§ 29-34-702 — Part definitions

As used in this part: (1) "AMA Guides to the Evaluation of Permanent Impairment" means the American Medical Association's Guides to the Evaluation of Permanent Impairment in effect at the time of the performance of any examination or test on the exposed person required under this part; (2) "Asbestos" has the same meaning as defined in § 29-34-602 ; (3) "Asbestos action" has the same meaning as defined in § 29-34-602 ; (4) "Asbestosis" means bilateral diffuse interstitial fibrosis of the lungs caused by inhalation of asbestos fibers; (5) "Board-certified in internal medicine" means a physician who is certified by the American Board of Internal Medicine or the American Osteopathic Board of Internal Medicine and whose certification was current at the time of the performance of any examination and rendition of any report required by this part; (6) "Board-certified in occupational medicine" means a physician who is certified in the subspecialty of occupational medicine by the American Board of Preventive Medicine or the American Osteopathic Board of Preventive Medicine and whose certification was current at the time of the performance of any examination and rendition of any report required by this part; (7) "Board-certified in pathology" means a physician who holds primary certification in anatomic pathology or clinical pathology from the American Board of Pathology or the American Osteopathic Board of Pathology, whose certification was current at the time of the performance of an examination and rendition of a report required by this part, and whose professional practice is principally in the field of pathology and involves regular evaluation of pathology materials obtained from surgical or postmortem specimens; (8) "Board-certified in pulmonary medicine" means a physician who is certified in the subspecialty of pulmonary medicine by the American Board of Internal Medicine or the American Osteopathic Board of Internal Medicine and whose certification was current at the time of the performance of an examination and rendition of a report required by this part; (9) "Certified B-reader" means an individual who has qualified as a national institute for occupational safety and health (NIOSH) "final" or "B-reader" of x-rays under 42 CFR 37.51(b) , whose certification was current at the time of any readings required under this part, and whose B-reads comply with the NIOSH B-Reader's Code of Ethics, Issues in Classification of Chest Radiographs, and Classification of Chest Radiographs in Contested Proceedings; (10) "Chest x-ray" means chest films taken in accordance with all applicable state and federal regulatory standards and taken in the posterior-anterior view; (11) "DLCO" means diffusing capacity of the lung for carbon monoxide, which is the measurement of carbon monoxide transfer from inspired gas to pulmonary capillary blood; (12) "Exposed person" means a person whose exposure to asbestos or to asbestos-containing products is the basis for an asbestos action; (13) "FEV1" means forced expiratory volume in the first second, which is the maximal volume of air expelled in one (1) second during performance of simple spirometric tests; (14) "FEV1/FVC" means the ratio between the actual values for FEV1 over FVC; (15) "Forced vital capacity" or "FVC" means the maximal volume of air expired with maximum effort from a position of full inspiration; (16) "ILO system and ILO scale" mean the radiological ratings and system for the classification of chest x-rays of the International Labour Office provided in Guidelines for the Use of ILO International Classification of Radiographs of Pneumoconioses in effect on the day any x-rays of the exposed person were reviewed by a certified B-reader; (17) "Nonmalignant condition" means any condition that can be caused by asbestos other than a diagnosed cancer; (18) "Official statements of the American Thoracic Society" means lung function testing standards set forth in statements from the American Thoracic Society, including standardizations of spirometry, standardizations of lung volume testing, standardizations of diffusion capacity testing or single-breath determination of carbon monoxide uptake in the lung, and interpretive strategies for lung function tests, which are in effect on the day of the pulmonary function testing of the exposed person; (19) "Pathological evidence of asbestosis" means a statement by a board-certified pathologist that more than one (1) representative section of lung tissue uninvolved with any other disease process demonstrates a pattern of peribronchiolar or parenchymal scarring in the presence of characteristic asbestos bodies graded 1(B) or higher under the criteria published in Asbestos-Associated Diseases, 106 Archive of Pathology and Laboratory Medicine 11, Appendix 3 (October 8, 1982), or grade one (1) or higher in pathology of asbestosis, 134 Archive of Pathology and Laboratory Medicine 462-80 (March 2010) (Tables 2 and 3), or as amended at the time of the exam, and there is no other more likely explanation for the presence of the fibrosis; (20) "Plaintiff" has the same meaning as defined in § 29-34-602 ; (21) "Plethysmography or body (box) plethysmography" means the test for determining lung volume in which the exposed person is enclosed in a chamber equipped to measure pressure, flow, or volume change; (22) "Predicted lower limit of normal" means the test value that is the calculated standard convention lying at the fifth percentile, below the upper ninety-five percent (95%) of the reference population, based on age, height, and gender, according to the recommendations by the American Thoracic Society and as referenced in the applicable AMA Guides to the Evaluation of Permanent Impairment, primarily National Health and Nutrition Examination Survey (NHANES) predicted values, or as amended; (23) "Pulmonary function test" means spirometry, lung volume testing, and diffusion capacity testing, including appropriate measurements, quality control data, and graphs, performed in accordance with the methods of calibration and techniques provided in the applicable AMA Guides to the Evaluation of Permanent Impairment and all standards provided in the official statements of the American Thoracic Society in effect on the day pulmonary function testing of the exposed person was conducted; (24) "Qualified physician" means a board-certified internist, pathologist, pulmonary specialist, or specialist in occupational and environmental medicine, as may be appropriate to the actual diagnostic specialty in question, who: (A) Has conducted a physical examination of the exposed person and has taken or has directed to be taken under the physician's supervision, direction and control, a detailed occupational, exposure, medical, smoking, and social history from the exposed person, or the physician has reviewed the pathology material and has taken or has directed to be taken under the physician's supervision, direction and control, a detailed history from the person most knowledgeable about the information forming the basis of the asbestos action; (B) Spends no more than thirty-five percent (35%) of the physician's professional practice time in providing consulting or expert services in connection with actual or potential civil actions, and whose medical group, professional corporation, clinic, or other affiliated group earns not more than fifty percent (50%) of its revenues from providing such services; (C) Does not require as a condition of diagnosing, examining, testing, screening, or treating the exposed person that legal services be retained by the exposed person or any other person pursuing an asbestos action based on the exposed person's exposure to asbestos; (D) Prepared or directly supervised the preparation and final review of any medical report under this part; and (E) Has not relied on any examinations, tests, radiographs, reports, or opinions of any doctor, clinic, laboratory, or testing company that performed an examination, test, radiograph, or screening of the exposed person in violation of any law, regulation, licensing requirement, or medical code of practice of the state in which the examination, test, or screening was conducted; (25) "Radiological evidence of asbestosis" means a quality 1 or 2 chest x-ray under the ILO system, showing bilateral small, irregular opacities (s, t, or u) occurring primarily in the lower lung zones graded by a certified B-reader as at least 1/0 on the ILO scale; (26) "Radiological evidence of diffuse bilateral pleural thickening" means a quality 1 or 2 chest x-ray under the ILO system, showing diffuse bilateral pleural thickening of at least b2 on the ILO scale and blunting of at least one (1) costophrenic angle as classified by a certified B-reader; (27) "Spirometry" means a test of air capacity of the lung through a spirometer to measure the volume of air inspired and expired; (28) "Supporting test results" means copies of the following documents and images: (A) Pulmonary function tests, including printouts of the flow volume loops, volume time curves, DLCO graphs, lung volume tests and graphs, quality control data, and other pertinent data for all trials and all other elements required to demonstrate compliance with the equipment, quality, interpretation, and reporting standards set forth in this part; (B) B-reading and B-reader reports; (C) Reports of xray examinations; (D) Diagnostic imaging of the chest; (E) Pathology reports; and (F) All other tests reviewed by the diagnosing physician or a qualified physician in reaching the physician's conclusions; (29) "Timed gas dilution" means a method for measuring total lung capacity in which the subject breathes into a spirometer containing a known concentration of an inert and insoluble gas for a specific time, and the concentration of that inert and insoluble gas in the lung is compared to the concentration of that type of gas in the spirometer; (30) "Total lung capacity" means the volume of gas contained in the lungs at the end of a maximal inspiration; (31) "Veterans' benefits" has the same meaning as defined in § 29-34-602 ; and (32) "Workers' compensation" has the same meaning as defined in § 29-34-602 .

Legislative History

Added by 2016 Tenn. Acts, ch. 635, s 2, eff. 7/1/2016.