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CLAIMS ADMINISTRATOR UPDATE
This is the most recent update
posted by the Claims Administrator on the
Settlement Facility website:
Claims Administrator's Desk
Last Updated: 09/18/2009 @ 7:17 AM
Claims Administrator's Desk Last Updated:
09/18/2009
Processing Changes
Some of you may have already
received written or verbal communication about
the processing changes for Review of Additional
Information and Option 2 Discretionary reviews.
Please read the statements below carefully as
these processing changes will affect how your
claim is reviewed.
Review of Additional Information
RAI reviews
Pursuant to Annex A 7.09biii of
the Settlement Agreement, the Claims Office may
establish regulations relating to the submission
of medical documentation and set reasonable
periods during which to conduct the evaluation
or reevaluation of a Claimant's eligibility and
benefits based on supplemental submissions and
for submission of supplemental documentation
after notice of deficiencies. Generally, the
Claims Office will not review a Claimant's
submissions in response to a deficiency notice
more than twice however, the Claims
Administrator may conduct a third review after
the completion of the review of all other Claims
for Disease.
In order to manage the volume of
requests for additional claim reviews, the
Settlement Facility will only review submissions
of additional information twice. If you submit
duplicate information or information that does
not address the deficiencies in your claim, on
the second re-review, we will 1 not review your
claim again, and 2 we will process your claim
for the payment you are eligible for at the time
of the second review, even though your cure
deadline may not have expired. Therefore, we
encourage you to read your notification of
Status letter carefully and make sure you
understand the deficiencies in your claim. If
you do not understand your deficiencies, we
strongly encourage you to call Claims Assistance
and make an appointment to speak with the
Disease Call Specialist. You should also review
the Disease Guidelines posted on the SFDCT
website to assist you in fixing the problems
with your claim. To avoid any confusion and
possibly another review of your claim before you
are ready, please do not send your records until
you are sure you understand the deficiencies in
your claim and you have collected all of the
documentation needed to cure the deficiencies in
your claim.
Discretionary Reviews
In an effort to expedite
processing Option 2 claims and to allow your
Option 2 and ACTD Discretionary reviews their
own cure deadline dates, these reviews will no
longer be done at the same time. If you are
unable to cure your Option 2 deficiencies by the
one year cure deadline date, and your claim was
not approved for any level of compensation, or
you did not request a lower level payment, we
will automatically place your ACTD claim in line
for review. You will have one year from the date
of the ACTD Notification of Status letter to
cure the deficiencies in your claim. However,
you may request an ACTD review at any time while
your Option 2 review is in progress. If you
choose this option, you will have two cure
deadline dates running that could expire at or
around the same time.
1. As a reminder, checks issued
by the SFDCT are valid for only 180 days from
the date on the check. The SFDCT will
automatically place a stop pay on all checks
that are uncashed after the check expiration
date. If you have an uncashed check that is more
than 180 days past the check date, you will need
to contact us in order to receive a new check.
If you receive Class 7 cash out check and want
to return it for a full disease review, you must
return the check within 180 days from the date
on the check. Failure to return the cash out
offer check by the deadline will result in
denying your disease review, we will, of course,
return your check.
If you are an attorney who
represents both claimants in the MDL926 Revised
Settlement Program RSP and the SFDCT and
recently received the Important Notice from the
MDL926 Claims Office, the deadline to negotiate
RSP checks is different than the SFDCT policy
stated above. Please remember that the SFDCT and
the MDL926 operate under very
different protocols. This means that certain
policies developed by one facility are not
necessarily implemented by the other facility.
2. Documents that are submitted
to the United States District Court are filed
and will become public record. This means that
anyone may be able to see the information you
have submitted. Any information you do not want
shared with the public should be redacted or
removed from the document prior to sending it
in. Before filing, you may want to visit the
website of the District Court for more
information regarding privacy.
3. If you have received a disease
NOS letter, please remember to submit your
documents prior to the cure deadline listed in
your letter. Documents received after the
applicable cure deadline will not be considered.
4. It is very important that you
keep the SFDCT informed when you move. Failure
to provide us with your new address can delay
your claim processing, may cause your benefit
check to be returned, or may prevent you from
receiving a premium payment.
David Austern |