Federal Black Lung Program, or Division of Coal Mine Workers’ Compensation, administers benefits filed under the Black Lung Benefits Act. Under this Act, miners who are totally disabled from pneumoconiosis due to coal mine employment and their survivors may file for compensation. “Totally disabled” means the victim is unable to perform the work they did as a coal miner as a result of breathing coal mine dust and has permanently impaired their ability to breathe normally.
Eligible claimants receive monthly compensation and medical coverage for lung diseases or pneumoconiosis. The coal miner’s employer, usually the last company that employed the miner for at least a year, may be required to pay a victim’s benefits if it meets specific legal requirements. The Black Lung Disability Trust Fund caters to federal Black Lung Program benefits if the responsible coal operator doesn’t meet its legal obligations to pay benefits.
The black lung program ensures that those found eligible receive their benefits every month and respond to any concerns they may have. They also contact all beneficiaries through mail annually to make sure that their benefit payments and information are up-to-date.
Has black lung disease disabled you or your loved one? Stephens and Stephens LLP help victims of coal mining get the compensation they deserve. Contact us today for a free case evaluation. You don’t need to worry about attorney fees, as your employer is legally obligated to pay them.
A summary of steps involved in filing a black lung claim
- Claims for black lung disease are filed by completing a claim form and employment history form at a district director’s office.
- The miner is then contacted for a physical examination.
- The district director then coordinates the collection of medical evidence and investigates the claimant’s employment history to determine the employer responsible for paying the benefits.
- After analyzing the evidence, the district director makes a determination and issues a proposed decision and order.
- If dissatisfied with the decision, the claimant is allowed 30 days to request a hearing.
- Hearing contesting a proposed decision and order are held at the Office of Administrative Law Judges (OALJ). It is best to hire an experienced black lung claim attorney to represent you at an OALJ hearing, which lasts an hour.
- The Chief Docket Clerk at the OALJ assigns a case number to your claim, which helps track all case evidence and outgoing decisions and orders. The hearing is held within 75 miles of the claimant’s residence.
- The presiding ALJ issues a pre-hearing order with the hearing date, time, and location. Each party is provided with a timeline for submitting their evidence, which may include medical records, opinions, and tests such as blood gas study, chest x-rays, and pulmonary function study reports.
- At the hearing, the miner or survivor testifies on the miner’s employment history, physical condition, medical treatment, and any prescribed medication. A family member or co-worker may also testify. Any remaining medical evidence may also be submitted for consideration.
- The ALJ make a ruling based on the testimony and evidence presented at the hearing. The decisions are also posted on the ALJ website.
- The ALJ’s decision is not binding as you are allowed to appeal with the Benefits Review Board (BRB).
- The board advises the parties involved of timelines for submitting arguments for the appeal.
- The board can affirm, reverse, or modify the ALJ’s decision or remand the claim for further consideration at the ALJ.
- The BRB’s decision can only be appealed to the appropriate United States Circuit Court of Appeals and then to the United States Supreme Court.
Do you need a black lung claim attorney or representative?
Hiring an experienced black lung claim attorney from the start would help you gather the required evidence and increase the chances of getting compensation. Stephens and Stephens EEOICPA claims attorneys will not charge any fee if you are not awarded any benefits for your black lung claim. Even after your claim is accepted, the Black Lung Disability Trust Fund or your employer will pay the attorney fees. It is always best to choose a qualified representative as fees for a lay representative will not be paid, and you may have to pay them from your pocket.
What are the black lung benefits?
The Black Lung Benefits rates are based on Federal employee salary rates and are usually adjusted annually to match changes in the Federal employee payment schedules. The monthly benefits for a miner without dependents is $737.90. For miners with three or more dependents, their monthly benefits can be as much as $1,475.80.
Medical benefits are taken care of separately from disability benefits. Benefit payments and related administrative expenses in cases where the responsible operators don’t pay are paid from the Black Lung Disability Trust Fund.
Also, if the claim is approved, the coal company responsible for your claim or the Black Lung Disability Trust Fund should pay the attorney fees.
What is black lung disease?
Black lung disease, or coal workers’ pneumoconiosis (CWP), occurs from exposure to coal dust. The disease type and severity depend on the level of exposure. Coal mine workers take time to develop signs of the disease. Thus, most of them are diagnosed in their retirement years. The common symptoms of black lung disease include:
- Coughing
- Difficulty breathing
- Shortness of breath
- Tightness of the chest
- Production of black mucus
- Inability to engage in physical activity
Black lung occurs from inhaling coal dust over prolonged periods. Thus, it hardly affects people not in close contact with coal dust. The dust contains carbon particles and sometimes silica particles that are harmful to the lungs when inhaled.
These particles settle in the lungs’ alveoli (small sacs that help uptake oxygen by blood). Over time, the lungs get inflamed and scarred as they fight to eliminate these external bodies. Black lung disease is categorized as simple or complicated, depending on the severity. CWP is incurable, but it can be managed with medication to improve the quality of life.
In 2016, the Centers for Disease Control and Prevention (CDC) reported that black lung decreases life expectancy by 12.6 years. During the last 30 years, over 10,000 men and boys have died and 25,000 injured in the coal mining industry. And the average age of those killed is 32.13. However, not all coal mine workers will develop black lung disease. Recent studies have shown that about 16% of coal miners in the U.S. contract the disease.
Who qualifies for black lung program benefits?
Those qualified for black lung program benefits include present and former coal miners, construction and certain transportation workers affected by coal mine dust, and their surviving dependents, such as surviving spouses, orphaned children, and totally dependent parents, brothers, and sisters.
Who Pays Monetary Benefits?
An affected miner can claim the payment of benefits from the last coal mine operator they worked for, and the miner should have worked for the operator for at least one year.
However, the Black Lung Disability Trust Fund can cater to these benefits in the following cases:
- Where a miner’s last coal mine employment was before January 1, 1970
- The coal mine operator the victim worked for no longer exists.
- If a miner’s most recent employment as an operator ended at least one year while the operator was authorized to self-insure, the operator is not financially capable of making the benefit payments.
If the responsible operator is later identified, the trust fund has legal authority to recover the amount of benefits paid from the trust fund from this operator, as well as any interest earned on these amounts.
What is the black lung trust fund?
The purpose of the Black Lung Disability Trust Fund and associated BLET was to take up the burden associated with providing black lung benefits without relying on taxpayers’ money. The primary source of this pool for the trust fund is the excise tax on coal produced and sold domestically, including the black lung excise tax, BLET. The trust fund borrows from the treasury if the revenue cannot finance Black Lung Program benefits.
The program provides the Following Medical Treatment:
- Medical treatment for black lung disease-related respiratory conditions
- Prescription drugs
- In-patient and out-patient services
- Doctors’ visits
- Medical equipment and home oxygen
- Pulmonary rehabilitation may also be covered with a doctor’s prescription
- Home nursing services
Medical treatment bills are checked and verified to ensure that payments are accurate and the requested treatments are necessary.
Steps for filing Miner black lung benefits
- Complete the “Miner’s Claim for Benefits under the Black Lung Act” (form CM-911) application form – it provides important basic information about the individual and their family.
- Complete the “Employment History” (form CM-911a)- This form includes information about the miner’s work, the number of years they worked, names of the coal companies they worked for, and their work outside the coal mining industry.
- Complete two copies of “Authorization to Obtain Earnings Data from the Social Security Administration” (SSA-581) and review the SSA-581
- Review guidelines on”Selection of Examining Provider” and complete the “Selection of Examining Provider” form. (Remember, you should select an approved provider in your home state or a contiguous state)
The victim may also be required to provide additional information, such as copies of marriage certificates, death certificates, children’s birth certificates, proof of dependent children’s enrollment in schools, etc.
DOL Evaluation
For a miner to be compensated, they must prove that they have Black Lung and are totally disabled from a breathing impairment contributed to by the disease.
The Department of Labor (DOL) provides a free examination to prove that the victim is entitled to black lung benefits. Under this examination, they will determine whether the miner is disabled due to work related to black lung disease. As such, even when you have already contracted black lung disease, if you are still able to seek employment, then your claim will be denied.
After filing a claim, DOL contacts victims to schedule a complete pulmonary evaluation (a medical examination to determine whether they are totally disabled by black lung disease.) DOL will then provide the victim with a list of physicians in the state or a bordering state. The individual might be asked to select a physician they wish to use but within certain limitations.
The expected examinations consist of the following:
- A chest X-ray;
- A physical examination by a physician
- A pulmonary function test
- An arterial blood gas test, if necessary, which measures your ability to breathe
If the miner refuses to be examined, their claim can be denied without any further consideration of entitlement to the benefits. They also have the right to have this examination’s results sent to their physician.
Once they receive the pulmonary examination results, the DOL conducts a preliminary review of the results to determine if they support an award or a denial of the claim.
DOL then sends a “Schedule for the Submission of Additional Evidence” explaining the examination results and the reasons for their opinion about the entitlement. This letter also informs the victim about the opportunity to submit additional evidence, their right to obtain medical evidence from a physician of choice, and the time limits for submitting the evidence.
If they find that a coal company is liable for the victim’s claim, it has the right to have the victim examined by a physician of its choice. If the victim refuses to be examined, their claim may be denied without further consideration of their entitlement to benefits.
Exchange of Medical Information
The parties involved should exchange any “medical information” concerning a claim for benefits and send a complete copy to DOL. Medical information may include an examining physician’s report and related test results, a non-examining physician’s report addressing the victim’s respiratory condition, and any other procedures or tests related to the respiratory or pulmonary condition.
Medical information sent to DOL should be indicated as “medical evidence” or “information for exchange only.” If identified as “evidence,” it should also clearly indicate whether it is “affirmative,” “rebuttal,” or “rehabilitative” evidence. Medical information shared with the parties without being indicated as evidence will not be considered as such when deciding the claim.
The program has certain limitations on the amount of medical evidence the victim and the liable company can give to determine entitlement to benefits.
Steps For Filing a Survivor Black Lung Claim
Surviving family members whose loved one died of black lung disease, or “pneumoconiosis,” coal miners can claim monthly benefits as provided in the Black Lung Benefits Act.
The steps are as follows:
- Complete an application form, ‘Survivor’s Claim for Benefits Under the Black Lung Act’ (Form CM-912), which includes basic information about the miner, yourself, and your family.
- Complete ‘Employment History’ (Supplemental Form CM-911a), requesting the miner’s work information as a miner, the number of years they worked, the names of the coal companies that employed the miner, and any work outside the coal mining industry.
- Other official documents required may include copies of children’s birth certificates, marriage certificates, death certificates, dependent children’s proof of school enrollment, etc.
Survivors entitled to benefits on the deceased’s lifetime claim may be automatically entitled to benefits.
Requirements when filing black lung survivor claims
Prove of claim: Survivors also need to prove that the miner died due to or their death was hastened by pneumoconiosis to be entitled to benefits. Thus, need to identify all sources of medical information about the miner, such as the names of physicians who treated the miner during their life, the names of hospitals where the miner received treatment, and any other information about the miner’s health and death (including any state or federal award for the miner’s disability or death).
Autopsy evidence: Where applicable, the victim should provide the name of the physician who obtained the autopsy of the miner and all the information relevant to determining if the miner died of black lung disease. The medical evidence may require verification from a physician.
Who can be paid black lung benefits?
Black lung benefits can be paid only to a beneficiary, their legal guardian, or a representative payee authorized to receive the payment on their behalf.
Where a beneficiary cannot handle their benefits, the District Director may direct the appointment of a payee to ensure that payments are only used to benefit the beneficiary. It can be an agency or institution directed to receive and manage the funds on behalf of an incapable beneficiary. It may include a parent who is receiving benefits on behalf of their minor child and nursing homes.
Representative Payees have to sign a DOL form as power of attorney and complete a CM-910, Request To Be Selected As Payee, and where applicable, they have to provide CM-787, Physician’s/Medical Officer’s Statement. It is important to note that a power of attorney alone is insufficient to authorize one to become a representative payee.
What is expected of a representative payee?
- A representative payee is not paid for their services.
- Black lung benefits are only for the use and benefit of the beneficiary. They should be used for the beneficiary’s expenses, such as food, clothing, shelter, personal comfort, and medical care.
- If the beneficiary is in an institution, the funds should be used for the institution’s customary charges and for personal needs to improve or maintain the beneficiary’s well-being.
- Black lung benefits may be used to support the beneficiary’s legal dependents as long as the beneficiary’s own needs are satisfied.
- Representative payees must provide a yearly report of benefits received and spent. They should also complete form CM-929P, “Report of Changes That May Affect Your Black Lung Benefits,” and keep an annual record of any unusual expenditure made with the beneficiary’s black lung benefits.
Black Lung Benefits Social Security and Taxation
Where a miner found to be totally disabled is employed or self-employed, his benefits are subject to reduction under the Social Security annual earnings retirement test. Earnings of widows, wives, and children do not require a reduction in the amount of black lung benefits payable.
The Black Lung Benefits Revenue Act of 1977 provides tax exemption to black lung benefit trusts, which qualify under section 501(c)(21) of the Code, created by coal mine operators to provide benefits because of disability or death of coal miners caused by black lung disease. Black lung benefit trusts are subject to excise taxes on taxable expenditures, certain acts of self-dealing, excess contributions to these trusts, and self-dealing and taxable expenditures per Treas.