17.307: Coal Mine Workers' Compensation


Popular Name: Black Lung

Objectives: To provide benefits to coal miners who have become totally disabled due to coal workers' pneumoconiosis (CWP), and to widows and other surviving dependents of miners who have died of this disease.


MAIN TOPICS:


17.307 ELIGIBILITY REQUIREMENTS:

Applicant Eligibility: The miner (including some workers involved in coal transportation in and around mines and coal mine construction workers) must have worked in the Nation's coal mines or a coal preparation facility and become "totally disabled" (as defined in the Act) from coal workers' pneumoconiosis. The applicant may be able to work in areas other than coal mines and still be eligible for benefits. Benefits to miner shall be reduced on account of excess earnings as determined under sections 203(b) through (1) of the Social Security Act for claims filed on or after January 1, 1982. Widows and other surviving dependents of coal miners whose death resulted from coal workers' pneumoconiosis are also eligible for benefits with earnings offsets applicable to certain classes of dependents. Applicants can reside anywhere in the world at the time they apply.

Beneficiary Eligibility: Disabled coal miners, widows and other surviving dependents of the deceased.

Credentials/Documentation: Medical tests, at Department of Labor expense, which include an x-ray, pulmonary function study, physical examination, and blood gas tests. Proof of work in or around a coal mine or coal preparation facility. Also proof of death, relationship and dependency required for widows and other survivors applying. Identification of a responsible mine operator is made as specified in regulations published in the Code of Federal Regulations (20 CFR 725).

17.307 APPLICATION & AWARD PROCESS:

Preapplication Coordination: Applicants are required to state on the claim form whether a claim for disability benefits due to the same condition has been filed under any State or other Federal workers' compensation law. Benefits received as a result of such a claim could be offset against Federal benefits.

Application Procedure: Phone, write-in, or visit the local Social Security Administration or local Division of Coal Mine Workers' Compensation district or local office listed in Appendix IV of the Catalog.

Award Procedure: After review of the application is completed, the applicant will be notified by mail.

Deadlines: A miner must file a claim for benefits within 3 years after a medical determination of total disability due to coal workers' pneumoconiosis or within 3 years after the date of enactment of Public Law 95-239, whichever comes later, (Black Lung Benefits Reform Act of 1977). There are no time limitations for dependent survivors to file claims.

Range of Approval/Disapproval Time: From 2 months to 8 months for initial findings depending on availability of supporting evidence.

Appeals: Notify Office of Workers' Compensation Programs (OWCP), Employment Standards Administration. The appeal process includes informal conferences, formal hearings, Benefits Review Board consideration, and review by Federal courts, as appropriate.

Renewals: Not applicable.

Criteria for Selecting Proposals: Not applicable.

Examples of Funded Projects: Not applicable.

Range & Average of Financial Assistance: Basic monthly rate: $435.10 (claimant only). For three or more dependents, $870.20 maximum effective January 1996 (this does not include medical services). Average monthly benefits check paid $500.79 for January 1996.

17.307 RELATED PROGRAMS: None.

17.307 PROGRAM ACCOMPLISHMENTS: In fiscal year 1995, 8,263 black lung claims were processed to initial findings and $517,147,000 in benefits were paid to about 86,524 claimants. In fiscal year 1996, it is anticipated that 6,500 claims will be processed to initial findings and $496,169,000 in benefits will be paid to 81,500 claimants. Projected data for fiscal year 1997 are 5,800 claims processed to initial findings and an estimated $496,665,000 in benefits to be paid to 77,000 claimants.

17.307 FINANCIAL & ADMINISTRATIVE INFO:

Federal Agency: OFFICE OF WORKERS' COMPENSATION PROGRAMS, EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR

Type of Assistance: Direct Payments with Unrestricted Use.

Obligations: (Benefits) FY 95 $517,147,000; FY 96 est $505,494,000; and FY 97 est $496,665,000.

Budget Account Number: 20-8144-0-7-601.

Authorization: Federal Mine Safety and Health Amendments Act of 1977, as amended, Public Laws 91-173, 92-303, 95-239, and 97-119.

Regulations, Guidelines, & Literature: Code of Federal Regulations, Title 20, Parts 410.401 et seq., 718, 722, 725, 726, and 727. Also, Black Lung Amendments of 1981, 30 U.S.C. 901 et seq. "Black Lung Benefits," Fact Sheet No. ESA 91-14.

17.307 INFO CONTACTS:

Regional or Local Office: Local Social Security Administration and local Division of Coal Mine Workers' Compensation district offices are listed in Appendix IV of the Catalog.

Headquarters Office: Division of Coal Mine Workers' Compensation, Office of Workers' Compensation Programs, Employment Standards Administration, Department of Labor, Washington, DC 20210. Phone: (202) 219-6692. Contact: James L. DeMarce, Director.

17.307 ASSISTANCE CONSIDERATIONS:

Formula & Matching Requirements: Not applicable.

Length & Time Phasing of Assistance: The period of total disability with no monetary limit. Death: Spouse - until death or remarriage; children - until age 18 or to age 23 if qualified as a student as defined by the Act unless under a disability as defined in Section 223(d) of the Social Security Act, 42 U.S.C. 423(d). Employers or their insurance carriers are required to begin compensation within 30 days of the initial determination of eligibility. Payments are disbursed on a monthly basis.

Uses & Use Restrictions: Monthly cash benefits are paid to coal miners disabled from coal workers' pneumoconiosis and to widows and other survivors of miners who have died of this disease. There are no restrictions on the use of these benefits by a beneficiary. Medical payments for treatment related to coal workers' pneumoconiosis are available to miners only after January 1, 1974.

17.307 POST ASSISTANCE REQUIREMENTS:

Reports: Any change in an eligibility requirement or in a factor affecting the amount of benefits, such as, State workers' compensation awards, or change in status of a dependent, must be reported to the Office of Workers' Compensation Programs when it occurs.

Audits: None.

Records: None.


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