1. 1 Copyright 2005 Medical Risk Appraisal and Life Expectancy Program Illustration Illustrating a Basic Approach to Life Expectancy in Medically Impaired People Anthony F. Milano, M.D., M.P.H. July 4, 2005 AMDG

2. 2 Copyright 2005 CONTENTSSLIDES Communicating with Dr. Milano3 Life Expectancy Program Overview4 PrefaceDisclaimer5, 6 Acknowledgements7 Life Expectancy Procedures & Methods for Preparing Reports8 Hypothetical Example: Male at Attained Age 66 Years8 Caveats: The Impact of Comorbidity on Life Expectancy9 Observed Male Life Expectancy at Attained Age 66-Years10 Expected (Normal) Male Life Expectancy at Attained Age 66 years11 Graph of Comparative Life Expectancy12 Report Conclusion12 Life Expectancy Table: Column Designations13 Glossary and Life Table Descriptive Summary13, 14 References15, 16 Adapted from: U.S. Decennial Life Tables for 1989-1991 1, Richard B. Singer, M.D 2,3,4 Terry W. Anderson, MD, PhD 5 and the American Academy of Insurance Medicine (AAIM). 9

3. 3 ANTHONY F. MILANO, MD, MA, MPH Milano Life Expectancy Services, Inc. Consultant Medical Risk Appraisal & Life Expectancy Phone: (508) 362-3695 P.O. Box 127 amilanomd@comcast.net Fax: (508) 362-3695Cummaquid, MA, 02637 www.LifeExpectancyAmerica.com Colonel, USAF, MC, FS, Retired Copyright 2005

4. 4 Life Expectancy Program Overview Copyright 2005

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14. 14 References 1. U.S. Department of Health and Human Services, National Center for Health Statistics.U.S. Decennial Life Tables for 1989-91. Volume 1, Number 1.Hyattsville, Maryland (1997). (DHHS Publication No. PHS-98-1150-1). 2. Singer RB. A method of Relating Life Expectancy in the U.S. Population Life Tables to Excess Mortality. J Ins Med 1992; 24:32-41. 3. Singer RB. The Impact of Excess Mortality on Life Expectancy - Tables Based on Levels of EDR (Excess Death Rate) and Rates in the U.S. Decennial Life Tables for 1989-91 (White Population). J Ins Med 1998; 30(3): 128-146. 4. Singer RB, Kita MW, and Avery JA.A Descriptive Index of Mortality Studies from Selected Sources 1951-1995 with Supplement Index to 2000.Westwood, Massachusetts, CMAS Books (2001). 5. Anderson TW.Life Expectancy in Court–A Textbook for Doctors and Lawyers. Vancouver, British Columbia, Canada, Teviot Press (2002). 6.Schmidt C and Singer RB. Structured Settlement Annuities Part I: Overview and the Underwriting Process. J Ins Med 2000;32: 131-136 7. Singer RB and Schmidt C. Structured Settlement Annuities Part II: Mortality Experience 1967-1995 and the Estimation of Life Expectancy. J Ins Med 2000: 32: 137-154. 8. Strauss DJ and Shavelle RM. Life Expectancy of Persons with Chronic Disabilities. J Ins Med 1998; 30: 96-108. 9. Singer RB, Kita MW and Avery JR.Medical Risks, 1991 Compend of Mortality and Morbidity. Praeger, Westport, Conn., 1991: Chapter 2: Pokorsky RJ. Mortality Methodology and Analysis Seminar; 4-36. 10.SEER*Stat Program: Cancer Statistics Branch, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute suite 504, MSC8316, 6116 Executive Boulevard, Bethesda, MD 20892-8316 11. Jay F. Piccirillo, MD, FACS. The Impact of Comorbidity on Cancer Statistics: MS PowerPoint Address to the St. Louis Surgical Society November 6, 2001. Washington University School of Medicine, St. Louis, Missouri. Research Supported by National Cancer Institute Grant Number: R25 CA 68304. Copyright 2005

15. 15 References continued 12. Kaplan MH, Feinstein AR. The Importance of Classifying Initial Co-morbidity in Evaluating the Outcome of Diabetes Mellitus. J. Chron Dis 1974; 27: 387-404. 13. Egede LE, Nietert PJ, Zheng D. Depression and All-Cause and Coronary Heart Disease Mortality Among Adults With and Without Diabetes. Diabetes Care 2005 (June); 28: 1339-1345. Copyright 2005