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October 22, 2008    DOL Home > ESA > OWCP > DCMWC > Black Lung Benefits: Miner's Claim   

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Division of Coal Mine Workers' Compensation (DCMWC)

Guide to Filing for Black Lung Benefits: Miner's Claim

The Black Lung Benefits Act provides monthly benefits to coal miners who are totally disabled by black lung disease caused by working in the coal mining industry.  “Totally disabled” means you are unable to perform the work you did as a coal miner because breathing coal mine dust has permanently impaired your ability to breathe normally.  You may also receive additional benefits for family members who are dependent on you and for the cost of your own medical treatment.  A coal mining company which employed you (usually the last company that employed you for a year or more) may be required to pay your benefits if it meets certain requirements under the law.  Otherwise, the Black Lung Disability Trust Fund will pay your benefits.

The first step in the process of applying for Black Lung benefits is to complete an application form.  You will be asked to provide important basic information about yourself and your family.  The form is called the “Miner’s Claim for Benefits Under the Black Lung Act” (Form CM-911).  You will also complete an “Employment History” (Form CM-911a).  This form requests information about your work as a miner, the number of years you worked, the names of the coal companies which employed you, and your work outside the coal mining industry.  We need this information to determine whether you were a coal miner and whether a specific coal mining company will pay your benefits.  A representative from the U. S. Department of Labor’s Division of Coal Mine Workers’ Compensation or the Social Security Administration can assist you in completing the application forms.   You may also file the forms by mail.

Based on the information in your benefits application and Employment History form, we may ask you to provide additional information, including additional forms and copies of official documents.  This information may include copies of marriage certificates, children’s birth certificates, death certificates, proof of enrollment in schools for dependent children, etc.  This information is necessary to establish basic facts about your entitlement to benefits or the entitlement of members of your family.

We will need proof of your coal mine employment.  We will usually ask for a detailed earnings record from the Social Security Administration, but any proof of your employment that you may have will be helpful.  Such proof could include W-2 forms, tax records, and letters from employers, among others.

After we have begun processing your benefits application, we will contact you to schedule a complete pulmonary evaluation.  A “pulmonary evaluation” is a medical examination to determine whether you are totally disabled by black lung disease.  The Department of Labor is required by law to offer you a free examination to prove that you may be entitled to black lung benefits.  We will provide you with a list of physicians who can perform this examination.  All of these physicians will be located in your state or a bordering state.  You will be asked to select a physician you wish to use, within certain limitations.  The examination consists of:

  • a physical examination by a physician;
  • a chest X-ray;
  • a pulmonary function test; and
  • an arterial blood gas test (unless medically contraindicated).

Additional information about choosing a physician and the pulmonary examination will be sent to you by the District Office.  Please review this information carefully.  If you refuse to be examined, your claim may be denied without any further consideration of your entitlement to benefits.  You also have the right to have the results of this examination sent to your personal physician.

After we receive the results of your pulmonary examination, we will conduct a preliminary review of those results and determine whether they support an award or a denial of your claim. This review is not final.  You will receive a letter explaining the results of the examination and the reasons for our opinion about your entitlement.  This letter is called the “Schedule for the Submission of Additional Evidence.”  The “Schedule” will inform you about your opportunity to submit additional evidence, your right to obtain medical evidence from a physician of your own choosing, and the time limits for submitting evidence.  If we find that a coal company is liable for your claim, that company has the right to have you examined by a physician of its choice.  If you refuse to be examined, your claim may be denied without any further consideration of your entitlement to benefits.

The most important part of applying for Black Lung benefits is obtaining medical evidence about your physical condition.   The Black Lung benefits program has limitations on the amount of medical evidence which you and the coal company may give us for determining whether you are entitled to benefits. We encourage you to get advice from an attorney or other qualified representative before submitting any additional medical evidence to the Department of Labor.  Ordinarily, attorney’s fees which must be paid if your claim is approved will be paid by the coal company liable for your claim or the Black Lung Disability Trust Fund.  We will explain to you the situations in which you may be liable for payment of the attorney’s fees.  You are not liable for any attorney’s fees if your claim is denied.

When we have received all of the evidence in your claim, we will decide whether your claim must be approved or denied.  In some cases, we may ask you to attend an “informal conference” to discuss your claim before we make this decision.  If we decide that an informal conference is necessary, we will inform you of your rights and obligations in writing when we schedule the conference.  After we have reviewed your claim and all of the evidence (and the results of the conference if one is held), we will issue a “Proposed Decision and Order.”  This decision will approve or deny your claim and explain the reasons for our decision.  We will also inform you (and the coal company if one is liable for your claim) of the options for challenging our decision and the time limits for taking any further action.  These options include asking the Department to reconsider its decision or asking for a hearing before an administrative law judge.

If you have any questions about the benefits application process, we are available to give you answers.  You should contact the district office that has jurisdiction of your state of residence.  The list of district offices and their toll-free numbers may be found here: http://www.dol.gov/esa/owcp/dcmwc/blcontac.htm.

 



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