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May 10, 2009   
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CFR  

Code of Federal Regulations Pertaining to U.S. Department of Labor

Title 20  

Employees' Benefits

 

Chapter VI  

Employment Standards Administration, Department of Labor

 

 

Part 725  

Claims for Benefits Under Part C of Title IV of the Federal Mine Safety and Health Act, As Amended

 

 

 

Subpart E  

Adjudication of Claims by the District Director


20 CFR 725.410 - Submission of additional evidence.

  • Section Number: 725.410
  • Section Name: Submission of additional evidence.

    (a) After the district director completes the development of 
medical evidence under Sec. 725.405 of this part, including the 
complete pulmonary evaluation authorized by Sec. 725.406, and receives 
the responses and evidence submitted pursuant to Sec. 725.408, he shall 
issue a schedule for the submission of additional evidence. The 
schedule shall contain the following information:
    (1) If the claim was filed by, or on behalf of, a miner, the 
schedule shall contain a summary of the complete pulmonary evaluation 
administered pursuant to Sec. 725.406. If the claim was filed by, or on 
behalf of, a survivor, the schedule shall contain a summary of any 
medical evidence developed by the district director pursuant to 
Sec. 725.405(c).
    (2) The schedule shall contain the district director's preliminary 
analysis of the medical evidence. If the district director believes 
that the evidence fails to establish any necessary element of 
entitlement, he shall inform the claimant of the element of entitlement 
not established and the reasons for his conclusions and advise the 
claimant that, unless he submits additional evidence, the district 
director will issue a proposed decision and order denying the claim.
    (3) The schedule shall contain the district director's designation 
of a responsible operator liable for the payment of benefits. In the 
event that the district director has designated as the responsible 
operator an employer other than the employer who last employed the 
claimant as a miner, the district director shall include, with the 
schedule, a copy of the statements required by Sec. 725.495(d) of this 
part. The district director may, in his discretion, dismiss as parties 
any of the operators notified of their potential liability pursuant to 
Sec. 725.407. If the district director thereafter determines that the 
participation of a party dismissed pursuant to this section is 
required, he may once again notify the operator in accordance with 
Sec. 725.407(d).
    (4) The schedule shall notify the claimant and the designated 
responsible operator that they have the right to obtain further 
adjudication of the claim in accordance with this subpart, and that 
they have the right to submit additional evidence in accordance with 
this subpart. The schedule shall also notify the claimant that he has 
the right to obtain representation, under the terms set forth in 
subpart D, in order to assist him. In a case in which the district 
director has designated a responsible operator pursuant to paragraph 
(a)(3), the schedule shall further notify the claimant that if the 
operator fails to accept the claimant's entitlement to benefits within 
the time limit provided by Sec. 725.412, the cost of obtaining 
additional medical and other necessary evidence, along with a 
reasonable attorney's fee, shall be reimbursed by the responsible 
operator in the event that the claimant establishes his entitlement to 
benefits payable by that operator. In a case in which there is no 
operator liable for the payment of benefits, the schedule shall notify 
the claimant that the cost of obtaining additional medical and other 
necessary evidence, along with a reasonable attorney's fee, shall be 
reimbursed by the fund.
    (b) The schedule shall allow all parties not less than 60 days 
within which to submit additional evidence, including evidence relevant 
to the claimant's eligibility for benefits and evidence relevant to the 
liability of the designated responsible operator, and shall provide not 
less than an additional 30 days within which the parties may respond to 
evidence submitted by other parties. Any such evidence must meet the 
requirements set forth in Sec. 725.414 in order to be admitted into the 
record.
    (c) The district director shall serve a copy of the schedule, 
together with a copy of all of the evidence developed, on the claimant, 
the designated responsible operator, and all other operators which 
received notification pursuant to Sec. 725.407. The schedule shall be 
served on each party by certified mail.
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