Appeals : Confirmed Referee Decisions : #13 - July 16th, 2001

D E C I S I O N

Background

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

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

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

4. The Claimant filed written submissions on May 25, 2001 and 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 deceased was infected with Hepatitis C.

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

i) that the deceased received only one blood transfusion in Canada during her lifetime.

ii) the deceased died on May 19, 1991.

iii) the deceased received one blood transfusion in Canada during the period January 1, 1986 and July 1, 1990.

8. The Treating Physician Form, which was signed on January 15, 2000, states as follows:

i) at Section F, question one, blood transfusions outside the period January 1, 1986 and July 1, 1990 were identified as a risk factor for the deceased.

ii) at Section F, question 2, the deceased did not receive a blood transfusion in the period January 1, 1986 to July 1, 1990 and a handwritten note states "February 2/91", indicating that a blood transfusion was received on that date.

9. The deceased's Blood Transfusion History Form provides no history of transfusion and is unsigned and undated.

Analysis

10. The Claimant seeks compensation on behalf of the deceased's estate 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 on behalf of 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 the Claimant did not provide the proof required by Article 3.01 to establish that the deceased was infected as a result of a blood transfusion during the Class Period. Based on the Treating Physician Form, the deceased's only blood transfusion occurred on February 2, 1991, outside the Class Period. Therefore, the deceased does not qualify as a Primarily-Infected Person and the estate is not entitled to compensation under the terms of the Transfused HCV Plan.

14. 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

15. I uphold the Administrator's denial of the Claimant's request for compensation on behalf of the deceased's estate.

July 16, 2001
JUDITH KILLORAN
Referee