Processing of Proof of Manufacturer (POM) claims for Dow Corning Breast Implant claimants is essentially current, i.e., the claims are reviewed within 30-45 days following receipt by the Settlement Facility. If you submitted a Proof of Manufacturer claim for Class 5 or 6.1 and have not received a response by now, you are urged to contact the Claims Assistance Program either by phone (toll free) at 866-874-6099 or by email: info@sfdct.com.

Review of Explant and Rupture claims are not current in processing, but are expected to be current either by the end of 2005 (for Rupture claims) or during the first quarter of 2006 (for Explant claims). We commend the new Claims Administrator and SF-DCT staff for this incredible improvement in processing time for claims.

Disease claims have a larger backlog and wait time for review. The Settlement Facility has 42 nurses on staff to review disease claims and conduct quality control reviews. For Disease Option 1 claims, nurse reviewers can review approximately 1.8 disease claim files a day. Disease Option 2 claims take longer to review because more medical records and documentation is required. As a result, the nurse reviewers can review approximately .9 Disease Option 2 claims per day.

The wait time for Class 5 and 6.1 claims is listed below:

  Estimated wait time for Rupture Review
If benefit form was submitted by: 0-2 months 2-4 months 4-6 months
Prior to January 2005 X    
01/05 - 07/05   X  


  Estimated wait time for Explant Review
If benefit form was submitted by: 0-2 months 2-4 months 4-6 months 6-8 months
Prior to October 2004 X      
10/04 - 04/05   X    
05/05 - 07/05     X  
  Estimated wait time for Disease Option 1 Review
If benefit form was submitted by: 0-2 months 2-4 months 4-6 months 6-8 months 8-10 months
Prior to August 2004 X        
08/04 - 09/04   X      
10/04 - 12/04     X    
01/05 - 06/05       X  
07/05         X


  Estimated wait time for Disease Option 2 Review
If benefit form was submitted by: 0-2 months 2-4 months 4-6 months 6-8 months 8-10 months
Prior to September 2004 X        
09/04 - 11/04   X      
12/04 - 06/05     X    
07/05       X  


The Claims Administrator reported that Requests for Re-Review, Error Correction and Appeals are currently behind (more than 60 days) but that the Settlement Facility is working to bring these claims more current. We urge claimants who believe that they received an incorrect result in the review of their claim to write to the SF-DCT and request a re-review, error correction and appeal on their claim. When you do this, you are not limited in the type of proof and documents that you can submit. You may also write a short summary of why you believe the claim should be approved. The CAC is posting several Requests for Re-Review and Error Correction on our website (www.tortcomm.org) under the heading "Claim Submissions." You can view or print these documents as a guide to draft your own Request for Re-Review, Error Correction and Appeal. These posts should be available on or before Monday, October 3, 2005.



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