(a) The Act requires the Department to provide each miner who
applies for benefits with the opportunity to undergo a complete
pulmonary evaluation at no expense to the miner. A complete pulmonary
evaluation includes a report of physical examination, a pulmonary
function study, a chest roentgenogram and, unless medically
contraindicated, a blood gas study.
(b) As soon as possible after a miner files an application for
benefits, the district director will provide the miner with a list of
medical facilities and physicians in the state of the miner's residence
and states contiguous to the state of the miner's residence that the
Office has authorized to perform complete pulmonary evaluations. The
miner shall select one of the facilities or physicians on the list,
provided that the miner may not select any physician to whom the miner
or the miner's spouse is related to the fourth degree of consanguinity,
and the miner may not select any physician who has examined or provided
medical treatment to the miner within the twelve months preceding the
date of the miner's application. The district director will make
arrangements for the miner to be given a complete pulmonary evaluation
by that facility or physician. The results of the complete pulmonary
evaluation shall not be counted as evidence submitted by the miner
under Sec. 725.414.
(c) If any medical examination or test conducted under paragraph
(a) of this section is not administered or reported in substantial
compliance with the provisions of part 718 of this subchapter, or does
not provide sufficient information to allow the district director to
decide whether the miner is eligible for benefits, the district
director shall schedule the miner for further examination and testing.
Where the deficiencies in the report are the result of a lack of effort
on the part of the miner, the miner will be afforded one additional
opportunity to produce a satisfactory result. In order to determine
whether any medical examination or test was administered and reported
in substantial compliance with the provisions of part 718 of this
subchapter, the district director may have any component of such
examination or test reviewed by a physician selected by the district
director.
(d) After the physician completes the report authorized by
paragraph (a), the district director will inform the miner that he may
elect to have the results of the objective testing sent to his treating
physician for use in preparing a medical opinion. The district director
will also inform the claimant that any medical opinion submitted by his
treating physician will count as one of the two medical opinions that
the miner may submit under Sec. 725.414 of this part.
(e) The cost of any medical examination or test authorized under
this section, including the cost of travel to and from the examination,
shall be paid by the fund. No reimbursement for overnight
accommodations shall be authorized unless the district director
determines that an adequate testing facility is unavailable within one
day's round trip travel by automobile from the miner's residence. The
fund shall be reimbursed for such payments by an operator, if any,
found liable for the payment of benefits to the claimant. If an
operator fails to repay such expenses, with interest, upon request of
the Office, the entire amount may be collected in
an action brought under section 424 of the Act and Sec. 725.603 of this
part.
