Office of Workers' Compensation, Black Lung Benefits Claim File.
Unclassified.
Office of Workers' Compensation Programs, Division of Coal Mine
Workers' Compensation, Department of Labor Building, 200 Constitution Avenue,
NW, Washington, DC 20210, and district offices (see addresses in the Appendix
to this document).
Individuals filing claims for black lung (pneumoconiosis) benefits
under the provisions of Black Lung Benefits Act, as amended, including miners,
and their surviving spouses, children, dependent parents and siblings.
Personal (name, date of birth, social security number, claim type,
miner's date of death,) medical, and financial. Information gathered in
connection with investigations concerning possible violations of Federal law,
whether civil or criminal, under the authorizing legislation and related Acts.
This record also contains investigative records and the work product of the
Department of Labor and other governmental personnel and consultants involved
in the investigations. If the individual has received benefits to which he or
she is not entitled, the system may contain consumer credit reports
correspondence to and from the debtor, information or records relating to the
debtor's current whereabouts, assets, liabilities, income and expenses,
debtor's personal financial statements, and other information such as the
nature, amount and history of a claim filed by an individual covered by this
system, and other records and reports relating to the implementation of the
Debt Collection Act of 1982 including any investigative records or
administrative review matters. The individual records listed herein are
included only as pertinent to the individual claimant.
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 records that are used to process all aspects of claims for
black lung (pneumoconiosis) benefits under the provisions of the Black Lung
Benefits Act, as amended, including claims filed by miners and their surviving
spouses, children, dependent parents and siblings. These records are also used
to process the recoupment of overpayments under the Act.
In addition to those universal routine uses listed in the General
Prefatory Statement of 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
benefits insurance) who have been determined potentially
liable for the claim at any time after the filing of a claim for Black
Lung Benefits 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. Representatives of the claimant for the purpose of processing the
claim, responsible operator and program representation on contested issues.
e. Labor unions and other voluntary employee associations of which the
claimant is a member for the purpose of assisting the member.
f. 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.
g. Federal, state or local agencies if necessary to obtain information
relevant to a Departmental decision concerning the determination of initial or
continuing eligibility for program benefits, including whether benefits have
been or are being paid improperly; whether dual benefits prohibited under any
federal or state law are being paid; and including salary offset and debt
collection procedures, including any action required by the Debt Collection Act
of 1982.
h. Debt collection agency that DOL has contracted for collection
services to recover indebtedness owed to the United States.
i. Internal Revenue Service for the purpose of obtaining taxpayer
mailing addresses in order to locate such taxpayers to collect, compromise, or
write-off a Federal claim against the taxpayer; discharging an indebtedness
owed by an individual.
j. 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 to a claimant or a
person who is duly authorized to act on the claimant's or beneficiary's behalf,
of information contained in the file may be made over the telephone. Disclosure
over the telephone will only be done where the requestor provides appropriate
identifying information to OWCP personnel. Telephonic disclosure of information
is essential to allow OWCP to efficiently perform its functions in adjudicating
and servicing 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 the Fair Credit Reporting Act (15 U.S.C. 1681a(f), or in
accordance with the Federal Claims Collection Act of 1966 as amended (31 U.S.C.
3711(e) for the purpose of encouraging the repayment of an overdue debt.
Case file documents, both original and copies, in manual files.
Coal miner's name, social security number, and claimant's social
security number different from miner's.
Files are located in the restricted area of a Federal building under
guard by security officers.
Approved claims files are destroyed 10 years after death of last
beneficiary. Denied claims are destroyed 30 years after final denial.
Director, Division of Coal Mine Workers' Compensation, Department of
Labor Building, Room C-3520, 200 Constitution Avenue, NW, Washington, DC 20210,
and district office directors (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 directors. (See addresses in the Appendix to this
document.)Individuals must furnish claimant's name, and signature.
Individuals wishing to request access to non-exempt records should
contact the appropriate office listed in the Notification Procedure section.
The individual must furnish his or her name, signature and address.
Specific materials in this system have been exempted from Privacy Act
provisions (5 U.S.C. 552a(d)), regarding access to records. The section of this
notice titled "Systems Exempted from Certain Provisions of the Act" indicates
the kinds of materials exempted from access and the reasons for exempting them
from access. 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, organizations, and investigators.
In accordance with 5 U.S.C. 552a(k)(2), investigatory material in this
system of records compiled for law enforcement purposes is exempt from
subsections (c)(3); (d); (e)(1); (e)(4)(G), (H), and (I); and (f) of 5 U.S.C.
552a, provided however, that if any individual is denied any right, privilege,
or benefit that he or she would otherwise be entitled to by Federal law, or for
which he or she would otherwise be eligible, as a result of the maintenance of
these records, such material shall be provided to the individual, except to the
extent that the disclosure of such material would reveal the identity of a
source who furnished information to the Government under an express promise
that the identity of the source would be held in confidence, or prior to
January 1, 1975, under an implied promise that the identity of the source would
be held in confidence.
|