Sybil Niden Goldrich
Ernest Hornsby, Esq.
Dianna Pendleton-Dominguez, Esq.
CLAIMANTS' ADVISORY COMMITTEE E-NEWSLETTER
Volume 2, No. 10, September 29, 2005
This is the 18h e-newsletter (Vol. 2, No.10) from the Claimants' Advisory Committee (CAC) in the Dow Corning bankruptcy Settlement Plan. You were sent a copy of the newsletter because our records show that you requested to be on the mailing list. If you wish to unsubscribe or to reply to this newsletter, send an email to: info@tortcomm.org. Please do not hit "Reply" to this email address. Please use the email address: info@tortcomm.org.
NOTE: The CAC is happy to answer questions you may have, but we urge you to first contact the Claims Assistance Program at their toll free number (866-874-6099) or by email at: info@sfdct.com. We apologize for any delay on our part in returning phone calls and answering inquiries. Please know that we will work to respond to each inquiry.
1. SUMMARY OF PRESENTATION AT INFORMATIONAL MEETINGS
The first informational meetings were recently – one in Dallas for attorneys and legal professionals followed by claimant meetings in Denver, Salt Lake City, Cleveland, Santa Barbara, Portland and Reno. Additional meeting dates and locations for the U.S. and Europe are listed below in Sections 2 and 3 of this Newsletter. For those who are unable to attend one of the meetings, we are providing a summary of the presentation and issues raised during the meetings in this version of the CAC E-Newsletter.
a) Claimants and Attorneys Affected by Hurricane Katrina
Following the Hurricane Katrina devastation to the Louisiana-Mississippi-Alabama coastal areas, the Settlement Facility (SF-DCT) sent an email to attorneys in these areas asking for information about the status of their law offices and for information on how clients could contact their attorney. Only a handful of law firms responded to this inquiry, indicating that most law firms are still dealing with the recovery efforts and are not fully operational.
Some claimants and law firms reside in one of the 26 postal zip code areas where mail is still not deliverable. The SF-DCT is holding award checks to these claimants. The checks and Notification of Status letters will be mailed to claimants in these 26 zip codes when either 1) the claimant or attorney of record contacts the SF-DCT to verify a deliverable address or 2) when the Post Office can assure mail in the affected zip codes can be delivered. If you want to check on the status of your claim and payment, you can do so on-line through the "My Claim" system or by contacting Claims Assistance at: info@sfdct.com or toll free at 866-874-6099. (To access the "My Claim" system, send an email request to Claims Assistance asking for a password. Once you receive the password, you will be able to check the progress of your claim review on-line.)
The SF-DCT will also make copies of claimant files available to those law firms and claimants whose records were lost or destroyed in the hurricane. To obtain a copy of your file, call Claims Assistance toll free at 866-874-6099. When you request a copy of your file, be sure to ask for a copy of the "History" screen for your claim in the SF-DCT computer database.
b) Hurricane Rita Update
The Settlement Facility closed temporarily from Wednesday, September 21 at noon Central Time until Wednesday, September 28, 2005 during the evacuation of and then return of residents to Houston-Galveston as a result of Hurricane Rita. Fortunately, the Settlement Facility offices did not suffer any damage, the staff is safe, and they are beginning to return to their homes and work. As a result of being closed for the past week though, the SF-DCT’s computer database was off-line, including the Claims Assistance Program’s telephone systems and the on-line claim review program ("My Claim"). Prior to closing the office, the SF-DCT successfully backed up its database and files and sent it off-site (outside of Texas) to assure that the data will not be lost. Please be patient while the office gets back to full-speed. If you have a question, we urge you to wait until next week to contact them.
The Claimants’ Advisory Committee was also unable to answer calls during this period. The phone number is now operational.
c) Claims Paid To Dow Corning Breast Implant Claimants From June 1, 2004 To August 31, 2005
From June 1, 2004 (the Effective Date) through August 31, 2005, approximately $400 million dollars have been paid to claimants in Classes 5, 6.1 and 6.2 (Dow Corning Breast Implant claimants). The Plan of Reorganization provides that Dow Corning is obligated to pay up to $2.35 billion Net Present Value over 15 years. Pursuant to Court Order, Base Payments are authorized to be paid for approved claims; however, Premium Payments are not authorized at this time.
Listed below are additional data concerning the processing of Dow Corning Breast Implant claims through August 31, 2005:
- 60,094 proof of manufacturer claims submitted
- 57,662 of these claim reviews have been completed
- 48,448 or 80.6% have been determined to have acceptable proof of an eligible Dow Corning breast implant
Once you submit the Proof of Manufacturer form and provide documents that you have a Dow Corning Breast Implant, then the SF-DCT will review your claim for Explant, Rupture, and Expedited Release or Disease. Your claim for benefits will not be reviewed until you first submit the Proof of Manufacturer Form and supporting documents. If you previously submitted proof of your implant manufacturer in the global settlement or another settlement, you do not need to re-submit these documents. However, you need to complete the Proof of Manufacturer Form (the one with the blue edge).
Claim Category |
Number of Claims Paid through August 31, 2005 |
Total $$ Paid in category through August 31, 2005 |
Expedited Release |
9,456 |
$ 18,140,430.84 |
Explant |
15,085 |
$ 73,972,116.25 |
Explant Assistance |
75 |
$ 325,000.00 |
Rupture |
10,398 |
$205,376,679.09 |
Disease |
6,561 |
$102,587,186.67 |
Total |
41,575 |
$400,401,412.85 |
The Claims Administrator also reported that the Settlement
Facility has brought the administrative expenses of operating the facility down
to 2.5%, which is below the industry standard of 3.5 – 4%. This is one guide
of how well the facility is performing, but there are other important guides as
well, such as whether claims are being processed fairly, and whether similar
claims have similar outcomes (also known as "horizontal justice"). The SF-DCT
is working on all of these aspects of claims processing according to the new
Claims Administrator.
Additional claims payments in September are approximately $42
million. This is in addition to the $400 million that has been authorized to
be paid. We will post updated claims payment statistics on the CAC website
each month, so please continue to check there for information (www.tortcomm.org).
d) Claims Processing Wait Times for Class 5 and 6.1
(Dow Corning Breast Implant Claims)
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 – 09/05 |
|
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 – 09/05 |
|
|
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 – 09/05 |
|
|
|
|
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 – 09/05 |
|
|
|
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.
e) Rupture Claim Reviews
The Claims Administrator reported on various terminology
that the Settlement Facility accepts for rupture claim submissions.
Specifically, the following words can be acceptable proof of rupture: rupture,
laceration, disintegrated or disintegration, broken, disrupted, fenestrated, herniated
or degraded. Language that is not acceptable proof of rupture (without more to
support it) includes defective and exhausted.
When reviewing Rupture claims, the newly instituted policy
at the Settlement Facility is to look at both the Operative and Pathology
reports. The Settlement Facility used to have a policy that the Pathology
report would trump over the rupture language in the Operative Report. However,
the Claims Administrator reported that he implemented a NEW policy as of two
months ago that reverses this. The new policy provides that the reviewer
should look at the report that came from the person who looked at the implant
most closely or carefully, and at which report is best and most reliable.
If the Operative and Pathology reports conflict, the Settlement Facility looks
at the report that contains the most information by a person who observed the
implant.
The Claimants’ Advisory Committee has also raised the following
issues with the Claims Administrator regarding rupture claims (the issues are
still under discussion / consideration):
► Pathologists typically do not examine
implants to determine if they are ruptured. They do a gross visual inspection
of the implant and/or implant capsule. Pathologists are not trained to detect
rupture but to examine tissue samples for signs of disease. Claimants should
not have their rupture claim denied based on the Pathology report where the
pathologist has not reviewed the implant itself but merely opines that it
"appears intact."
► Pathology reports often reference their
receipt of both the breast implants and the implant capsules. The implant
capsule consists only of the tissue surrounding the implant. Where the report
notes the receipt of only implant capsules and does not mention anything as to
whether the implant was ruptured, the CAC does not believe that the Rupture
claim should be denied because the Pathology Report is silent or, conversely,
gives conflicting information about the rupture issue. We believe that some
claims may have been mistakenly denied based on the pathology report that
mentioned only the implant capsules, not the implants.
► Section 6.02(e)(iii)( c)(2) of Annex A,
the Claims Resolution Procedures, provides that where the explanting surgeon
refuses to write the supplemental report giving his or her opinion when the
Rupture occurs, the claimant may submit a statement from another doctor who
examined the removed implant. The CAC has received reports, however, that
statements from doctors other than the explanting doctor have been denied as
unacceptable. We have asked the Claims Administrator to provide us with
information on the status of this issue.
► Can the explanting surgeon write
supplemental letters that explain, expound or otherwise clarify the Operative
Report or other medical records regarding the implant’s rupture status? This
question is also pending before the Claims Administrator. The CAC believes
that supplemental statements should be permitted and, in fact, should be
encouraged so that the doctor can better explain whether the implant was
ruptured.
If you believe your rupture claim was unfairly denied, we
urge you to re-submit it using the Re-Review, Error Correction and Appeal
processes described in the Plan and discussed in this newsletter. You may also
scan and email a copy to us at info@tortcomm.org
or fax it to us at 419-394-1748. We cannot help every individual claimant, but
we can use the examples of claims (with names removed) that we believe should
have been approved to discuss it further with the Claims Administrator and
SF-DCT. This has proven very helpful in the past and we encourage you to
provide us feedback on your experiences.
f) Disease Claim Reviews
Disease Option 1 Claims
Claimants who submitted a disease claim in 1994 during the
original global settlement may rely on that submission. You do not need to supplement
or update your records if you believe your original submission was complete.
In fact, if you provide new or more current records that show you no longer
suffer from your eligible symptoms or that you do not meet the disease or
disability criteria, the Settlement Facility will look at the more current
records. If the more current record shows that a symptom is no longer present,
then that symptom can no longer be counted. Claimants do not have an
obligation to submit current medical records for Disease Option 1 claims.
If you do submit new or more current medical records to
update your 1994 disease submission, the Settlement Facility requires that a
doctor actually examine you. They will not accept phone interviews of a
claimant by a doctor or where the doctor reviewed a questionnaire completed by
the claimant. A personal examination is required.
A claimant can complete a questionnaire on her eligible
symptoms and disability and provide that questionnaire to her doctor. The
doctor’s letter must state though that he/she reviewed the questionnaire
answers and is relying on it to provide his/her disease and/or disability
rating.
If you submitted medical records that document both your
symptoms and factors relating to your disability, but your treating doctor will
not write a letter detailing your disability rating, what can you do? The
nurse reviewer for the SF-DCT stated at the Dallas attorney meeting that you
will likely receive a deficiency notice (Notification of Status letter) from
the SF-DCT. You can then write to the SF-DCT and request a Re-Review / Error
Correction and inform them that the treating doctor refuses to provide you with
the disability statement. If your records show that you suffer moderate pain
related to an eligible symptom, then they will approve you on the second
review for Disability C (20% disabled or $10,000).
Claimants’ Advisory Committee Issues:
As reported in prior newsletters, there is an ongoing
dispute over the criteria for Disability "A" (100% disability) claims. The Plan
provides that 100% disability can be documented by vocation or
self-care. This is the way that the MDL-926 Claims Office processed these
claims in the Revised Settlement Program from its inception (1996) until late
1997. The Settlement Facility reported, however, that it received annotations
from the MDL-926 Claims Office that suggests the Disability A criteria was
changed by an Order entered by then-MDL-926 Judge Sam C. Pointer in an
individual RSP claimant appeal. Therefore, Disability A claims have been
processed requiring claimants to be 100% disabled in both vocation and
self-care. A motion on this issue is pending before Judge Hood in the Dow
Corning case and before Judge U.W. Clemon in MDL-926.
If you applied for an "A" disability claim in Disease Option
1 but were not approved because of this pending dispute, but your Disability B
claim (35% disabled) was approved, you have several options: 1) attempt to
meet the new criteria for 100% disability in both vocation and
self-care, or 2) accept the B disability payment ($20,000) and, if the Court
rules that A disability qualifies based on 100% disability in either vocation
or self-care, then the SF-DCT will issue payment to you for the
difference between the B level payment ($20,000) and the A level payment
($50,000).
The CAC is posting examples of approved Disease Option 1
claims and, in particular, approved disability statements on our website (www.tortcomm.org). We also have a
Self-Care Questionnaire that may be helpful in working up Disease Option 1
claims, particularly disability A claims. These documents will be available to
download on or before Monday, October 3 so please check the website then. (For
claimants who are not email accessible, we will provide a copy by regular U.S. mail upon request.)
In an upcoming CAC newsletter, we will compile some helpful
tips on how to compile your medical records to submit a disease claim.
Disease Option 2 Claims
General Connective Tissue Symptom claims – The Settlement
Facility will not accept claim submissions that are based only on a checklist
of symptoms. The underlying office notes from the physician and lab tests must
be submitted.
Systemic Lupus Erythematosus (SLE) claims – The Settlement
Facility requires the claimant be undergoing treatment for SLE to qualify for
the Severity Level "C" payment in Disease Option 2. You must submit medical
records showing ongoing treatment, not simply a statement from the doctor that
you have SLE.
Claims for Scleroderma, SLE, Polymyositis and
Dermatomyositis in Disease Option 2 require an affirmative diagnosis of the
disease by a Board Certified Rheumatologist. This means that it must be a clinical
diagnosis of the disease, not one based on the Plan’s settlement criteria.
For example, a statement by the QMD that (s)he has read the settlement criteria
and the claimant meets that criteria will not be acceptable. It must be
a clinical diagnosis.
Claimants’ Advisory Committee Issues
The CAC has raised the following issue with the Settlement
Facility:
► If a claimant was diagnosed with either
Scleroderma, SLE, Polymyositis or Dermatomyositis and the diagnosis is from 1989
or earlier, is the claimant barred from receiving a Disease Option 2 claim?
g) MDL Pass Through Disease Claims
Claimants who had multiple implants – one from Dow Corning
and at least one other from Bristol, Baxter or 3M – may have had their disease
claim processed by the MDL 926 Claims Office already. As a result of their
multiple manufacturers, claimants received a 50% reduction in their award from
the MDL 926 Claims Office. These claimants may now submit their Disease claim
form to the SF-DCT and, if you are seeking the same award that you received
from the MDL 926 Claims Office – then you are an "MDL Pass Through" claim. In
other words, your disease claim should pass through the SF-DCT without further
review, and you should receive 50% of the Disease Compensation Grid. Keep in
mind though that you must first submit the Proof of Manufacturer Form and the
Disease Claim Form for the Dow Corning settlement before your claim will be
paid. Several issues have arisen regarding this issue:
► If you apply for a higher disease
payment than what MDL 926 awarded you, then the SF-DCT has informed us that
they will review the file to determine if you qualify for the higher amount. However,
they are reviewing the file using processing annotations that have apparently
changed over the years and have become stricter. In other words, we have
learned over the past 15 months that it is harder to qualify for a disease
payment from SF-DCT than it was to qualify for the same payment in the Revised
Settlement Program. This was not intended when the Plan was negotiated by the
Tort Claimants’ Committee, and we are working to address and correct this very
serious issue.
► More significantly, if you do not
qualify for the higher award, the SF-DCT has now informed us that they will not
automatically honor the MDL 926 disease award. If you do not qualify for a
disease payment under the newer, stricter processing annotations, your claim
could be deemed deficient, and you will not get paid. The CAC will continue to
discuss this issue with the Claims Administrator to determine if this policy
can be reversed, i.e., to allow claimants to be paid at least the same
level they were approved at by the MDL 926 Claims Office. In the meantime,
what can you do? You may consider accepting the MDL 926 payment amount and, if
you were seeking the "A" disability payment in Disease Option 1, you can then
apply for the difference between the "A" and "B" disability levels through the
Increased Severity Fund. By doing this, the SF-DCT cannot look at your
original MDL 926 disease claim or refuse to pay you the remaining 50% of the
disease claim if you no longer qualify for that award. A cautionary note
though is that Increased Severity Payments are treated as Premium Payments
under the Plan. In other words, Increased Severity Payments will be made only
if Premium Payments are authorized. In addition, for Disease Option 1 claims,
the Increased Severity Fund is capped at $15 million.
►Another
issue with MDL Pass Through claims is what happens if the MDL 926 approved the
disease claim but did not pay it because the claimant either did not have
acceptable proof of an implant eligible in the Revised Settlement Program or
the claimant opted out of the Revised Settlement Program. In these instances,
the Claims Administrator has indicated that the SF-DCT will treat these as MDL
Pass Through claims and will pay 50% of the Disease Compensation Grid for the
disease approved by the MDL 926 Claims Office.
► If you are an MDL Pass Through
claim but your doctor’s name now appears on a "watch list", the new SF-DCT
policy is to allow these claims to pass through and be paid.
h) Class 7 Issues (Silicone Gel Claims)
Class 7 claims consist of persons who have never had a Dow
Corning Breast Implant or a "Covered" Dow Corning Other Product but who
have or had a silicone gel breast implant implanted from 1976-1991 from any one
of the following companies: Baxter, Bristol, Bioplasty, Cox-Uphoff or Mentor.
Saline implants are not eligible. 3M and McGhan implants are also not eligible
if these are your only implants. Class 7 is a capped fund of $57.5 million.
Class 7 provide claimants with a choice of either an
Expedited Release Payment (the amount has not been determined) or up to 40% of
the Disease Grid. Class 7 does NOT offer either explant or rupture money. The
deadline to submit the Class 7 Claim Form is June 1, 2006. If you do not
submit a Class 7 claim form by that date, you will be barred from seeking any
benefits from the Class 7 fund.
The Settlement Facility will begin to process Class 7 claims
in December 2005. Because of the volume of anticipated claims and other
restrictions, Class 7 payments will not likely be paid until 2007.
The Settlement Facility will mail a letter to all claimants
initially classified as a Class 7 claim. The letter will include a reminder of
the approaching deadline to submit the Class 7 claim form and other helpful
information about submitting claims, marshaling, etc.
If you received claim forms for Class 7 but you have a Dow
Corning breast implant, call Claims Assistance at 866-874-6099 (or contact them
by email at info@sfdct.com) and request a
new set of claim forms. Similarly, if you received the wrong claim forms
and/or have misplaced them, call Claims Assistance and request a new set of
claim forms be mailed to you.
Claimants in Class 7 who have an implant made by Baxter
(Heyer-Schulte), Bristol (Surgitek, Medical Engineering, etc.) or 3M McGhan are
urged to contact the MDL 926 Claims Office for further information about what
benefits they may be eligible for in the Revised Settlement Program. For
example, the Revised Settlement Program offers $3,000 in Explant benefits to
have your Baxter, Bristol or 3M breast implant removed. The RSP does not offer
Rupture benefits however. The toll free number for the MDL 926 Claims Office
is: 800-600-0311. Their website address is: www.claimsoffice-926.com.
i) Class 9 Issues (Dow Corning Covered Other Products)
The Claims Administrator reported that he will begin to pay approved
Expedited Release claims in Class 9 this year. Other types of approved claims
in Class 9 – like hip, TMJ, knee, etc -- may be authorized to be paid in early
2006 depending on the volume of claim submissions. To be eligible for the Class
9 fund, your Covered Dow Corning implant must have been implanted after 1979.
However, the Claims Administrator reported that the volume of claims submitted
to date are low, so claimants in this Class who were implanted prior to 1979 may
consider submitting a claim for compensation. The deadline to file the Class 9
claim forms is June 1, 2006. Claims submitted after this date will not be
allowed.
Claimants in Class 9 who are unable to have their implant removed because
surgery is medically contraindicated should obtain a statement to this effect
from their doctor and submit it to the SF-DCT along with other documents that
support their claim, i.e., for Rupture, Implant Failure, etc. The Claims
Administrator indicated that he will consider this in allowing a claim for
benefits even though the Dow Corning implant has not been removed.
j) SF-DCT Action Plan To Address Issues Raised in the Independent Claims Audit
As noted in prior newsletters, the audit conducted of the SF-DCT is largely
complete. The SF-DCT has issued its "Action Plan" to address some problems
noted in the audit. The Action Plan is on the SF-DCT and CAC websites and is
reprinted below:
Summary of Action Plan for Issues Identified by ARPC Audit
In June 2005, Analysis Research Planning Consultants (ARPC) provided a Report
on the Audit of The Processes and Procedures of the Settlement Facility-Dow
Corning Trust (the Facility). The results of the audit were presented to The
Honorable Judge Denise Page Hood, the Finance Committee, the Claimants Advisory
Committee and the Debtors Representatives. As a result of the audit, the
Facility will take the following actions:
► The Facility has met with the developer of the current system for
processing claims to identify and plan improvements. The goal is to improve the
speed, accuracy, and efficiency of our current processes and communications to
Claimants.
► In the areas identified as needing improvement the Facility has
retrained staff. A new trainer has been hired to focus specifically on
enhancement of our training resources.
► The Facility is reviewing claims approved at MDL that were not
approved by the Facility. If the claim was for the same disease and
compensation level approved at MDL, the claim will be paid at the same
level here. If the claim is for a new disease or higher compensation level,
new records are required for the review.
► The Facility is in the process of reviewing the letters used to
communicate claim status. Where possible, letters will be edited for clarity of
content.
► The Facility has enhanced the resources used for Internal Quality
Control of claims already approved or denied. Additional staff has been added to
the audit team. This team is in the process of reviewing claims already
processed to ensure consistency in outcomes.
► As a result, if your claim is audited and found to be in error, the
Facility will correct its error and contact you with the new results.
► In the interim, we encourage you to complete and return the Request
for Review of Additional Information forms enclosed with your status letters.
► Also, if you disagree with the outcome of a review we encourage you
to use all options available to you in Annex A:
- If you believe we made an error in the review, please write us and let us
know where the error may have occurred. We will revisit the information in your
file and communicate to you the results of the Error Correction Review.
- If you have new information to submit, please provide this information
along with the Request for Review of Additional Information form. We will
continue to review new information until your expiration deadline.
- If the results of the additional reviews are unfavorable to you, you may
request an Appeal to the Claims Administrator.
- If the Claims Administrator determination is unfavorable to you, you may
request an Appeal to the Appeals Judge.
The Settlement Facility is committed to addressing the claims processing and
quality control issues raised in the audit findings. A new Claims Administrator
was hired in May 2005 to review existing policies and practices and to
restructure areas that were found deficient. He will soon issue information and
guidelines for submission of claims and will conduct a series of informational
meetings in the U.S. and Europe. We appreciate your patience as we work to
improve the quality of our service.
Sincerely,
Settlement Facility – Dow Corning Trust
k) Proof of Manufacturer Issues Revisited
Many claimants have asked what can they do to find their
implant manufacturer where the medical records are now lost or destroyed, the
doctor is deceased and/or the hospital is no longer in existence. There may be
several things claimants in this situation can do:
► First, make sure you have
contacted everyone connected with both the doctor’s office and hospital to
locate the files. Often, the spouse of a deceased doctor may have the records
at her home or in storage, or the hospital has had the records imaged or placed
on microfiche. Be persistent in trying to locate the records from the doctor
and hospital.
► If you know your doctor’s name
and can document that he/she was your implanting doctor, you can check to see
if the doctor wrote an "affirmative statement" that describes his/her exclusive
use of one manufacturer’s implant in his practice. For example, Dr. John Smith
may have written a letter to claimant Jane Doe stating that he implanted breast
implants from 1972 – 1990 and during that time he only used Dow Corning breast
implants. If you were implanted by that doctor during that time frame, then
you can "piggy back" off of this statement to have your Proof of Manufacturer
approved. The CAC has obtained some affirmative statements for claimants whose
Proof of Manufacturer for Dow Corning has been approved. We are working with
the SF-DCT to obtain additional statements and will update our website on this
within the next 30 days. We will also publish a chart in a future newsletter
that contains the information we have collected.
► Call Claims Assistance
(866-874-6099) or the Office of Plaintiffs’ Liaison Counsel (205-252-6784) and
ask them to search the "Dow Corning Sales Database" to see if your doctor
and/or hospital’s name appears therein. This in and of itself is not acceptable
proof of a Dow Corning implant, but it can be used with other documents to
advocate why your implant should be accepted as a Dow Corning implant. In
addition, you can ask the Office of Plaintiffs’ Liaison Counsel to search the
"discovery databases" that were compiled during the litigation phase to see if
there are any records with your doctor’s name.
► The CAC is working to develop a
database of claimant names whose medical records were sent to Dow Corning by
their doctor or hospital over the past 35 years. Many doctors routinely
supplied operative and/or pathology reports to Dow Corning when implants were
removed and a rupture was found. We hope to locate all such records and make
them available to the claimant to whom the record belongs and also to the
SF-DCT. Please do not contact us now regarding this though because the project
is not complete. We expect to have a database with this information by early
November 2005.
► For some, their only proof may be
the implant that remains implanted in them. Surgical removal of an implant involves
risks attendant with any surgery. We do not and cannot make any
recommendations to claimants about whether they should undergo this surgery.
This is something that should be discussed with your doctor and family. For
those who do decide to have the implant removed, it is important to provide the
doctor and hospital with a written letter prior to the surgery asking that the
implants be preserved and returned to you following the surgery. There are
experts who can examine the removed implant to determine what company made the
implant. The names of these individuals were reported in one of our earlier
newsletters and are also located on our website under "Product Identification."
► The CAC recently negotiated a new
Proof of Manufacturer protocol that deems silicone breast implants implanted
prior to 1971 as being made by Dow Corning (barring any contradictory
information in the medical records). If you do not have records showing that
you were implanted prior to 1971, you can use the explant report if it states
or makes reference to a date that shows implantation was prior to 1971. You
can also use an insurance payment dated prior to 1971 or other types of
documents that otherwise would not be acceptable by themself.
Other Proof of Manufacturer Issues
Several issues affecting Proof of Manufacturer are still pending and unresolved:
► Claimants whose award in the
Revised Settlement Program was reduced by 50% because the MDL 926 Claims Office
classified one of the breast implants as a Dow Corning have been refused
compensation from the SF-DCT because the Dow Corning Plan does not recognize
the implant as one made by Dow Corning. These claims are largely based on
references to "Cronin" in the medical records. The Dow Corning Plan deems
acceptable only those references to Cronin prior to 1972. The CAC is
continuing to work to resolve this issue cooperatively with the MDL 926
defendants and Court.
► The issue of whether saline
tissue expanders implanted in the breast qualify as Dow Corning Breast Implants
is still pending before Judge Hood. Of concern is a timing question raised by
several claimants: if a claimant has a silicone gel breast implant from one of
the eligible companies in Class 7 and their only Dow Corning implant is a
tissue expander implanted in the breast, what class do they fall in? The
answer to this is urgent since the deadline to file a Class 7 claim is June 1,
2006, and claimants must know whether they are in Class 5 or 7 to file the
correct claim by the applicable deadlines. You may consider requesting a copy
of claim forms for both Class 5 and 7 and completing both sets of claim forms
by the June 1, 2006 deadline. We will continue to urge the Court to issue a
ruling promptly.
2. U.S. INFORMATION MEETING SCHEDULE
The Settlement Facility will sponsor a series of informational meetings this
fall in the United States and Europe. Please note that the meeting originally
set for November 4th in New Orleans has been cancelled. The SF-DCT
is working to move this meeting to Nashville, but details have not been
confirmed at this time. The schedule for meetings in the U.S. is:
Date |
City |
Location Address |
Time |
October 18, 2005 |
Washington DC |
Washington Plaza Hotel
10 Thomas Circle NW
P: (202)842-1300 |
8:00 AM – 12:00 PM
|
October 21, 2005 |
Charleston , SC |
The Francis Marion Hotel
387 King Street
P: (843) 722-0600 |
8:00 AM – 12:00 PM
|
October 24, 2005 |
Miami , FL |
JW Marriott Hotel Miami
1109 Brickell Avenue
P: (305)374-1224 |
1:00 PM – 4:00 PM
|
November 4, 2005 |
Tentative: Nashville, TN |
To be determined |
To be determined |
The meetings are open to all Settling Claimants, their
family and attorneys/law firm members who represent SF-DCT claimants.
3. EUROPEAN CLAIM MEETING SCHEDULE
The following meetings in Europe have been schedule for the
fall of 2005 (listed below). The SF-DCT attempted to schedule the meetings
near major transportation lines to provide easy access for claimants to attend.
The meetings in London, Dublin and Glasgow will be conducted in English.
Representatives from the SF-DCT who are fluent in Dutch and English will be
present at the meeting in The Hague. Representatives from the SF-DCT who are
fluent in German and English will be present at the meetings in Frankfurt and Zurich.
A representative of the CAC and/or the Foreign Liaison Counsel to the CAC
(Melissa Ferarri) will be present to answer questions as well.
Date |
City |
Location Address |
Time |
14 November 2005 |
London |
Le Meridien Piccadilly
21 Piccadilly, London, W1J0BH, UK |
09:00 – 12:00 |
15 November 2005 |
Dublin |
Holiday Inn Dublin City Centre
99-107 Pearse St. , Dublin Ireland |
09:00 – 12:00 |
16 November 2005 |
Glasgow |
Jurys Inn Glasgow
80 Jamaica Street , Glasgow, UK |
09:00 – 12:00 |
19 November 2005 |
The Hague |
Theater Diligentia, Lange Voorhout 5
2514 EA Den Haag |
09:00 – 12:00 |
21 November 2005 |
Frankfurt |
Frankfurt Airport Conference Center
Fraport AG—60547 Frankfurt am Main, Germany |
09:00 – 12:00 |
22 November 2005 |
Zurich |
Hotel Intercontinental Zurich
420 Badenerstrasse, 8040 Zurich, Switzerland |
09:00 – 12:00 |
4. DEADLINES TO FILE CLAIMS
Please mark your calendar with the claim submission
deadlines. Please note that most of these deadlines mean that your claim forms
and materials must be received by the appropriate entity by the posted
deadline. Please mail all forms early enough so that they are received by the
deadline listed below. If your claim form is not received by the deadline
listed below, you will not be permitted to file a claim later. For example, if
you do not file a Rupture claim by June 1, 2006 but discover in 2008 that you
have a rupture, your rupture claim will not be allowed. It will be denied.
For more information on the life expectancy and rupture
rates associated with silicone gel breast implants, you may contact the Office
of Plaintiffs’ Liaison Counsel at info@oplc.org
or at 205-252-6784.
Deadline Date |
Type of Deadline |
June 1, 2006 |
Rupture Claim submission deadline for Classes 5,
6.1 and 6.2 |
June 1, 2006 |
Silicone Material Claim submission deadline – Class
7. All claims for Disease or Expedited Release must be submitted by this
date. The Fund will close permanently and no new claims will be allowed
after this date. |
June 1, 2006 |
Covered Other Products submission deadline –
Classes 9, 10.1 and 10.2. All claims for Expedited Release or a Medical
Condition must be submitted by this date. The Fund will close permanently
and no new claims will be allowed after this date. |
June 1, 2007 |
Expedited Release submission deadline – Classes 5,
6.1 and 6.2 |
June 2, 2014 |
Explant Claims submission deadline for Classes 5,
6.1 and 6.2 |
June 3, 2019 |
Disease Claim submission deadline for Classes 5,
6.1 and 6.2 |
Deficiency / Cure Deadlines
If you receive a Notification of
Status letter from the Settlement Facility stating that you have a deficiency
in your claim submission, please note that there are very short deadlines
to cure most deficiencies. The deadlines are listed below:
Settlement Benefit |
Deadline to Cure Deficiency |
Proof of Manufacturer |
No deadline but your claim for Explant, Rupture, Medical
Condition or Disease will not be reviewed until you first have acceptable
proof of an eligible implant |
Explant |
6 months from date of Notification of Status letter |
Rupture |
6 months from date of Notification of Status letter |
Medical Condition (Classes 9, 10.1 and 10.2) |
6 months from date of Notification of Status letter |
Disease |
1 year from date of Notification of Status letter |
If you would like to read
prior CAC e-newsletters, they are available on the CAC website by clicking on
"Electronic Newsletter." We urge you to visit the CAC website (www.tortcomm.org) on a regular basis to
download or view relevant documents and read updates and new information. To
contact the CAC, send an email to: info@tortcomm.org
or send a letter to the new Post Office Box address for the CAC at:
Claimants’ Advisory Committee
P.O. Box 665
St. Marys, Ohio 45885
This is a NEW P.O. Box
address for the CAC so please update your records.
Questions about the status of
your claim or a claim-specific question (i.e., when am I going to be paid, has
my claim been processed, etc.) should be directed to the Claims Assistance
Program at info@sfdct.com. Please do
not send these types of questions to the CAC because we are unable to answer
them. The CAC does not have access to individual claimant files and
information. When we receive inquiries such as this, we have to forward them
to the Claims Assistance Program for a response which delays the response.
NOTICE: This document is copyrighted. You are not
authorized to post it on any website without express, prior written permission
of the Claimants’ Advisory Committee.
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