I
103D CONGRESS
1ST SESSION
H. R. 792
To amend the Black Lung Benefits Act to provide special procedures for
certain claims due to pneumoconiosis, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
FEBRUARY 3, 1993
Mr. RAHALL introduced the following bill; which was referred to the
Committee on Education and Labor
A BILL
To amend the Black Lung Benefits Act to provide special
procedures for certain claims due to pneumoconiosis, and
for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Black Lung Benefits
Act Amendments of 1993’’.
SEC. 2. CLAIMS PROCEDURE.
The Black Lung Benefits Act is amended by adding
at the end the following new part:
‘‘PART D—SPECIAL PROVISIONS
‘‘SEC. 441. CLAIMS.
‘‘(a) STANDARD.—If a claim is filed after the date
of the enactment of this section under part C for death
or total disability of a miner due to pneumoconiosis, such
miner shall be presumed to have been totally disabled by
pneumoconiosis or to have died because of pneumoconiosis
if the conditions described in any one of the following
paragraphs are met:
‘‘(1) A single positive chest roentgenogram (x-
ray), biopsy, or autopsy of such miner indicates the
existence of pneumoconiosis.
‘‘(2) A single set of ventilatory studies of such
miner indicates the presence of a chronic respiratory
or pulmonary disease that meets or exceeds the se-
verity standards of regulations of the Secretary of
Health and Human Services published at 20 C.F.R.
410.490(b)(1)(ii).
‘‘(3) A single set of blood gas studies of such
miner indicates the presence of an impairment in the
transfer of oxygen from the lungs to the blood that
meets or exceeds the severity standards of regula-
tions of the Secretary of Labor published at 20
C.F.R. 727.203(a)(3).
‘‘(4) Other medical evidence involving such
miner, including the documented opinion of a physi-
cian exercising reasonable medical judgment, indi-
cates the presence of a respiratory disease or pul-
monary impairment that would prevent the miner
from performing his usual coal mine work.
The person who submits such claim shall not be required
to prove the matters described in paragraph (1), (2), (3),
or (4) by a preponderance of the evidence or by any higher
evidentiary standard.
‘‘(b) CAUSATION.—
‘‘(1) If a claim is filed after the date of the en-
actment of this section under part C for death or
total disability due to pneumoconiosis and if the
miner with respect to whom the claim was filed
worked 10 or more years in a coal mine and pre-
sents evidence which proves the evidence of the mat-
ter described in any paragraph of subsection (a),
there shall be a rebuttable presumption that the
miner’s pneumoconiosis arose out of the miner’s coal
mine employment. No evidence shall be excluded in
determining the length of a miner’s coal mine em-
ployment. In the absence of complete Social Security
Administration records, affidavits from the miner’s
co-workers shall be accepted as sufficient proof of
the coal miner’s period of employment.
‘‘(2) If a miner is unable to prove 10 years of
employment in a coal mine, the miner may prove
that the miner’s pneumoconiosis is due to the min-
er’s coal mine employment through other evidence.
‘‘(c) REBUTTAL OF PRESUMPTION.—
‘‘(1) The presumption under subsection (a) that
a miner is totally disabled by pneumoconiosis may be
rebutted only if—
‘‘(A) there is evidence that establishes that
the claimant is in fact doing the claimant’s
usual coal mine work, or
‘‘(B) in light of all relevant evidence, it is
established that the miner is able to do the
miner’s usual coal mine work or comparable
and gainful work.
A physician’s opinion that the miner is not totally
disabled shall not rebut such presumption when in-
voked by qualifying ventilatory studies or arterial
blood gas testing.
‘‘(2) In connection with a rebuttal of a pre-
sumption under subsection (a), the Secretary of
Labor may submit not more than 1 opinion from an
examining or consulting physician and not more
than 3 x-ray readings to supplement such evidence.
‘‘(3) The presumption under subsection (b) may
be rebutted only by clear and convincing proof that
the miner’s pneumoconiosis, established by a condi-
tion described in subsection (a), did not arise, in
whole or in part, out of the miner’s coal mine em-
ployment.
‘‘SEC. 442. APPLICATION OF SECTION 441.
‘‘(a) IN GENERAL.—Section 441 shall apply to all
claims filed under part C on and after the date of the
enactment of this Act, except that the Secretary of Labor
shall review any claim that—
‘‘(1) was filed under part B or part C, and
‘‘(2) is either pending on the date of enactment
of this Act or has been denied on or before such
date,
to determine if the evidence establishes eligibility under
the presumption of section 441(a). The Secretary shall re-
view each such claim regardless of whether the claimant
also filed any subsequent claim under part B or C or such
claim resulted in an award of benefits. The Secretary’s
review of a claim which resulted in the award of benefits
may not result in the reversal or forfeiture of such bene-
fits. The Secretary shall promptly notify each claimant
having a claim subject to review under this subsection that
the claim shall be reviewed by the Secretary in accordance
with this subsection.
‘‘(b) PROCEDURE.—
‘‘(1) In carrying out the review of a claim
under subsection (a), the Secretary shall not allow
the claimant or any other party to submit additional
medical or other evidence if the Secretary deter-
mines that the evidence on file meets the criteria of
eligibility set forth in section 441(a). If the Sec-
retary determines that the evidence on file does not
meet the criteria of eligibility set forth in section
441(a), the Secretary shall provide an opportunity
for the claimant to present additional medical or
other evidence to substantiate the claimant’s claim
under such criteria and shall notify the claimant of
that opportunity. The Secretary shall not be per-
mitted to supplement the evidence in any claim re-
viewed under subsection (a). Each claim reviewed
under this section shall be afforded the administra-
tive and judicial review that is afforded claims that
are not subject to this section.
‘‘(2) If a claim is determined under subsection
(a) to meet the eligibility requirements of section
441(a), the individual for which the claim was sub-
mitted shall be awarded benefits prospectively (un-
less, at the time of such determination, the individ-
ual is receiving black lung benefits prospectively pur-
suant to an award made in connection with a sepa-
rate claim) and retroactively for any period begin-
ning on or after January 1, 1974, for which the
claimant (1) has not received benefits, and (2) is eli-
gible under the statutory and regulatory provisions
governing the retroactive payment of benefits for
claims that are not subject to the special review re-
quired by subsection (a).
‘‘SEC. 443. PAYMENT OF BENEFITS.
Benefits payable under any claim which is determined
under section 441 or 442 to be eligible for benefits shall
be paid from the fund.
‘‘SEC. 444. JUDICIAL REVIEW.
‘‘A claimant who files a claim after the date of enact-
ment of this Act and whose claim is denied by the Depart-
ment of Labor’s Benefits Review Board pursuant to the
procedure of section 21(b) of the Longshore and Harbor
Workers’ Compensation Act (33 U.S.C. 921(b)), may peti-
tion for review in the United States District Court for the
district in which the claimant last worked as a coal miner
or where the claimant resides at the time the appeal is
filed, whichever the claimant chooses. Section 205(g) of
the Social Security Act (42 U.S.C. 405(g)) shall govern
all such petitions for review, except that (1) each reference
therein to the Secretary shall be interpreted as meaning
the Secretary of Labor, and (2) if the claim was denied
because of the application of a regulation which violates
this Act or any other Federal law, the period in which
a claimant may petition for review shall not apply. A peti-
tion for review under this section may not be denied be-
cause the claimant has not exhausted the administrative
remedies available to the claimant.
‘‘SEC. 445. SURVIVORS AND DEPENDENTS.
‘‘(a) IN GENERAL.—The Secretary shall award the
survivor or dependent of a deceased miner benefits under
a claim under part C if the conditions in any one of the
following paragraphs are met:
‘‘(1) The deceased miner worked 25 years or
more in one or more coal mines.
‘‘(2) The miner’s death was due in whole or in
part to pneumoconiosis.
‘‘(3) The miner was receiving benefits for
pneumoconiosis at the time of the miner’s death.
‘‘(4) The miner had a claim for benefits for
pneumoconiosis pending at the time of the miner’s
death—
‘‘(A) in which the existing medical evidence
or such evidence combined with any additional
medical evidence submitted by survivors or de-
pendents demonstrates a level of impairment
sufficient to qualify for benefits under section
441(a), or
‘‘(B) in which the medical evidence was not
sufficient to qualify for benefits under section
441(a) but lay evidence (i) demonstrates by a
preponderance of the evidence the existence of
a respiatory disease or pulmonary impairment
that would prevent the miner from performing
the miner’s usual coal mine work, and (ii) such
disease or impairment is established in accord-
ance with section 441(b)(2) as resulting from
the miner’s coal mine work.
‘‘(b) DEFINITION.—For purposes of this section, sur-
vivors and dependents are those individuals who filed
claims under part C after the date of enactment of this
Act or whose claims under part B or C are eligible for
review under section 442.
‘‘SEC. 446. GENERAL PROVISIONS.
‘‘(a) MULTIPLE CLAIMS.—If a claimant has had a
claim denied under this Act, the Secretary shall permit
the claimant to file an additional claim under this part
without a showing of a material change in the claim. Such
an additional claim shall be considered de novo on the
merits.
‘‘(b) APPEALS BY THE SECRETARY.—The Secretary
may not file an appeal from a decision of the Deputy Com-
missioner, the Office of Administrative Law Judges, the
Benefits Review Board, or a district court of the United
States with respect to a claim under this part which is
adverse to the Secretary.
‘‘(c) REOPENING CLAIMS.—No claim under this part
under which the claimant was awarded benefits and with
respect to which no appeal is pending may be reopened
by the Secretary unless the Secretary offers reasonable
evidence to suspect fraud in connection with the adjudica-
tion of the claim.’’.
SEC. 3. CONFORMING AMENDMENT.
Section 224(a)(2)(B) of the Social Security Act (42
U.S.C. 424a(a)(2)(B)) is amended by striking out ‘‘and
(iv)’’ and inserting in lieu thereof ‘‘(iv)’’ and by inserting
at the end the following: ‘‘and (v) benefits payable under
the Black Lung Benefits Act,’’.
SEC. 4. BENEFIT REPAYMENTS.
Part C of the Black Lung Benefits Act is amended
by adding at the end the following:
‘‘SEC. 436. (a) In the administration of the benefits
payable under this part, if a claimant receives benefits
under this part under a claim but before final adjudication
of the claim for benefits is made and if the final adjudica-
tion is that the claimant is ineligible for benefits, the pay-
ment of such benefits to the claimant shall not be consid-
ered an overpayment of benefits and the claimant shall
not be legally responsible for the return of such benefits.
‘‘(b) If, before the date of the enactment of this sec-
tion, a claimant received benefits under this part under
a claim but before a final adjudication of the claim for
benefits was made, the claimant will not be required to
repay such benefits. If, before the date of the enactment
of this section, a claimant who received benefits under this
part under a claim but before final adjudication of the
claim for benefits was made was required under regula-
tions of the Secretary to repay the benefits as an overpay-
ment of benefits, the Secretary shall refund to the claim-
ant the amount repaid by the claimant.’’.
SEC. 5. WIDOW’S BENEFITS.
(a) IN GENERAL.—In the administration of the Black
Lung Benefits Act—
(1) a widow of a miner who received or is re-
ceiving benefits under that Act shall not be disquali-
fied to receive such benefits if the widow remarries,
and
(2) a widow of a miner shall be entitled to re-
ceive such benefits without regard to the length of
time the widow was married to the miner.
Any regulations of the Secretary of Labor which disqualify
a widow described in paragraph (1) or impose a minimum
marriage period as described in paragraph (2) shall on
and after the date of the enactment of this Act have no
legal effect.
APPLICATIONS.—Any widow who on the date of the
enactment of this Act is entitled to receive benefits under
the Black Lung Benefits Act because of subsection (a)
shall file a claim for such benefits within 3 years of the
date of the enactment of this Act.
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