Except as otherwise provided in section 924 of
this title, no payment of benefits shall be made under this part
except pursuant to a claim filed therefor on or before December
31, 1973, in such manner, in such form, and containing such
information, as the Secretary shall by regulation prescribe.
(b) Utilization of personnel and procedures; evidence
required to establish claim; medical evidence; affidavits;
autopsy reports; reimbursement of expenses
In carrying out the provisions of this part, the Secretary
shall to the maximum extent feasible (and consistent with the
provisions of this part) utilize the personnel and procedures he
uses in determining entitlement to disability insurance benefit
payments under section 223 of the Social Security Act (42 U.S.C.
423), but no claim for benefits under this part shall be denied
solely on the basis of the results of a chest roentgenogram. In
determining the validity of claims under this part, all relevant
evidence shall be considered, including, where relevant, medical
tests such as blood gas studies, X-ray examination,
electrocardiogram, pulmonary function studies, or physical
performance tests, and any medical history, evidence submitted by
the claimant's physician, or his wife's affidavits, and in the
case of a deceased miner, other appropriate affidavits of persons
with knowledge of the miner's physical condition, and other
supportive materials. Where there is no medical or other relevant
evidence in the case of a deceased miner, such affidavits, from
persons not eligible for benefits in such case with respect to
claims filed on or after the effective date of the Black Lung
Benefits Amendments of 1981, shall be considered to be sufficient
to establish that the miner was totally disabled due to
pneumoconiosis or that his or her death was due to
pneumoconiosis. In any case, other than that involving a claim
filed on or after the effective date of the Black Lung Benefits
Amendments of 1981, in which there is other evidence that a miner
has a pulmonary or respiratory impairment, the Secretary shall
accept a board certified or board eligible radiologist's
interpretation of a chest roentgenogram which is of a quality
sufficient to demonstrate the presence of pneumoconiosis
submitted in support of a claim for benefits under this
subchapter if such roentgenogram has been taken by a radiologist
or qualified technician, except where the Secretary has reason to
believe that the claim has been fraudulently represented. In
order to insure that any such roentgenogram is of adequate
quality to demonstrate the presence of pneumoconiosis, and in
order to provide for uniform quality in the roentgenograms, the
Secretary of Labor may, by regulation, establish specific
requirements for the techniques used to take roentgenograms of
the chest. Unless the Secretary has good cause to believe that an
autopsy report is not accurate, or that the condition of the
miner is being fraudulently misrepresented, the Secretary shall
accept such autopsy report concerning the presence of
pneumoconiosis and the stage of advancement of pneumoconiosis.
Claimants under this part shall be reimbursed for reasonable
medical expenses incurred by them in establishing their claims.
For purposes of determining total disability under this part, the
provisions of subsections (a), (b), (c), (d), and (g) of section
221 of such Act (42 U.S.C. 421(a) to (d), (g)) shall be
applicable. The provisions of sections 204, 205(a), (b), (d),
(e),
(g), (h), (j), (k), (l), and (n), 206, 207, and 208 of the
Social Security Act (42 U.S.C. 404, 405(a), (b), (d), (e), (g),
(h), (j),
(k), (l), and (n), 406, 407, 408) shall be applicable under
this part with respect to a miner, widow, child, parent, brother,
sister, or dependent, as if benefits under this part were
benefits under title II of such Act (42 U.S.C. 401 et seq.). Each
miner who files a claim for benefits under this subchapter shall
upon request be provided an opportunity to substantiate his or
her claim by means of a complete pulmonary evaluation.
(c) Filing of claim for workmen's compensation; necessity;
exceptions
No claim for benefits under this section shall be considered
unless the claimant has also filed a claim under the applicable
State workmen's compensation law prior to or at the same time his
claim was filed for benefits under this section; except that the
foregoing provisions of this paragraph shall not apply in any
case in which the filing of a claim under such law would clearly
be futile because the period within which such a claim may be
filed thereunder has expired or because pneumoconiosis is not
compensable under such law, or in any other situation in which,
in the opinion of the Secretary, the filing of a claim would
clearly be futile.
(d) Employment termination and benefits entitlement
No miner who is engaged in coal mine employment shall (except
as provided in section 921(c)(3)
of this title) be entitled to any benefits under this part while
so employed. Any miner who has been determined to be eligible for
benefits pursuant to a claim filed while such miner was engaged
in coal mine employment shall be entitled to such benefits if his
or her employment terminates within one year after the date such
determination becomes final.