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 Form
Claim Form (Word)
Claim Form (PDF)
Claim Checklists
Checklist – Grade I Asbestosis (09/15/04)
Checklist – Grade I Enhanced Asbestosis (09/15/04)
Checklist – Grade II Asbestos Related Pleural Disease (09/15/04)
Checklist – Grade I Serious Asbestosis (09/15/04)
Checklist – Lung Cancer (09/15/04)
Checklist – Mesothelioma (09/15/04)
Checklist – Other Cancer (09/15/04)
Trust Approved 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)
Minnesota Claim Form Interrogatories (11/09/04)
Sample Verification for Answers to Interrogatories (08/19/04)
Litigation Declaration
Litigation Declaration — Claimant (08/12/04)
Litigation Declaration — Attorney (08/12/04)
Traditional Occupation List
Occupational List (07/26/05) (PDF)
Occupational List (07/26/05) (Excel)
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.
Site List
California On Land Site List (April 2018) (PDF)
California On Land Site List (April 2018) (Excel)
California On Land Site List_Deleted Sites
Minnesota On Land Site List(02/17/2011) (PDF)
Minnesota On Land Site List (02/17/2011) (Excel)
Minnesota On Land Deleted Site List (06/18/2008) (PDF)
North Dakota On Land Site List (03/06/2009) (PDF)
North Dakota On Land Site List (03/06/2009) (Excel)
Ships List
Western Ships Repaired List (04/2015) (PDF)
Western Ships Repaired List (04/2015) (Excel)
Western Ships Built List (09/20/2013) (PDF)
Western Ships Built List (09/20/2013) (Excel)Western Ships Repaired List – Deleted Ships (04/19/2007) (PDF)
Western Ships Built List – Deleted Ships (04/17/2008) (PDF)
How to Add a Site or Ship to the List
——————————————————————————–
The Western Asbestos Settlement Trust Web site 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.