Below are links to SF-DCT claim forms for
PROOF OF MANUFACTURER (POM)
EXPLANT and DISEASE or EXPEDITED RELEASE
CLAIMANT INFORMATION GUIDE
If you need a Rupture Form, you may contact the CAC for a copy of the Form.
You must have sent your medical records to the SF-DCT prior to June 1, 2006
indicating you have an eligible rupture under the plan
© 2010 Claimants' Advisory Committee. All Rights Reserved.