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V. THE GREEN FORM (MATRIX COMPENSATION BENEFITS) A. Who is eligible for Matrix Compensation benefits? B. How do I apply to receive Matrix Compensation benefits? E. If I qualify for Matrix Compensation benefits, how do I know if I am on Matrix A-1 or Matrix B-1? F. Whose benefits are determined by Matrix A-2 and Matrix B-2? A. Who is eligible for Matrix Compensation benefits? There are five levels of serious valvular heart disease for which you can be compensated. A brief summary of the five levels is as follows:
For a complete description with explanation of these five levels, refer to pages 18-21 of the Matrix Compensation Benefits Claim Form (GREEN Form), or refer to the Settlement Agreement. B. How do I apply to receive Matrix Compensation benefits? There are three parts in the GREEN Form. Parts I and II must be completed in all cases before the Form can be submitted. Part III must be completed if you have an attorney.
( back to top of this set ) C. Since Part III of the GREEN Form must be completed by an attorney, do I need an attorney to complete my submission for Matrix Compensation benefits? D. Can I receive Matrix Compensation benefits if I am diagnosed as being FDA Positive or as having Mild Mitral Regurgitation by the end of the Screening Period? For more information regarding the five levels of serious valvular heart disease, please refer to pages 18-21 of the GREEN Form. E. If I qualify for Matrix Compensation benefits, how do I know if I am on Matrix A-1 or Matrix B-1? Matrix A-1 benefits will apply for Diet Drug Users (or their Representative Claimants) who ingested Pondimin® and/or Redux™ for 61 days or more, have been diagnosed by a Qualified Physician as FDA Positive by an Echocardiogram performed after Diet Drug use and before the end of the Screening Period (unless they are the recipient of an exception under the Fifth Amendment (click here for more information about the Fifth Amendment to the Settlement Agreement)), and whose conditions are eligible for Matrix payments but who do not have a condition or circumstance that makes Matrix B-1 applicable. (See next paragraph, below.) Matrix B-1 benefits for Diet Drug Users (or their Representative Claimants) will apply to Class Members who demonstrate Matrix Level conditions and to whom any one or more of the following apply: 1) For claims as to the mitral valve, Diet Drug Users who were diagnosed by a Qualified Physician by an Echocardiogram performed after Diet Drug use and before the end of the Screening Period (or such later date as may be applicable, if they are the recipient of an exception under the Fifth Amendment) as having Mild Mitral Regurgitation regardless of the duration of use of Pondimin® and/or Redux™. Thus, if you have only Mild Mitral Regurgitation by the end of the Screening Period (or such later date as may be applicable, if you are the recipient of an exception under the Fifth Amendment), and your condition thereafter worsens to a Matrix Level condition, you will be paid according to Matrix B-1. 2) Diet Drug Users who ingested Pondimin® and/or Redux™for 60 days or less, who were diagnosed by a Qualified Physician by an Echocardiogram performed after Diet Drug use and before the end of the Screening Period (or such later date as may be applicable, if they are the recipient of an exception under the Fifth Amendment) as FDA Positive. 3) Diet Drug Users who ingested Pondimin® and/or Redux™ for 61 days or more, who were diagnosed by a Qualified Physician by an Echocardiogram performed after Diet Drug use and before the end of the Screening Period (or such later date as may be applicable, if they are the recipient of an exception under the Fifth Amendment) as FDA Positive with any of the following conditions: With respect to an aortic valve claim: · The following congenital aortic valve abnormalities: unicuspid, bicuspid or quadricuspid valves, or ventricular septal defect associated with aortic regurgitation; · Aortic dissection involving the aortic root and/or aortic valve; · Aortic sclerosis in people who are 60 years of age or older when they are first diagnosed as FDA positive; · Aortic root dilation greater than 5.0 cm; · Aortic stenosis with an aortic valve area less than 1.0 square centimeter by the Continuity Equation. With respect to a mitral valve claim: · The following congenital mitral valve abnormalities: parachute valve, cleft of the mitral valve associated with atrial septal defect; · Mitral Valve Prolapse as determined by an Echocardiogram. ("Mitral Valve Prolapse" refers to a condition where (a) the Echocardiogram video tape or disk includes the parasternal long axis view and (b) that Echocardiographic view shows displacement of one or both mitral leaflets > 2mm above the atrial-ventricular border during systole, and >5mm leaflet thickening during diastole, as determined by a Board-Certified Cardiologist); · Chordae tendineae rupture or papillary muscle rupture; or acute myocardial infarction associated with acute mitral regurgitation; · Mitral annular calcification; · M-Mode and 2-D Echocardiographic evidence of rheumatic mitral valves (doming of the anterior leaflet and/or anterior motion of the posterior leaflet and/or commissural fusion), except where there is no evidence of rheumatic valve disease upon pathological examination of mitral valve tissue. With respect to claims for the aortic and/or mitral valve(s): · Heart valve surgery prior to Pondimin® and/or Redux™ use on the valve that is the basis of the claim; · Bacterial endocarditis prior to Pondimin® and/or Redux™ use; · FDA positive regurgitation (confirmed by Echocardiogram) prior to Pondimin® and/or Redux™ use for the valve that is the basis of the claim; · Systemic Lupus Erythematosus or Rheumatoid Arthritis and valvular regurgitation and/or valvular abnormalities of a type associated with those conditions; · Carcinoid tumor of a type associated with aortic and/or mitral valve lesions; · History of daily use of methysergide or ergotamines for a continuous period of longer than 120 days. For more information regarding the five levels of serious valvular heart disease necessary to be eligible for Matrix Compensation benefits, refer to pages 18-21 of the GREEN Form. F. Whose benefits are determined by Matrix A-2 and Matrix B-2? The Matrix Level Condition and age of diagnosis of the Diet Drug User whose alleged injury forms the basis of the Derivative Claim will be used to determine placement on Matrix A-2 or Matrix B-2. Matrix A-2 will apply if the Diet Drug User, whose alleged injury forms the basis of the Derivative Claim, meets the criteria for payment on Matrix A-1. Matrix B-2 will apply if the Diet Drug User, whose alleged injury forms the basis of the Derivative Claim, meets the criteria for payment on Matrix B-1. G. Who is a Derivative Claimant? H. If there is more than one Representative Claimant, does each eligible Representative Claimant receive the amount on either Matrix A-1 or Matrix B-1? I. If there is more than one Derivative Claimant, does each eligible Derivative Claimant receive the amount on either Matrix A-2 or Matrix B-2? J. If I am entitled to Matrix Compensation benefits now and my condition progresses to a more severe level, can I receive additional compensation? To be considered for additional compensation based on progression to a higher level of the payment Matrix, you have to complete and file a separate GREEN Form demonstrating the change in your medical condition. Compensation will be based on the benefits you are entitled to under the supplemental GREEN Form less any benefit amount you may have already received from your original GREEN Form. K. What is the deadline for submitting the GREEN Form?
( back to top of this set ) B. What was the Initial Opt-Out (the ORANGE Form #1)? C. Can I revoke my submission of the ORANGE Form #1 (Initial Opt-Out Form)? D. What are Intermediate and Back-End Opt-Out Rights and when can I exercise these rights? If you do not wish to be included in the Settlement, in order to pursue your own independent legal action against Wyeth, you can choose to "Opt Out" under certain conditions. Originally the Settlement Agreement provided three ways of Opting Out: Initial, Intermediate and Back-End. It is too late to exercise the Initial Opt-Out. B. What was the Initial Opt-Out (the ORANGE Form #1)? C. Can I revoke my submission of the ORANGE Form #1 (Initial Opt-Out Form)? To view and obtain the Form to Request Revocation of Initial, Intermediate or Back-End Opt-Outs (click here). NOTE: New Address and Fax Number below. All information mailed or faxed to the old address or fax number will be forwarded.
Each request for revocation must be signed by the Diet Drug User and provide the Diet Drug User''s full name and address. The Diet Drug User will be notified of Wyeth''s action on the request. D. What are Intermediate and Back-End Opt-Out Rights and when can I exercise these rights? a. was not diagnosed as FDA Positive before September 30, 1999; b. is first diagnosed by a Qualified Physician as FDA Positive based on an Echocardiogram performed after beginning use of the Diet Drugs and after September 30, 1999, but on or before January 3, 2003 (or such later date as may be applicable, if the Diet Drug User is the recipient of an exception under the Fifth Amendment (click here for more information about the Fifth Amendment to the Settlement Agreement)); c. did not submit a PINK AIO Form to the Trust; and d. has not been paid a Cash/Med Benefit from the Trust. Details, including the effect of exercising the right of Intermediate Opt-Out and the restrictions on any suit you may bring, are discussed in Section IV.D.3 (pages 53-55) of the Settlement Agreement, Sections E.4 and E.5 of the Court-Approved Notice of May 3, 2003 Deadline, and the Fifth Amendment to the Settlement Agreement. If you qualify for and wish to exercise your right of Intermediate Opt-Out, you must complete and sign an ORANGE Form #2 and must mail the original of the signed ORANGE Form #2 to the Trust and a copy of it to Wyeth, as instructed in the ORANGE Form #2. Both mailings must be postmarked no later than May 3, 2003 (or such later date as may be applicable, if the Diet Drug User is the recipient of an exception under the Fifth Amendment). 2. Back-End Opt-Out. A Diet Drug User (or the Representative Claimant of this Diet Drug User) is eligible to exercise a Back-End Opt-Out if the Diet Drug User: a. is diagnosed by a Qualified Physician as FDA Positive or as having Mild Mitral Regurgitation based on an Echocardiogram performed after beginning use of the Diet Drugs and on or before January 3, 2003 (or such later date as may be applicable, if the Diet Drug User is the recipient of an exception under the Fifth Amendment to the Settlement Agreement); b. did not submit a PINK AIO Form to the Trust; c. has first reached a Matrix-Level condition based on valvular heart disease after September 30, 1999, and has mailed to the Trust a signed BLUE Form postmarked no later than May 3, 2003, or is first diagnosed as having Endocardial Fibrosis between September 30, 1999 and September 30, 2005; and d. has not claimed any Matrix-Level Benefits from the Trust. Details, including the effect of exercising the right of Back-End Opt-Out and the restrictions on any suit you may bring, are discussed in Section IV.D.4 (pages 55-58) of the Settlement Agreement and Sections E.4 and E.6 of the Court-Approved Notice of May 3, 2003 deadline. If you qualify for and wish to exercise your right of Back-End Opt-Out, you must complete and sign an ORANGE Form #3 and must mail the original of the signed ORANGE Form #3 to the Trust and a copy of it to Wyeth, as instructed in the ORANGE Form #3. Both mailings must be postmarked within 120 days of the date on which the Diet Drug User first knows or should have known in the exercise of reasonable diligence that he or she had a Matrix-Level condition, or by May 3, 2003, whichever date is later. The Settlement Agreement does not refer to revocation of the ORANGE Form #2 or the ORANGE Form #3, but anyone who would like to raise the issue may fill out the appropriate revocation request form and send it to Wyeth for its consideration. You must request approval for revocation from Wyeth, which is considering these requests on a case-by-case basis. Class Members who have submitted an ORANGE Form #2 or ORANGE Form #3 and would like to revoke that election and participate in the Settlement should send their requests for revocation in writing to: NOTE: New Address and Fax Number below. All information mailed or faxed to the old address or fax number will be forwarded.
You can obtain the Form to Request Revocation of Initial, Intermediate or Back-End Opt-Outs at the ORANGE Form section of this web site (click here). |
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