Medical Criteria

Information regarding medical deficiencies, requirements

A chest x-ray report reflecting bilateral asbestos-related changes has been provided, but the claim still bears cxr deficiencies. What could be causing this?
Because asbestos-related non-malignant diseases do not improve in time, our application assesses chest x-ray criteria based on the most recent chest x-ray r...
Thu, May 21, 2020 at 7:10 AM
What are pulmonary function tests?
Pulmonary Function Tests ("PFT") are tests designed to measure the capacity and mechanics of the lungs to determine the nature and extent of any i...
Thu, May 21, 2020 at 7:01 AM
What does the "consistent with"/"compatible with" deficiency mean?
Most of the TDPs associated with the Trusts administered by Verus hold that "a finding by a physician after the Effective Date that a claimant’s diseas...
Thu, May 21, 2020 at 7:02 AM
What is a primary carcinoma?
A carcinoma is considered to be primary if it originated from the site which forms the basis for the claim. For example, a cancer that originated in the lun...
Thu, May 21, 2020 at 7:02 AM
What is an equivocal diagnosis?
A diagnosis is considered equivocal when there is some uncertainty as to whether it supports the disease level that forms the basis of the claim's disea...
Thu, May 21, 2020 at 7:03 AM
What is the difference between a carcinoma, sarcoma and lymphoma?
The difference among these malignancies lies in the tissue in which they arise. In a carcinoma, the abnormal cells start their growth in the epithelial tiss...
Thu, May 21, 2020 at 7:03 AM
What is the FEV1/FVC?
The FEV1/FVC measures the amount of air exhaled in the first second of the forced vital capacity maneuver compared to the amount of air which is exhaled ove...
Thu, May 21, 2020 at 7:04 AM
What is the Forced Vital Capacity?
The forced vital capacity ("FVC") refers to the volume change of the lung between a full inspiration to total lung capacity and a maximal expirati...
Thu, May 21, 2020 at 7:07 AM
What is the Total Lung Capacity?
Total lung capacity "TLC") refers to the total amount of air in the lungs after taking the deepest breath possible. The TLC is measured in terms o...
Thu, May 21, 2020 at 7:07 AM
When is it necessary to clarify the malignant nature of a mesothelioma?
The TDPs associated with most of the Trusts administered by Verus state that and "all diagnoses of Mesothelioma shall be presumed to be based on findin...
Thu, May 21, 2020 at 7:08 AM