Guest guest Posted December 27, 2002 Report Share Posted December 27, 2002 ----- Original Message ----- From: " Kathi " <pureheart@...> Sent: Sunday, December 22, 2002 12:52 PM Subject: Re: explain " like " > For Option II Disease compensation the " qualified " doctor (various > specialists listed in Annex A) cannot express an opinion that a person > has one of those > specific diseases. There are objective medical tests and objective > visible findings (rashes, etc. which often have to be seen by the doctor > AND tested to be > autoimmune) which have to have been performed within a window of time. > The window of time for Option II diseases is MUCH tighter than Option I > -- > described at the bottom of page A-100 and top of A-101. For Option II, > it is a 24-month window of time that can fall over a broader range of > time. > Everything qualifying documentation must fit in one 24-month period for > Option II. > > All the tests and criteria for Option II begin on A-100. As it is > stated in Annex A, pg. A-11, Option I is the same disease criteria as > the " Fixed Amount Benefit > Program " of the RSP (Revised Settlement Program of the other > manufacturers), and Option II is the same as the RSP " Long-Term Disease " > category. As of a > couple of years ago, only 700 women qualified for " Long-Term Disease " in > the RSP. It seems that the big reasons why so few would qualified in > the RSP are > because of two overly strict (tending to DISqualify, geee or I could > call it INtending to DISqualify) criteria: > > 1-The extra small window of time in the Long-Term Disease (like Dow's > Option II) documentation of qualifying criteria, and > 2-All the required classic disease testing that has to have occurred > within the small time frame of such chronic illnesses, wouldn't > necessarily been ordered by > a doctor and found as positive in such a small 24-month window of time. > > After all, in the real world of medical practice, doctors would not so > often run each and all tests for their own opinion of the person even > appearing to have > the full-blown classic disease, and certainly not have it in such a > small window of time. After all, we know, it is tough to get into see > the doctor in time for > the flaring symptom to still exist at an appointment. Then the doc may > not order tests. Think about how often you've been into see the doctor > with a > history of autoimmune disease symptoms and findings, and the doctor sees > a rash on you ... but doesn't order a test of it. Or, by the time > you've gotten in > to see the doc, they rash, or whatever, has subsided. Maybe it's still > there a bit, but since it's subsiding it doesn't turn out positive in > tests as autoimmune. > The " 24-month window " concept is TOO TIGHT and seems to be a designed to > disqualify. > > It would be good to be prepared for this surprise, as I think women in > the RSP ran into and silently fell out of the bigger (I'll call it) > disease categories. In the > RSP, going on memory here, it was something like 1800 who applied for > the bigger disease categories, and only about 700 qualified (as of a > couple of years > ago). > > Makes one wonder a couple of things ... Although those Option II > criteria are for certain classic diseases, does regular medical standard > require such objective > results within a 24-month window of time in order to be diagnosed > ordinarily? Do the standard diagnoses require the same number of items > having to be the > minimum to meet the diagnosis? or, is it set higher in this deal? > > The second one, might be customary, but even if the minimum number of > medical findings are the same in the standard medical community, I'll > bet you that > the 24-month window is not in there. > > Another question, that I cannot find that it is addressed in the written > criteria -- what happens to the 24-month window of time in Option II > when Dow > requests RE-testing? Can Dow request re-testing arbitrarily? It looks > like it. There's nothing about having to have good cause for requiring > something be > re-tested. Geesch, what about the fact that these are chronic diseases > and we might not be in a flare-up at the time the test is ordered. > Marti > > > > > I wonder about that " new " testing procedure for Lupus--hate > to use it and have it kicked back because it isn't " approved " > by the FDA. > > It sounds as if it has pre-market approval, which is different > from just plain approval after being used for awhile. . . .you > know, like the saline implants that were " approved " in July. > The manufacturer has said it's accurate (probably based on > very few people) but we'll really find out how accurate it is in > a few years when enough labs use it and report the statistics. > > ??????? > > A lot of meds that say they are FDA approved are actually > " pre-market approved " and if they wind up killing a lot people, > they get yanked and don't get approval. > > I agree--more confusion. > > Even more confusion re the Criteria because there was an amendment to > the 1982 > Revision in 1994-97 (somewhere in there) that says a positive > antiphospholipid antibody test is acceptable also. . . and we have found > a high percentage of it > in silicone-associated disorders. > > If you don't have copies of your medical records, it might be a good > idea to see if the doc tested for the APL antibody (mine did, didn't > tell > me and I found it years later) and it would be a surprise if one wasn't > > already found to have an acceptable Lupus antibody--I would think > the new test would only apply to a few people. . .they would have > a lot of Lupus symptoms with no explanation and no antibodies, in > which case I would exhaust all other possibilities for testing before > trying this one. > > Caroline brought out the amendment to the 1982 Revised Criteria > some weeks ago--I'd have to look for it. . .I doubt the claims > " checkers " > are going to volunteer the info--attention was not brought to it in > Annex A--so it would behoove anyone to find out all about it and the > APL antibody test. > Bonnie > > > > Another thing that can cause a big problem is that the antiphospholipid > readings can go up and down and be normal or near normal at one testing > and way off in another. It can fluctuate greatly, kind of like being in > remission and out of it............. > Kathi > > > ----- Original Message ----- > > From: Kathi > Sent: Saturday, December 21, 2002 2:19 PM > Subject: Re: explain " like " > > On Page " Annex A-11 " (i) Disease Payment Options Defined: The > second Paragraph Second Line " No > Claims based solely on atypical or " like " presentations of > disease are compensable for Systemic Lupus, " etc etc > etc Then it says a Breast Implant Claimant must clearly suffer > from these diseases exactly as defined in Schedule > II, Part B. After carefully re-reading - I think this puts us > in the position of making sure the doctor says we > have " them " diseases. This is hard as Lupus is supposed to be > difficult to define. > <scarab@...> > > > Due to the new testing procedure and the Revised Criteria for > classification that written prior to the settlement criteria being > written, but for one reason or > another, was not > used or considered, I think that these taken together, could > really further confuse the situation. > Kathi > > RE: > FOR IMMEDIATE RELEASE > Aug. 28, 2002 > FDA Clears For Market New Diagnostic Test For > Lupus > > Test will help bridge detection > gap for systemic lupus > erythematosis, or SLE > http://www.fhcrc.org/news/science/2002/08/28/lupus.html > > 1982 Revised Criteria for classification of SLE > http://www.rheumatology.org/research/classification/sle.html > > > -- > Finally, brethren, whatsoever things are true, whatsoever things are > honest, whatsoever things are just, whatsoever things are pure, > whatsoever > things are lovely, whatsoever things are of good report; if there be any > > virtue, and if there be any praise, think on these things. > > Quote Link to comment Share on other sites More sharing options...
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