- A. Miner
1. Coal Mine; Coal Mine Dust
2. Status/Function/Situs & Situs/Function Tests
- a. Status of the Coal
- b. Function Test
- c. Situs Test
3. Construction/Transportation Workers
4. General Case Listings For Covered and Not Covered Coal Mine
Employment
[listed in Circuit order]
- a. Cases: Covered Coal Mine Employment
- b. Cases: Not Covered Coal Mine Employment
- B. Survivors/Dependents
[Digest Headings: Widow-Subsequent Remarriage; SSA Benefits As Miner's Property; Impact
of State Law; Conveyance of a Home; Disabled Child]
- C. Pneumoconiosis
[Digest Headings: Anthracosis in Lymph Nodes]
- D. Total Disability
[Digest Headings: Establishing Total Disability Under the Act; Age as a Cause of
Disability]
- E. Length of Coal Mine Employment
- F. Usual Coal Mine Work
[Digest Headings: Voluntary Overtime]
- G. Comparable and Gainful Work
- H. Responsible Operator
[Digest Headings: Changing Form of Business Entity; Withdrawal of Controversion;
Federal Government as Operator; Notice to Carrier; Identifying the Responsible Operator]
PART II PROCEDURAL ISSUES
- A. Requirement to File State Workers'
Compensation Claim; Offset
[Digest Headings: Section 725.535(b); Validity]
- B. Consequences of Filing a Part B Claim
[Digest Headings: Converting Part B Claims to Part C; Prior Findings of Entitlement]
- C. Payment of Benefits
- 1. Generally; Assessment of Interest On Past Due Benefit
Installments.
- 2. Under the 1981 Amendments to the Act
[Digest Headings: Trust Fund Liability]
- 3. Overpayments
- a. Erroneous Information
b. Income and Expenses
- c. Defeat the Purpose of the Act
- d. Changed Position for the Worse
- e. Miscellaneous
- D. Applicable Law
[Digest Headings: Application of Current Law By Appellate Tribunal]
- E. Viability of Claims
- 1. Abandonment
[Digest Headings: Distinguishing Sections 725.409 and 725.410]
- 2. Merger of Claims/Duplicate Claims
- a. Tenth Circuit's Duplicate Claim Approach
- b. Material Change of Conditions
- 1). Seventh Circuit
- c. Merging Duplicate Claims
- d. Duplicate Survivor's Claims
- F. Modifications
- 1. Generally
- 2. Procedural issues
- 3. Mistake of fact/change in conditions
- G. Commencement of Benefits
- 1. Onset of Total Disability Due to Pneumoconiosis
- a. Section 727.302; Validity
- b. Generally
- 2. The Effect of Continued Employment
- H. Scope of Review
- 1. Generally; Timeliness
- a. Thirty Day Notice; Section 725.458
- 2. Administrative Procedure Act
- 3. Law of the Case
- 4. Issues on Appeal
- a. Board's Authority
- b. Jurisdiction
[Digest Headings: Jurisdiction on Interest Cases]
- I. Policies in General
- 1. Settlements and Releases
PART III ADMINISTRATIVE PROCESSING OF CLAIMS
- A. The Claims Process
- 1. Filing of Claims/Appeals, Service, Sufficiency of Pleadings
[Digest Headings: Actual Knowledge of Service; Sufficiency of Pleadings
(Cross-appeals); Timely Filing of Appeals; Interlocutory Appeals; Validity of Section
802.206(e)]
- 2. The District Director's Role and Representative
[Digest Headings: Deference to the Director in Interpreting Regulations; Relationship
Between District Director and the Director; Validity of DOL Denial Letter]
- 3. Claimants' Rights [Including Criteria for Ordering a
Physical Examination]
- B. Full and Fair Hearing
- 1. Right to a Hearing; Waiver
- 2. Due Process
- 3. Right to Counsel
- a. Role of Government Attorney
[Digest Headings: Absence of Counsel; Acts of Counsel Binding on Party]
- 4. Admission of Evidence
- C. Evaluation and Weighing of Evidence
- 1. Elements of Entitlement
- a. Generally; Interpretation of Medical Data
- b. Disability
[Digest Headings: Date at Which Disability is Judged; Inferring Total Disability]
- c. Existence of Pneumoconiosis
- d. Cause of Disability and Pneumoconiosis
[Digest Headings: Concurrent Causes of Disability; Silent Evidence]
- 2. Specific Evidentiary Principles
- a. Blevins Test for Admissibility
- b. Later Evidence
- c. True Doubt Rule
- d. Adverse Inferences
-
- 3. Medical Reports
- a. Physicians: Qualifications/Treating/Non-Examining
- b. Hostility
-
- 4. Miscellaneous
- a. Lay Testimony
- b. X-Rays, Readers, Quality Standards
[Digest Headings: Distinguishing "B" Readers; Section 413(b) Prohibition]
- c. Autopsy and Biopsy Evidence, Quality Standards
- d. Ventilatory and Blood Gas Studies, Quality Standards
- e. Vocational Experts and Evidence
- f. Contraindication of Continued Employment
PART
IV ESTABLISHING ENTITLEMENT UNDER 20 C.F.R. PART 718
- A. In General
- 1. Applicability
- 2. Validity
- 3. Quality Standards
- B. Existence of Pneumoconiosis
- 1. Section 718.202(a)(1): X-ray Evidence
- 2. Section 718.202(a)(2): Biopsy or Autopsy Evidence
- 3. Section 718.202(a)(3): Presumptions
[NOTE: for digests and discussion of Sections 718.304, 718.305 and 718.306 please refer
to Parts V and VII of this outline]
- 4. Section 718.202(a)(4): Medical Reports
- C. Pneumoconiosis Arising Out of Coal Mine Employment
- D. Total Disability: Section 718.204
- 1. Generally
- 2. Section 718.204(c)(1)
- 3. Section 718.204(c)(2)
- 4. Section 718.204(c)(3)
- 5. Section 718.204(c)(4)
- 6. Section 718.204(c)(5)
- E. Cause of Disability: Section 718.204(b)
- F. Survivors' Claims Without Benefit of a Presumption: Section
718.205
[NOTE: for digests and discussion of Section 718.303, please refer to Part VII of this
outline]
PART V STATUTORY PRESUMPTIONS IN
MINERS' CLAIMS
- A. Section 411(c)(1)
- B. Section 411(c)(3)
- C. Section 411(c)(4)
PART VI REGULATORY PRESUMPTIONS
- A. 20 C.F.R. §727.203 Interim Presumption
- 1. Section 727.203(a)(1)
- 2. Section 727.203(a)(2)
- 3. Section 727.203(a)(3)
- 4. Section 727.203(a)(4)
- 5. Section 727.203(a)(5)
- B. Rebuttal of the Interim Presumption
- 1. Section 727.203(b)(1), (b)(2)
- a. Total disability is without regard to cause
- b. Rebuttal can not be established on the basis of no impairment
- c. Total disability from a respiratory standpoint
- d. Comparable and Gainful Work
- 2. Section 727.203(b)(3)
- a. Third Circuit
- b. Fourth Circuit
- c. Sixth Circuit
- d. Seventh Circuit
- e. Eighth Circuit
- f. Ninth Circuit
- g. Tenth Circuit
- h. Eleventh Circuit
- 3. Section 727.203(b)(4)
- C. 20 C.F.R. §410.490 Interim Presumption
[Claims Filed Prior to March 31, 1980]
- 1. Miners with Ten or More Years of Coal Mine Employment
- 2. Miners with Less than Ten Years of Coal Mine Employment
PART VII SURVIVORS' CLAIMS
- A. Derivative Entitlement
- B. Section 411(c)(1)
- C. Section 411(c)(2)
- D. Section 411(c)(3)
- E. Section 411(c)(4)
- F. Section 411(c)(5)
PART VIII ATTORNEY FEES
- A. Board Review of Attorney Fee Awards Made Below
- 1. General Overview
- 2. Successful Prosecution of the Claim
- 3. Jurisdiction
- 4. Issues on Appeal of Attorney Fee Awards
- a. Opposition to Attorney Fees
- b. Counsel's Appeal of Substantial Reductions in the Requested
Fee
- 1). The Hourly Rate
-
- 5. Liability for Attorney Fees
-
- 6. Miscellaneous Issues
-
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