SFDCT / Dow Settlement Medical Criteria

Polymyositis / Dermatomyositis - Option 1

1. A diagnosis of polymyositis or dermatomyositis shall be made in accordance with diagnostic criteria proposed by Bohan and Peter, i.e.,
   • Symmetrical proximal muscle weakness;
   • EMG changes characteristic of myositis including:
     1. Short duration, small, low amplitude polyphasic potential,
     2. Fibrillation potentials,
     3. Bizarre high- frequency repetitive discharges;
   • Elevated serum muscle enzymes (CPK, aldolase, SGOT, SGPT, and LDH);
   • Muscle biopsy showing evidence of necrosis of type I and II muscle fibers, areas of degeneration and regeneration of fibers, phagocytosis, and an interstitial or perivascular inflammatory response; dermatologic features including a lilac (heliotrope), erythematous, scaly involvement of the face, neck, shawl area and extensor surfaces of the knees, elbows and medial malleoli, and Gottron's papules. A diagnosis of dermatomyositis requires presence of three (3) of the criteria plus the rash (fifth criterion). A diagnosis of polymyositis requires the presence of four (4) criteria without the rash. See. Kelley, et al., at 1163.
   • Dermatologic features including a lilac (heliotrope), erythematous, scaly involvement of the face, neck, shawl area and extensor surfaces of the knees, elbows and medial malleoli, and Gottron's papules. A diagnosis of dermatomyositis requires presence of three (3) of the criteria plus the rash (fifth criterion). A diagnosis of polymyositis requires the presence of four (4) criteria without the rash. See. Kelley, et al., at 1163.
2. 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 polymyositis or dermatomyositis but who nonetheless have a polymyositis or dermatomyositis-like disease, except that an individual will not be compensated in this category if her symptomology more closely resembles an Atypical Connective Tissue Disease.
3. Severity/Disability Compensation Categories:
   • Death or total disability resulting from polymyositis or dermatomyositis. An individual will be considered totally disabled based on the functional capacity test set forth for Severity/Disability Category A for Atypical Connective Tissue Disease/Atypical Rheumatic Syndrome.
   • Polymyositis or dermatomyositis with associated malignancy and/or respiratory muscle involvement.
   • Other, including polymyositis or dermatomyositis with muscle strength of Grade III or less.