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| Deficiency Code | Code Text | Detail Text | Instructions |
|---|---|---|---|
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 015 | No Date of Death Provided | On the Claim Form, you have indicated that the injured party is diseased, however, you did not provide the date of death. Please submit the date of death for the injured party. | On the Claim Form, you have indicated that the injured party is diseased, however, you did not provide the date of death. Please submit the date of death for the injured party. |
| 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. |
| 023 | Failure to Choose Description for Significant Occupational Exposure (Disease levels II & III only) | 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. |
| 045 | Invalid CEL Claim | The Celotex Trust claim number provided is invalid. The claim number provided either does not exist in our system, has not been paid, does not match the claimant, does not match the alleged injury indicated on this claim or was submitted as a secondary exposure claim. | Please edit the Celotex Trust Settled Claim Number field with a valid Celotex Trust paid claim number. If one does not exist and this field was completed in error, please uncheck the box and remove the claim number. Once the CEL claim number is removed, the claim form must be completed in its entirety with all medical and exposure information. |
| 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. |
| 105 | Missing Information for Celotex Trust Settled Approved Claim | The Celotex Trust Settled Claim number provided with the RA claim has been determined to be a valid Celotex claim; however, the RA claim is missing certain information or data necessary to complete the review. Please see the RA deficiency codes for further information on how to cure the missing information. | Please review the additional deficiency codes and where applicable, submit the missing RA information with any additional documentation in order to cure the deficiency code. |
| 120 | Medical Report not by a Qualified Physician | The physical examination provided was either not performed by a qualified physician, or the Trust was unable to determine the physician's qualifications. | Please provide a physical examination preformed by a qualified physician or provide the qualifications of the physician who performed the previously submitted physical examination. |
| 121 | Chest x-ray Report does not Identify the Physician | The medical records provided contain chest x-ray findings; however, the Trust was unable to determine the identity of the physician who performed the reading of the chest x-ray. | Please provide a chest x-ray report in which the physician who read the film is identified. Please provide either a new chest x-ray report, or the complete original document that identifies the full name of the interpreting physician. |
| 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. |
| 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. |
| 128 | No Medical Documents Provided | Medical documentation in support of this claim has not been provided to the Trust. | Please provide complete medical documents for the injured party which support the disease alleged on the claim form. |
| 129 | Medical Report does not Qualify as a Physical Exam | A physical exam report is required to support the injured party's diagnosis of the disease alleged on the claim form per the TDP section 4.4 (a)(1)(A). The medical report provided does not qualify as a physical exam as it was not written comtemporaneous with the physical exam in which the injured party was diagnosed with the disease alleged and/or the report provided is a review of a physical exam report or previous medical records. The Trust does not accept medical reviews of physical examinations. | Please submit a medical report for the alleged diagnosis based on a physical examination of the claimant by the physician documenting the diagnosis of the asbestos-related disease. |
| 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. |
| 131 | Medical Report Unacceptable Diagnosis | The most recent physical examination report, pathology report or autopsy report does not provide an acceptable diagnosis for the injury alleged. | Please provide a physical exam 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 who examined the injured party and has documented the diagnosis. A pathology report from a board-certified pathologist (if the claimant is deceased) is acceptable if it provides the appropriate diagnosis. |
| 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 physician and must include a diagnosis based upon a physical examination by the physician making the diagnosis. A pathology report from a board-certified pathologist (if the claimant is deceased) is acceptable if it provides the appropriate diagnosis. |
| 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. |
| 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. |
| 135 | Pathologist not Board-Certified | The pathology report provided with the claim does not indicate that it was performed by a board-certified pathologist. | Please provide documentation of the pathologist's certification, or provide a pathology report from a board-certified pathologist who diagnoses the injury alleged on the claim form. |
| 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 diagnoses of the injury alleged and was performed by an acceptable physician. |
| 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 exam which documents the diagnosis of the alleged injury and is from an acceptable facility . |
| 139 | Chest X-ray was not read by a Qualified Physician | The chest x-ray or CT scan provided does not indicate if it was read by a Qualified Physician, or the physician who read the chest x-ray or CT scan was not board-certified at the time of the reading. | Please provide documentation of the physician's certification, or provide a chest x-ray or CT scan which was read by a Qualified Physician. The physician must be board-certified at the time of the reading. |
| 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-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. |
| 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 or CT scan which documents a Bilateral Asbestos-Related Non-malignant Disease. The chest x-ray or CT scan must be read by a Qualified Physician. |
| 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 . |
| 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 the 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. |
| 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-read report which documents a bilateral asbestos-related non-malignant disease. The chest x-ray or CT scan 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. |
| 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-read 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. |
| 147 | Chest X-Ray Report is from an Unacceptable Physician | The chest x-ray, CT scan, or B-reader 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-read report for the alleged injury from an acceptable physician. The report must provide evidence of the alleged injury and demonstrate bilateral findings. |
| 148 | Chest X-Ray Report is from an Unacceptable Facility | The chest x-ray, CT scan, or B-reader 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 or CT scan 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. |
| 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 board certified pathologist which provides an acceptable diagnosis of the alleged disease. If the pathologist is not board certified, the facility must be JCAHO-accredited. If there is no pathological material, please provide the initial diagnosing physical exam or discharge summary along with treating medical documents that confirm the alleged injury. |
| 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 authored by a board certified pathologist which provides an acceptable diagnosis for the disease alleged. If the pathologist is not board certified, the facility must be JCAHO-accredited. |
| 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 level alleged. |
| 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 from a board-certified pathologist which contains an acceptable diagnosis for the disease alleged on the claim form. |
| 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 authored by a board certified pathologist which provides an acceptable diagnosis for the disease alleged on the claim form. If the pathologist is not board certified, the facility must be JCAHO-accredited. |
| 156 | Failure to Choose Description for Significant Occupational Exposure (Disease levels II & III only) | 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. |
| 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 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 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. |
| 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-read report which supports an acceptable diagnosis for bilateral asbestos-related non-malignant disease. |
| 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 suports the diagnosis provided in the physical exam may also cure the deficiency. |
| 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. |
| 173 | No Causation Statement Provided | The Trust requires a medical report which documents a correlation between the disease alleged on the claim form and the injured party's asbestos exposure. The medical reports provided in support of your claim fail to provide this correlation. | Please provide a medical report which documents the correlation between the injured party's asbestos exposure to the disease alleged on the claim form. |
| 174 | Causation Statement is Incomplete | The causation statement provided is either for the wrong party, illegible, not dated, missing pages, altered, amended, or otherwise incomplete. | Please provide a complete causation report, without revisions or amendments, which links the injured party's asbestos exposure to the disease alleged on the claim form. If the current report has been revised or amended, documentation from the doctor or facility who revised or amended the report which indicates who made the revisions and when they were made, may cure the deficiency. |
| 175 | Causation-Doctor not Qualified/Unacceptable Doctor | The medical report submitted with your claim documenting a correlation between the alleged injury and asbestos exposure is unacceptable because it was not authored by a qualified physician, or the qualified doctor providing the link to asbestos exposure relies upon medical records from a physician deemed unacceptable by the Trust. | Please submit a medical report documenting the correlation between the alleged injury and asbestos exposure from a qualified physician that does not rely upon medical records from an unacceptable physician. |
| 176 | Medical Documents Not Available | Medical documents are not currently available for Trust Online on claims originally converted from Celotex historical information. | Please provide the complete medical documents in support of your claim. |
| 212 | Description for SOE may not meet Criteria (Disease levels II & III 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. 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. |
| 228 | Significant or Cumulative Occupational Exposure is Insufficient | Five qualifying years of significant or cumulative occupational exposure, two years of which must be prior to 12/31/1982, are required to satisfy the Trust's criteria for compensation. The exposure information you have provided has been evaluated and does not provide an adequate exposure time period. | Please provide additional exposure sites to meet the Trust requirement for 5 years of significant or cumulative occupational exposure. Please provide supporting documentation for any exposure updates that are made. |
| 229 | Exposure is all Post 1967 | You have failed to provide appropriate exposure information prior to June 1, 1967. The Trust requires the injured party's exposure to Company products occur prior to June 1, 1967. | Please provide additional sites of exposure at which the injured party was exposed to Company products prior to June 1, 1967. Please provide supporting documentation for any exposure updates that are made. |
| 231 | Pre-1983 Significant Occupational Exposure is Insufficient | The Trust requires at least 2 years of the injured party's significant occupational exposure occur prior to December 31, 1982. The exposure as currently submitted does not meet this requirement. Please refer to the TDP for significant occupational exposure requirements. | Please provide additional exposure information identifying where the injured party garnered significant occupational exposure (SOE) to asbestos prior to December 31, 1982. Please provide supporting documentation for any exposure updates that are made. |
| 269 | Check Box for Previously Submitted Physical Examinations | You have not provided an acceptable Physical Examination performed by the diagnosing doctor as required by the TDP. | If you checked the box for Physical Examination on the injury page in error, please uncheck the box. If you have a Physical Examination that meets the TDP requirements, please provide. |
| 270 | Incomplete or No Vessel Service History Provided (Maritime) | 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 on each ship aboard 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. |
| 701RA | 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. |
| 702aRA | Name of Site or Plant not provided. | The name of the Site, Plant or Ship where the Injured Party's exposure occurred is not provided. | Please provide the name of the Site, Plant or Ship where the Injured Party's exposure occurred. |
| 702bRA | Various Sites Provided. | "Various" sites do not satisfy the Trust’s criteria for compensation. | Please provide the name(s) of each Site, Plant or Ship, including city and state, where the Injured Party's exposure to Trust product occurred. |
| 702cRA | City not provided. | The City where the Injured Party's exposure occurred is not provided. | Please provide the name of the city where the Injured Party's exposure occurred. |
| 702dRA | State not provided. | The State where the Injured Party's exposure occurred is not provided. | Please provide the name of the state where the Injured Party's exposure occurred. |
| 704RA | 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. |
| 713RA | Failure to Provide Description of Cumulative Exposure | A Level I 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. 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. |
| 724RA | 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. |
| 725RA | 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 6/1/67. 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 6/1/67. 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. |
| 730RA | Pre-1967 Exposure is Insufficient | The exposure information for pre-June 1, 1967 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 June 1, 1967. Please provide supporting documentation for any exposure updates that are made. |
| 732RA | 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. |
| 736RA | The Industry/Occupation and/or description of exposure is not acceptable | The description of exposure is inconsistent with the products identified and/or the industry/occupation of the Injured Party. | Please amend your description of exposure to include an explanation as to how someone in the Industry/Occupation selected would have been exposed to the company asbestos containing product you have provided. |
| 737RA | 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. |
| 738RA | 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. |
| 750RA | 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. |
| 751RA | 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. |
| 757RA | 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. |
| 771RA | 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. |
| 773RA | 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. |
| 777RA | 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 appointment of the Power of Attorney. | Please provide documentation confirming the appointment of the Power of Attorney for the affiant. |
| 778RA | Product Dates Outside Recognized Manufacture Dates | The product claimed is a known product; however, the period of claimed exposure does not coincide with the date the product was known to have been in use. | Please provide more complete exposure information that identifies acceptable company asbestos-containing products during acceptable time frames. |
| 782RA | Failure to Provide Description of Exposure to Company Products | No description was provided regarding how the claimant was exposed to asbestos-containing company products. | Please provide a description regarding how the claimant was specifically exposed to the Company product at the known or documented site on the claim form. The specific job duties performed should be provided. It is not sufficient to indicate proximity to the product or to those using the product. Specific details should be provided. |
| 784RA | 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. |
| 789RA | 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. |
| 790RA | Insufficient Description of Exposure to Company Product | The description provided as to how the injured party was exposed to Company products is not sufficient. | Please provide a description regarding how the claimant was specifically exposed to the Company product at the known or documented site on the claim form. The specific job duties performed should be provided. It is not sufficient to indicate proximity to the product or to those using the product. Specific details should be provided. |
| 793RA | 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. |
| 796RA | Failure to Specify Length of Company Exposure Prior to 6/1/1967. | 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 June 1, 1967. 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 6/1/1967. |
| 798RA | 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. |
| 799RA | 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. |
| 1201 | Incomplete Exposure Information | The Exposure information that you provided in the claim form is either incomplete. | Please provide complete exposure information for the claim. |
| 1203 | Litigation Date is Prior to Alleged Exposure | The litigation date entered for the claim is prior to any alleged exposure on the Claim Form. | Please update the claim form to reflect the proper litigation date (Part 5 of the Claim Form) or the proper exposure information (Part 3 of the Claim Form). |
| 1206 | Inconsistent Injured Party Affidavits | You have submitted more than one Injured Party affidavit in the claim. The affidavits submitted are inconsistent with each other related to the Injured Party's job sites, years of employment and/or occupation. | Please provide a legal verified document which provides clarification regarding the inconsistencies between the previously submitted affidavits. |
| 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. |
| 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. |
| 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. |
| 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). |
| 7204RA | 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. |
| 7205RA | 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. |
| 7208RA | Litigation Page Failure to Elect 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. |
| 7214RA | 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. |
| 7217RA | Ship/Shipyard Exposure Conflict | The claim form alleges exposure at a known or documented shipyard, however additional information provided indicates the Injured Party was aboard an undocumented ship during the alleged exposure time frame. The Trust must have credible evidence to confirm the location of and manner in which exposure to Trust products or operations occurred. Please provide evidence of 1) the manner in which the claimant was exposed to asbestos at the known or documented site during the alleged time frame or; 2) Trust exposure on the undocumented ship. | Please provide a legal verified document which: 1) provides the manner in which the claimant was exposed to asbestos at the Documented Site during the alleged time frame or; 2) Company exposure on the undocumented ship. |
| 7224RA | 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. |
| 7228RA | Environmental Exposure Alleged. | The Injured Party has alleged environmental exposure. Environmental exposure does not satisfy the Trust's criteria for compensation. | Please provide additional exposure sites to meet the Trust requirements for exposure. Please provide supporting documentation for any exposure updates that are made. |
| 7229RA | Claim Not Completely Reviewed – No Company Exposure Provided | The referenced claim has only been reviewed for exposure and has not had a medical review since no Company Exposure has been provided. | Please provide Company Exposure documentation and the claim will be fully reviewed. |
| R01 | Certificate of Official Capacity | No Certificate of Official Capacity was provided. | Please provide the Certificate of Official Capacity. |
| R02 | Personal Representative's Name and/or Relationship not provided. | Please provide the personal representative's name, social security number and/or relationship to the Injured Party. | Please provide the personal representative's name, social security number and/or relationship to the Injured Party. |
| 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. |
| R04 | Missing Two Witness Signatures | The release has not been witnessed by two people. | Please resubmit the release with two witness signatures. |
| R05 | No Death Certificate | No Death Certificate has been provided. | Please provide the Death Certificate for the Injured Party. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| R16 | Notary not complete or missing information | There is no commission expiration date, no notary signature or sworn date, or the notary is expired. | Please provide a new release containing complete notary information. You may also choose to have two witnesses sign the new release in place of a notary. |
| 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. |
| R18 | No claimant signature | The release is missing the claimant's signature. | Please resubmit the release containing the signature of the claimant. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |