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| CARD |
| 214 E. 3rd Street |
| Libby, MT 59923 |
| Phone: (406) 293-9274 |
| Fax: (406) 293-9280 |
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| Q. |
What is CARD? |
| A. |
The Center for Asbestos Related Disease (CARD) is an independent, non-profit specialty healthcare clinic that is governed by a volunteer community-based Board of Directors. The multidisciplinary professional team specializes in Libby Amphibole Asbestos, with Pulmonary Function labs on site. CARD provides extensive asbestos health screening, health management and can provide education, counseling, and outreach. CARD also facilitates research surrounding amphibole asbestos health issues. |
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| Q. |
Can anyone be screened at CARD? |
| A. |
Anyone can be screened at CARD, but to be eligible for free LAMP (Libby Asbestos Medical Plan) screening benefits, you must have lived in Libby prior to the year 2000 for at least 6 months. |
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| Q. |
Is CARD associated with W. R. Grace? |
| A. |
No. CARD is a community-based, independent, non-profit, specialty healthcare clinic. CARD is not involved with W. R. Grace in any way nor is it funded by the government. |
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| Q. |
Is any research being done on Libby amphibole asbestos? |
| A. |
Yes! CARD is seriously involved in research. Many projects have been initiated, completed or are ongoing. There is great interest for continued research to understand the health effects related to different levels of asbestos exposure as this is the foundation for developing new treatments for patients. Top |
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| Q. |
Can I still file a suit against WR Grace? |
| A. |
Yes, you can still file a suit against W. R. Grace. You can file a personal civil suit by contacting a private attorney to represent you. Another option is that you can be part of the criminal trial. The United States Department of Justice-District of Montana is asking anyone who feels they are “a victim” of the asbestos exposure to complete a form entitled “Request for Notification of Case Events”. You can contact Sheryl Nordahl at the United States Department of Justice-District of Montana, 406-542-8851 (press 1, then 3) for more information. |
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| Q. |
Can I apply for disability because of my ARD? |
| A. |
Yes. Anyone can apply for disability if they have a health condition (physical or mental) that prevents them from being able to work. Asbestos related diseases are no different and the Social Security Disability Division even recognizes Libby amphibole (aka “tremolite”) asbestos disease as having a different presentation than other types of asbestos disease thus warranting different disability criteria. To start the process, contact your local Social Security Office. Or for more information see the CARD NEWS Summer 2006 edition for the article Amphibole Asbestos Disease Recognized by Social Security. |
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| Q. |
How can I give or donate to CARD? |
| A. |
Donations to CARD are received via the CARD Foundation. The Foundation accepts gifts on behalf of CARD and works to fund present and future needs. Philanthropic support of CARD or the CARD Foundation is greatly appreciated, with 100% of all gifts benefiting CARD and its patients. For more information, please visit the CARD Foundation section of this website. |
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| Q. |
I didn’t work at the mine but I hunted in the woods and got firewood up by Rainy Creek, and fished in the Kootenai River. Do you think I had a significant exposure? |
| A. |
Since those areas are located so close to the mine site and if you spent a fair amount of time there, it would be a good idea for you to get screened. |
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| Q. |
My grandfather worked at the mine and now I am having trouble with my breathing. Should I be screened? |
| A. |
Yes, it would be a very good idea to get screened. Chances are you were exposed to asbestos fibers. Asbestos fibers could have traveled on your grandfather’s clothing, car upholstery and they can even linger in the air for long periods of time when disturbed. Getting screened will help you know about your respiratory health. |
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| Q. |
I played in the piles while my oldest brother played baseball in Libby. Will I get asbestos disease? |
| A. |
Playing on or around the ball fields and the ore piles was an area where high exposures occurred. You should be screened to determine your health status. |
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| Q. |
I loved to help my grandmother in the garden. She is now on oxygen, should I be screened? |
| A. |
Many folks used vermiculite from the mine to enrich the soil in their yards and gardens. It might be unknown if your grandmother had vermiculite asbestos in her garden as she could have been exposed in a different way. Getting screened is always a good idea to know your asbestos health status. |
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| Q. |
Can I get lung cancer from asbestos? |
| A. |
Yes, The risk of lung cancer is increased with asbestos exposure. |
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| Q. |
What does “screening” mean and what does it involve? |
| A. |
Screening involves collection of information relating to your asbestos exposure, health history, current respiratory signs and symptoms. A chest x-ray, and CT scan if warranted, will be done to look at your lungs. A breathing test (pulmonary function test) will be done to see how your lungs are working. The doctor will then evaluate all your information and discuss the findings with you. An individual health plan will be established that will help you to maintain and/or improve your health status. You will then be set-up for annual asbestos health screening to monitor and/or manage any changes in your lungs as well as to provide lung cancer screening tests. |
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| Q. |
What is the Grace Medical Plan and who manages it? |
| A. |
W. R. Grace implemented a volunteer medical plan (not to be confused with medical insurance) that covers some asbestos related healthcare services for members of the plan. It is administered by Health Network of America and it is commonly referred to as the Grace Libby Medical Program or "the Grace plan." |
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| Q. |
Is the Grace Libby Medical Plan a medical insurance? |
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No. It is a volunteer medical plan funded by W. R. Grace to assist patients with the costs of the medical care that according to their experts (not a treating medical provider) is related to Asbestos Related Disease. It is their decision on what will or will not be covered on an individual basis. |
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| Q. |
How long does it take to get accepted for Grace benefits? |
| A. |
HNA has their experts review your application and medical record to determine if you have a qualifying Asbestos Related Disease in their opinion. They make an independent decision regardless of the referring medical provider. It can take several months to receive a ruling on your eligibility. If you have questions about your status, contact HNA. |
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| Q. |
If the Grace Libby Medical Program does not cover my visit, am I responsible for the bill? |
| A. |
Yes. We can bill your LAMP supplemental, private insurance, or Medicare, but if that is denied, you will receive a statement in the mail showing the balance due. An individual payment plan can be arranged by calling our billing office. |
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| Q. |
Is the CARD run by HNA? |
| A. |
No! Health Network of America is who administers the Grace Libby Medical Program (LMP) which is funded by W. R. Grace. CARD is an independent 501(c) 3 non-profit organization. Although CARD receives reimbursement from HNA for medical services rendered, CARD relies on fee for service to sustain its operations. |
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| Q. |
Why do I get letters from HNA doctors who have not examined me, saying I do not have asbestos related disease? Who do I believe? |
| A. |
HNA has many consulting physicians who are paid to review your records and give their expert opinion. Libby amphibole asbestos disease is a different presentation and affects the lungs differently and many physicians do not recognize and/or acknowledge these differences. Another discovery identified after many years of caring for individuals with Libby amphibole asbestos disease is that it is a “clinical” disease. This means that it can not be diagnosed by only considering radiography (x-ray’s & CT’s), exposure history, and lung functions. Symptoms are also VERY important. ALL factors are important components in making a diagnosis. In addition, people often have symptoms long before x-ray changes or changes on pulmonary function tests. That is why it is so important to be followed by a provider who can examine you face to face and follow you in the clinic over time. Who do you believe? Would you by a car without looking under the hood and driving it? |
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| Q. |
What is LAMP and who manages it? |
| A. |
The Libby Asbestos Medical Plan (LAMP) emerged out of a court settlement between W. R. Grace and the Environmental Protection Agency (EPA). The court awarded $2.75 million to go to current and former Libby residents for asbestos healthcare. LAMP is managed by a volunteer community board called the ARHCP (Asbestos Related Health Care Project). LAMP funds are administered by New West Health Services in Kalispell, Montana. |
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| Q. |
How do I know if I qualify for LAMP? |
| A. |
If you lived in Libby for at least 6 months prior to 2000, you are eligible to receive LAMP screening benefits. You can obtain an application at CARD, the EPA office in Libby, the DEQ office in Troy or click here. |
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| Q. |
How long does it take to get accepted for LAMP benefits? |
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After submitting your completed application by mail to New West Health Services, you can expect a response from LAMP within 2-4 weeks. LAMP will send information explaining benefits. Please read this information so you are aware of the benefits available as well as the limitations. You will also receive a LAMP card for your wallet. |
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| Q. |
If LAMP benefits do not cover my visit, am I responsible for the bill? |
| A. |
Yes, or we can bill your private health insurance or Medicare. If you don’t have private insurance, you will receive a statement showing the balance due. An individual payment plan can be arranged by calling our billing office. |
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| Q. |
Are there different types of LAMP benefits? |
| A. |
Yes, click here for details of LAMP benefits. |
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| Q. |
Is there a difference between LMP and LAMP? |
| A. |
Yes, a big difference! LMP stands for the Libby Medical Plan which is the Grace Medical Plan administered by Health Network of America. LAMP stands for the Libby Asbestos Medical Program and it is a community based program which is administered by New West Health Services. |
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| Q. |
Why is it important that I get my screening every year, even if I don’t have any signs or symptoms? |
| A. |
After exposure, asbestos related disease has a 10-40 year latency period before symptoms may develop and it can be a progressive disease. In addition, with asbestos exposure there is an increased risk for lung cancer. Annual screening provides you the opportunity to manage your respiratory health. Early detection of disease translates to early intervention and better health outcomes. |
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| Q. |
Do I have to live in Libby in order to be screened? |
| A. |
Many people lived in Libby and have moved away. You are encouraged to make an effort to come to Libby for a face to face evaluation. However, in the event that this is a hardship, CARD offers long distance screening. After you complete initial paperwork, you can obtain your x-rays, CT’s if warranted, and breathing tests in your home town. Then CARD physicians can review your case. CARD providers work closely with your primary care provider to assist in managing your respiratory healthcare. If this option is what you need to do, please visit “Long Distance Screening” on this web site or contact us for more specific information. |
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| Q. |
Does CARD pay for my annual screening visit? If not, who does? |
| A. |
CARD is not an insurance company and can not provide healthcare services for free.
LAMP screening, LAMP supplemental, HNA, private insurance or Medicare will be billed. If any of these claims are denied, the patient is then responsible for the bill. An individual payment plan can be arranged by calling our billing office.
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| Q. |
I was exposed to asbestos in a shipyard. Can I be screened at CARD? |
| A. |
Yes, you can be screened at CARD. CARD specializes in Libby asbestos and if you lived in Libby prior to 2000, or if you were exposed to products containing Libby vermiculite, you should probably be screened. Regarding other types of asbestos, the physicians would be available to evaluate your respiratory health. They can provide screening and will help you to connect with a medical provider who can manage your ongoing care if needed. |
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| Q. |
Are medications covered by LAMP? If so, which ones? |
| A. |
LAMP supplemental benefits do cover some medications that are used for asbestos related diseases. Typically LAMP covers pain medications, anti-anxiety medications, and acid reflux medications resulting from asbestos related disease. These are medications that are not covered by the W. R. Grace Libby Medical Plan which covers respiratory medications, antibiotics, diuretics, potassium and smoking cessation medications. You will need a “letter of medical necessity” from your health care provider and submit it to LAMP for approval. Only medications with approval letter will be covered. |
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| Q. |
Does smoking cause asbestos related disease? |
| A. |
Smoking does damage your lungs and can cause lung disease but it does not cause asbestos related disease. Medical evidence has shown that smoking can worsen your shortness of breath and/or other symptoms if you already have an asbestos related disease. It can also increase your risk for lung and throat cancers. |
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| Q. |
How important is it to quit smoking? |
| A. |
Many studies have shown that the combination of smoking and asbestos exposure is particularly hazardous. Cigarette smokers, on the average, are 10 times as likely to develop lung cancer as are non-smokers. For non-smokers with asbestos exposure, the risk is about 5 times greater than for those in the general population. By contrast, smokers who are heavily exposed to asbestos are as much as 90 times more likely to develop lung cancer than are non-exposed individuals who do not smoke. Smoking does not appear to increase the risk of mesothelioma. |
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| Q. |
What is the difference between asbestos related disease, asbestosis and mesothelioma? |
| A. |
Asbestos related diseases are diseases associated with asbestos exposure. These may include but are not limited to: pleural plaques, pleural thickening, lung cancer and mesothelioma. Asbestosis is a commonly used term but sometimes it is not used correctly. Appropriately used it describes scarring of actual lung tissue which can also be called interstitial disease. A pleural plaque is a single spot of scarring on the lining around the lung where as pleural thickening is scaring that is more extensive along the lining around the lung. Mesothelioma is an aggressive cancer caused by exposure to asbestos that can occur in the lining around the lung as well as the linings around the abdominal cavity or the heart. For more detailed information on this subject see the section on Libby Amphibole Asbestos Related Diseases. |
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| Q. |
Are medications covered by the W. R. Grace Libby Medical Plan? Is so, which ones? |
| A. |
There are two levels of prescription benefits. Level 01 covers respiratory medications, antibiotics, diuretics, potassium and smoking cessation meds. Level 02 covers all medications but specific criteria must be met to qualify for Level 02 prescription benefits. Contact HNA for more information. |
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| Q. |
Will my disease go away? |
| A. |
No. Asbestos related disease is a chronic lung condition that does not go away. Some people may experience increasing signs and symptoms and/or a progression of disease, but it is highly individual. This is all the more reason to have your annual screening. |
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| Q. |
What can I do to help my symptoms? |
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monia vaccinations. If you smoke, it is very important that you quit as soon as possible. Take your medications as directed and visit your health care provider as to changes in signs or symptoms or any medication issues. Don’t be afraid to ask for HELP. |
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| Q. |
Are asbestos related diseases fatal? |
| A. |
They can be. Although many people have died from asbestos related disease and/or complications, it is not the most common path of the disease. Asbestos related diseases can be managed by taking your medications, seeing a doctor when the first signs of respiratory infection present to prevent complications, maintaining overall good health, including smoking cessation. It is also important to follow your doctor’s advice regarding how often you should be seen to manage your condition effectively. |
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| Q. |
I get so tired and worn out taking care of myself and I do not have any energy or enjoyment for the things I used to do. Is there any help? |
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There are techniques that you can adopt for conserving your energy. Visit the health education on this website or ask you medical provider. Other help may be available through specific programs. Contact us to learn about what programs are currently available. |
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| Q. |
If I feel better, can I skip a dose of my medicine or quit taking it altogether? |
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It is not recommended that you skip any medications or quit taking them altogether without discussing it with your medical provider. Many medications have a “half-life” or need to get to certain levels in the blood stream in order to be effective. If you quit taking them you may feel okay for several days but your symptoms will most likely come back. If you have questions about your medications, feel they are no longer effective, or you are experiencing unpleasant side effects, consult your medical provider. Never stop a medication on your own because you may experience negative health effects. |
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| Q. |
Can I increase my oxygen at home if I feel I need to? |
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You should not increase your supplemental oxygen use at home without a doctor’s order. Oxygen is classified as a “prescription drug”. Several criteria have to be met in order for a person to receive supplemental oxygen or have it increased. People who have COPD or emphysema should be very careful with the amount of oxygen they use, as it is possible for them to get “too much” oxygen thus further worsening their breathing. If you feel you are not getting enough oxygen, contact your medical provider to have your condition re-evaluated. |
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