SFDCT / Dow Settlement Medical Criteria

Mixed Connective Tissue Disease (MCTD)/Overlap Syndrome

1. A diagnosis of mixed connective tissue disease (MCTD) shall be based on the presence of clinical symptoms characteristic of two (2) or more rheumatic diseases (systemic sclerosis, SLE, myositis, and Rheumatoid Arthritis), accompanied by positive RNP Antibodies. See. e.g., Kelley, et al. Table 63-1, at 1061.
2. Overlap Syndrome is defined as anyone (1) of the following three (3):
   • Diffuse cutaneous scleroderma,
   • Limited cutaneous scleroderma, or
   • Sine scleroderma, occurring concomitantly with diagnosis of systemic lupus erythematosus, inflammatory muscle disease, or rheumatoid arthritis. See Kelley et al., Table 66-2, at 1114.
3. The application of the above diagnostic criteria is not intended to exclude from the compensation program individuals who present clinical symptoms or laboratory findings atypical of MCTD but who nonetheless have an Overlap Syndrome, except that an individual will not be compensated in this category if her symptomology more closely resembles an atypical connective tissue disease condition/atypical rheumatic syndrome/non-specific autoimmune condition.
4. Severity/Disability Compensation Categories
   • Death or total disability resulting from MCTD or Overlap Syndrome. An individual will be considered totally disabled based on the functional capacity test set forth in Severity/Disability Category A of Atypical Connective Tissue Disease/Atypical Rheumatic Syndrome.
   • MCTD or Overlap Syndrome, plus major organ involvement or major disease activity including central nervous system, cardio-pulmonary, vasculitic, or renal involvement or hemolytic anemia (marked) or thrombocytopenic purpura or severe granulocytopenia.
   • C. Other.