Treating Physician Information Form/authorization For Release Of Medical Records Form - September 11th Victim Compensation Fund - Page 9

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Health Condition
Diagnostic Information
Reference Guidelines Supporting the
1
Category
Needed for Physician
Medical Basis for Diagnostic Information
Determination
by Type of Condition
 American Thoracic Society(ATS)/European
Interstitial Lung
2
Disease
Pulmonary disease:
Respiratory Society International
 History (Symptoms) & Physical
Multidisciplinary Consensus Classification of
Exam Findings
the Idiopathic Interstitial Pneumonias (2002)
 PFTs/Spirometry
 Radiographic/Imaging Evidence
ces/ interstitial-lung-disease/idio02.pdf
for lung findings*
 An Official American Thoracic
Society(ATS)/European Respiratory Society
Statement: Update of the International
Multidisciplinary Classification of the
Idiopathic Interstitial Pneumonias (2013)
ces/ interstitial-lung-disease/classification-
of-IIPs.pdf
 ATS Statement on Sarcoidosis (1999)
ces/interstitial-lung-disease/sarcoid1-20.pdf
 Vij R, Strek MA. Diagnosis and Treatment of
Connective Tissue Disease-Associated
Interstitial Lung Disease. CHEST 2013;
143(3):814–824.
 Casian A, Jayne D. Current modalities in the
diagnosis of pulmonary vasculitis. Expert
Opin Med Diagn 2012; 6(6):499-516.
1
The general categories of health conditions that are listed in this Table have been drawn from the List of Health Conditions
for Responders found at 42 U.S.C. §§ 300mm-22(a)(3)(A) and 300mm—32(b)(1).
2
Interstitial lung disease (ILD) is a term used to describe the pulmonary manifestation of more than 100 health conditions.
ILD is characterized by inflammation and/or fibrosis of the lungs. Some of the health conditions manifesting ILD may
include, but are not limited to, idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, sarcoidosis, eosinophilic
granuloma, bronchiolitis obliterans, pneumoconioses and certain systemic autoimmune diseases such as the connective
tissue diseases (CTD), and small vessel vasculitides.

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