Office of Workers' Compensation Programs, Black Lung Automated Support
Package.
Unclassified.
Office of Workers' Compensation Programs, Division of Coal Mine
Workers' Compensation, U.S. Department of Labor Building, 200 Constitution
Ave., NW, Washington, DC 20210, and district offices (see addresses in the
Appendix to this document).
Individuals filing claims for black lung benefits; claimants receiving
benefits; dependents of claimants and beneficiaries; medical providers;
attorneys representing claimants; coal mine operators (workers' compensation
insurance carriers).
Records included are personal (name, date of birth, SSN, claim type,
miner's date of death); demographic (state, county, city, congressional
district, zip code); mine employment history; medical records; initial
determination; conference results; hearing results; medical and disability
payment history; accounting information including data on debts owed to the
United States; Social Security Administration black lung benefits data; state
workers' compensation claim and benefits data; coal mine operator names,
addresses, states of operation and histories of insurance coverage; and medical
service providers names, addresses, license numbers, medical specialties, tax
identifications and payment histories.
30 U.S.C. 901 et seq., 20 CFR 715.1 et seq., 20 CFR 720.1
et seq., 20 CFR 725.1 et seq.
To maintain data on claimants, beneficiaries and their dependents;
attorneys representing claimants; medical service providers; coal mine
operators and insurance carriers. Provide means of automated payment of medical
and disability benefits. Maintain a history of medical bills submitted by
beneficiaries and medical service providers. Maintain a history of disability
benefit payments made to beneficiaries and medical benefit payments made to
beneficiaries and medical service providers. Maintain program accounting
information including information on debts owed to the United States. Provide a
means for the automatic recoupment of overpayments made to beneficiaries and
medical service providers.
In addition to those universal routine uses listed in the General
Prefatory Statement to this document , disclosure of relevant and necessary
information may be made to the following:
a. Mine operators (and/or any party providing the operator with
workers' compensation insurance) who have been determined potentially liable
for the claim at any time after the filing of a notice of injury or claim
related to such injury or occupational illness, for the purpose of determining
liability for payment.
b. State workers' compensation agencies and the Social Security
Administration for the purpose of determining offsets as specified under the
Act.
c. Doctors and medical services providers for the purpose of obtaining
medical evaluations, physical rehabilitation or other services.
d. Other Federal agencies conducting scientific research concerning the
incidence and prevention of black lung disease.
e. Legal representatives, or person authorized to act on behalf of the
claimant, responsible operator and program representation on contested issues.
f. Labor unions and other voluntary employee associations of which the
claimant is a member for the purpose of exercising an interest in claims of
members as part of their service to the members.
g. Contractors providing automated data processing services to the
Department of Labor, or to any agency or entity to whom release is authorized,
where the contractor is providing a service relating to the purpose for which
the information can be released.
h. Federal, state or local agencies if necessary to obtain information
relevant to a Department decision concerning the determination of initial or
continuing eligibility for program benefits, whether benefits have been or are
being paid improperly, including whether dual benefits prohibited under any
federal or state law are being paid; and salary offset and debt collection
procedures, including any action required by the Debt Collection Act of 1982,
31 U.S.C. 3711.
i. Debt collection agency that DOL has contracted for collection
services to recover indebtedness owed to the United States.
j. Internal Revenue Service for the purpose of obtaining taxpayer
mailing addresses in order to locate taxpayers to collect, compromise, or
write-off a Federal claim against the taxpayer; discharging an indebtedness
owed by an individual.
k. Credit Bureaus for the purpose of receiving consumer credit reports
identifying the assets, liabilities, income and expenses of a debtor to
ascertain the debtor's ability to pay a debt and to establish a payment
schedule.
Disclosure of information contained
in the file to the claimant, a person who is duly authorized to act on his/her
behalf, or to others to whom disclosure is authorized by these routine uses,
may be made over the telephone. Disclosure over the telephone will only be done
where the requestor provides appropriate identifying information. Telephonic
disclosure of information is essential to permit efficient administration and
adjudication of claims.
The amount, status and history of overdue debts; the name and address,
taxpayer identification (SSAN), and other information necessary to establish
the identity of a debtor, the agency and program under which the claim arose,
are disclosed pursuant to 5 U.S.C. 552a(b)(12) to consumer reporting agencies
as defined by section 603(f) of the Fair Credit Reporting Act (15 U.S.C.
1681a(f); or in accordance with section 3(d)(4)(A)(ii) of the Federal Claims
Collection Act of 1966 as amended (31 U.S.C. 3711(f) for the purpose of
encouraging the repayment of an overdue debt.
Magnetic media. Medical bills and supporting medical reports transferred
to microfilm and magnetic media.
Coal miner's name and social security number; medical provider number;
coal mine operator number; insurance carrier number.
Files secured in a guarded facility; teleprocessing access protected by
restrictions on access to equipment and through use of encrypted passwords.
Electronic file data has permanent retention. Claimant and benefit
master file data will be transferred to magnetic tape and transmitted to NARA
every ten years. This data (which includes both open and closed cases) will not
be made available to the public until 90 years after transfer to NARA due to
Privacy Act restrictions.
Director, Division of Coal Mine Workers' Compensation, U.S. Department
of Labor, Room C-3520, 200 Constitution Ave., NW, Washington, DC 20210, and
district office director (see addresses in The Appendix to this document).
Individuals wishing to inquire whether this system of records contains
information about them should contact the system manager at the above address
or district office director (see addresses in the Appendix to this document).
Individuals must furnish their name, address, and signature.
Individuals wishing to access any records
should contact the appropriate office listed in the Notification Procedure
section. Individuals must furnish their name, address and signature.
Individuals wishing to request amendment of any non-exempt records
should contact the appropriate office listed in the Notification Procedure
section. Individuals must furnish their name, address, and signature.
Individuals, and organizations.
Investigatory portion of system exempted from certain provisions of the
ACT: In accordance with paragraph 3(k)(2) of the Privacy Act, investigatory
material compiled for civil law enforcement purposes, which is maintained in
this system's files of the Office of Workers' Compensation Programs of the
Employment Standards Administration, is exempt from paragraphs (c)(3),
(d),(e)(1),(e)(4) (G), (H), and (I), and paragraph (f) of 5 U.S.C. 552a. The
disclosure of civil investigatory information, if any, contained in this
system's files, including the names of persons and agencies to whom the
information has been transmitted, would substantially compromise the
effectiveness of investigations. Knowledge of such investigations would enable
subjects to take such action as is necessary to prevent detection of illegal
activities, conceal evidence, or otherwise escape civil enforcement action.
Disclosure of this information could lead to the intimidation of, or harm to
informants, witnesses, and their respective families, and in addition, could
jeopardize the safety and well-being of investigative personnel and their
families.
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