Law Firm Portal Instructions
Contents
1. 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT VIOXX Ao Dx CONSUMER SETTLEMENT gt Establishing Claimant Portal Home Establishing Claimant Claimant Name Jones Suffix wv Country United States Firm Administration EER 1103 Any St Address 2 Claimant Search Establish New Claimant City Richmond State VA Zip Code 23221 Policy Keeper Telephone Number 555 555 5555 Email Address rjones gmail com Date of Birth 01 01 1950 7 Social Security Number 555 55 5555 Confirm Social Security Number 555 55 15555 Change Password Email Indicates required information Establish Claimant You will need to have Adobe 7 0 or higher to view Printed Documents To get the latest Version of Adobe Reader click the icon above The Claimant Activity screen for the new Claimant will appear so that you can complete the Claim Form and upload any documents on behalf of the Claimant I Change Password Email Click the Change Password Email tab to change your Password and or email address 24 9 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT Change Password Change Password eiue Case sensitive Use 6 15 characters with no spaces Must contain at least one number and one letter Confirm New Indicates required information C2. Printed Documents To get the latest Version of Adobe Reader click the icon above Establish Claimant This site is optimized for Internet Explorer with Javascript enabled The Claimant Activity screen for the new Claimant will then appear allowing you immediately to complete the Claim Form and upload any documents on behalf of the new Claimant see section C 3 below 9 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT am VIOXX Ws DS Cums ADMINISTRATOR 2 Claimant Search You can search for your claimants in two different ways a Specific Search Click Specific Search to search for a Claimant by Claimant ID Last Name or Social Security Number Fill in the information in the search criteria you choose to use and click Search The Last Name search request is not case sensitive but you must enter at least the first two characters of the Claimant s last name You can search using more than one search criteria The Search Results will appear on screen Claimant Search Search amp Specific Search O Search All Establish New Claimant Claimant ID 0 sw J TT C m Search Results Page 1 of 1 1 records Claimant ID Name Claim Status Total Amount Claims Payment Option 100230 Jones Robert A Claim Form Not Yet Begun You will see the Claimant ID Claimant Name Claim Status the Total Amount Claimed and the Payment Options selected Click the Claimant ID hyperlink to access the Cla
3. out of pocket for Vioxx You may also be paid up to 75 for visiting with a doctor to discuss alternatives to Vioxx INSTRUCTIONS mS You can file a claim online or print and mail a claim form FREQUENTLY ASKED FILE A CLAIM ONLINE DOWNLOAD A CLAIM FORM QUESTIONS CONTACT THE CLAIMS ADMINISTRATOR You may also request that the Claims Administrator send you a copy of the paper Claim Form MAIL ME A CLAIM FORM E a If you still have questions about qualifying for a payment you can use the Program s Do I Qualify utility to see if you may be DO QUALIFY FOR PAYMENT You will need to have Adobe 7 0 or eligible higher to view Printed Documents To get the latest Version of Adobe Reader click the icon above Attorneys Click Here Espanol 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT P as VIOXX Ms DS Cums ADMINSTRATOR 2 If you are a member of a law firm that has not been granted access select Request Law Firm Portal Access CONSUMER SETTLEMENT MDL 1657 BROWNGREER CuuMs ADMINISTRATOR Portal Home Welcome to the Nationwide Vioxx Consumer Settlement Program s Secure Claims Portal Login ID Request Claimant Access Return To Public Website Password Request Law Firm Portal Access m Forgotten Login ID Password A Get ADOBE Reader You will need to have Adobe 7 0 or higher to view Printed Do
4. will be asked to provide the name of the pharmacy as well as the address and telephone number Required fields are marked with a red asterisk If you select Yes and no longer wish to provide this information press Cancel then select No 14 9 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT TY VIOXX DS Cums AOMINISTRATOR 2 Prescriber Pharmacy Information Do you know the name of the physician who prescribed Vioxx to you Yes No Do you know the name and address of the pharmacy where you purchased Vioxx Yes O No Pharmacy Name i 7 1 Address City EE State Zip Code Country V Telephone Number ma ma EE NN Cancel The next section will ask you select the forms of proof you are submitting for your client s Claim If you selected Option 1 you will be asked to select your proof of purchase If you selected Option 2 you will be asked to select your proof of Vioxx prescription c Payment Option 1 If you chose Payment Option 1 you will see the screen below You will need to enter the total amount your client paid out of pocket for Vioxx You can also indicate which documents you are submitting to support your client s claim You can check more than one box 15 9 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT BROWNGREER MDL 1657 Cums AOMINISTRATOS 3 Proof of Payment Vioxx Purchases Enter the total amount of out
5. 5 m L Firm Email jsmith samplelaw com Physical Address aoares usas M esn Cs Smet v Zptode zi x Indicates required information Request Access The Claims Administrator will review your credentials and establish access for your firm You will receive an email within one business day confirming your successful registration You will also receive further instructions for logging in to the Secure Claims Portal C Portal Usage 1 When you log into the Portal for the first time you will need to agree to the Conditions of Use You will only need to do this once 9 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT BROWNGREER MDL 1657 Cums AOMINISTRATOR 16 Choice of Forum The United States District Court for the Eastern District of Louisiana shall have exclusive jurisdiction over all disputes or proceedings arising from or relating to the Vioxx Portal and or these Conditions of Use Agree O Disagree 2 Click Submit and you will be taken to the Home Page of the Attorney Portal D Portal Home The Portal Home Page displays basic instructions for beginning claims updates on the Settlement Program and a link to download the Attorney Portal User Manual CONSUMER SETTLEMENT P Home Welcome JOHN SMITH to your Nationwide Vioxx Consumer Settlement Portal You have signed in as a member of SAMPLE LAW FIRM Portal Ho
6. CONSUMER SETTLEMENT MDL 1657 CONSUMER SETTLEMENT MDL 1657 ATTORNEY PORTAL http vioxxsettlement com USER MANUAL 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT P am VIOXX Ws DS Cums ADMINISTRATOR TABLE OF CONTENTS PAGE As Omm 3 B Accessing the Attorney es eise EE ee 3 POr SA oe 5 D Portal HORE ERI ie ee ie Ge 6 E Claimant SCAN CON OE Tem 7 NEM E lere New M CIPRO T 7 El Se ALC sae in ed 8 3 eon ee spe ceo RE __________ E 8 d Bes iss N TRUE 9 AY SR OE 9 a View Documents amp Notices esse sees see ee eene ee ee ee ee ee ee ee 10 ip Hoload M NOE 11 va OE EE EO EE 11 1 _____ _ _ 11 ES ____________ 12 a clau Payment OO OS one ER OE MERE IE EO NE DO OE OE NE EE ED EO AE OO GE DOG 12 Skies ie id EN EE EE EE EE EE 12 TOPI N OE N N 13 b Prescriber Dispensary InformatHOn esse ss ss ss ss ee ee ee RR RR EE EE Ee ee ee ee ee ee 13 SIEOT E EE Ee EE EE EE ee TO EG 14 id ay ee OOo EE 16 Ds Re leid METTE 17 G Firm Administration oe E N TUE EXE UTI UP Eb Ge oru a DIS d ahi 19 1 Editing Law Firm esse ss se 19 AA IWATA A EE RE EE 20 D Ad ES
7. E ane ee N ER 21 b Search For and Manage US60S sesse ss ees Ai Ge ed De oe aa 22 H Establish New ee ee ee ee nennen eene nnne nennen 23 I Change Password bmail iss ees EE es De US au ee ee GE ee iS RUE 24 Me 25 GENIUS 25 J Lor O EE 25 2 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT TY VIOXX Ws DS Crams ADMINESTRATOR ACCESSING AND USING THE ATTORNEY PORTAL A Introduction Welcome to the Nationwide Vioxx Consumer Settlement Program The Secure Claims Attorney Portal allows attorneys to file claims and exchange information with the Claims Administrator on behalf of their client claimants These instructions explain and illustrate how to access and use the Portal B Accessing the Attorney Portal 1 From your web browser go to http www vioxxsettlement com Click on the link Secure Claims Portal You will then be taken to the Portal Home Page where you may request access to the Portal and login CONSUMER SETTLEMENT am VIOXX D Cras ADMINISTRATOR HOME PAGE Vioxx Consumers Could Get Up to 50 or More From a Settlement SECURE CLAIMS PORTAL 5 You can get 50 or more if you purchased Vioxx before October 1 2004 for yourself or a family member f you don t have records you can get up to 50 IMPORTANT DOCUMENTS f you have records you can be reimbursed for all that you spent
8. cuments To get the latest Version of TEE EK ii The Nationwide Vioxx Consumer Settlement Portal the Portal is a secure website that brings together information from the icon above Claims Administrator and a claimant or a claimant s law firm or authorized representative in the Nationwide Vioxx Consumer This site is optimized for Settlement Program the Settlement Program It allows the Claims Administrator and the claimant to exchange information Internet Explorer with and provides a place to track deadlines and the status of a claim in the Settlement Program Only persons authorized by the Javascript enabled Claims Administrator can use the Portal If you are a pro se claimant not represented by an attorney click the Request Access button to obtain a Login ID and Password If you do not remember your Login ID and or Password click the Forgotten Login ID Password button If you have questions or need assistance with the Portal contact the Claims Administrator by email at PortalHelp VioxxSettlement com If you are a claimant who is represented by an attorney in the Settlement Program you cannot access the Portal Only your attorney can access the Portal If you are represented by an attorney contact your attorney for information on the status of your claim s This site is optimized for Internet Explorer with Javascript enabled Only one person from each law firm needs to request Portal Access If a member of your law firm has bee
9. dobe PDF or JPEG file Upload Document 3 Confirmation In this section you can review the information you have provided so far If any of your client s demographic information is incorrect you can select Edit Contact Info You will return to the Contact Info section where you can make any additional edits If any of your client s claim information is incorrect you can select Edit Claim Details You will return to the Claim Details section where you can make any additional edits 18 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT VIOXX SE D Cums AOMINISTRATOR Review Your Claim Review the information you entered to ensure that it is correct Use the edit buttons below to edit your claim Contact Information John Doe 111 Main Street Anytown AL 11111 United States 1 1 1950 oe gggg Edit Contact Info Claim Details Claim Payment Option Option 2 Form s of Proof Sworn Statement Edit Claim Details If your information is correct you can sign and submit your client s claim Type your client s name in the Signature box and select Submit If all the information above is correct click Submit Claim below to submit your claim You must click the Submit Claim button to complete the process If you need to correct any of the information above click the Back button By typing your name below you declare under penalty of perjury that the information in this Clai
10. e of the follawing forms of proof showing you were prescribed Vioxx Check the form s of proof you are submitting Medical Record am submitting a medical record showing that was prescribed Vioxx by the health care provider listed in Section 2 above Doctor s Letter am submitting a letter from my doctor listed in Section 2 above saying that he or she prescribed Vioxx to me and the approximate dates of my prescribed usage Prescription Bottle am submitting an empty prescription bottle and label showing that filled a prescription of Vioxx that was prescribed to me by the doctor listed in Section 2 above Swern Statement By checking this box and signing this Claim Form am declaring that purchased Vioxx using personal or family funds and that the other forms of proof of payment or proof of prescription are not available Upload Documents Supporting documents can also be submitted via mail Click here for more information You also have the option to upload documents at this time but it 1s not required To upload documents press the Upload Documents button You will need to select the document on your computer and select Upload Supporting documents can also be submitted by mail Select the Click Here hyperlink for more information on mailing documents Upload Document Click the Browse button to navigate to the file location on your local network You can upload any file that is an Excel A
11. f your client is submitting a Claim because he or she purchased Vioxx or you are assisting a Vioxx purchase you will need to enter the demographic information of the Vioxx purchaser on the screen below You must complete all fields marked with a red asterisk When you are finished click Continue 11 9 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT VIOXA SM DY Cums ADMINSTRATOR Did you purchase Vioxx or are you filing as a representative of someone who purchased Vioxx amp purchased Vioxx I m filing for someone else Vioxx Purchaser Personal Information Country Uniedsuis Address address Date of Birth MM DD YYYY Social Security Number 16789 Your Social Security Number and the other personally identifiable information you provide are Confirm Social Security Number E 6789 EE iem gt b If your client is submitting a Claim on behalf of someone else who purchased Vioxx you will need to enter the information for the person who purchased Vioxx see previous screen as well as your client s demographic information You will also need to indicate your client s relationship to the Vioxx purchaser Complete all required fields Select Continue when you are finished 2 Claim Details a Claim Payment Options You must indicate whether you are submitting an Option 1 claim or an Option 2 claim on behalf of your chent 1 Option 1 provides
12. h All Establish New Claimant lastname seel 1 Establish New Claimant For ease of use you can establish a new claimant within the Claimant Search feature or you can go straight to the Establish New Claimant feature in the left hand navigational column To establish a new claimant within the Claimant Search feature click the Establish New Claimant button to add a new Claimant to your Portal 9 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT P VIOXX M DS Cums AOMINSTRATOR Claimant Search Search Specific Search C Search All Establish New Claimant last Name Provide the requested information and click Establish Claimant CONSUMER SETTLEMENT P al VIOXX Ss D ADMIN RAT Establishing Claimant Portal Home Establishing Claimant Claimant Name Jones Middle Name Claimant Search Suffix Country United States Firm Administration Ds UENIT Address 2 Establish New Claimant City Richmond State VA Zip Code 23221 Change Password Telephone Number 555 E 555 5555 Email Address rjonesG gmail com Date of Birth 0101 1950 21 Social Security Number 555 55 5555 5 Confirm Social Security Number 555 55 5555 You will need to have Indicates required information Adobe 7 0 or higher to view
13. hange Email Confirm New Email EE Indicates required information 1 Change Password Enter your current Password your new Password confirm your new Password and click the Submit button to change your Password 2 Change Email Enter your current Email your new Email confirm your new Email and click the Submit button to change your email address J Log Off When you are finished using the Portal application click the Log Off tab on the left side of the screen This will immediately shutdown your connection to your portal Click the Go to Login Screen link to log in to your portal 25 9 2014 BrownGreer PLC 436391 03 10 2014
14. imant Claimant Search Search Specific Search Search All Establish New Claimant Claimant iD Last Name J Page 1 of 1 1 records Claimant ID Name Claim Status Total Amount Claims Payment Option 100230 Jones Robert A Claim Form Not Yet Begun 1 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT VIOXX SM D b Search Click Search to view a list of all Claimants in your Portal Find the Claimant whose information you wish to access Click the Claimant ID hyperlink to access that Claimant After selecting the hyperlink you will be taken to the Claimant Activity Screen 3 Claimant Activity The Claimant Activity screen allows you to view pertinent information for the selected Claimant and manage the Claimant s claim On the Claimant Activity screen you can submit a Claim Form upload documents view documents and view Notices Claimaint ID 100048 Step 1 Contact Information Step 2 Claim Details Step 3 Confirmation Did you purchase Vioxx or are you filing as the legal representative of someone who purchased Vioxx amp purchased Vioxx Lam filing for someone else Vioxx Purchaser Personal Information ai lu es Country Address 1 Address ES mee 2 O Email rjones gmail com Date of Birth 03 02 1942 MM DD YYYY Social Security Number 19999 Your Social Security Number and the other personally identifiable infor
15. l Consultation If you chose Payment Option 1 your client can also be reimbursed up to 75 if he or she visited a doctor between September 30 2004 and November 30 2004 in order to receive diagnostic testing or a medical consultation about finding an alternative to Vioxx If you answer Yes to this question you will need to provide the physician information 16 9 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT JP Ae VIOXX M DS Cums AOMINISTRATOR Physician Information ADD A NEW PHYSICIAN Total Amount Paid Out Of Pocket fora _ Post Withdrawal Medical Consultation gt i You must also include 1 proof of the medical consultation 2 proof of the amount of the cost of loss claimed that was out of pocket and not reimbursed and 3 a statement that the medical consultation or diagnostic testing occurring between September 30 2004 and November 30 2004 had not been scheduled or recommended before September 30 2004 d Payment Option 2 If you chose Payment Option 2 you will see the screen below You must provide proof that your client was prescribed Vioxx You can check all boxes that apply You do not need to provide any additional proof if you select the Sworn Statement checkbox 17 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT P di CuuMS ADMINISTRATOR 3 Proof of Prescription To make a claim under Option 2 above you must provide an
16. led Checks Credit Card Statements E 1 Option 2 Check this box if you select option 1 Check this box if you select option 2 b Prescriber Pharmacy Information In the next section you can indicate the physician that prescribed your client Vioxx as well as the name and address of the pharmacy where your client purchased Vioxx You are not required to submit this information so if your client no longer remembers the physician or pharmacy answer No to both of these questions 13 9 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT MDL 1657 _ 2 Prescriber Pharmacy Information Do you know the name of the physician who prescribed Vioxx to you O Yes No Do you know the name and address of the pharmacy where you purchased Vioxx Yes If you answer Y es to the physician question you will need to provide the physician s name address and phone number as well as the hospital or facility Required fields are marked with a red asterisk If you select Yes and then no longer wish to provide this information press Cancel then select No 2 Prescriber Pharmacy Information Do you know the name of the physician who prescribed Vioxx to you Yes O No Hospitsl Medieal Facing area City fs State Zip Code Country Telephone Number 7 NN __ Cancel If you answer Y es to the Pharmacy question you
17. m Form and any documentation that you have submitted or will submit are true and correct to the best of your knowledge The Settlement Agreement requires that a Claim Form be signed by the submitting Settlement Class Member to be valid Thus the Settlement Class Member must sign below himself or herself Signature Smith x Submit G Firm Administration Click the Firm Administration tab found on the left side of the screen to change any law firm information manage law firm users and Claimant logins and upload law firm documents 1 Editing Law Firm Information Click the Edit button to make changes to the Law Firm Information You may change any information on this screen Note that a field with an 19 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT 9 due VIOXX Ws D asterisk before it indicates that it is required When you have completed making the necessary changes to the Law Firm Information click the Update button at the top of the screen to save your changes Firm Administration q am Firm Firm Name Sample Law Firm PrimaryAtomey smith HO Mailing Address Addressi 23 Ast City Richmond State va VI Hp ede 23221 SSS Main Telephone 555 EE Firm Email jsmith samplelaw com Physical Address Mdh o zip Code 23221 Indicates required information A confirmation box will appear for you to confirm that you want to save your cha
18. mation you provide are Eed ed d subject to court protection a View Documents amp Notices Click this button to view any documents or Notices associated with your client 10 9 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT P VIOXA S 155 LAMS AOMINISTRATOR b Upload Files Click this button to upload documents to the claimant s file You can use this feature at any time Choose the type of document you are uploading then click Browse to locate the file on your computer Then select Upload Upload Document Click the Browse button to navigate to the file location on your local network You can upload any file that is an Excel Adobe PDF or JPEG file Documentlype Upload Document F Filing a Claim 1 Contact Information You will need to indicate whether you are submitting a Claim for Vioxx your client purchased or your client is the legal representative of someone else who purchased Vioxx If your client is a Vioxx purchaser in filing their Claim select I purchased Vioxx Only select I m filing for someone else if your client is the legal guardian or representative of a deceased incapacitated or minor Vioxx purchaser Step 1 Contact Information Step 2 Claim Details Step 3 Confirmation Did you purchase Vioxx or are you filing as a representative of someone who purchased Vioxx 0 purchased Vioxx I m filing for someone else t a I
19. me Claimant Search Click on the Establish New Claimant tab to the left to begin adding claimants to your Portal After you have established each claimant click the Claim Form button to begin the filing process Firm Administration Click here for the Portal User Manual Establish New Claimant Change Password Email ETE ADOBE Reader You will need to have Adobe 7 0 or higher to view Printed Documents To get the latest Version of Adobe Reader click the icon above This site is optimized for Internet Explorer with Javascript enabled 1 Portal sections The left side of the Home screen lists the following options 9 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT P am VIOXX Ws DS a Portal Home b Claimant Search c Firm Administration d Establish New Claimant e Change Password Email f Log Off You can navigate between these sections by left clicking on the section you wish to access Each section except Home is described below E Claimant Search The Claimant Search tab allows you to access information on your claimant s add new claimants and determine the status of your claimants through all phases of the Settlement Program The Search feature allows you to search by Claimant ID Last Name and or Social Security Number Click the Search All radio button for a listing of all of your active Claimants Claimant Search Search amp Specific Search Searc
20. n granted access to the Portal that person as Law Firm Administrator for your law firm can add new users on the Firm Administration tab of the Portal See Section F 2 for more information on adding firm users 3 After selecting Request Law Firm Portal Access complete all required fields and select Request Access 9 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT XX MDL 1657 Cums ADMINISTRATOR CONSUMER SETTLEMENT HRUOW N REER MDL 1657 Liane Ferre Request Law Firm Portal Access Portal Home If you are an attorney requesting access to the Portal and you are a member of a law firm that has not been granted access fill out the required fields below and click Request Access We will contact you once your account is activated If a member of your law firm has Return To Public Website been granted access to the Portal that person as Law Firm Administrator for your law firm can add new users on the Firm Administration tab of the Portal If you have any questions email AttorneyAccess VioxxSettlement com ADOBE Reader Firm Name Firm Name Sample Law Firm Primary Attorneys view Printed Documents To Reader ciak the Login ID jsmith Adobe Reader click the I EE Ed Confirm Password eeeseee Mailing Address Address1 123 Any St Address Gty Rihmend state va v You will need to have Main Telephone 552 555
21. nges Confirmation Are you sure you want to save the data Click the Yes button to save your changes The following message will appear on the Firm Administration screen Your data has been successfully saved 2 Manage Users Click the Manage Users button to add and change the users who can access the information in your Portal 20 9 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT VIOXX Ms DS Manage Firm Users Click the Manage Firm Users button to grant edit or remove access to this portal for attorneys and staff at your firm For security purposes and proper use of the portal each person accessing this portal should have his or her own login credentials A Firm Administrator can create as many accounts as needed and will have the option to limit the level of access granted to each user CT dam a Add Users Click the Add New User button to provide access to your Portal to a new user in your law firm Manage Firm Users Back To grant access to the Nationwide Vioxx Consumer Settlement Portal to another attorney or employee of your law firm click the Add New User button and provide the required information When complete click the Add button and the new user will have access to the portal Use the Search function to find a user for whom you want to edit or remove access to the portal Select Search All for a complete list of firm users that have access to the portal Click the Edit but
22. of pocket costs and losses that you are claiming Total Amount Paid Out Of Pocket on Vioxx 5 ____ 5 Proof of out of pocket expenses for your Vioxx prescriptions Check the form s of proof you are submitting Receipt of Payment am submitting receipt s cancelled check s or credit card statement s showing paid out of pocket for Vioxx for my personal or family use for which was not reimbursed Insurer EOB am submitting an explanation of benefits from my insurer Medicare or Medicaid that shows Vioxx was prescribed and the amount of co payments paid Pharmacy Record am submitting records from my pharmacy PBM pharmacy benefit manager or similar entity showing was prescribed Vioxx and the amount of my unreimbursed out of pocket costs in buying Vioxx Upload Documents Supporting documents can also be submitted via mail Click Here more information You also have the option to upload documents at this time but it is not required To upload documents press the Upload Documents button You will need to select the document on your computer and select Upload Supporting documents can also be submitted by mail Select the Click Here hyperlink for more information on mailing documents Upload Document Click the Browse button to navigate to the file location on your local network You can upload any file that is an Excel Adobe PDF or JPEG file Upload Document Post Withdrawal Medica
23. reimbursement for out of pocket expenses for purchases of Vioxx In order to make an Option 1 claim your client must provide one or more of the following forms of proof Receipts Pharmacy Records Insurer Explanation of Benefits Canceled Checks Credit Card Statements 12 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT VIOXX SM D Crams AOMINISTRATOR 2 Option 2 provides a one time payment of up to 50 if your client can provide proof of a Vioxx prescription or if your client signs a declaration swearing under penalty of perjury that he or she bought and paid for Vioxx before October 1 2004 Your client must provide one of the following forms of proof Medical Records Doctor s Letter Prescription Bottle Sworn Statement Step 2 Claim Details Step 3 Confirmation 1 Claim Payment Option Select One Option 1 provides reimbursement for out of pocket Option 2 provides a one time payment of up to 550 if expenses for purchases of Vioxx In order to make an you can provide proof of a Vioxx prescription or if you Option 1 claim you must provide one or more of the sign a declaration swearing under penalty of prejury following forms of proof that you bought and paid for Vioxx before October 1 2004 You must provide one of the following forms of proof Receipts Medical Records Doctor s Letter Prescription Bottle Sworn Statement Pharmacy Records Insurer Explanation of Benefits Cance
24. ructions in the confirmation email to gain access to the portal b Search For and Manage Users Select Specific Search or Search All to search for the user whose information you need to change You must enter a minimum of the first three characters for the Last Name you need to locate Search All will provide a complete list of your users All matches will appear in the Search Results table Click the Edit hyperlink to make changes to the selected user s information 22 9 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT de MDL 1657 Ie D LAMS AOMINISTRATOR Search O Specific Search Search All BL New User Page 1 of 1 1 records User ID Status Login ID Name Email Phone Number Smith John jsmith samplelaw com 555 555 5555 Edit Make any needed changes and click the Update button to save your changes Once the system has updated the information you will see a message on the Firm User Access screen that states that the data was saved successfully To remove access for a selected user uncheck the Active checkbox and click the Update button H Establish New Claimant As noted previously you can establish a claimant either through the Claimant Search feature or through the direct Establish New Claimant feature To do the latter click the Establish New Claimant button to add a new Claimant to your Portal Provide the requested information and click Establish Claimant 23
25. ton next to the user s name on the user list make the desired changes and click the Update button To remove a user s access to this portal uncheck the Active box and click the Update button Search Specific Search O Search All Add New User LastName You will see the screen below 21 2014 BrownGreer PLC 436391 03 10 2014 CONSUMER SETTLEMENT P VIOXX S 155 ADMINISTRATOR Add User 1 User Information Contact Phone ___ 2 Select a Login ID and Password Use 6 16 characters with no spaces Password Capitalization matters Use 6 16 characters no spaces Must contain at least 1 numeric character and 1 alphabet character Confirm Password Confirm Email Can function as Law Firm Administrator E Fill in the blanks with the required information on the new user Choose a Login ID for the new user and click the Verify button to confirm that the Login ID is available If the Login ID is not available select another Login ID and provide a password that is between 6 16 characters in length and contains at least one number and one letter Once you have provided the required information click the Add button to add the new user Once the system has added the information you will see a message on the Firm User Access screen that states that the registration was successful The new user will receive a confirmation email The new user must follow the inst
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