CRITICAL CLAIM DOCUMENTS:

This section contains all the documents and information necessary to complete the claim process. You may submit your claim electronically or by mail. These documents may be printed off the web site, or you may write to the Trust and we will send you the documents that you request.

• Claim Filing Instructions
• Thorpe Training Seminar Slides
  
• Electronic Claim Template (to be filed by law firm representing claimant)(Microsoft Access Required) 06/19/2008
• The Electronic Claim Template is not supported if you utilize Microsoft Office 2007. Please contact the trust if you have any questions



• Claim Form
  • Full Claim Form
  • Section 1: Representation
  • Section 2: Injured Party/Decedent Information
  • Section 3: Injuries
  • Section 4: Diagnosis
  • Section 5: Chest X-Ray
  • Section 6: CT Scan
  • Section 7: Pulmonary Function Test
  • Section 8: Pathology Report
  • Section 9: Dependent & Beneficiary
  • Section 10: Land Exposure
  • Section 11: Shipboard Exposure
  • Section 12: Secondary Exposure
  • Section 13/14: Smoking History and Economic Loss and Medical Expense
  • Section 15: Asbestos Litigation
  • Section 16: Signature Page
• Claim Checklists
  • Checklist - Grade I Asbestosis
  • Checklist - Grade I Enhanced Asbestosis
  • Checklist - Grade II Asbestos Related Pleural Disease
  • Checklist - Grade I Serious Asbestosis
  • Checklist - Lung Cancer
  • Checklist - Mesothelioma
  • Checklist - Other Cancer
• Trust Abbreviated Interrogatories
  
  • California Claim Form Interrogatories — Personal Injury (PDF)
  • California Claim Form Interrogatories — Personal Injury (Word)
  • California Claim Form Interrogatories — Wrongful Death (PDF)
  • California Claim Form Interrogatories — Wrongful Death (Word)
• Litigation Declaration
  • Litigation Declaration — Claimant
  • Litigation Declaration — Attorney
• Traditional Occupation List
• High Exposure Jobtypes

Disclaimer
Pursuant to Section VII, subsection b, of the Case Valuation Matrix, the site/ship lists may be modified in light of additional evidence or experience with claims processing. However, if a claim is submitted with exposure at a site or on a ship which is subsequently removed from the approved list after the claim was submitted and before it is approved for payment, the claim’s filing fee will be fully refunded.

• Land Based Site List
• J.T. Thorpe Site List 04/20/2010 (Excel)
• J.T. Thorpe Site List 04/20/2010 (PDF)
• J.T. Thorpe Site List-DELETED SITES 06/19/2008 (PDF)
• Ship List
• J.T. Thorpe Ship List 04/20/2010 (Excel)
• J.T. Thorpe Ship List 04/20/2010 (PDF)

The Western Asbestor Settlement Trust website uses Portable Document Formats (PDF) to provide our visitors with the most extensive information available.

In order to view some of these documents, please follow the link provided below to download Adobe Acrobat Reader.