and why the Injured Party was present at such a young age. | Both |
| 301 | Third and Final Disallowance Notce | Please contact the Trust for additional information. | Please contact the Trust for additional information. | Both |
| A01 | No Power of Attorney | No Power of Attorney | Please provide the Power of Attorney papers for the injured party. | Both |
| A02 | No Acknowledgement Signature | No acknowledgment signature provided | Please contact the Trust for additional information. | Both |
| A03 | No Witness Signature | No witness signature provided | Please provide a witness signature on the enclosed preprinted release. | Both |
| A04 | Wrong Injured Party Social Security number | Need injured person's correct Social Security number | Please provide the correct injured person's social security number on the attached claim form. | Both |
| A05 | Wrong Injured Party Name | Submit injured person's correct name | Please provide the correct name for the injured party on the attached claim form. | Both |
| A06 | Past Trial Date | Original trial date has passed | Please provide written notification as to the result of the trial. | Both |
| A07 | No Original Release | Original release not returned | The original release was not returned. | Both |
| B01 | Personal Representative - Name / Social Security Number | Missing name or Social Security number of Personal Representative | Please provide the Personal Representative's name and Social Security number. | Both |
| B02 | Wrong Personal Representative | Personal Representative name does not match the name on the Claim Form | Please provide the Personal Representative's Name and Social Security number. | Both |
| B03 | No Witness Signature | No witness signature provided | Please provide a witness signature on the enclosed preprinted release. | Both |
| B04 | No Death Certificate | No death certificate provided | Please provide a copy of the injured party's death certificate. | Both |
| B05 | No Attorney Signature | No attorney signature provided | The attorney's signature is missing from the release. | Both |
| B06 | No Acknowledgement Signature | No acknowledgment signature provided | Please contact the Trust for additional information. | Both |
| B07 | Wrong Injured Party Social Security Number | Need injured person's correct Social Security number | Please provide the correct injured person's Social Security number on the attached claim form. | Both |
| B08 | Wrong Injured Party Name | Need injured person's correct name | Please provide the correct name for the injured party on the attached claim form. | Both |
| B09 | Past Trial Date | Original trial date has passed | Please provide written notification as to the result of the trial. | Both |
| B10 | No Original Release | Original release not returned | The original release was not returned. | Both |
| R04 | Missing Two Witness Signatures | Two witness signatures are required on the release. | Please provide two witness signatures on the release. | Both |
| R07 | Incomplete Release Uploaded | An incomplete release has been received by the Trust. Please resend or upload the completed release to the Trust. | An incomplete release has been received by the Trust. Please resend or upload the completed release to the Trust. | Both |
| R08 | Corrected SSN | The release contains a Social Security number for the claimant that does not match the SSN provided on the Claim Form. | Please verify and provide the correct Social Security number for the claimant. | Both |
| R14 | Incorrect Release Received | Information on the release that was received does not match current claim data. | Please upload or resend the correct release to the Trust, ensuring that the claimant name, referenced trust and the Liquidated Value match what appears in Trust Online. | Both |
| R17 | Signature dates do not match on the release | The notary date and the claimant's signature date do not match. | The signature dates must match for the release to be complete and acceptable. | Both |
| R19 | Missing signature page of release | Release not complete because missing signature page. | Cannot verify release without the signature page. | Both |
| R26 | Electronic Signature History or Certification not complete | The required documentation needed to confirm the Certification and History of the Electronic Signature was not received or is incomplete. | The required documentation needed to confirm the Certification and History of the Electronic Signature was not received or is incomplete. Please re-upload the completed Electronic Signature History or Certifications to the Trust. | Both |
| R27 | Electronic Signature does not match claimant or personal representative | The Electronic Signature that was submitted does not match the Trust’s current claim data. The Electronic Signature must be completed by the claimant or appointed personal representative. | The Electronic Signature that was submitted does not match the Trust’s current claim data. The Electronic Signature must be completed by the claimant or appointed personal representative. Please re-upload the completed Electronic Signature Certification to the Trust. | Both |
| R28 | IP Address for Originator and Signer are the same | The IP address of the Originator and Signer must be sent from two different IP addresses. | The IP address of the Originator and Signer must be sent from two different IP addresses. Please re-upload the Electronic Signature Certification that includes two different IP addresses. | Both |
| 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. | IRC Only |
| 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 |
| 1224 | 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 |
| 1225 | Report Rejected | The chest x-ray, CT scan, or B-read submitted with the claim was evaluated by a physician whose x-ray, CT scan and/or B-reader reports are no longer accepted by the Trust. | Please submit a chest x-ray, CT scan, or B-read report for the alleged injury from an acceptable physician. The report must provide evidence of the alleged injury and demonstrate bilateral findings. | Both |
| 1226 | PFT Report Rejected | The Pulmonary Function Test submitted with the claim was evaluated by a PFT facility that is no longer accepted by the Trust. | Please submit a Pulmonary Function Test for the alleged injury from an acceptable PFT facility that meets the criteria set forth in the Trust Distribution Procedures. | Both |
| 1227 | Medical Provider Trust Research - B-Reader | The Trust must have reasonable confidence that medical evidence provided in support of a claim is credible and consistent with recognized medical standards. The B-read submitted with this claim was evaluated by a physician whose medical evidence is currently being audited by the Trust; the Trust cannot pay claims based on B-reads submitted by this physician unless and until it determines that B-reads from this physician are credible, reliable and consistent with recognized medical standards. | You may submit a new B-read report for the alleged injury from an acceptable physician (that includes evidence of the alleged injury and demonstrates bilateral findings). Alternately, you may wait until the Trust concludes its audit of the physician’s evidence; if the audit determines the physician’s evidence is credible and consistent with recognized medical standards, the claim processing will move forward, but if the audit results in a determination that the physician’s medical evidence may lack credibility or fail to meet recognized medical standards, then the claim will remain deficient unless and until you obtain a new B-read report for the alleged injury from an acceptable physician (that includes evidence of the alleged injury and demonstrates bilateral findings). | Both |