(a) A miner who is determined to be eligible for benefits under
this part or part 727 of this subchapter (see Sec. 725.4(d)) is
entitled to medical benefits as set forth in this subpart as of the
date of his or her claim, but in no event before January 1, 1974. No
medical benefits shall be provided to the survivor or dependent of a
miner under this part.
(b) A responsible operator, other employer, or where there is
neither, the fund, shall furnish a miner entitled to benefits under
this part with such
medical, surgical, and other attendance and treatment, nursing and
hospital services, medicine and apparatus, and any other medical
service or supply, for such periods as the nature of the miner's
pneumoconiosis and disability requires.
(c) The medical benefits referred to in paragraphs (a) and (b) of
this section shall include palliative measures useful only to prevent
pain or discomfort associated with the miner's pneumoconiosis or
attendant disability.
(d) The costs recoverable under this subpart shall include the
reasonable cost of travel necessary for medical treatment (to be
determined in accordance with prevailing United States government
mileage rates) and the reasonable documented cost to the miner or
medical provider incurred in communicating with the employer, carrier,
or district director on matters connected with medical benefits.
(e) If a miner receives a medical service or supply, as described
in this section, for any pulmonary disorder, there shall be a
rebuttable presumption that the disorder is caused or aggravated by the
miner's pneumoconiosis. The party liable for the payment of benefits
may rebut the presumption by producing credible evidence that the
medical service or supply provided was for a pulmonary disorder apart
from those previously associated with the miner's disability, or was
beyond that necessary to effectively treat a covered disorder, or was
not for a pulmonary disorder at all.
(f) Evidence that the miner does not have pneumoconiosis or is not
totally disabled by pneumoconiosis arising out of coal mine employment
is insufficient to defeat a request for coverage of any medical service
or supply under this subpart. In determining whether the treatment is
compensable, the opinion of the miner's treating physician may be
entitled to controlling weight pursuant to Sec. 718.104(d). A finding
that a medical service or supply is not covered under this subpart
shall not otherwise affect the miner's entitlement to benefits.
