Okla. Stat. tit. 76, § 76-95

Medical report - Evidence requirements.

Oklahoma Statutes - Title 76. Torts Page 62

A. No person shall have a silica claim placed on any active

trial roster in this state, or brought to trial in this state, or

conduct discovery in a silica claim in this state, in the absence of

a prima facie showing of impairment as shown by service on each

defendant of a report by a physician who is board-certified in

pulmonary medicine, internal medicine, oncology, pathology, or

occupational medicine at the time of issuing the relevant medical

report.

B. In a case alleging silicosis, the medical report must be

issued by a physician who is board-certified in pulmonary medicine,

internal medicine, occupational medicine, or pathology that:

1. The exposed person has been diagnosed with a silica-related

condition; and

2. Confirms that a physician actually treating or who treated

the exposed person, or who has or who had a doctor-patient

relationship with the exposed person or a medical professional

employed by and under the direct supervision and control of such

physician:

a. performed a physical examination of the exposed

person, or if the exposed person is deceased, reviewed

available records relating to the exposed person's

medical condition,

b. took a detailed occupational and exposure history from

the exposed person or, if the exposed person is

deceased, from a person knowledgeable about the

alleged exposure or exposures that form the basis of

the action, and

c. took a detailed medical and smoking history that

includes a thorough review of the exposed person's

significant past and present medical problems and the

most probable cause of any such problem that is

relevant to the exposed person's impairment or

disease.

C. The medical report must set out the details of the exposed

person's occupational, exposure, medical, and smoking history, and

set forth that there has been a sufficient latency period for the

applicable type of silicosis.

D. The medical report must confirm, on the basis of medical

examination, chest x-ray and pulmonary function testing, that the

exposed person has permanent respiratory impairment:

1. Rated at least Class 2 pursuant to the AMA Guides to the

Evaluation of Permanent Impairment; and

2. Accompanied by:

a. a chest x-ray that is an ILO quality 1 film, except

that in the case of a deceased exposed individual

where no pathology is available, the film can be ILO

quality 2, showing bilateral nodular opacities (p, q,

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or r) occurring primarily in the upper lung fields,

graded 1/1 or higher under the ILO system of

classification, or

b. a chest x-ray that is an ILO quality 1 film, except

that in the case of a deceased exposed individual

where no pathology is available, the film can be ILO

quality 2, showing large opacities (A, B, or C) in

addition to the small opacities referred to in the

preceding section, or

c. a chest x-ray that is an ILO quality 1 film showing

acute silicosis as described in Occupational Lung

Diseases, Third Edition, as amended from time to time,

or

d. pathological demonstration of classic silicotic

nodules exceeding one (1) centimeter in diameter as

published in 112 Archive of Pathology and Laboratory

Medicine 7 (July 1988), as amended from time to time,

or

e. pathological demonstration of acute silicosis.

E. For all other silica-related claims, other than silicosis,

the medical report must:

1. Be issued by a physician who is board-certified in pulmonary

medicine, internal medicine, occupational medicine, or pathology

that:

a. the exposed person has been diagnosed with a silica-

related condition, and

b. confirms that a physician actually treating or who

treated the exposed person, or who has or who had a

doctor-patient relationship with the exposed person or

a medical professional employed by and under the

direct supervision and control of such physician:
l medicine, occupational medicine, or pathology

that:

a. the exposed person has been diagnosed with a silica-

related condition, and

b. confirms that a physician actually treating or who

treated the exposed person, or who has or who had a

doctor-patient relationship with the exposed person or

a medical professional employed by and under the

direct supervision and control of such physician:

(1) stating a diagnosis of silica-related lung cancer

based on a sufficient latency period which is not

less than fifteen (15) years and a statement that

to a reasonable degree of medical certainty

exposure to silica was a proximate cause of the

exposed person's physical impairment, accompanied

by a conclusion that the exposed person's silica-

related lung cancer was not more probably the

result of causes other than exposure to silica

revealed by the exposed person's occupational,

exposure, medical, and smoking history, or

(2) stating a diagnosis of silicosis complicated by

documented tuberculosis, or

(3) stating a diagnosis of any other silica-related

disease, accompanied by a diagnosis of silicosis

as defined herein, based on a sufficient latency

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period and a statement that to a reasonable

degree of medical certainty exposure to silica

was a proximate cause of the exposed person's

physical impairment, accompanied by a conclusion

that the exposed person's silica-related disease

was not more probably the result of causes other

than exposure to silica revealed by the exposed

person's occupational, exposure, medical, and

smoking history; and

2. Be accompanied by:

a. a chest x-ray that is an ILO quality 1 film, except

that in the case of a deceased exposed individual

where no pathology is available, the film can be ILO

quality 2, showing bilateral nodular opacities (p, q,

or r) occurring primarily in the upper lung fields,

graded 1/1 or higher under the ILO system of

classification,

b. chest x-ray that is an ILO quality 1 film, except that

in the case of a deceased exposed individual where no

pathology is available, the film can be ILO quality 2,

showing large opacities (A, B, or C) in addition to

the small opacities referred to in subparagraph a of

this paragraph,

c. chest x-ray that is an ILO quality 1 film showing

acute silicosis as described in Occupational Lung

Diseases, Third Edition, as amended from time to time,

d. pathological demonstration of classic silicotic

nodules exceeding one (1) centimeter in diameter as

published in 112 Archive of Pathology and Laboratory

Medicine 7 (July 1988), as amended from time to time,

or

e. pathological demonstration of acute silicosis.

F. All evidence and reports used in presenting the prima facie

showing required in this section, including pulmonary function

testing and diffusing studies, if any:

1. Must comply with the technical recommendations for

examinations, testing procedures, quality assurance, quality

controls, and equipment in the AMA's Guidelines to the Evaluation of

Permanent Impairment and the most current version of the Official

Statements of the American Thoracic Society regarding lung function

testing, including general considerations for lung function testing,

standardization of spirometry, standardization of the measurement of

lung volumes, standardization of the single breath determination of

carbon monoxide uptake in the lung, and interpretive strategies of

lung testing in effect at the time of the performance of any

examination or test on the exposed person required by this act.

Testing performed in a hospital or other medical facility that is

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fully licensed and accredited by all appropriate regulatory bodies

in the state in which the facility is located, is presumed to meet

the requirements of this subsection. This presumption may be

rebutted by evidence demonstrating that the accreditation or
person required by this act.

Testing performed in a hospital or other medical facility that is

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fully licensed and accredited by all appropriate regulatory bodies

in the state in which the facility is located, is presumed to meet

the requirements of this subsection. This presumption may be

rebutted by evidence demonstrating that the accreditation or

licensing of the hospital or other medical facility has lapsed, or

providing specific facts demonstrating that the technical

recommendations for examinations, testing procedures, quality

assurance, quality control, and equipment have not been followed;

2. Must not be obtained through testing or examinations that

violate any applicable law, regulation, licensing requirement, or

medical code of practice;

3. Must not be obtained under the condition that the exposed

person retains legal services in exchange for the examination, test,

or screening;

4. Shall not result in any presumption at trial that the

exposed person is impaired by an asbestos- or silica-related

condition; and

5. Shall not be conclusive as to the liability of any

defendant.

G. The conclusion that a prima facie showing has been made is

not admissible at trial.