Decision Considerations
Disease Protocols - Thromboembolic Disease

An applicant with a history of thromboembolic disease must submit the following if consideration for medical certification is desired:
  1. Hospital admission and discharge summary
  2. Current status report including:
    • Detailed family history of thromboembolic disease
    • Neoplastic workup, if clinically indicated
    • PT/PTT
    • Protein S & C
    • Leiden Factor V
    • If still anticoagulated with warfarin (Coumadin), submit all (no less than monthly) INRs from time of hospital discharge to present

    For applicants who are just beginning warfarin (Coumadin) treatment the following is required:

    • Minimum observation time of 6 weeks after initiation of warfarin therapy;
    • Must also meet any required observation time for the underlying condition; AND
    • 6 INRs, no more frequently than 1 per week