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Claimants: Essential Information : Compensation Schedule

DISEASE-BASED COMPENSATION* SCHEDULE
FOR HCV-INFECTED CLASS MEMBERS

(*NOTE: Fixed payments are cumulative)

Table of Contents

LEVEL

MEDICAL CONDITIONS
CAUSED BY HCV

COMPENSATION

 

S. 4.01

S. 4.02

S. 4.05

S. 4.06

S. 4.07

S. 4.04

Maximum Cumulative Fixed Payments as Compensation for Damages Fixed Payments as Compensation for Damages

Loss of Income or Compensation for Loss of Home Services (Claim One or the Other)

Additional Payment if You Take HCV Drug Therapy Reimbursement for Uninsured Treatment and Medication Costs Reimbursement for Out-of-Pocket Expenses Reimbursement for Care Costs

6

You are considered a Level 6 claimant if:
  1. you receive a liver transplant;
  2. you develop
  1. decompensation of the liver;
  2. hepatocellular cancer;
  3. B-cell lymphoma;
  4. symptomatic mixed cryoglobulinemia;
  5. glomerulonephritis requiring dialysis; or
  6. renal failure.
       
$225,000* You will receive $100,000 Yes $1,000 per month of completed therapy Yes Yes up to $50,000 per year

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LEVEL

MEDICAL CONDITIONS
CAUSED BY HCV

COMPENSATION

 

S. 4.01

S. 4.02

S. 4.05

S. 4.06

S. 4.07

S. 4.04

Maximum Cumulative Fixed Payments as Compensation for Damages Fixed Payments as Compensation for Damages

Loss of Income or Compensation for Loss of Home Services (Claim One or the Other)

Additional Payment if You Take HCV Drug Therapy Reimbursement for Uninsured Treatment and Medication Costs Reimbursement for Out-of-Pocket Expenses Reimbursement for Care Costs

5

You are considered a Level 5 claimant if you develop:
  1. cirrhosis (i.e. fibrous bands in the liver extending or bridging from portal area to portal area with the development of nodules and regeneration);
  2. unresponsive porphyria cutanea tarda which is causing significant disfigurement and disability;
  3. Unresponsive thrombocytopenia (low
    platelets) which is associated with purpura or other spontaneous bleeding, or which results in excessive bleeding following trauma or a platelet count below 30x10 9; or
  4. glomerulonephritis not requiring dialysis.
      
$125,000* You will receive $65,000 Yes $1,000 per month of completed therapy Yes Yes No

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LEVEL

MEDICAL CONDITIONS
CAUSED BY HCV

COMPENSATION

 

S. 4.01

S. 4.02

S. 4.05

S. 4.06

S. 4.07

S. 4.04

Maximum Cumulative Fixed Payments as Compensation for Damages Fixed Payments as Compensation for Damages

Loss of Income or Compensation for Loss of Home Services (Claim One or the Other)

Additional Payment if You Take HCV Drug Therapy Reimbursement for Uninsured Treatment and Medication Costs Reimbursement for Out-of-Pocket Expenses Reimbursement for Care Costs

4

You are considered a Level 4 claimant if:

you develop bridging fibrous (i.e. fibrous tissue in the portal areas of the liver with fibrous bands bridging to other portal areas or to central veins but without nodular formation or nodular regeneration).
  
$60,000* There is no further fixed payment at this level Yes $1,000 per month of completed therapy Yes Yes No

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LEVEL

MEDICAL CONDITIONS
CAUSED BY HCV

COMPENSATION

 

S. 4.01

S. 4.02

S. 4.05

S. 4.06

S. 4.07

S. 4.04

Maximum Cumulative Fixed Payments as Compensation for Damages Fixed Payments as Compensation for Damages

Loss of Income or Compensation for Loss of Home Services (Claim One or the Other)

Additional Payment if You Take HCV Drug Therapy Reimbursement for Uninsured Treatment and Medication Costs Reimbursement for Out-of-Pocket Expenses Reimbursement for Care Costs

3

You are considered a Level 3 claimant if:
  1. you develop non-bridging fibrosis (i.e. fibrous tissue in the portal areas of the liver with fibrous bands extending out from the portal area but without any bridging to other portal tracts or to central veins); or
  2. you receive Compensable HCV Drug Therapy (i.e. interferon or ribarivin); or
  3. you have met or meet a protocol for
    Compensable HCV Drug Therapy even though you have not taken the therapy.
  OPTION 2:
If you waive the $30,000 payment, you may claim loss of income or compensation for loss of services in the home
Yes $1,000 per month of completed therapy Yes Yes No
If you elect OPTION 1 $60,000 OPTION 1:
You receive $30,000
No

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LEVEL

MEDICAL CONDITIONS
CAUSED BY HCV

COMPENSATION

 

S. 4.01

S. 4.02

S. 4.05

S. 4.06

S. 4.07

S. 4.04

Maximum Cumulative Fixed Payments as Compensation for Damages Fixed Payments as Compensation for Damages

Loss of Income or Compensation for Loss of Home Services (Claim One or the Other)

Additional Payment if You Take HCV Drug Therapy Reimbursement for Uninsured Treatment and Medication Costs Reimbursement for Out-of-Pocket Expenses Reimbursement for Care Costs

2

You are considered a Level 2 claimant if:
 
you test positive on a polymerase chain reaction (PCR) test demonstrating that HCV is present in your blood.
  
$30,000 You will receive $20,000 No Not applicable Yes Yes No

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LEVEL

MEDICAL CONDITIONS
CAUSED BY HCV

COMPENSATION

 

S. 4.01

S. 4.02

S. 4.05

S. 4.06

S. 4.07

S. 4.04

Maximum Cumulative Fixed Payments as Compensation for Damages Fixed Payments as Compensation for Damages

Loss of Income or Compensation for Loss of Home Services (Claim One or the Other)

Additional Payment if You Take HCV Drug Therapy Reimbursement for Uninsured Treatment and Medication Costs Reimbursement for Out-of-Pocket Expenses Reimbursement for Care Costs

1


You are considered a Level 1 claimant if:
your blood test demonstrates that the HCV
antibody is present in your blood.
 
$10,000 You will receive $10,000 No Not applicable Yes Yes No

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* assuming the $30,000 Fixed Payment was not waived at Level 3

 

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