Guide to Filing for Black Lung Benefits: Survivor's Claim

Division of Coal Mine Workers' Compensation (DCMWC)

GUIDE TO FILING FOR BLACK LUNG BENEFITS
(SURVIVOR)

The Black Lung Benefits Act provides monthly benefits to eligible surviving family members of coal miners whose deaths were due to black lung disease, or "pneumoconiosis." The Act also provides monthly benefits to survivors of miners who were entitled to benefits based on their own lifetime claims. In either case, you may receive additional benefits for family members who are dependent on you. A coal mining company which employed the deceased coal miner (usually the last company that employed the miner for a year or more) may be required to pay your benefits if it meets certain requirements under the law. Otherwise, the Black Lung Disability Trust Fund will pay your benefits.

The first step in the process of applying for Black Lung benefits is to complete an application form. You will be asked to provide important basic information about the miner, yourself and your family. The form is called the 'Survivor's Claim for Benefits Under the Black Lung Act' (Form CM-912). You will also complete an 'Employment History' (Supplemental Form CM-911a). This form requests information about the miner's work as a miner, the number of years (he or she worked, the names of the coal companies which employed him or her, and any work outside the coal mining industry. We need this information to determine whether the individual was a coal miner and whether a specific coal mining company will pay your benefits. A representative from the U. S. Department of Labor (Division of Coal Mine Workers' Compensation) or the Social Security Administration can assist you in completing the application forms.

Based on the information in your benefits application and Employment History form, we may ask you to provide additional information, including copies of official documents. This information may include copies of marriage certificates, children's birth certificates, death certificates, proof of enrollment in schools for dependent children, etc. This information is necessary to establish basic facts about your entitlement to benefits or the entitlement of members of your family.

If you are a survivor of a miner who was entitled to benefits on his or her own lifetime claim, then you may be automatically entitled to benefits. In these circumstances, we may use expedited procedures to adjudicate your claim.

If you must prove that the miner's death was due to or hastened by pneumoconiosis to be entitled to benefits, we will also ask you to identify all sources of medical information about the miner. This information should include the names of hospitals where the miner received treatment, the names of physicians who treated the miner during his or her life, and any other sources of information about the miner's health or death (including any state or federal award for the miner's disability or death). If you obtained an autopsy of the miner, we will need to know the name of the physician who performed it. We will request copies from you or the medical facility of all the information that appears relevant to determining whether black lung disease caused the miner's death. If necessary, we may ask a physician of our choosing to review the medical evidence and provide an opinion on the cause(s) of the miner's death.

After we receive all of the relevant information, we will conduct a preliminary review and determine whether the information supports an award or a denial of your claim. This review is not final. You will receive a letter describing the information we received and the reasons for our opinion about your entitlement. This letter is the 'Schedule for the Submission of Additional Evidence'. The 'Schedule' will inform you about your opportunity to submit additional evidence, your right to obtain medical evidence from a physician of your own choosing, and the time limits for submitting evidence. If we find that a coal company is liable for your claim, that company has the right to submit evidence from a physician of its choice.

The most important part of applying for survivor's Black Lung benefits is obtaining medical evidence about the miner's physical condition and his or her cause of death. The Black Lung benefits program has limitations on the amount of medical evidence which you or the coal company can give us for determining whether you are entitled to benefits. We encourage you to get advice from an attorney or other qualified representative before submitting any additional medical evidence to the Department of Labor. Ordinarily, attorney's fees (paid only if your claim is approved) will be paid by the coal company liable for your claim or the Black Lung Disability Trust Fund. We will explain to you the situations in which you may be liable for payment of the attorney's fees. You are not liable for any attorney's fees if your claim is denied.

NOTE: Recent changes to the regulations governing the Federal Black Lung Program require the parties to exchange – with all other parties – any "medical information" developed in connection with a claim for benefits, even if the submitting party does not intend to offer the information as evidence to be considered by the DOL's deciding official. This rule applies to your claim.

Generally, the exchange must be made within 30 days of the party's receipt of the information. You must send a complete copy of the information to the other parties in the claim, including the Department of Labor, within 30 days after either you or your agent receives it. If you have medical information from a prior claim that you did not put into the record or otherwise share with the other parties, you must also send this information to the other parties.

"Medical information" includes an examining physician's report and associated test results, a non-examining physician's report addressing the miner's respiratory or pulmonary condition, and any other tests or procedures related to the miner's respiratory or pulmonary condition. Medical records related to hospitalization or treatment—such as a visit to a primary care physician–do not have to be exchanged with the other parties under this rule. You also do not have to share any correspondence between your representative (either an attorney or a lay representative) and a medical expert.

When submitting medical information to DOL, please identify the information as medical "information for exchange only" or "evidence." (If you identify it as "evidence," you should also indicate whether it is "affirmative," "rebuttal" or "rehabilitative" evidence; we will explain this to you if you do not have an attorney or representative.) Unless you tell us that you want the medical information you shared with the parties to be considered as evidence, we will not consider it when deciding your claim.

When we have received and reviewed all of the evidence in your claim, we will decide whether your claim must be approved or denied and issue a "Proposed Decision and Order." This written decision will explain our reasons for approving or denying your claim. We will also inform you (and the coal company if one is liable for your claim) of the options for challenging our decision and the time limits for taking any further action. These options include asking the Department to reconsider its decision or asking for a hearing before an administrative law judge.

If you have any questions about the benefits application process, we are available to give you answers. You can contact the district office at the telephone number listed on the enclosed letter.

Or, information can be submitted to your claim electronically at:  https://coalmine.dol.gov/ 

If you have any questions about the benefits application process, we are available to give you answers. You should contact the district office that has jurisdiction of your state of residence. The list of district offices and their toll-free numbers may be found here: https://www.dol.gov/owcp/dcmwc/districtoffices.htm.