TABLE OF CONTENTS
PART I |
INTRODUCTION |
PART II |
DEFINITIONS |
PART III |
PROCEDURAL ISSUES |
PART IV |
ADMINISTRATIVE PROCESSING OF CLAIMS, POWERS AND DUTIES OF THE
ADMINISTRATIVE LAW JUDGE |
PART V |
BENEFITS REVIEW BOARD POLICIES AND PROCEDURES |
PART VI |
ESTABLISHING ENTITLEMENT UNDER 20 C.F.R. PART 410 |
PART VII |
ESTABLISHING ENTITLEMENT UNDER 20 C.F.R. PART 718 |
PART VIII |
STATUTORY PRESUMPTIONS IN MINERS' CLAIMS |
PART IX |
REGULATORY PRESUMPTIONS |
PART X |
SURVIVORS' CLAIMS |
PART XI |
ATTORNEY FEES |
I. INTRODUCTION
A. General History and
Purposes
B. Structure of the Act; Responsibility
for
Payment of Benefits; Establishment of Black
Lung Disability Trust Fund
C. Structure
and Applicability of the Regulations
D. Constitutionality of the Act and
Regulations
E. Incorporation of the Provisions of
the
Longshore and Harbor Workers' Compensation
Act (LHWCA) into the Act through Section 422
F. Statute of Limitations, Summary of
Prior Law
and Reform Act Changes.
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2. DEFINITIONS
A. Miner
1. General
2. Coal Dust/Coal Mine
Dust
3. Status/Function/Situs & Situs/Function
Tests
a. Status of the Coal
b. Function Test
c. Situs Test
4. Construction/Transportation
Workers
B. Survivors/Dependents
1. Surviving Spouse
2. Dependent or Surviving
Child
C. Coal Mine
D. Pneumoconiosis
E. Total Disability
F. Length of Coal Mine Employment
G. Usual Coal Mine Work
H. Effect of Current Coal Mine Employment or
Coal Mine Employment at Time of Death
I. Comparable and Gainful Work
J. Primary Cause
K. Chronic Disease or Respiratory Impairment
L. Responsible Operator
1. Generally
2. Successor Operator
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III. PROCEDURAL ISSUES
A. Requirement
to File State Workers'
Compensation
Claim; Offset
B. Consequences
of Filing a Part B Claim
1. Medical Benefits Only Claims (MBO)
C. Payment of Benefits
1. Generally; Assessment of Interest On
Past Due Benefit Installments
2.
Under the 1981 Amendments to the Act
a. General Provisions
b. Claim "Denied"
c. Approval under Section 435
d. Procedural Issues Involving Transfer
of Liability
e. Overpayments
D. Parties
E. Applicable
Law
F. Viability of Claims
1. Abandonment
2. Merger of Claims/Duplicate Claims
G. Modifications
H. Commencement of Benefits
1. Date of Onset of Total Disability Due to
Pneumoconiosis
2. The Effect of Continued Employment
3. Survivor's Claims
4. Part B and Transitional Period Claims
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IV. ADMINISTRATIVE PROCESSING OF CLAIMS, POWERS
AND DUTIES OF THE ADMINISTRATIVE LAW JUDGE
A. The
Claims Process
1. Filing of Claims, Withdrawal
2. The District Director's Role
3. Formal Hearing
4.
Procedural Issues at the District Director
or the Hearing Level
a. General Evidentiary Matters
b. Hearing Issues
c. Burden to Produce Evidence
d. Admission of Evidence
(1). Generally; Timely Evidence
(2). Late Evidence
e. Hearsay; Right to Cross-Examination
f. Claimants' Rights (Including Criteria
for Ordering a Physical Examination)
g. Controversion
B. Jurisdiction;
Dismissals
C. Full and Fair Hearing
1. Right to a Hearing; Waiver
2. Conduct of Hearing; Due Process
3. Right to Counsel; Pro Se Status;
Notice to Counsel
D. Evaluation and Weighing of
Evidence
1. General Principles; Burden of Proof
2. Elements
of Entitlement
a. Generally; Interpretation of Medical Data
b. Impairment
c. Disability
d. Existence of Pneumoconiosis
e. Cause of Disability and Pneumoconiosis
3. Specific
Evidentiary Principles
a. Blevins Test for Admissibility
b. Later Evidence
c. True Doubt Rule
d. Adverse Inferences
4. Medical
Reports
a. Documented Opinion
b. Reasoned Opinion
c. Non-Examining Physician
d. Opinions in Conflict with the Spirit of the Act
e. Qualifications of Physicians
f. Treating Physicians
5. Lay Testimony
6. X-Rays,
Readers, Quality Standards
a. Generally
b. Section 413(b)
7. Autopsy and Biopsy Evidence, Quality Standards
8. Ventilatory and Blood Gas Studies, Quality Standards
9. Vocational Experts and Evidence
10. Determinations of State Medical Boards and
Other Governmental Agencies
11. Contraindication of Continued Employment
12. Prejudice of Witnesses
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