Division of Coal Mine Workers' Compensation (DCMWC)
For Your Black Lung Pulmonary Evaluation
The U.S. Department of Labor is required to provide you with a complete pulmonary evaluation in connection with your Black Lung benefits claim. To ensure that you receive a high-quality evaluation, the Department of Labor has made arrangements with qualified providers to perform the evaluation. The Department of Labor will pay the cost of the diagnostic evaluation. The evaluation consists of a chest X-ray, pulmonary function study, arterial blood gas study, and physical examination.
After you file your claim, we will send you a list of medical providers in your state or a neighboring state that are authorized to perform this evaluation. You must select a DOL-approved provider from this geographic area. You may not select any provider who:
- Has examined or treated you in the 12 months before you filed your claim.
- Is a close relative of yours or of your spouse—such as parents, children, grandchildren, brothers, sisters, nephews, nieces, aunts, uncles, and first cousins.
If you have a question about whether you may select a particular provider, please contact DCMWC.
WITHIN 15 DAYS AFTER YOU RECEIVE THE LIST FROM US, SELECT YOUR PROVIDER AND RETURN THE ENCLOSED 'SELECTION OF EXAMINING PROVIDER' FORM, LETTING US KNOW YOUR SELECTION. Your signature on the form verifies that you have followed the requirements and restrictions described above. You will receive another letter authorizing the specific tests the provider will perform. You will then be instructed to contact the provider to arrange for an examination. DO NOT CONTACT THE PROVIDER UNTIL YOU GET BOTH AUTHORIZATION LETTERS.
The Department of Labor will pay for the cost of travel to and from the examination. However, specific requirements and restrictions apply to the travel costs the Department will pay for:
- You must pay your travel expenses out of pocket initially; expenses that meet the requirements below will be reimbursed by the Department of Labor after you submit a completed Form OWCP-957B (available at https://www.dol.gov/sites/dolgov/files/OWCP/regs/compliance/OWCP-957B.pdf). The authorization letters from the Department of Labor permitting the examination with your selected provider is the only pre-authorization required for reimbursement of these basic travel expenses.
- The Department of Labor will reimburse you for the actual round-trip mileage (for a personal vehicle), along with meals and incidental expenses, such as tolls or parking fees. Mileage, meals, and incidentals are all reimbursed according to the U.S. General Services Administration rate Per Diem Rates | GSA.
- Overnight accommodations (motel, hotel, or lodging) and travel costs exceeding those described above may be reimbursed only (1) when there is no approved provider within one day’s round trip travel from your residence, AND (2) this office has specifically pre-approved such expenses. One day’s round-trip travel means 100 miles one way or 200 miles round-trip. SEPARATE, PRIOR APPROVAL must be requested and granted by the Department of Labor prior to travel if overnight accommodations are needed.
- Overnight accommodations (motel, hotel, or other lodging) and transportation costs over 200 miles will NOT be authorized or reimbursed in situations where there is an approved provider within one day’s round trip travel from your residence.
- If there is a provider within one day’s round trip travel, but you have selected one farther away, you may still have your examination conducted by the provider you selected, assuming that your selection of provider is otherwise allowed. However, you will NOT be eligible for reimbursement for overnight accommodations.
- If you travel over 100 miles from your home for your Department of Labor-provided examination, the responsible mine operator named in your claim has the right to send you for an examination up to the distance you choose to travel for the Department of Labor's examination.
Once you have made your selection from the Approved Diagnostic Provider list, complete the selection of provider form indicating your choice. Please send the completed form to:
U.S. Department of Labor OWCP/DCMWC
P.O. Box 8307
London, KY 40742-8307
You can also submit documents through the C.O.A.L. Mine portal at: