Claimant Relations | 800.708.8925
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| Deficiency Code | Code Text | Detail Text | Instructions | Option |
|---|---|---|---|---|
| 001 | Death Certificate not Provided | A death certificate has not been provided. Please provide a copy of the death certificate for the injured party. | A death certificate has not been provided. Please provide a copy of the death certificate for the injured party. | BOTH |
| 002 | Certificate of Official Capacity Not Provided | You have indicated that this claim is being made on behalf of the injured party or his/her estate. The Trust requires documentation of the representative's authority to act on behalf of the injured party or the injured party's estate. Such documentation might include Powers of Attorney appointing the representative to act on behalf of the injured party in pursuing a claim for silica injuries or, where the injured party is deceased, Letters Testamentary or Letters of Administration from a court appointing the representative as executor or administrator of the claimant's estate. This does not include birth certificates, marriage certificates, or Last Will and Testament. | You have indicated that this claim is being made on behalf of the injured party or his/her estate. The Trust requires documentation of the representative's authority to act on behalf of the injured party or the injured party's estate. Such documentation might include Powers of Attorney appointing the representative to act on behalf of the injured party in pursuing a claim for silica injuries or, where the injured party is deceased, Letters Testamentary or Letters of Administration from a court appointing the representative as executor or administrator of the claimant's estate. This does not include birth certificates, marriage certificates, or Last Will and Testament. | BOTH |
| 003 | Injured Party's Social Security Number not Provided | Please provide the injured party's Social Security number. | Please provide the injured party's Social Security number. | BOTH |
| 004 | Injured Party's Date of Birth not Provided | Please provide the injured party's date of birth. | Please provide the injured party's date of birth. | BOTH |
| 005 | Original Lawsuit/Resident State Not Provided | Please provide the state of the court where the original lawsuit was filed and/or the state of residence for the claimant when lawsuit was filed. | Please provide the state of the court where the original lawsuit was filed and/or the state of residence for the claimant when lawsuit was filed. | BOTH |
| 006 | Original Lawsuit Date Not Provided | Please provide the date on which the original lawsuit regarding this claim was filed. | Please provide the date on which the original lawsuit regarding this claim was filed. | BOTH |
| 008 | Date of Alleged Diagnosis Not Provided | You have failed to designate an alleged silica-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. | You have failed to designate an alleged silica-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. | BOTH |
| 011 | No Beginning or Ending Dates of Exposure Provided | Your submission regarding the injured party's exposure to Halliburton and/or Harbison-Walker silica products does not include complete information. Please provide the dates on which exposure began and ended for each work site, industry, and/or occupation claimed. Remember to submit a separate page for each employer and/or work site where exposure is being alleged. | Your submission regarding the injured party's exposure to Halliburton and/or Harbison-Walker silica products does not include complete information. Please provide the dates on which exposure began and ended for each work site, industry, and/or occupation claimed. Remember to submit a separate page for each employer and/or work site where exposure is being alleged. | BOTH |
| 012 | No Occupation and/or Industry Provided | Your submission regarding the injured party's exposure to Halliburton and/or Harbison-Walker silica products, does not include the occupation and/or the industry for the injured party. Please provide complete employment information on the claim form. | Your submission regarding the injured party's exposure to Halliburton and/or Harbison-Walker silica products, does not include the occupation and/or the industry for the injured party. Please provide complete employment information on the claim form. | BOTH |
| 013 | No PR Name, SSN, and/or Relationship | Please provide the personal representative's name, Social Security number, and relationship to the injured party. | Please provide the personal representative's name, Social Security number, and relationship to the injured party. | BOTH |
| 014 | Injured Party Information is Inconsistent with Death Certificate | Please note that the Social Security number, date of birth, and/or date of death on the claim form is inconsistent with what appears on the injured party's death certificate. | Please note that the Social Security number, date of birth, and/or date of death on the claim form is inconsistent with what appears on the injured party's death certificate. | BOTH |
| 015 | Death Certificate/Wrong Party | The death certificate provided is not for the injured party of this claim. Please provide an official death certificate for the injured party. | The death certificate provided is not for the injured party of this claim. Please provide an official death certificate for the injured party. | BOTH |
| 016 | Death Certificate is Unacceptable or Otherwise Incomplete | The death certificate provided is not acceptable (i.e., illegible, name, date, or signature cut off during photocopying, etc.) or is, otherwise, incomplete. Please provide an official and complete death certificate for the injured party. | The death certificate provided is not acceptable (i.e., illegible, name, date, or signature cut off during photocopying, etc.) or is, otherwise, incomplete. Please provide an official and complete death certificate for the injured party. | BOTH |
| 018 | Claim Process Disallowed | You have chosen the Expedited Review process. According to the claim filing criteria, the contents of this claim require, at least, an Individual Review process. | You have chosen the Expedited Review process. According to the claim filing criteria, the contents of this claim require, at least, an Individual Review process. | BOTH |
| 019 | Smoking and Disease History | The information provided on Part 8: Smoking and Disease History of the claim form conflicts with medical reports and/or other supporting documents. Please verify the information and amend this part of the claim form in order to further process this claim. | The information provided on Part 8: Smoking and Disease History of the claim form conflicts with medical reports and/or other supporting documents. Please verify the information and amend this part of the claim form in order to further process this claim. | BOTH |
| 100 | Failure to Substantiate Claimed Injury | The records you have provided do not substantiate the alleged injury on the claim form. Records submitted indicate the injured party suffered from a silica-related injury different from that alleged. Please provide additional medical records substantiating the claimed injury, or resubmit an amended Page 3. | The records you have provided do not substantiate the alleged injury on the claim form. Records submitted indicate the injured party suffered from a silica-related injury different from that alleged. Please provide additional medical records substantiating the claimed injury, or resubmit an amended Page 3. | BOTH |
| 101 | No Causation | The medical reports submitted in support of your claim fail to indicate a correlation between the injury alleged and silica exposure. Please submit any additional or amended reports relating to this issue. | The medical reports submitted in support of your claim fail to indicate a correlation between the injury alleged and silica exposure. Please submit any additional or amended reports relating to this issue. | BOTH |
| 102 | Causation Unacceptable | The causation statement submitted is unacceptable examination and/or not from a board-certified physician as specified in the TDP, or is otherwise incomplete. Please submit any additional or amended reports relating to this issue. | The causation statement submitted is unacceptable because it is not based on a physical examination and/or not from a board-certified physician as specified in the TDP, or is otherwise incomplete. Please submit any additional or amended reports relating to this issue. | BOTH |
| 104 | No Silica-Related Disease | The medical records submitted diagnose and/or support an injury no recognized as silica-related by the DII Silica PI Trust. The Trust cannot pay on claims not included in one of the four categories on Page 3, Part 4 of the claim form. Please review, and where applicable, resubmit Part 4 of the claim form, along with any additional documentation substantiating one of the listed Disease Levels for compensation. Claims for injuries for mixed-dust pneumoconiosis are not eligible for compensation as stated in the TDP. | The medical records submitted diagnose and/or support an injury no recognized as silica-related by the DII Silica PI Trust. The Trust cannot pay on claims not included in one of the four categories on Page 3, Part 4 of the claim form. Please review, and where applicable, resubmit Part 4 of the claim form, along with any additional documentation substantiating one of the listed Disease Levels for compensation. Claims for injuries for mixed-dust pneumoconiosis are not eligible for compensation as stated in the TDP. | BOTH |
| 103 | Latency Does Not Meet Criteria | The medical records submitted in support of the claim report a date of diagnosis that does not satisfy the Trust's latency period criteria. Please refer to the TDP for latency criteria. | The medical records submitted in support of the claim report a date of diagnosis that does not satisfy the Trust's latency period criteria. Please refer to the TDP for latency criteria. | BOTH |
| 105 | No PFTs submitted | In order to fully substantiate your claim for Severe Silicosis or Silicosis, please submit qualifying Pulmonary Function Test (PFT) reports, including the FVC, FEV1 and/or DLCO scores, that meet the criteria established in the Instructions for Filing a Claim. | In order to fully substantiate your claim for Severe Silicosis or Silicosis, please submit qualifying Pulmonary Function Test (PFT) reports, including the FVC, FEV1 and/or DLCO scores, that meet the criteria established in the Instructions for Filing a Claim. | BOTH |
| 106 | Most recent PFT report does not qualify | The most recent Pulmonary Function Test (PFT) report provided does not qualify and/or disputes earlier qualifying report(s). Please submit more recent, qualifying Pulmonary Function Test (PFT) reports, including the FVC, FEV1 and/or DLCO scores, that meet the criteria established in the Instructions for Filing a Claim. | The most recent Pulmonary Function Test (PFT) report provided does not qualify and/or disputes earlier qualifying report(s). Please submit more recent, qualifying Pulmonary Function Test (PFT) reports, including the FVC, FEV1 and/or DLCO scores, that meet the criteria established in the Instructions for Filing a Claim. | BOTH |
| 107 | PFT report is for Wrong Party | The PFT report provided is for the wrong party. Please submit qualifying Pulmonary Function Test (PFT) reports for the injured party. | The PFT report provided is for the wrong party. Please submit qualifying Pulmonary Function Test (PFT) reports for the injured party. | BOTH |
| 108 | PFT report provided was performed by an unacceptable facility and/or reviewed by an unacceptable physician. | The Pulmonary Function Test (PFT) submitted with the claim was performed by an unacceptable facility and/or reviewed by an unacceptable physician. Please submit a qualifying PFT report that is from an unacceptable facility and/or physician. Without additional information, this claim will not be capable of further review. | The Pulmonary Function Test (PFT) submitted with the claim was performed by an unacceptable facility and/or reviewed by an unacceptable physician. Please submit a qualifying PFT report that is from an unacceptable facility and/or physician. Without additional information, this claim will not be capable of further review. | BOTH |
| 109 | No Underlying Silicosis | In order to fully substantiate your claim for Complex Silicosis or Lung Cancer, please submit medical records supporting bilateral silicosis or, if injured party is deceased, pathological evidence of bilateral silicosis, as required in the Instructions for Filing a Claim. | In order to fully substantiate your claim for Complex Silicosis or Lung Cancer, please submit medical records supporting bilateral silicosis or, if injured party is deceased, pathological evidence of bilateral silicosis, as required in the Instructions for Filing a Claim. | BOTH |
| 110 | No Smoking and/or Physical History | In order to fully substantiate Disease Level III or IV, you must submit a physical history (to include a reference to smoking history). You have either not submitted such a report, it does not include smoking history, or is otherwise incomplete or unacceptable. | In order to fully substantiate Disease Level III or IV, you must submit a physical history (to include a reference to smoking history). You have either not submitted such a report, it does not include smoking history, or is otherwise incomplete or unacceptable. | BOTH |
| 111 | No Medical Report Provided | No physical examination has been provided in the claim. Please provide a report that is dated and signed by a board-certified physician, as specified in the TDP, and includes a diagnosis based on a physical examination. A pathology or autopsy report from a board-certified pathologist diagnosing bilateral silicosis is acceptable if the injured party is deceased. | No physical examination has been provided in the claim. Please provide a report that is dated and signed by a board-certified physician, as specified in the TDP, and includes a diagnosis based on a physical examination. A pathology or autopsy report from a board-certified pathologist diagnosing bilateral silicosis is acceptable if the injured party is deceased. | BOTH |
| 112 | Medical Report is Unacceptable | The most recent physical examination report does not provide an acceptable diagnosis for the alleged injury or uses the language "consistent or compatible with". Please provide a report that is dated and signed by a board-certified physician and includes a diagnosis based on a physical examination. A pathology or autopsy report is acceptable if injured party is deceased and it provides the appropriate diagnosis. | The most recent physical examination report does not provide an acceptable diagnosis for the alleged injury or uses the language "consistent or compatible with". Please provide a report that is dated and signed by a board-certified physician and includes a diagnosis based on a physical examination. A pathology or autopsy report is acceptable if injured party is deceased and it provides the appropriate diagnosis. | BOTH |
| 113 | Medical Report/Dispute | The most recent physical examination report provided disputes an earlier report and does not provide an acceptable diagnosis for the alleged injury. Please provide a more recent medical report that documents the diagnosis of the injury alleged on the claim form. The report must be dated and signed by a board-certified physician and include a diagnosis based on a physical examination. A pathology or autopsy report is acceptable if injured party is deceased and it provides the appropriate diagnosis. | The most recent physical examination report provided disputes an earlier report and does not provide an acceptable diagnosis for the alleged injury. Please provide a more recent medical report that documents the diagnosis of the injury alleged on the claim form. The report must be dated and signed by a board-certified physician and include a diagnosis based on a physical examination. A pathology or autopsy report is acceptable if injured party is deceased and it provides the appropriate diagnosis. | BOTH |
| 114 | Medical Report is for Wrong Party | The physical examination report submitted is not for the injured person. Please provide a medical report for the injured party that documents the diagnosis of the injury alleged on the claim form. | The physical examination report submitted is not for the injured person. Please provide a medical report for the injured party that documents the diagnosis of the injury alleged on the claim form. | BOTH |
| 115 | Medical Report is Incomplete | The physical examination report in this claim is not acceptable because it is missing pages, is illegible, is not dated or signed by a qualified physician and/or is, otherwise, incomplete. Please provide a completed medical report that documents the diagnosis of the injury alleged on the claim form, as required by the Trust's Instructions for Filing a Claim. A pathology or autopsy report is acceptable if it provides the appropriate diagnosis. | The physical examination report in this claim is not acceptable because it is missing pages, is illegible, is not dated or signed by a qualified physician and/or is, otherwise, incomplete. Please provide a completed medical report that documents the diagnosis of the injury alleged on the claim form, as required by the Trust's Instructions for Filing a Claim. A pathology or autopsy report is acceptable if it provides the appropriate diagnosis. | BOTH |
| 117 | Physician Not Board-Certified | The submitted medical reports do not include evidence of a diagnosis from a board-certified physician in any of the required specialized fields of medicine as outlined in the TDP. Please provide a medical report that documents the diagnosis of the injury alleged performed by a board-certified physician as specified in the TDP. | The submitted medical reports do not include evidence of a diagnosis from a board-certified physician in any of the required specialized fields of medicine as outlined in the TDP. Please provide a medical report that documents the diagnosis of the injury alleged performed by a board-certified physician as specified in the TDP. | BOTH |
| 118 | No Chest X-ray | A chest x-ray, CT scan, or B-reader report has not been provided with the claim. Please submit a report based on the review of a chest x-ray, CT scan, or a B-reader report indicating the alleged injury. The chest x-ray must be read by a certified B-reader a the time of reading or a CT scan must be read by a board-certified pulmonologist. The report must be dated and signed by the radiologist or physician and must include information identifying the injured party. | A chest x-ray, CT scan, or B-reader report has not been provided with the claim. Please submit a report based on the review of a chest x-ray, CT scan, or a B-reader report indicating the alleged injury. The chest x-ray must be read by a certified B-reader a the time of reading or a CT scan must be read by a board-certified pulmonologist. The report must be dated and signed by the radiologist or physician and must include information identifying the injured party. | BOTH |
| 119 | Chest X-Ray Report is Unacceptable | The most recent chest x-ray, CT scan or B-reader report does not provide an acceptable diagnosis for the alleged injury. Please do not send duplicates of previously submitted reports. Please submit a report based on the review of a chest x-ray, CT scan, or a B-reader report indicating the alleged injury. The chest x-ray must be read by a certified B-reader at the time of reading or a CT scan must be read by a board-certified pulmonologist. The report must be dated and signed by the radiologist or physician and must include information identifying the injured party. | The most recent chest x-ray, CT scan or B-reader report does not provide an acceptable diagnosis for the alleged injury. Please do not send duplicates of previously submitted reports. Please submit a report based on the review of a chest x-ray, CT scan, or a B-reader report indicating the alleged injury. The chest x-ray must be read by a certified B-reader at the time of reading or a CT scan must be read by a board-certified pulmonologist. The report must be dated and signed by the radiologist or physician and must include information identifying the injured party. | BOTH |
| 120 | Chest X-Ray Report Dispute | The most recent chest x-ray, CT scan, or B-reader report disputes an earlier report and does not provide an acceptable diagnosis for the alleged injury. Please submit a more recent report based on the review of a chest x-ray, CT scan, or a B-reader report indicating the alleged injury. The chest x-ray must be read by a certified B-reader at the time of reading or a CT scan must be read by a board-certified pulmonologist. The report must be dated and signed by the radiologist or physician and must include information identifying the injured party. | The most recent chest x-ray, CT scan, or B-reader report disputes an earlier report and does not provide an acceptable diagnosis for the alleged injury. Please submit a more recent report based on the review of a chest x-ray, CT scan, or a B-reader report indicating the alleged injury. The chest x-ray must be read by a certified B-reader at the time of reading or a CT scan must be read by a board-certified pulmonologist. The report must be dated and signed by the radiologist or physician and must include information identifying the injured party. | BOTH |
| 121 | Chest X-Ray Report is for Wrong Party | The chest x-ray, CT scan, or B-reader report submitted is not for the injured party identified on Page 2, part 3 of the claim form. Please submit a report for the injured party based on the review of a chest x-ray, CT scan, or a B-reader report indicating the alleged injury. The chest x-ray must be read by a certified B-reader at the time of reading or a CT scan must be read by a board-certified pulmonologist. The report must be dated and signed by the radiologist or physician, and must include information identifying the injured party. | The chest x-ray, CT scan, or B-reader report submitted is not for the injured party identified on Page 2, part 3 of the claim form. Please submit a report for the injured party based on the review of a chest x-ray, CT scan, or a B-reader report indicating the alleged injury. The chest x-ray must be read by a certified B-reader at the time of reading or a CT scan must be read by a board-certified pulmonologist. The report must be dated and signed by the radiologist or physician, and must include information identifying the injured party. | BOTH |
| 122 | Chest X-Ray Report is Incomplete | The chest x-ray, CT scan, or B-reader report is not acceptable because it either does not identify the injured person, has not been signed by the radiologist or physician, is illegible, or is otherwise incomplete. Please submit a complete report based on the review of a chest x-ray, CT scan, or a B-reader report indicating the alleged injury. The chest x-ray must be read by a certified B-reader at the time of reading or a CT scan must be read by a board-certified pulmonologist. The report must be dated and signed by the radiologist or physician and must include information identifying the injured party. | The chest x-ray, CT scan, or B-reader report is not acceptable because it either does not identify the injured person, has not been signed by the radiologist or physician, is illegible, or is otherwise incomplete. Please submit a complete report based on the review of a chest x-ray, CT scan, or a B-reader report indicating the alleged injury. The chest x-ray must be read by a certified B-reader at the time of reading or a CT scan must be read by a board-certified pulmonologist. The report must be dated and signed by the radiologist or physician and must include information identifying the injured party. | BOTH |
| 123 | Chest X-Ray Report is Unilateral | The chest x-ray, CT scan, or B-reader submitted does not show bilateral findings or disbursement of findings. Please submit a report based on the review of a chest x-ray, CT scan, or a B-reader report indicating the alleged injury and evidencing bilateral findings in, at least, the upper lobes. The chest x-ray must be read by a certified B-reader at the time of reading or a CT scan must be read by a board-certified pulmonologist. The report must be dated and signed by the radiologist or physician and must include information identifying the injured party. | The chest x-ray, CT scan, or B-reader submitted does not show bilateral findings or disbursement of findings. Please submit a report based on the review of a chest x-ray, CT scan, or a B-reader report indicating the alleged injury and evidencing bilateral findings in, at least, the upper lobes. The chest x-ray must be read by a certified B-reader at the time of reading or a CT scan must be read by a board-certified pulmonologist. The report must be dated and signed by the radiologist or physician and must include information identifying the injured party. | BOTH |
| 124 | The Most Recent Chest X-ray or CT scan Not Read By A Certified Physician | The most recent chest x-ray or CT scan report has not been read by a certified B-reader or board-certified pulmonologist as instructed in the TDP. Please submit a report based on the review of a chest x-ray or CT scan. The physician must be certified at the time of reading or review. The report must identify the injured party and be dated and signed by the certified B-reader or board-certified pulmonologist. | The most recent chest x-ray or CT scan report has not been read by a certified B-reader or board-certified pulmonologist as instructed in the TDP. Please submit a report based on the review of a chest x-ray or CT scan. The physician must be certified at the time of reading or review. The report must identify the injured party and be dated and signed by the certified B-reader or board-certified pulmonologist. | BOTH |
| 125 | The Most Recent ILO Does Not Qualify | The most recent ILO reading does not qualify for the alleged injury according to the requirements expressed in the TDP. Please submit an acceptable report that meets the ILO requirement for the alleged injury. | The most recent ILO reading does not qualify for the alleged injury according to the requirements expressed in the TDP. Please submit an acceptable report that meets the ILO requirement for the alleged injury. | BOTH |
| 126 | Chest X-Ray Report Does Not Indicate P, Q, or R Opacities | The chest x-ray report submitted does not indicate any rounded opacities of type p, q, or r, as outlined in the TDP. Please submit a more recent chest x-ray report that includes findings of p, q, or r size/type opacities involving, but not limited to, the upper lobes. | The chest x-ray report submitted does not indicate any rounded opacities of type p, q, or r, as outlined in the TDP. Please submit a more recent chest x-ray report that includes findings of p, q, or r size/type opacities involving, but not limited to, the upper lobes. | BOTH |
| 127 | Pathology Report/Disputes | The pathology report submitted disputes an earlier reports(s) and does not provide an acceptable diagnosis for the alleged malignancy. Without additional information, this claim will not be capable of further review. Please provide a pathology report from a board-certified pathologist that documents the diagnosis of the silica-related malignancy alleged on the claim form. | The pathology report submitted disputes an earlier reports(s) and does not provide an acceptable diagnosis for the alleged malignancy. Without additional information, this claim will not be capable of further review. Please provide a pathology report from a board-certified pathologist that documents the diagnosis of the silica-related malignancy alleged on the claim form. | BOTH |
| 128 | Pathology Report is for Wrong Injury | A pathology report has been submitted but it indicates the wrong injury for the alleged disease. Please provide a pathology report for the injured party that documents the appropriate diagnosis that corresponds to the requirement outlined in the TDP. | A pathology report has been submitted but it indicates the wrong injury for the alleged disease. Please provide a pathology report for the injured party that documents the appropriate diagnosis that corresponds to the requirement outlined in the TDP. | BOTH |
| 129 | Primary Site not Indicated | For Lung Cancer, Level III, the medical reports submitted does not indicate that the lung(s) was the primary cancer site. In order for the Trust to establish that the alleged malignancy was a primary site, a board-certified pulmonologist, oncologist, or pathologist must provide a report expressly stating that the lung(s) was the primary site for the malignancy. Please submit any additional amended reports relating to this issue. | For Lung Cancer, Level III, the medical reports submitted does not indicate that the lung(s) was the primary cancer site. In order for the Trust to establish that the alleged malignancy was a primary site, a board-certified pulmonologist, oncologist, or pathologist must provide a report expressly stating that the lung(s) was the primary site for the malignancy. Please submit any additional amended reports relating to this issue. | BOTH |
| 130 | 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 board-certified pathologist, or is otherwise incomplete. Please provide a complete pathology report that documents the appropriate diagnosis relevant to the TDP requirements. | The pathology report submitted is not acceptable because it is either missing pages, is illegible, is not dated and/or signed by a board-certified pathologist, or is otherwise incomplete. Please provide a complete pathology report that documents the appropriate diagnosis relevant to the TDP requirements. | BOTH |
| 131 | Pathology Report/Unacceptable Diagnosis | A pathology report has been submitted but it does not provide an acceptable diagnosis for the alleged injury and its corresponding TDP requirement. Please provide a pathology report for the injured party that documents the appropriate diagnosis that corresponds to the requirement outlined in the TDP. | A pathology report has been submitted but it does not provide an acceptable diagnosis for the alleged injury and its corresponding TDP requirement. Please provide a pathology report for the injured party that documents the appropriate diagnosis that corresponds to the requirement outlined in the TDP. | BOTH |
| 132 | No Pathology Report Provided | A pathology report has not been provided with your claim. Please provide a pathology report that properly documents a diagnosis in support of the Disease Level and its corresponding criteria, as specified in the TDP. | A pathology report has not been provided with your claim. Please provide a pathology report that properly documents a diagnosis in support of the Disease Level and its corresponding criteria, as specified in the TDP. | BOTH |
| 133 | Criteria Not Met for Disorders/Conditions to Establish Complex Silicosis | In order to satisfy the medical criteria for Complex Silicosis Level IV, a diagnosis for tuberculosis, silicoproteinosis, coalescence of silicotic opacities (PMF), scleroderma, lupus, or rheumatoid arthritis either was not provided at all or is not definitely established. Please provide further necessary and complete medical reports from a physician with the proper board certification that documents an acceptable diagnosis, as specified in the TDP. | In order to satisfy the medical criteria for Complex Silicosis Level IV, a diagnosis for tuberculosis, silicoproteinosis, coalescence of silicotic opacities (PMF), scleroderma, lupus, or rheumatoid arthritis either was not provided at all or is not definitely established. Please provide further necessary and complete medical reports from a physician with the proper board certification that documents an acceptable diagnosis, as specified in the TDP. | BOTH |
| 134 | Chest x-ray/CT scan from unacceptable physician and/or facility. | A chest x-ray and/or CT scan submitted with the claim was performed by an unacceptable facility and/or reviewed by an unacceptable physician. Please submit a qualifying chest x-ray/CT scan report that is from an unacceptable facility and/or physician. Without additional information, this claim will not be capable of further review. | A chest x-ray and/or CT scan submitted with the claim was performed by an unacceptable facility and/or reviewed by an unacceptable physician. Please submit a qualifying chest x-ray/CT scan report that is from an unacceptable facility and/or physician. Without additional information, this claim will not be capable of further review. | BOTH |
| 135 | Pathologist is not board certified. | The pathology report provided with the claim does not indicate that it was performed by a board-certified pathologist, or the pathologist was not board-certified at the time of the report. Please provide documentation of the pathologist's certification, or provide a pathology report from a board-certified pathologist who diagnosed the injury alleged on the Claim Form. | The pathology report provided with the claim does not indicate that it was performed by a board-certified pathologist, or the pathologist was not board-certified at the time of the report. Please provide documentation of the pathologist's certification, or provide a pathology report from a board-certified pathologist who diagnosed the injury alleged on the Claim Form. | BOTH |
| 136 | PFT's do Not Meet ATS Standards | The PFT report provided does not meet ATS standards. Please provide a more recent PFT report that meets ATS standards. | The PFT report provided does not meet ATS standards. Please provide a more recent PFT report that meets ATS standards. | BOTH |
| 137 | PFT's are Incomplete | The PFT report provided is not acceptable because it is missing pages, is illegible, is not dated or signed by a qualified physician and/or is, otherwise incomplete. Please provide a complete PFT report that supports the alleged injury on the claim form. | The PFT report provided is not acceptable because it is missing pages, is illegible, is not dated or signed by a qualified physician and/or is, otherwise incomplete. Please provide a complete PFT report that supports the alleged injury on the claim form. | BOTH |
| 138 | PFT's do Not Meet ATS Standards | The PFT report provided does not meet ATS standards. Please provide a more recent PFT report that meets ATS standards. | The PFT report provided does not meet ATS standards. Please provide a more recent PFT report that meets ATS standards. | BOTH |
| 200 | Exposure Information is Inconsistent | The injured party's exposure to silica, including the industry, occupation, work site, employer, and/or duration of exposure is inconsistent with information provided in the medical reports, attachments, affidavits, depositions, and/or other supporting documents submitted with the claim. Please provide supporting documentation or an explanation with evidence that the information stated on the claim form is correct. | The injured party's exposure to silica, including the industry, occupation, work site, employer, and/or duration of exposure is inconsistent with information provided in the medical reports, attachments, affidavits, depositions, and/or other supporting documents submitted with the claim. Please provide supporting documentation or an explanation with evidence that the information stated on the claim form is correct. | BOTH |
| 201 | No Plant/Site of Exposure | Please provide the name of plant/site of exposure (including city and state) where the injured party's exposure to silica products occurred. | Please provide the name of plant/site of exposure (including city and state) where the injured party's exposure to silica products occurred. | BOTH |
| 202 | No Circumstances of Exposure | No circumstances of exposure have been indicated. As specified in the TDP, one of these circumstances must be present in order to satisfy Significant Occupational Exposure (SOE). Please submit an amended Page 6, Part 6, 1g. In order to continue processing this claim. Without this information, the claim will be incapable of further review. | No circumstances of exposure have been indicated. As specified in the TDP, one of these circumstances must be present in order to satisfy Significant Occupational Exposure (SOE). Please submit an amended Page 6, Part 6, 1g. In order to continue processing this claim. Without this information, the claim will be incapable of further review. | BOTH |
| 204 | Insufficient Years of Significant Occupational Exposure | The alleged exposure(s) do not meet the requisite number of years for Significant Occupational Exposure (SOE) as outlined in the TDP. Please provide additional, acceptable exposure in order to satisfy an adequate cumulative period of time required for SOE. | The alleged exposure(s) do not meet the requisite number of years for Significant Occupational Exposure (SOE) as outlined in the TDP. Please provide additional, acceptable exposure in order to satisfy an adequate cumulative period of time required for SOE. | BOTH |
| 206 | Insufficient Pre-1983 Significant Occupational Exposure | The alleged exposure(s) do not satisfy the requisite amount of time of Significant Occupational Exposure (SOE) prior to December 31, 1982. Please provide additional exposure that will meet the minimum amount of time for SOE prior to this date, as specified in the TDP. | The alleged exposure(s) do not satisfy the requisite amount of time of Significant Occupational Exposure (SOE) prior to December 31, 1982. Please provide additional exposure that will meet the minimum amount of time for SOE prior to this date, as specified in the TDP. | BOTH |
| 212 | Description for Significant Occupational Exposure does not meet Criteria | One or more occupations in the industries that you have submitted do not meet the Trust's eligibility criteria for Significant Occupational Exposure. Absent further information substantiating asbestos exposure, duties and responsibilities involved in the described occupation, this claim will not be capable of further review. Please provide a written description as to how the claimant, in the industry and occupation provided, was exposed to silica. | One or more occupations in the industries that you have submitted do not meet the Trust's eligibility criteria for Significant Occupational Exposure. Absent further information substantiating asbestos exposure, duties and responsibilities involved in the described occupation, this claim will not be capable of further review. Please provide a written description as to how the claimant, in the industry and occupation provided, was exposed to silica. | BOTH |
| 403 | No Company Exposure Provided | No meaningful and credible Company Exposure has been alleged or evidenced, as required by the TDP. Such evidence must be established by acceptable affidavit, sworn deposition, or trial testimony or sales, construction, employment, or other contemporaneous records that establishes that a Halliburton and/or Harbison-Walker entity's products were present at the site. | No meaningful and credible Company Exposure has been alleged or evidenced, as required by the TDP. Such evidence must be established by acceptable affidavit, sworn deposition, or trial testimony or sales, construction, employment, or other contemporaneous records that establishes that a Halliburton and/or Harbison-Walker entity's products were present at the site. | BOTH |
| 803 | No Company Exposure Provided | No meaningful and credible Company Exposure has been alleged or evidenced, as required by the TDP. Such evidence must be established by acceptable affidavit, sworn deposition, or trial testimony or sales, construction, employment, or other contemporaneous records that establishes that a Halliburton and/or Harbison-Walker entity's products were present at the site. | No meaningful and credible Company Exposure has been alleged or evidenced, as required by the TDP. Such evidence must be established by acceptable affidavit, sworn deposition, or trial testimony or sales, construction, employment, or other contemporaneous records that establishes that a Halliburton and/or Harbison-Walker entity's products were present at the site. | BOTH |
| 405 | Company Exposure is Insufficient | The alleged exposure(s) do not meet the requisite time for Company Exposure as outlined in the TDP. Please provide additional, acceptable exposure to Halliburton and/or Harbison-Walker entities and/or their predecessors in order to satisfy an adequate period of time required for Company Exposure. | The alleged exposure(s) do not meet the requisite time for Company Exposure as outlined in the TDP. Please provide additional, acceptable exposure to Halliburton and/or Harbison-Walker entities and/or their predecessors in order to satisfy an adequate period of time required for Company Exposure. | BOTH |
| 805 | Company Exposure is Insufficient | The alleged exposure(s) do not meet the requisite time for Company Exposure as outlined in the TDP. Please provide additional, acceptable exposure to Halliburton and/or Harbison-Walker entities and/or their predecessors in order to satisfy an adequate period of time required for Company Exposure. | The alleged exposure(s) do not meet the requisite time for Company Exposure as outlined in the TDP. Please provide additional, acceptable exposure to Halliburton and/or Harbison-Walker entities and/or their predecessors in order to satisfy an adequate period of time required for Company Exposure. | BOTH |
| 407 | Insufficient Pre-1983 Company Exposure | The alleged exposure(s) do not satisfy the requisite amount of time for Company Exposure prior to December 31, 1982. Please provide additional exposure that will meet the minimum amount of time for Company Exposure prior to this date, as specified in the TDP. | The alleged exposure(s) do not satisfy the requisite amount of time for Company Exposure prior to December 31, 1982. Please provide additional exposure that will meet the minimum amount of time for Company Exposure prior to this date, as specified in the TDP. | BOTH |
| 807 | Insufficient Pre-1983 Company Exposure | The alleged exposure(s) do not satisfy the requisite amount of time for Company Exposure prior to December 31, 1982. Please provide additional exposure that will meet the minimum amount of time for Company Exposure prior to this date, as specified in the TDP. | The alleged exposure(s) do not satisfy the requisite amount of time for Company Exposure prior to December 31, 1982. Please provide additional exposure that will meet the minimum amount of time for Company Exposure prior to this date, as specified in the TDP. | BOTH |
| 408 | Need Information for Occupationally Exposed Person | You have filed a claim alleging a silica-related injury resulting from contact with an occupationally exposed individual. As listed, the information submitted about the occupationally exposed person's exposure is incomplete or insufficient to meet the Trust's eligibility criteria for compensation. Please completely fill out Part 6 of the claim form and provide additional information that supplements the information already submitted. | You have filed a claim alleging a silica-related injury resulting from contact with an occupationally exposed individual. As listed, the information submitted about the occupationally exposed person's exposure is incomplete or insufficient to meet the Trust's eligibility criteria for compensation. Please completely fill out Part 6 of the claim form and provide additional information that supplements the information already submitted. | BOTH |
| 808 | Need Information for Occupationally Exposed Person | You have filed a claim alleging a silica-related injury resulting from contact with an occupationally exposed individual. As listed, the information submitted about the occupationally exposed person's exposure is incomplete or insufficient to meet the Trust's eligibility criteria for compensation. Please completely fill out Part 6 of the claim form and provide additional information that supplements the information already submitted. | You have filed a claim alleging a silica-related injury resulting from contact with an occupationally exposed individual. As listed, the information submitted about the occupationally exposed person's exposure is incomplete or insufficient to meet the Trust's eligibility criteria for compensation. Please completely fill out Part 6 of the claim form and provide additional information that supplements the information already submitted. | BOTH |
| 409 | Exposure to Occupationally Exposed Person is Inadequate | Please provide additional detail regarding how the injured party was exposed to silica. | Please provide additional detail regarding how the injured party was exposed to silica. | BOTH |
| 809 | Exposure to Occupationally Exposed Person is Inadequate | Please provide additional detail regarding how the injured party was exposed to silica. | Please provide additional detail regarding how the injured party was exposed to silica. | BOTH |
| 410 | Company Exposure - Name of Plant/Site of Exposure Does Not Coincide | The date exposure began and ended for the DII Industries Plant/Site you have alleged on the claim form does not coincide with our records as to the range of dates DII Silica products were present at said Plant/Site. Please provide further evidence of Company Exposure. Such evidence must be established by acceptable affidavit, sworn deposition, or trial testimony or sales, construction, employment or other contemporaneous records that establishes that a Halliburton and/or Harbison-Walker entity's products were present at the time of alleged Company Exposure. | The date exposure began and ended for the DII Industries Plant/Site you have alleged on the claim form does not coincide with our records as to the range of dates DII Silica products were present at said Plant/Site. Please provide further evidence of Company Exposure. Such evidence must be established by acceptable affidavit, sworn deposition, or trial testimony or sales, construction, employment or other contemporaneous records that establishes that a Halliburton and/or Harbison-Walker entity's products were present at the time of alleged Company Exposure. | BOTH |
| 810 | Company Exposure - Name of Plant/Site of Exposure Does Not Coincide | The date exposure began and ended for the DII Industries Plant/Site you have alleged on the claim form does not coincide with our records as to the range of dates DII Silica products were present at said Plant/Site. Please provide further evidence of Company Exposure. Such evidence must be established by acceptable affidavit, sworn deposition, or trial testimony or sales, construction, employment or other contemporaneous records that establishes that a Halliburton and/or Harbison-Walker entity's products were present at the time of alleged Company Exposure. | The date exposure began and ended for the DII Industries Plant/Site you have alleged on the claim form does not coincide with our records as to the range of dates DII Silica products were present at said Plant/Site. Please provide further evidence of Company Exposure. Such evidence must be established by acceptable affidavit, sworn deposition, or trial testimony or sales, construction, employment or other contemporaneous records that establishes that a Halliburton and/or Harbison-Walker entity's products were present at the time of alleged Company Exposure. | BOTH |
| 411 | Undocumented Site - Product Required | The alleged site(s) on the claim form and/or affidavit site(s) is not on the published site list, then Halliburton and/or Harbison-Walker silica containing products or operations must be identified. No Halliburton and/or Harbison-Walker silica-containing products or operations were identified in the claim, or the product identified is not a Halliburton or Harbison-Walker product. | The alleged site(s) on the claim form and/or affidavit site(s) is not on the published site list, then Halliburton and/or Harbison-Walker silica containing products or operations must be identified. No Halliburton and/or Harbison-Walker silica-containing products or operations were identified in the claim, or the product identified is not a Halliburton or Harbison-Walker product. | BOTH |
| 811 | Undocumented Site - Product Required | The alleged site(s) on the claim form and/or affidavit site(s) is not on the published site list, then Halliburton and/or Harbison-Walker silica containing products or operations must be identified. No Halliburton and/or Harbison-Walker silica-containing products or operations were identified in the claim, or the product identified is not a Halliburton or Harbison-Walker product. | The alleged site(s) on the claim form and/or affidavit site(s) is not on the published site list, then Halliburton and/or Harbison-Walker silica containing products or operations must be identified. No Halliburton and/or Harbison-Walker silica-containing products or operations were identified in the claim, or the product identified is not a Halliburton or Harbison-Walker product. | BOTH |
| 413 | Deceased claimant - Unacceptable Affidavit | For proof of Company Exposure, an affidavit from a family member of the deceased claimant has been submitted. In the case of a deceased claimant, the Trust will not accept an affidavit from a family member who did not work at the site. In order to cure this deficiency, you must provide credible evidence of Company Exposure. This may be established by documentation including, but not limited to, the following: (1) a signed affidavit by a co-worker, (2) discovery responses, (3) deposition testimony, (4) invoices of sale, or (5) construction or similar records. | For proof of Company Exposure, an affidavit from a family member of the deceased claimant has been submitted. In the case of a deceased claimant, the Trust will not accept an affidavit from a family member who did not work at the site. In order to cure this deficiency, you must provide credible evidence of Company Exposure. This may be established by documentation including, but not limited to, the following: (1) a signed affidavit by a co-worker, (2) discovery responses, (3) deposition testimony, (4) invoices of sale, or (5) construction or similar records. | BOTH |
| 813 | Deceased claimant - Unacceptable Affidavit | For proof of Company Exposure, an affidavit from a family member of the deceased claimant has been submitted. In the case of a deceased claimant, the Trust will not accept an affidavit from a family member who did not work at the site. In order to cure this deficiency, you must provide credible evidence of Company Exposure. This may be established by documentation including, but not limited to, the following: (1) a signed affidavit by a co-worker, (2) discovery responses, (3) deposition testimony, (4) invoices of sale, or (5) construction or similar records. | For proof of Company Exposure, an affidavit from a family member of the deceased claimant has been submitted. In the case of a deceased claimant, the Trust will not accept an affidavit from a family member who did not work at the site. In order to cure this deficiency, you must provide credible evidence of Company Exposure. This may be established by documentation including, but not limited to, the following: (1) a signed affidavit by a co-worker, (2) discovery responses, (3) deposition testimony, (4) invoices of sale, or (5) construction or similar records. | BOTH |
| 414 | Exposure Dates/Separate Years | Separate exposure years for each entity and/or plant/site needs to be provided. Please provide the dates on which exposure began and ended for each entity, occupation, and/or plant/site claimed. Remember to submit a separate page for each entity and/or plant/site. | Separate exposure years for each entity and/or plant/site needs to be provided. Please provide the dates on which exposure began and ended for each entity, occupation, and/or plant/site claimed. Remember to submit a separate page for each entity and/or plant/site. | BOTH |
| 814 | Exposure Dates/Separate Years | Separate exposure years for each entity and/or plant/site needs to be provided. Please provide the dates on which exposure began and ended for each entity, occupation, and/or plant/site claimed. Remember to submit a separate page for each entity and/or plant/site. | Separate exposure years for each entity and/or plant/site needs to be provided. Please provide the dates on which exposure began and ended for each entity, occupation, and/or plant/site claimed. Remember to submit a separate page for each entity and/or plant/site. | BOTH |
| 415 | SOL | Based on the information and documentation submitted, you claim fails to meet the required Statute of Limitations (SOL). | Based on the information and documentation submitted, you claim fails to meet the required Statute of Limitations (SOL). | BOTH |
| 815 | SOL | Based on the information and documentation submitted, you claim fails to meet the required Statute of Limitations (SOL). | Based on the information and documentation submitted, you claim fails to meet the required Statute of Limitations (SOL). | BOTH |