Title 20--EMPLOYEES' BENEFITS
Chapter VI--EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR


of this subchapter and subchapter B. 701.102 Organization of this subchapter. Office of Workmen's...


regulations in this subchapter, information as to the persons and agencies within the Department of Labor authorized by the Secretary of Labor to administer the Longshoremen's...


by authority vested in him or her by the Secretary of Labor in Secretary's Order No. 7-87 (52 FR 48466), established in the Employment Standards...


Assistant Secretary for Employment Standards transferred from the Bureau of Employees' Compensation to the Office of Workers' Compensation Programs all functions of the...


(and the Federal Employees' Compensation Act, formerly known as the U.S. Employees' Compensation Act), was initially vested in an independent establishment known as the U.S....


otherwise: (1) Act means the Longshoremen's and Harbor Workers' Compensation Act, as amended (33 U.S.C. 901 et seq.), also referred to in this subchapter as...


701.301(a)(12), and the employees of small vessel facilities otherwise covered which are exempted from coverage under Sec. 702.171, are dependent upon coverage under a...


jurisdictional areas. (a) The Director has, pursuant to section 39(b) of the Longshore and Harbor Workers' Compensation Act, 33 U.S.C. 939(b), established...


Director establishes a suboffice or jurisdictional area, those reports, records, or other documents with respect to processing of claims that are required to be filed with...


district director having jurisdiction thereof may, with the prior or subsequent approval of the Director, transfer such case to the district director in another...


the statute refers to Deputy Commissioner, these regulations have substituted the term District Director. The substitution is purely an administrative one, and in no way...


by employees while in his employ, and which shall also contain information of disease, other impairments or disabilities, or death relating to said injury. Such...


OWCP with respect to claims are the records of the OWCP. The Director shall be the official custodian of those records maintained by the OWCP at its national office, and...


examine the record of the case in which he is interested. The official custodian of the record sought to be inspected shall permit or deny inspection in accordance with...


has been permitted to inspect. Such requests shall be addressed to the official custodian of the records sought to be copied. The official custodian shall provide...


forms for the reporting of any information required to be reported by the regulations in this subchapter, or by the Act or any of its extensions. ...


may be represented in any proceeding under the Act by an attorney or other person previously authorized in writing by such claimant, employer or carrier to...


of a claimant with respect to claims filed under the Act shall make application therefor to the district director, administrative law judge, Board, or court, as the case...


section 28(e) of the Act, 33 U.S.C. 928(e), any person who receives any fees, other consideration, or any gratuity on account of services rendered as a representative of a...


or carrier declines to pay any compensation on or before [[Page 864]] the 30th day after receiving written notice from the district director of a claim...


where an attorney's fee is awarded against an employer or carrier there may be further assessed against such employer or carrier as costs, fees and mileage for necessary...


shall, upon request, provide persons covered by the Act with information and assistance relating to the Act's coverage and compensation and the procedures for obtaining...


(a) Pursuant to section 9(g) of the Act, 33 U.S.C. 909(g), compensation paid to aliens not residents, or about to become nonresidents, of the United States or Canada shall be...


established in the U.S. Treasury a special fund, to be administered by the Secretary. The Treasurer of the United States is the custodian of such fund, and all monies...


a congressional policy determination that, under certain circumstances, the employer of a particular employee should not be required to bear the entire burden of paying for...


for initial and subsequent annual adjustments in compensation and continuing payments to beneficiaries in cases of permanent [[Page 866]] total disability...


the several provisions of the Act shall be paid into the special fund (33 U.S.C. 44(c)(3)). (b) Whenever an employee dies under circumstances creating a...


the Act, 33 U.S.C. 944(d)(1), for the purpose of making rules, regulations, and determinations under the special fund provisions in section 44 and for providing...


(a) Each carrier and self-insured employer shall make, keep, and preserve such records, and make such reports and provide such additional information as the Director prescribes or...


been made from the special fund pursuant to section 18(b) of the Act, 33 U.S.C. 918(b) and Sec. 704.145(f) the Secretary of Labor shall, for the benefit of the fund, be subrogated...


section 17 of the Act, 33 U.S.C. 917, when a trust fund which complies with section 302(c) of the Labor-Management Relations Act of 1947, 29 U.S.C. 186(c) [LMRA],...


his/her designee to certify a particular facility as one engaged in the building, repairing or dismantling of exclusively small vessels, as defined. Once certified,...


with certification of small vessel facilities, the following definitions are applicable. (a)(1) ``Small vessel'' means only those vessels described in...


by the Act are exempted only upon certification that the facility is: (1) Engaged in the building, repairing or dismantling of exclusively small commercial vessels; and...


exempt from coverage under the Act, the facility must apply for and receive a certificate of exemption from the Director or his/her designee. The application must be made by...


When a vessel other than a small commercial vessel, as defined in Sec. 702.172, enters a facility which has been certified as exempt from coverage, the exemption shall...


Employer's Reports (a) Within 10 days from the date of an employee's injury or death, or 10 days [[Page 873]] from the date an employer has...


or death shall be in writing and on a form prescribed by the Director for this purpose, and shall contain: (a) The name, address and business of the employer; ...


[Code of Federal Regulations] [Title 20, Volume 3] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR702.203] [Page 873] TITLE 20--EMPLOYEES' BENEFITS CHAPTER VI--EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR PART 702_ADMINISTRATION AND PROCEDURE--Table of Contents Subpart B_Claims Procedures Sec. 702.203 Employer's report; how given. The employer's report, an original and one copy, may be furnished by delivering it to the appropriate office of the district director, or by mailing it to said office. ...


Any employer, insurance carrier, or self-insured employer who knowingly and willfully fails or refuses to send any report required by Sec. 702.201, or who knowingly or willfully makes...


Where the employer, or agent in charge of the business, or carrier has been given notice or has knowledge of an employee's injury or death, and fails, neglects, or refuses to file...


(a) In order to claim compensation under the Act, an employee or claimant must first give notice of the fact of an injury or death to the employer and also may give notice to...


(a) For other than occupational diseases described in (b), the employee must give notice within thirty (30) days of the date of the injury or death. For this purpose the date of injury...


his behalf, or in the case of death, by the deceased employee's beneficiary or someone on his behalf. [38 FR 26861, Sept. 26, 1973. Redesignated at 50 FR 397, Jan....


the Director for this purpose; such form shall be made available to the employee or beneficiary by the employer. The notice shall be signed by the person authorized to give...


mail at the address posted by the employer--to the individual designated to receive such notices. Notice when given to the district director, may be by hand or by mail on a...


official shall not bar any claim for compensation if: (a) The employer, carrier, or designated official had actual knowledge of the injury or death; or (b)...


a claimant who knowingly and willfully makes a false statement or representation for the purpose of obtaining a benefit or payment under this Act shall be guilty of...


disability or death shall be in writing and filed with the district director for the [[Page 876]] compensation district in which the injury or death occurred. The...


the Act is mentally incompetent or a minor, the time limitation provision of Sec. 702.221 shall not apply to a mentally incompetent person so long as such person...


Sec. 702.221, failure to file a claim within the period prescribed in such section shall not be a bar to such right unless objection to such failure is made at the first...


filing of a claim for compensation for injury or death under the Act, the district director shall give written notice thereof to the employer or carrier, served personally or...


who is authorized to execute a claim on his behalf) may withdraw his previously filed claim: Provided, That: (1) He files with the district director with whom the...


employer controverts its liability to pay compensation under this Act, the employer or insurance carrier shall pay periodically, promptly and directly to the person...


become due by the fourteenth (14th) day after the employer has been notified, through the designated official or by any other means described in Sec. 702.211 et seq.,...


without an award is not paid within 14 days after it becomes due, there shall be added to such unpaid installment an amount equal to 10 per centum thereof which shall...


making the first payment of compensation, and upon the suspension of payments once begun, the employer shall notify the district director having jurisdiction over the...


final payment of compensation has been made, the employer, the insurance carrier, or where the employer is self-insured, the employer shall notify the district director on a...


notify the district director that the final payment of compensation has been made as required by Sec. 702.235 shall be assessed a civil penalty in the amount of $100.00....


adjudicator shall mean district director or administrative law judge (ALJ). (b) If a settlement application is submitted to an adjudicator and the case is pending at...


shall be a self-sufficient document which can be evaluated without further reference to the administrative file. The application shall be in the form of a...


(a) When the parties to a claim for compensation, including survivor benefits and medical benefits, agree to a settlement they shall submit a complete application to...


the right to compensation after notice or [[Page 881]] knowledge of the injury or death, or after receipt of a written claim, he shall give...


Upon receiving the employer's notice of controversion, the district director shall forthwith commence proceedings for the adjudication of the claim in accordance with the procedures...


Where the claimant contests an action by the employer or carrier reducing, suspending, or terminating benefits, including medical care, he should immediately notify...


of the claimant's notice of contest, the district director shall forthwith commence proceedings for adjudication of the claim in accordance with the procedures set forth in...


(a)(1) No employer or its duly authorized agent may discharge or in any manner discriminate against an employee as to his/her employment because that employee: (i)...


that the employee has been discharged or suffered discrimination and is able to resume his or her duties, the district director will recommend that the employer...


Administrative Law Judges is responsible for final determinations of all disputed issues connected with the discrimination complaint, including the amount of penalty to be...


penalty assessed, the district director shall refer the complete administrative file to the Associate Director, Division of Longshore and Harbor Workers' Compensation,...


the representative) shall promptly notify the employer and the district director when: (1) A claim is made that someone other than the employer or person or persons in...


paid from the Special Fund) may require an employee to whom it is paying compensation to submit a report on earnings from employment or self- employment. This report may...


to submit the report on earnings from employment or self-employment under Sec. 702.285 or, who knowingly and willingly omits or understates any part of such earnings, shall upon...


The regulations in this subpart govern the adjudication of claims in which the employer has filed a notice of controversion under Sec. 702.251, or the employee has filed notice...


The district director is empowered to resolve disputes with respect to claims in a manner designed to protect the rights of the parties and also to resolve such disputes at...


be called by the district director or his designee assigned or reassigned the case and held before that same person, unless such person is absent or unavailable. When...


called upon not less than 10 days' notice to the parties, unless the parties agree to meet at an earlier date. The notice may be given by telephone, but shall be confirmed by...


shall be taken at informal conferences and no witnesses shall be called. The district [[Page 885]] director shall guide the discussion toward the achievement of...


(a) Following an informal conference at which agreement is reached on all issues, the district director shall (within 10 days after conclusion of the conference), embody...


When it becomes apparent during the course of the informal conference that agreement on all issues cannot be reached, the district director shall bring the conference to...


transfer in the following manner: (a) The district director shall furnish each of the parties or their representatives with a copy of a prehearing statement form. (b)...


For the purpose of any further proceedings under the Act, the formal record of proceedings shall consist of the hearing record made before the administrative law judge (see...


Whenever any party considers any document in the administrative file essential to any further proceedings under the Act, it is the responsibility of such party...


(a) Application: filing, service, contents. (1) An employer or insurance carrier which seeks to invoke the provisions of section 8(f) of the Act must...


to the Office of the Chief Administrative Law Judge the pre-hearing statement forms, the available evidence which the parties intend to submit at the formal hearing,...


administrative law judge assigned the case by the Office of the Chief Administrative Law Judge in accordance with the provisions of the Administrative Procedure Act, 5 U.S.C....


the claimant and the employer or insurance carrier, and the administrative law judge assigned the case. (b) The Solicitor of Labor or his designee may appear...


[Code of Federal Regulations] [Title 20, Volume 3] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR702.334] [Page 889] TITLE 20--EMPLOYEES' BENEFITS CHAPTER VI--EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR PART 702_ADMINISTRATION AND PROCEDURE--Table of Contents Subpart C_Adjudication Procedures Sec. 702.334 Formal hearings; representatives of parties. The claimant and the employer or carrier may be represented by persons of their choice. ...


the Chief Administrative Law Judge shall notify the parties (See Sec. 702.333) of the place and time of the formal hearing not less than 30 days in...


evidence presented warrants consideration of an issue or issues not previously considered, the hearing may be expanded to include the new issue. If in the opinion of...


(a) Except for good cause shown, hearings shall be held at convenient locations not more than 75 miles from the claimant's residence. (b) Once a formal hearing has...


the parties or their representatives and such other persons as the administrative law judge deems necessary and proper. The administrative law...


hearing, the administrative law judge shall not be bound by common law or statutory rules of evidence or by technical or formal rules of procedure, except as provided by...


oath or affirmation. The administrative law judge may examine the witnesses and shall allow the parties or their representatives to do so. (b) No person shall be required...


any party represented by counsel, may be taken by deposition or interrogatory according to the Federal Rules of Civil Procedure as supplemented by local rules...


an administrative law judge or whose depositions are taken shall receive the same fees and mileage as witnesses in courts of the United States (33...


shall be allowed a reasonable time for presentation of oral argument and shall be permitted to file a pre- hearing brief or other written statement of fact or law. A copy of...


the public and shall be stenographically reported. All evidence upon which the administrative law judge relies for his final decision shall be contained in the transcript...


more additional issues are raised by the administrative law judge pursuant to Sec. 702.336, such issues may, in the discretion of the administrative law judge, be consolidated...


to appear before the administrative law judge or to present evidence or argument personally or by representative, it shall not be necessary for the administrative law judge...


the conclusion of the proceeding at which evidence is submitted to the administrative law judge. (b) In exceptional cases the Chief Administrative Law Judge or...


Within 20 days after the official termination of the hearing as defined by Sec. 702.347, the administrative law judge shall have prepared a final decision and order, in the form of...


The administrative law judge shall, within 20 days after the official termination of the hearing, deliver by mail, or otherwise, to the office of the...


filed in the office of the district director, and unless proceedings for suspension or setting aside of such orders are instituted within 30 days of such filing,...


Whenever a party withdraws his controversion of the issues set for a formal hearing, the administrative law judge shall halt the proceedings upon receipt from said party of a...


[Code of Federal Regulations] [Title 20, Volume 3] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR702.371] [Page 892] TITLE 20--EMPLOYEES' BENEFITS CHAPTER VI--EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR PART 702_ADMINISTRATION AND PROCEDURE--Table of Contents Subpart C_Adjudication Procedures Sec. 702.371 Interlocutory matters. Compensation orders shall not be made or filed with respect to interlocutory matters of a procedural nature arising during the pendency of a compensation case. ...


insurance carrier is in default in the payment of compensation due under any award of compensation, for a period of 30 days after the compensation is due and payable, the...


any party in interest (including an employer or carrier which has been granted relief under section 8(f) of the Act, 33 U.S.C. 908(f)), the district director may...


of Labor, Washington, D.C. 20210, by filing a notice of appeals with the office of the district director for the compensation district in which the decision or...


law or fact may be taken from a decision with respect to a claim under the Act. Such appeals may be taken from compensation orders when they have been filed as provided for...


filed with the district director within 30 days of the filing of the decision or order complained of, as defined and described in Sec. Sec. 802.205 and 802.206 of this title....


[Code of Federal Regulations] [Title 20, Volume 3] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR702.394] [Page 893] TITLE 20--EMPLOYEES' BENEFITS CHAPTER VI--EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR PART 702_ADMINISTRATION AND PROCEDURE--Table of Contents Subpart C_Adjudication Procedures Sec. 702.394 Appeals; procedure. The procedure for appeals to the Benefits Review Board shall be as provided by the Board in its Rules of Practice and Procedure, set forth in part 802 of this title. ...


and other attendance or treatment, nursing and hospital services, laboratory, X- ray and other technical services, medicines, crutches, or other apparatus and...


furnish appropriate medical care (as defined in Sec. 702.401(a)) for the employee's injury, and for such period as the nature of the injury or the process of recovery...


the right to choose his/her attending physician from among those authorized by the Director, OWCP, to furnish such care and treatment, except those physicians included on...


podiatrists, dentists, clinical psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined by State law....


such that immediate medical care is required and the injured employee is unable to select a physician, the employer shall select a physician. Thereafter the employee may...


made his initial, free choice of an attending physician, he may not thereafter change physicians without the prior written consent of the employer (or carrier) or the...


and their designees, shall actively supervise the medical care of an injured employee covered by the Act. Such supervision shall include: (a) The requirement...


which medical questions arise with respect to the appropriate diagnosis, extent, effect of, appropriate treatment, and the duration of any such care or treatment, for an injury...


with such report may request a review or reexamination of the employee by one or more different physicians employed by or selected by the Director, and such review...


special examination required of an employee by Sec. Sec. 702.408 and 702.409, the employee shall submit to such examination at such place as is designated in the order to report,...


examinations required by Sec. 702.408 shall be accomplished in a manner designed to preclude prejudgment by the impartial examiner. No physician previously connected with the...


or his designee ordering the special examination shall have the power, in the exercise of his discretion, to charge the cost of the examination or review to the employer, to...


by medical care providers for persons covered by this Act shall be limited to such charges for the same or similar care (including supplies) as prevails in the community in...


(a) The Director may, upon written complaint of an interested party, or upon the Director's own initiative, investigate any medical care provider or any fee for medical...


After issuance of specific findings of fact and proposed action by the Director as provided in Sec. 702.414 any affected provider employer or other interested party has the right...


At formal hearings held pursuant to Sec. 702.415, the necessary parties shall be the person whose fee or cost charge is [[Page 898]] in question and the Director,...


If the final decision and order upholds the finding of the Director that the fee or charge in dispute was not in accordance with prevailing community charges or the provider's...


(a) As soon as practicable, but within 30 days after occurrence of an injury covered by the Act, or within 30 days after an employee becomes aware, or in the exercise...


Whenever an employer acquires knowledge of an employee's injury, through receipt of a written notice or otherwise, said employer shall forthwith authorize, in...


The issuance of an authorization for treatment by the employer shall bind his insurance carrier to furnish and pay for such care and...


be entitled to recover for medical services and supplies unless: (a) The employer shall have refused or neglected a request to furnish such services and the employee...


(a) Notwithstanding that medical care is properly obtained in accordance with these regulations, a finding by the Director that a medical care provider has failed to comply...


if it is found, after appropriate investigation as described in Sec. 702.414 and proceedings under Sec. Sec. 702.432 and 702.433, that such physician or health care...


of information indicating that a physician or health care provider has engaged in activities enumerated in subparagraphs (a) through (c) of Sec. 702.431, the Director,...


district director and contain a concise notice of the issues on which the physician, health care provider or claims representative desires to give evidence at the hearing...


any final decision of the Administrative Review Board made after a hearing to which such person was a party, irrespective of the amount of controversy, may...


a physician, hospital, or provider of medical support services or supplies to: (1) All OWCP district offices; (2) The Health Care Financing Administration; ...


or pursuant to Sec. 702.431(d) or if a claims representative has been debarred pursuant to Sec. 702.131(c) (1) or (3) the person debarred will be automatically...


or filed after September 28, 1984 (the date of enactment of Pub. L. 98-426) shall be adjudicated with respect to the determination of the degree of hearing impairment in...


is the return of permanently disabled persons to gainful employment commensurate with their physical or mental impairments, or both, through a program of...


are likely to result in, or have resulted in, permanent disability, and which are of a character likely to require review by a vocational rehabilitation adviser on the staff...


upon receipt of the referral, shall promptly consider the feasibility of a vocational referral or request for cooperative services from available resources or...


Vocational rehabilitation advisers will arrange referral procedures with State Employment Service units within their assigned geographical districts for the purpose of...


Referrals to such other public and private agencies providing assistance to disabled persons such as public welfare agencies, Public Health Services facilities,...


be planned in anticipation of a short, realistic, attainable vocational objective terminating in remunerable employment, and in restoring wage-earning capacity or...


as a result of injury, is or may be expected to be totally or partially incapacitated for a remunerative occupation and who, under the direction of the Director is...


will be observed to protect the confidential character of information released regarding an individual undergoing rehabilitation: (a) Information will be released...


Source: 50 FR 406, Jan. 3, 1985, unless otherwise noted. (a) Time of injury. For purposes of this subpart and with respect to an occupational disease which...


[Code of Federal Regulations] [Title 20, Volume 3] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR702.602] [Page 905] TITLE 20--EMPLOYEES' BENEFITS CHAPTER VI--EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR PART 702_ADMINISTRATION AND PROCEDURE--Table of Contents Subpart F_Occupational Disease Which Does Not Immediately Result in Death or Disability Sec. 702.602 Notice and claims. (a) Time for giving notice of injury or death. Refer to Sec. 702.207. (b) Time for filing of claims. Refer to Sec. 702.212. ...


for compensating occupational disease claims which become manifest after retirement. (a) If the time of injury occurs within the first year after the employee...


of compensation for occupational disease claims which become manifest after retirement. (a) If the claim is for disability benefits and the time of injury occurs...


Authorization of Insurance Carriers 703.101 Types of companies which may be authorized by the OWCP. 703.102 Applications for authority to write insurance; how...


[Code of Federal Regulations] [Title 20, Volume 3] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR703.002] [Page 906] TITLE 20--EMPLOYEES' BENEFITS CHAPTER VI--EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR PART 703_INSURANCE REGULATIONS--Table of Contents Sec. 703.002 Forms. Any information required by the regulations in this part to be submitted to the OWCP shall be submitted on such forms as the Director may deem appropriate and may authorize from time to time for such purpose. ...


carrier or by becoming an authoried self-insurer. An employer who fails to secure coverage by either manner described in section 32(a), (1) or (2) of the Act, 33...


and Harbor Workers' Compensation Act and its extensions the application of any stock company, mutual company or association, or any other person or fund, while...


insurance under this Act shall be made in writing, signed by an officer of the applicant duly authorized to make such application, and transmitted to the Office of...


insurance under the laws of the United States or of any State, which holds a certificate of authority from the Secretary of the Treasury as an acceptable surety on...


insurance under any extension of the LHWCA need not support its application under the LHWCA or any other LHWCA extension with the evidence required by the regulations in...


the approval of the Office copies of the forms of policies which the applicant proposes to issue in writing insurance under the LHWCA, or its extensions, to which shall...


first having received from the OWCP a certificate of authority to write such insurance. Any such certificate issued by the Office, after application therefor in accordance...


authority to write insurance coverage under the Act is no longer necessary. Beginning July 1, 1984, and thereafter, newly issued Certificates of Authority will...


the standard workmen's compensation and employer's liability policy, shall be used, if required by the OWCP, with the form of policy approved by the Office for use by an...


a form of policy approved for use by the Office no modification thereof shall be used unless specifically approved by the Office. Where the form of policy is designed...


be used by an insurer authorized by the Office under the regulations in this part to write insurance under said Act except after submission to and approval by the Office....


but if such insurance be not needed except for a particular contract or operation, the term of the policy may be limited to the period of such contract...


policy, may specify the particular vessel or vessels in respect of which the policy applies and the address of the employer at the home port thereof. The report of the...


than as provided by 33 U.S.C. 936(b); and notice of a proposed cancellation shall be given to the district director and to the employer in accordance with the provisions...


medical and other treatment and care, the payment or furnishing of any other benefit required by said Act and in respect of the carrying out of the administrative...


policy and endorsement issued by it to an employer who carries on operations in such compensation district. The report shall be made in such manner and on such form as...


carrier, except that any carrier may authorize its agency or agencies in any compensation district to make such reports to the district director, provided the carrier...


in its application an agreement that the acceptance by the district director of a report of the issuance of a policy of insurance, as provided for by Sec. 703.116,...


engaging in work subject to the Act in another compensation district, his carrier may submit to the district director of such latter district a report pursuant to...


703.116, shall be made for each employer covered by a policy. If a policy is issued insuring more than one employer, a separate report for each employer so covered shall be sent to...


of compensation under the Longshoremen's and Harbor Workers' Compensation Act, or its extensions, any employer who, pursuant to the regulations in this part, furnishes to...


become a self-insurer may be made by any employer desiring such privilege and shall be addressed to the OWCP and be made on a form provided by the Office. Such application...


an employer for authority to pay compensation under said Act as a self-insurer will be transmitted to the applicant on a form prescribed by the Office. Such grant shall...


to act as a self- insurer, execute and file with the Office and agreement and undertaking in a form prescribed and provided by the Office in whch the applicant...


of self-insurance, as a condition subsequent to receiving authorization to act as self-insurer, shall give security for the payment of compensation and the discharge of all...


electing to deposit negotiable securities to secure his obligations under said Act in the amount fixed by the Office under the regulations in this part shall deposit...


Deposits of securities provided for by the regulations in this part shall be made with any Federal Reserve bank or any branch of a Federal Reserve bank...


be made except upon authorization by the Office. A self-insurer discontinuing business, or discontinuing operations within the purview of said Act, or providing security for...


the indemnity bond filed or the amount of negotiable securities deposited by a self-insurer is insufficient to afford adequate security for the payment of compensation and...


submit such of the following reports as may be requested: (a) A certified financial statement of the self-insurer's assets and liabilities, or a...


reauthorization of the self-insurance privilege is no longer necessary. Beginning July 1, 1984, and thereafter, newly approved and renewed self-insurance authorizations...


by a self-insurer to comply with any provision or requirement of law or of the regulations in this part, or with any lawful order or communication of the Office, or the...


in this part may request a certificate from the district director in the compensation district in which he has operations, and for which a certificate is required by...


insurance with the notation authorized by Sec. 703.119, will file such report until he receives from the insured employer named therein a request for certificate of...


provisions of law and these regulations, or the revocation or termination of the privilege of self- insurance granted by the Office, all certificates of compliance issued on...


Defense Base Act 704.101 Administration; compensation districts. 704.102 Commutation of payments to aliens and nonresidents. 704.103 Removal...


the administration of the LHWCA extensions (see Sec. 704.001) in nearly every respect, and are not repeated in this part 704. Such special provisions as are necessary...


established for administration of the Longshoremen's and Harbor Workers' Compensation Act as set forth in part 702 of this subchapter shall be extended in the following...


the United States and Canada, section 2(b) of the Defense Base Act, 42 U.S.C. 1652(b), though separately stated in this Act, is identical in language to section 9(g) of...


by section 6 of the LHWCA, 33 U.S.C. 906, and the minimum limit on the average weekly wages on which death benefits are to be computed under section 9 of...


shall be used, if required by the OWCP, with the form of policy approved by the Office for use by an authorized carrier: For attachment to Policy No. ----, ...


[Code of Federal Regulations] [Title 20, Volume 3] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR704.201] [Page 916] TITLE 20--EMPLOYEES' BENEFITS CHAPTER VI--EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR PART 704_SPECIAL PROVISIONS FOR LHWCA EXTENSIONS--Table of Contents Sec. 704.201 Administration; compensation districts. For the purpose of administration of this Act, the District of Columbia shall be the compensation district and is designated as District No. 40. ...


shall be used, if required by the OWCP, with the form of policy approved by the Office for use by an authorized carrier: For attachment to Policy No....


the Longshoremen's and Harbor Workers' Compensation Act as set forth in part 702 of this subchapter shall administer this Act, and their jurisdiction for this purpose...


policy shall be used, if required by the [[Page 917]] OWCP, with the form of policy approved by the Office for use by an authorized carrier: ...


and Alaska, the compensation districts established for administration of the Longshoremen's and Harbor Workers' Compensation Act as set forth in part 702 of this...


shall be used, if required by the OWCP, with the form of policy approved by the Office for use by an authorized carrier: For attachment to Policy...


Subpart A_General Sec. 718.1 Statutory provisions. 718.2 Applicability of this part. 718.3 Scope and intent of this...


With the exception of the second sentence of Sec. 718.204(a), this part is applicable to the adjudication of all claims filed after March 31, 1980, and considered by the...


(a) This part sets forth the standards to be applied in determining whether a coal miner is or was totally, or in the case of a claim subject to Sec. 718.306 partially,...


Except as is otherwise provided by this part, the definitions and usages of terms contained in Sec. 725.101 of subpart A of part 725 of this title shall be applicable to...


Source: 65 FR 80045, Dec. 20, 2000, unless otherwise noted. (a) The Office of Workers' Compensation Programs (hereinafter OWCP or the Office) shall...


(a) A chest roentgenogram (X-ray) shall be of suitable quality for proper classification of pneumoconiosis and shall conform to the standards...


tests. (a) Any report of pulmonary function tests submitted in connection with a claim for benefits shall record the results of flow versus volume...


physical examinations. (a) A report of any physical examination conducted in connection with a claim shall be prepared on a medical report form supplied by the Office...


studies. (a) Blood-gas studies are performed to detect an impairment in the process of alveolar gas exchange. This defect will manifest itself primarily as...


(a) A report of an autopsy or biopsy submitted in connection with a claim shall include a detailed gross macroscopic and microscopic description of the lungs...


(a) The results of any medically acceptable test or procedure reported by a physician and not addressed in this subpart, which tends to demonstrate the...


Source: 65 FR 80045, Dec. 20, 2000, unless otherwise noted. (a) For the purpose of the Act, ``pneumoconiosis'' means a chronic dust disease of...


existence of pneumoconiosis. (a) A finding of the existence of pneumoconiosis may be made as follows: (1) A chest X-ray conducted and classified in accordance...


pneumoconiosis to coal mine employment. (a) In order for a claimant to be found eligible for benefits under the Act, it must be determined that the...


disability causation defined; criteria for determining total disability and total disability due to pneumoconiosis. (a) General. Benefits are provided under the Act...


pneumoconiosis. (a) Benefits are provided to eligible survivors of a miner whose death was due to pneumoconiosis. In order to receive benefits, the claimant must...


persons or agencies. Decisions, statements, reports, opinions, or the like, of agencies, organizations, physicians or other individuals, about the existence, cause,...


of employment as a miner. Source: 65 FR 80045, Dec. 20, 2000, unless otherwise noted. The presumptions set forth in Sec. Sec. 718.302, 718.303,...


pneumoconiosis to coal mine employment. If a miner who is suffering or suffered from pneumoconiosis was employed for ten years or more in one or more coal mines,...


a respirable disease. (a)(1) If a deceased miner was employed for ten or more years in one or more coal mines and died from a respirable disease, there shall be...


of total disability or death due to pneumoconiosis. There is an irrebuttable presumption that a miner is totally disabled due to pneumoconiosis, that...


pneumoconiosis. (a) If a miner was employed for fifteen years or more in one or more underground coal mines, and if there is a chest X-ray submitted in...


entitlement applicable to certain death claims. (a) In the case of a miner who died on or before March 1, 1978, who was employed for 25 or more years in one...


Definitions. 722.3 General criteria; inclusion in and removal from the Secretary's list. 722.4 The Secretary's list. ...


this part. (b) For purposes of this part, the following definitions apply: [[Page 946]] (1) State agency means, with respect to any State, the...


agency may, at any time, request that the Secretary include such State's workers' compensation law on his list of those State workers' compensation laws...


is appropriate. Accordingly, in addition to its publication in the Federal Register as required by section 421 of the Black Lung Benefits Act, the list shall also...


Subpart A_General Sec. 725.1 Statutory provisions. 725.2 Purpose and applicability of this part. 725.3 Contents of...


this part. (a) This part sets forth the procedures to be followed and standards to be applied in filing, processing, adjudicating, and paying claims filed under part...


(a) This subpart describes the statutory provisions which relate to claims considered under this part, the purpose and scope of this part, definitions and usages...


in this title. (a) Part 718. Part 718 of this subchapter, which contains the criteria and standards to be applied in determining whether a miner is or was...


of terms. (a) Definitions. For purposes of this subchapter, except where the content clearly indicates otherwise, the following definitions apply: (1) The Act...


(a) All reports, records, or other documents filed with the OWCP with respect to claims are the records of the OWCP. The Director or his or her...


Except as otherwise provided in this part and part 718, the burden of proving a fact alleged in connection with any provision shall rest with the party making...


Entitlement Sec. 725.201 Who is entitled to benefits; contents of this subpart. (a) Section 415 and part C of the Act provide for the payment...


Entitlement Sec. 725.202 Miner defined; condition of entitlement, miner. (a) Miner defined. A ``miner'' for the purposes of this part is...


Entitlement Sec. 725.203 Duration and cessation of entitlement; miner. (a) An individual is entitled to benefits as a miner for each month...


Entitlement Sec. 725.204 Determination of relationship; spouse. (a) For the purpose of augmenting benefits, an individual will be considered to...


Entitlement Sec. 725.205 Determination of dependency; spouse. For the purposes of augmenting benefits, an individual who is the miner's spouse...


Entitlement Sec. 725.206 Determination of relationship; divorced spouse. For the purposes of augmenting benefits with respect to any claim...


Entitlement Sec. 725.207 Determination of dependency; divorced spouse. For the purpose of augmenting benefits, an individual who is the...


Entitlement Sec. 725.208 Determination of relationship; child. As used in this section, the term ``beneficiary'' means only a surviving...


Entitlement Sec. 725.209 Determination of dependency; child. (a) For purposes of augmenting the benefits of a miner or surviving spouse, the...


Entitlement Sec. 725.210 Duration of augmented benefits. Augmented benefits payable on behalf of a spouse or divorced spouse, or a child, shall...


Entitlement Sec. 725.211 Time of determination of relationship and dependency of spouse or child for purposes of augmentation of benefits. ...


Entitlement Sec. 725.212 Conditions of entitlement; surviving spouse or surviving divorced spouse. (a) An individual who is the surviving spouse...


Entitlement Sec. 725.213 Duration of entitlement; surviving spouse or surviving divorced spouse. (a) An individual is entitled to benefits as...


Entitlement Sec. 725.214 Determination of relationship; surviving spouse. An individual shall be considered to be the surviving spouse of a...


Entitlement Sec. 725.215 Determination of dependency; surviving spouse. An individual who is the miner's surviving spouse (see Sec. 725.214) shall...


Entitlement Sec. 725.216 Determination of relationship; surviving divorced spouse. An individual will be considered to be the surviving divorced...


Entitlement Sec. 725.217 Determination of dependency; surviving divorced spouse. An individual who is the miner's surviving divorced spouse (see...


Entitlement Sec. 725.218 Conditions of entitlement; child. (a) An individual is entitled to benefits where he or she meets the required standards...


Entitlement Sec. 725.219 Duration of entitlement; child. (a) An individual is entitled to benefits as a child for each month beginning with the...


Entitlement Sec. 725.220 Determination of relationship; child. For purposes of determining whether an individual may qualify for benefits as the...


Entitlement Sec. 725.221 Determination of dependency; child. For the purposes of determining whether a child was dependent upon a deceased miner,...


Entitlement Sec. 725.222 Conditions of entitlement; parent, brother, or sister. (a) An individual is eligible for benefits as a surviving...


Entitlement Sec. 725.223 Duration of entitlement; parent, brother, or sister. (a) A parent, sister, or brother is entitled to benefits beginning...


Entitlement Sec. 725.224 Determination of relationship; parent, brother, or sister. (a) An individual will be considered to be the parent, brother,...


Entitlement Sec. 725.225 Determination of dependency; parent, brother, or sister. An individual who is the miner's parent, brother, or sister will...


Entitlement Sec. 725.226 ``Good cause'' for delayed filing of proof of support. (a) What constitutes ``good cause.'' ``Good cause'' may be found...


Entitlement Sec. 725.227 Time of determination of relationship and dependency of survivors. The determination as to whether an individual...


Entitlement Sec. 725.228 Effect of conviction of felonious and intentional homicide on entitlement to benefits. An individual who has been...


Entitlement Sec. 725.229 Intestate personal property. References in this subpart to the ``same right to share in the intestate personal property''...


Entitlement Sec. 725.230 Legal impediment. For purposes of this subpart, ``legal impediment'' means an impediment resulting from the lack...


Entitlement Sec. 725.231 Domicile. (a) For purposes of this subpart, the term ``domicile'' means the place of an individual's true, fixed,...


Entitlement Sec. 725.232 Member of the same household--``living with,'' ``living in the same household,'' and ``living in the miner's...


Entitlement Sec. 725.233 Support and contributions. (a) Support defined. The term ``support'' includes food, shelter, clothing, ordinary...


Entitlement Sec. 725.301 Who may file a claim. (a) Any person who believes he or she may be entitled to benefits under the Act may file a claim...


Entitlement Sec. 725.302 Evidence of authority to file a claim on behalf of another. A person filing a claim on behalf of a claimant shall...


Entitlement Sec. 725.303 Date and place of filing of claims. (a)(1) Claims for benefits shall be delivered, mailed to, or presented at, any of...


Entitlement Sec. 725.304 Forms and initial processing. (a) Claims shall be filed on forms prescribed and approved by the Office. The...


Entitlement Sec. 725.305 When a written statement is considered a claim. (a) The filing of a statement signed by an individual indicating an...


Entitlement Sec. 725.306 Withdrawal of a claim. (a) A claimant or an individual authorized to execute a claim on a claimant's behalf or on behalf...


Entitlement Sec. 725.307 Cancellation of a request for withdrawal. At any time prior to approval, a request for withdrawal may be canceled by...


Entitlement Sec. 725.308 Time limits for filing claims. (a) A claim for benefits filed under this part by, or on behalf of, a miner shall be...


Entitlement Sec. 725.309 Additional claims; effect of a prior denial of benefits. (a) A claimant whose claim for benefits was previously...


Entitlement Sec. 725.310 Modification of awards and denials. (a) Upon his or her own initiative, or upon the request of any party on grounds of...


Entitlement Sec. 725.311 Communications with respect to claims; time computations. (a) Unless otherwise specified by this part, all...


Who are the adjudication officers? (a) General. The persons authorized by the Secretary of Labor to accept evidence and decide claims on the basis of such evidence...


Powers of adjudication officers. (a) District Director. The district director is authorized to: (1) Make determinations with respect to claims as is provided...


Disqualification of adjudication officer. (a) No adjudication officer shall conduct any proceedings in a claim in which he or she is prejudiced or partial, or where he or...


Parties to proceedings. (a) Except as provided in Sec. 725.361, no person other than the Secretary of Labor and authorized personnel of the Department of Labor...


Party amicus curiae. At the discretion of the Chief Administrative Law Judge or the administrative law judge assigned to the case, a person or entity which is not a...


Representation of parties. (a) Except for the Secretary of Labor, whose interests shall be represented by the Solicitor of Labor or his or her designee, each of...


Qualification of representative. (a) Attorney. Any attorney in good standing who is admitted to practice before a court of a State, territory, district, or...


Authority of representative. A representative, appointed and qualified as provided in Sec. Sec. 725.362 and 725.363, may make or give on behalf of the party he or...


Approval of representative's fees; lien against benefits. No fee charged for representation services rendered to a claimant with respect to any claim under this part shall...


Fees for representatives. (a) A representative seeking a fee for services performed on behalf of a claimant shall make application therefor to the district...


Payment of a claimant's attorney's fee by responsible operator or fund. (a) An attorney who represents a claimant in the successful prosecution of a claim for...


Claims development--general. After a claim has been received by the district director, the district director shall take such action as is necessary to...


Approved State workers' compensation law. If a district director determines that any claim filed under this part is one subject to adjudication under a workers' compensation...


Development of evidence--general. (a) Employment history. Each claimant shall furnish the district director with a complete and detailed history of the coal...


Development of medical evidence; scheduling of medical examinations and tests. (a) Upon receipt of a claim, the district director shall ascertain whether the claim...


Medical examinations and tests. (a) The Act requires the Department to provide each miner who applies for benefits with the opportunity to undergo a complete...


Identification and notification of responsible operator. (a) Upon receipt of the miner's employment history, the district director shall investigate whether any operator may...


Operator's response to notification. (a)(1) An operator which receives notification under Sec. 725.407 shall, within 30 days of receipt, file a response indicating...


Denial of a claim by reason of abandonment. (a) A claim may be denied at any time by the district director by reason of abandonment where the claimant fails: (1)...


Submission of additional evidence. (a) After the district director completes the development of medical evidence under Sec. 725.405 of this part, including the...


Initial adjudication in Trust Fund cases. Notwithstanding the requirements of Sec. 725.410 of this part, if the district director concludes that the results of the...


Operator's response. (a)(1) Within 30 days after the district director issues a schedule pursuant to Sec. 725.410 of this part containing a designation of the...


Development of evidence. (a) Medical evidence. (1) For purposes of this section, a medical report shall consist of a physician's written assessment of the...


Action by the district director after development of evidence. (a) At the end of the period permitted under Sec. 725.410(b) for the submission of evidence, the district...


Conferences. (a) At the conclusion of the period permitted by Sec. 725.410(b) of this part for the submission of evidence, the district director may conduct an...


Action at the conclusion of conference. (a) At the conclusion of a conference, the district director shall prepare a stipulation of contested and uncontested issues which...


Proposed decision and order. (a) Within 20 days after the termination of all informal conference proceedings, or, if no informal conference is held, at the conclusion...


Response to proposed decision and order. (a) Within 30 days after the date of issuance of a proposed decision and order, any party may, in writing, request a revision of...


Initial determinations. (a) Section 9501(d)(1)(A)(1) of the Internal Revenue Code (26 U.S.C.) provides that the Black Lung Disability Trust Fund shall begin the...


Referral of a claim to the Office of Administrative Law Judges. (a) In any claim for which a formal hearing is requested or ordered, and with respect to which the...


Legal assistance. The Secretary or his or her designee may, upon request, provide a claimant with legal assistance in processing a claim under the Act. Such...


Extensions of time. Except for the 30-day time limit set forth in Sec. 725.419, any of the time periods set forth in this subpart may be extended, for good cause shown,...


Any party to a claim (see Sec. 725.360) shall have a right to a hearing concerning any contested issue of fact or law unresolved by the district director. There...


After the completion of proceedings before the district director, or as is otherwise indicated in this part, any party may in writing request a hearing on any...


(a) A hearing held under this part shall be conducted by an administrative law judge designated by the Chief Administrative Law Judge. Except as otherwise provided...


All parties shall be given at least 30 days written notice of the date and place of a hearing and the issues to be resolved at the hearing. Such notice shall be sent to...


hearing; transfer of cases. (a) The Chief Administrative Law Judge shall assign a definite time and place for a formal hearing, and shall, where possible, schedule...


(a) General. The purpose of any hearing conducted under this subpart shall be to resolve contested issues of fact or law. Except as provided in...


documentary evidence. (a) All documents transmitted to the Office of Administrative Law Judges under Sec. 725.421 shall be placed into evidence by the administrative...


(a) Witnesses at the hearing shall testify under oath or affirmation. The administrative law judge and the parties may question witnesses with respect to any matters...


The testimony of any witness or party may be taken by deposition or interrogatory according to the rules of practice of the Federal district court for...


(a) A witness testifying at a hearing before an administrative law judge, or whose deposition is taken, shall receive the same fees and mileage as witnesses in courts of...


When two or more hearings are to be held, and the same or substantially similar evidence is relevant and material to the matters at issue at each such hearing, the...


appear and present evidence. (a) If all parties waive their right to appear before the administrative law judge, it shall not be necessary for the administrative...


issues set for formal hearing; effect. A party may, on the record, withdraw his or her controversion of any or all issues set for hearing. If a party...


hearing; new issues. (a) Except as otherwise provided in this section, the hearing shall be confined to those contested issues which have been identified by...


All hearings shall be open to the public and shall be mechanically or stenographically reported. All evidence upon which the administrative law judge relies for...


(a) The administrative law judge may, at the request of any party, or on his or her own motion, dismiss a claim: (1) Upon the failure of the claimant or his or...


(a) An order dismissing a claim shall be served on the parties in accordance with Sec. 725.478. The dismissal of a claim shall have the same effect as a decision and...


Hearings are officially terminated when all the evidence has been received, witnesses heard, pleadings and briefs submitted to the administrative law judge, and...


order. Within 20 days after the official termination of the hearing (see Sec. 725.475), the administrative law judge shall issue a decision and order with respect...


decision and order. (a) Orders adjudicating claims for benefits shall be designated by the term ``decision and order'' or ``supplemental decision and order''...


decision and order. On the date of issuance of a decision and order under Sec. 725.477, the administrative law judge shall serve the decision and order on all parties...


and orders. (a) A decision and order shall become effective when filed in the office of the district director (see Sec. 725.478), and unless proceedings...


and orders. A party who is dissatisfied with a decision and order which has become final in accordance with Sec. 725.479 may request a modification of the...


the Benefits Review Board. Any party dissatisfied with a decision and order issued by an administrative law judge may, before the decision and order becomes final (see...


(a) Any person adversely affected or aggrieved by a final order of the Benefits Review Board may obtain a review of that order in the U.S. court of appeals for the circuit...


without reasonable grounds. If a United States court having jurisdiction of proceedings regarding any claim or final decision and order, determines that...


provisions and scope. (a) One of the major purposes of the black lung benefits amendments of 1977 was to provide a more effective means of transferring...


(a) For purposes of this part, the term ``operator'' shall include: (1) Any owner, lessee, or other person who operates, controls, or supervises a coal...


operator defined. (a) Any person who, on or after January 1, 1970, acquired a mine or mines, or substantially all of the assets thereof, from a prior operator,...


relationship defined. (a)(1) In determining the identity of a responsible operator under this part, the terms ``employ'' and ``employment'' shall be construed...


liable operators. An operator may be considered a ``potentially liable operator'' with respect to a claim for benefits under this part if each of the...


for determining a responsible operator. (a)(1) The operator responsible for the payment of benefits in a claim adjudicated under this part (the ``responsible...


Special claims transferred to the fund. (a) The 1981 amendments to the Act amended section 422 of the Act and transferred liability for payment of certain special claims...


Procedures in special claims transferred to the fund. (a) General. It is the purpose of this section to define procedures to expedite the handling and disposition of...


General Provisions The provisions of this subpart govern the payment of benefits to claimants whose claims are...


payments are due; manner of payment. (a)(1) Except with respect to benefits paid by the fund pursuant to an initial determination issued in accordance with Sec....


benefits are payable. (a) In accordance with the provisions of section 6(a) of the Longshore Act as incorporated by section 422(a) of the Act, and except as provided...


a claimant employed as a miner. (a) In the case of a claimant who is employed as a miner (see Sec. 725.202) at the time of a final determination of such...


Benefits may be paid, as appropriate, to a beneficiary, to a qualified dependent, or to a representative authorized under this subpart to receive payments on behalf of...


of another; ``legal guardian'' defined. Benefits are paid only to the beneficiary, his or her representative payee (see Sec. 725.510) or his or her legal guardian. As...


minor or incompetent. An adjudication officer may require that a legal guardian or representative be appointed to receive benefit payments payable to any person who...


(a) If the district director determines that the best interests of a beneficiary are served thereby, the district director may certify the payment of...


benefit defined. (a) Payments certified to a representative payee shall be considered as having been applied for the use and benefit of the beneficiary when they are...


dependent spouse, child, or parent. If current maintenance needs of a beneficiary are being reasonably met, a relative or other person to whom payments are certified...


(a) The district director may require a representative payee to submit periodic reports including a full accounting of the use of all benefit...


dependent of augmentation portion of benefit. (a) If the basic benefit of a miner or of a surviving spouse is augmented because of one or more dependents, and...


exemption from claims of creditors. (a) Except as provided by the Act and this part, no assignment, release, or commutation of benefits due or payable under this part by...


benefits. (a) Basic rate. The amount of benefits payable to a beneficiary for a month is determined, in the first instance, by computing the ``basic rate.''...


payments; lump sum awards. (a) Whenever the district director determines that it is in the interest of justice, the liability for benefits or any part thereof...


to final adjudication. (a) If an operator or carrier fails or refuses to commence the payment of benefits within 30 days of issuance of an initial determination...


generally. (a) Benefits payable by an operator or carrier pursuant to an effective order issued by a district director, administrative law judge, Benefits...


Any individual receiving benefits under the Act in his or her own right, or as a representative payee, or as the duly appointed agent for the estate of a...


or termination of payments. (a) No suspension, reduction, or termination in the payment of benefits is permitted unless authorized by the district...


benefits amounts; general. (a) Under certain circumstances, the amount of monthly benefits as computed in Sec. 725.520 or lump-sum award (Sec. 725.521) shall...


State benefits. No benefits under section 415 of part B of title IV of the Act shall be payable to the residents of a State which, after December 31, 1969, reduces...


of State or Federal benefit. (a) As used in this section the term ``State or Federal benefit'' means a payment to an individual on account of total or...


earnings. In the case of a surviving parent, brother, or sister, whose claim was filed at any time, or of a miner whose claim was filed on or after January 1,...


effect of an additional claim for benefits. Except as provided in Sec. 725.212(b), beginning with the month in which a person other than a miner files a...


of augmentation of benefits based on subsequent qualification of individual. (a) Ordinarily, a written request that the benefits of a miner or surviving...


reduction event. If a reduction for receipt of State or Federal benefits and a reduction on account of excess earnings are chargeable to the same month, the benefit...


(a) General. As used in this subpart, the term ``overpayment'' includes: (1) Payment where no amount is payable under this part; (2) Payment in excess of...


of adjustment or recovery of overpayment. Whenever a determination is made that more than the correct amount of payment has been made, notice of the provisions of...


adjustment or recovery may be applied. There shall be no adjustment or recovery of an overpayment in any case where an incorrect payment has been made with respect to...


waiver of adjustment or recovery. The standards for determining the applicability of the criteria listed in Sec. 725.542 shall be the same as those applied by the...


compromise of claims for overpayment. (a) General effect of 31 U.S.C. 3711. In accordance with 31 U.S.C. 3711 and applicable regulations, claims by the Office against...


(a) General. As used in this subpart, the term ``underpayment'' includes a payment in an amount less than the amount of the benefit due for such month,...


provisions for reductions or increases. The amount of an overpayment or an underpayment is the difference between the amount to which the beneficiary was actually entitled...


overpayment and underpayment provisions to operator or carrier. (a) The provisions of this subpart relating to overpayments and underpayments shall be applicable...


to overpayments and underpayments. (a) In any case involving either overpayments or underpayments, the Office may take any necessary action, and district directors...


(a) The Act, together with certain incorporated provisions from the Longshoremen's and Harbor Workers' Compensation Act, contains a number...


the fund. (a) In any case in which the fund has paid benefits, including medical benefits, on behalf of an operator or other employer which is determined...


the fund on behalf of an operator; liens. (a) If an amount is paid out of the fund to an individual entitled to benefits under this part or part 727 of this...


Enforcement of final awards. Notwithstanding the provisions of Sec. 725.603, if an operator or other employer or its officers or agents fails to comply with an...


(a) Except as is otherwise provided in this part, no suspension, termination or other failure to pay benefits awarded to a claimant is permitted. If an employer...


Security for the payment of benefits. (a) Following the issuance of an effective order by a district director (see Sec. 725.418), administrative law judge (see...


Payments in addition to compensation. (a) If any benefits payable under the terms of an award by a district director (Sec. 725.419(d)), a decision and order filed and...


Interest. (a)(1) In any case in which an operator fails to pay benefits that are due (Sec. 725.502), the beneficiary shall also be entitled to simple annual...


other persons. In any case in which an award of benefits creates obligations on the part of an operator or insurer that may be enforced under the...


Failure to secure benefits; other penalties. (a) If an operator fails to discharge its insurance obligations under the Act, the provisions of subpart D of part 726 of...


(a) Upon making the first payment of benefits and upon suspension, reduction, or increase of payments, the operator or other employer responsible for making...


Availability of medical benefits. (a) A miner who is determined to be eligible for benefits under this part or part 727 of this subchapter (see Sec. 725.4(d))...


Claims for medical benefits only under section 11 of the Reform Act. (a) Section 11 of the Reform Act directs the Secretary of Health, Education and Welfare to...


Physician defined. The term ``physician'' includes only doctors of medicine (MD) and osteopathic practitioners within the scope of their practices as defined by State...


Notification of right to medical benefits; authorization of treatment. (a) Upon notification to a miner of such miner's entitlement to benefits, the Office shall...


Arrangements for medical care. (a) Operator liability. If an operator has been determined liable for the payment of benefits to a miner, the Office shall notify...


Authorization to provide medical services. (a) Except as provided in paragraph (b) of this section, medical services from an authorized provider which are payable...


Reports of physicians and supervision of medical care. (a) Within 30 days following the first medical or surgical treatment provided under Sec. 725.701, the treating...


Disputes concerning medical benefits. (a) Whenever a dispute develops concerning medical services under this part, the district director shall attempt to informally...


Objective of vocational rehabilitation. The objective of vocational rehabilitation is the return of a miner who is totally disabled for work in or around a coal mine and who...


Requests for referral to vocational rehabilitation assistance. Each miner who has been determined entitled to receive benefits under part C of title IV of the Act shall...


Subpart A_General Sec. 726.1 Statutory insurance requirements for coal mine operators. 726.2 Purpose and scope...


(a) This part provides rules directing and controlling the circumstances under which a coal mine operator shall fulfill his insurance obligations under the...


(a) This part 726 implements and effectuates responsibilities for the payment of black lung benefits placed upon coal mine operators by sections 415 and 422 of...


Section 423 of part C of title IV of the Act requires each operator of a coal mine or former operator in any State which does meet the requirements prescribed by the Secretary...


Pursuant to section 422(c) of part C of title IV of the Act, no coal mine operator shall be responsible for the payment of any benefits whatsoever for any period prior to January 1,...


The Office of Workers' Compensation Programs (hereinafter the Office or OWCP) is that subdivision of the Employment Standards Administration of the U.S. Department of Labor...


required by this part 726 to be submitted to the Office of Workmen's Compensation Programs or any other office or official of the Department of Labor, shall be submitted...


provided in part 725 of this subchapter, the following definitions apply to this part: (a) Director means the Director, Office of Workers' Compensation Programs,...


(a) Pursuant to section 423 of part C of title IV of the Act, authorization to self-insure against liability incurred by coal mine operators on account of the...


a self-insurer; how filed; information to be submitted. (a) How filed. Application for authority to become a self-insurer shall be addressed to the Office and be made...


of regulations contained in this part. As appropriate, each of the regulations, interpretations and requirements contained in this part 726 including...


operator. (a) Upon receipt of a completed application for authorization to self-insure, the Office shall, after examination of the information contained in...


The Office shall require the amount of security which it deems necessary and sufficient to secure the performance by the applicant of all obligations imposed upon him as...


Office shall determine the type or types of security which an applicant shall or may procure. (See Sec. 726.104(b).) (b) In the event the indemnity bond option is selected, the...


Federal Reserve banks or the Treasurer of the United States; authority to sell such securities; interest thereon. Deposits of securities provided for by...


No withdrawal of negotiable securities deposited by a self-insurer, shall be made except upon authorization by the Office. A self-insurer discontinuing business,...


of security. Whenever in the opinion of the Office the amount of security given by the self-insurer is insufficient to afford adequate security for the payment...


(a) In addition to the requirement that adequate security be procured as set forth in this subpart, the applicant for the authorization to self-insure shall, as a...


Upon receipt of a completed agreement and undertaking and satisfactory proof that adequate security has been provided, an applicant for authorization to self-insure...


of accounts of self-insurer. (a) Each operator who has been authorized to self-insure under this part shall submit to the Office reports containing such...


Any financial information or records, or other information relating to the business of an authorized self-insurer or applicant for the authorization of...


(a) No initial authorization to self-insure shall be granted for a period in excess of 18 months. A self-insurer who has made an adequate...


The Office may for good cause shown suspend or revoke the authorization of any self-insurer. Failure by a self-insurer to comply with any provision or requirement...


Each operator of a coal mine who has not obtained authorization as a self-insurer shall purchase a policy or enter into a contract with a commercial insurance carrier or...


Each coal mine operator who is not authorized to self-insure shall insure and keep insured the payment of benefits as required by the Act with any stock company or...


endorsement. (a) The following form of endorsement shall be attached and applicable to the standard workmen's compensation and employer's liability policy prepared by...


Pursuant to section 423(b) of part C of title IV of the Act each policy or contract of insurance obtained to comply with the requirements of section 423(a) of the Act must contain...


Forms of endorsement or policies other than that described in Sec. 726.203 may be entered into by operators to insure their liability under the Act. However, any form...


contract of insurance shall be issued for the term of 1 year from the date that it becomes effective, but if such insurance be not needed except for a particular contract or...


duties of operator. Every obligation and duty in respect of payment of benefits, the providing of medical and other treatment and care, the payment or furnishing...


endorsement. Each carrier shall report to the Office each policy and endorsement issued, canceled, or renewed by it to an operator. The report shall be made in such...


of issuance, cancellation, or renewal of a policy and endorsement provided for in Sec. 726.208 shall be sent by the home office of the carrier, except that any carrier may...


Every carrier seeking to write insurance under the provisions of the Act shall be deemed to have agreed that the acceptance by the Office of a report of the issuance or renewal of...


each report. A separate report of the issuance or renewal of a policy and endorsement, provided for by Sec. 726.208, shall be made for each operator covered by a...


Cancellation of a contract or policy of insurance issued under authority of the Act shall not become effective otherwise than as provided by 33 U.S.C. 936(b); and notice of a...


benefits. Pursuant to 33 U.S.C. 914(c) as incorporated by section 422(a) of part C of title IV of the Act and Sec. 726.207 each carrier issuing a policy or contract...


which is required to secure the payment of benefits under section 423 of the Act and Sec. 726.4 and which fails to secure such benefits, shall be subject to a civil penalty...


the definitions provided in part 725 of this subchapter and Sec. 726.8, the following definitions apply to this subpart: (a) Division Director means the Director, Division...


(a) The following method shall be used for determining the amount of any penalty assessed under this subpart. (b) The penalty shall be determined by multiplying the daily...


(a) If the Director determines that an operator has violated the provisions of section 423 of the Act and Sec. 726.4, he or she shall notify the operator of its violation...


(a) After an operator receives notification under Sec. 726.303 and fails to secure its obligations for the period defined in Sec. 726.302(b), and following the completion of...


by Sec. 726.304 shall: (a) Identify the operator against whom the penalty is assessed, as well as the name of any other person severally liable for such penalty; ...


Except as provided in Sec. 726.307(c), if any person identified as potentially liable for the assessment does not, within 30 days after receipt of notice, contest...


hearing. (a) Any person desiring to contest the Director's notice of initial assessment shall request an administrative hearing pursuant to this part. The notice...


(a) Service of documents under this part shall be made by delivery to the person, an officer of a corporation, or attorney of record, or by mailing the document to the last...


Judges. (a) Upon receipt of a timely notice of contest filed in accordance with Sec. 726.307, the Director, by the Associate Solicitor for Black Lung Benefits or...


and notification of hearing date. Upon receipt from the Director of a complaint filed pursuant to Sec. 726.309, [[Page 1038]] the Chief...


in this subpart, and to the extent they do not conflict with the provisions of this subpart, the Rules of Practice and Procedure for Administrative Hearings Before...


shall bear the burden of proving the existence of a violation, and the time period for which the violation occurred. To prove a violation, the Director must establish: ...


Judge. (a) The Administrative Law Judge shall render a decision on the issues referred by the Director. (b) The decision of the Administrative Law Judge shall...


The Director or any party aggrieved by a decision of the Administrative Law Judge may petition the Secretary for review of the decision by filing a petition within 30 days of the...


for review shall: (a) Be dated; (b) Be typewritten or legibly written; (c) State the specific reason or reasons why the party petitioning for...


documents submitted to the Secretary shall be filed with the Secretary of Labor, U.S. Department of Labor, 200 Constitution Ave., N.W., Washington, DC 20210. (b)...


(a) Following receipt of a timely petition for review, the Secretary shall determine whether the decision warrants review, and shall send a notice of such determination to the parties...


The Secretary's review shall be based upon the hearing record. The findings of fact in the decision under review shall be conclusive if supported by substantial evidence in...


The official record of every completed administrative hearing held pursuant to this part shall be maintained and filed under the custody and control of...


(a) When the determination of the amount of any civil money penalty provided for in this part becomes final, in accordance with the administrative assessment thereof, or...




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