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Appeals : Confirmed Referee Decisions : #11 - July 16th, 2001

D E C I S I O N

BACKGROUND

1. On March 19, 2001, the Administrator denied the Claimant's request for compensation as a Primarily-Infected Person under the Transfused HCV Plan on the basis that the Claimant had not provided sufficient evidence that he had received a blood transfusion within the Class Period.

2. The Claimant requested that the Administrator's denial of his claim be reviewed by a referee.

3. Both parties waived their entitlement to an oral hearing.

4. The Claimant did not file submissions but requested that the referee review all the material in his claim file from The 86-90 Hepatitis C Claims Centre.

5. Fund counsel, on behalf of the Administrator, filed written submissions on June 25, 2001 with copies of previously rendered decisions. The written hearing concluded on July 9, 2001 when the Claimant did not file any written submissions in reply.

FACTS

6. The Claimant is infected with Hepatitis C.

7. The Claimant certifies, in the General Claimant Information Form, that the following is true and correct:

(i) He believes that he was infected with the Hepatitis C virus through a blood transfusion received in Canada on March 14, 1991.

(ii) He has never received blood transfusions in Canada during the period between January 1, 1986 and July 1, 1990.

8. The Claimant's Blood Transfusion History Form completed by the treating physician on June 17, 2000 states that, in March 1991, the Claimant received four units of blood while being treated for post-operative hemorrhage.

9. The Treating Physician Form, which was signed by another treating physician on May 17, 2000, states that the Claimant received a blood transfusion during the period between January 1, 1986 to July 1, 1990. The treating physician has not provided an explanation despite three requests by a nurse in the Fund Administrator's office.

ANALYSIS

10. The Claimant seeks compensation as a Primarily-Infected Person under the Transfused HCV Plan. The Transfused HCV Plan defines "Primarily-Infected Person", in part, as meaning "a person who received a Blood transfusion in Canada during the Class Period ...".

11. The 1986-1990 Hepatitis C Settlement Agreement defines "Class Period" as meaning "the period from and including 1 January 1986 to and including 1 July 1990". "Class Period" is defined identically in the Transfused HCV Plan.

12. Article 3.01 of the Transfused HCV Plan requires that a person claiming to be a Primarily-Infected Person must deliver to the Administrator an application form together with, among other things, medical "records demonstrating that the Claimant received a Blood transfusion in Canada during the Class Period".

13. I find that it is reasonable to infer that the Treating Physician Form, which was signed on May 17, 2000, and indicated that the Claimant received a blood transfusion during the Class Period, was completed in error. According to the Claimant, he never received a blood transfusion in Canada during the Class Period, which is corroborated by the Blood Transfusion History Form.

14. I find that the Claimant did not provide the proof required by Article 3.01 to establish that he was infected as a result of a blood transfusion during the Class Period. Based on the General Claimant Information Form and the Blood Transfusion History Form, the Claimant's only blood transfusion was in March 1991, outside the Class Period. Therefore, the Claimant does not qualify as a Primarily-Infected Person and is not entitled to compensation under the terms of the Transfused HCV Plan.

15. The Administrator under the Settlement Agreement is required to administer the Transfused HCV Plan in accordance with its terms. The Administrator does not have authority to vary the terms of the Plan nor does an arbitrator or a referee when asked to review the Administrator's decision.

CONCLUSION

16. I uphold the Administrator's denial of the Claimant's request for compensation.

DATE: July 16, 2001

JUDITH KILLORAN
Referee

 

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