Coal Mine Workers' Compensation
Published on AidPage by IDILOGIC
on Jun 24, 2005
Purpose of this program:
To provide benefits to coal miners who have become totally disabled due to coal workers' pneumoconiosis (CWP), and to widows and other surviving dependents of miners who have died of this disease.
Possible uses and use restrictions...
Monthly cash benefits are paid to coal miners disabled from coal workers' pneumoconiosis and to widows and other survivors of miners who have died of this disease. There are no restrictions on the use of these benefits by a beneficiary. Medical payments for treatment related to coal workers' pneumoconiosis are available to miners only after January 1, 1974.
Who is eligible to apply...
The miner (including some workers involved in coal transportation in and around mines and coal mine construction workers) must have worked in the Nation's coal mines or a coal preparation facility and become "totally disabled" (as defined in the Act) from pneumoconiosis. The applicant may be able to work in areas other than coal mines and still be eligible for benefits. Benefits to miner shall be reduced on account of excess earnings as determined under sections 203(b) through (1) of the Social Security Act for claims filed on or after January 1, 1982. Widows and other surviving dependents of coal miners whose death resulted from coal workers' pneumoconiosis are also eligible for benefits with earnings offsets applicable to certain classes of dependents. Applicants can reside anywhere in the world at the time they apply.
Medical tests, at Department of Labor expense, which include an x-ray, pulmonary function study, physical examination, and blood gas tests. Proof of work in or around a coal mine or coal preparation facility. Also proof of death, relationship and dependency required for widows and other survivors applying. Identification of a responsible mine operator is made as specified in regulations published in the Code of Federal Regulations (20 CFR 725).
Note:This is a brief description of the credentials or documentation required prior to, or along with, an application for assistance.
About this section:
This section indicates who can apply to the Federal government for assistance and the criteria the potential applicant must satisfy.
For example, individuals may be eligible for research grants, and the criteria to be satisfied may be that they have a professional or scientific degree,
3 years of research experience, and be a citizen of the United States. Universities, medical schools, hospitals, or State and local governments may also be eligible.
Where State governments are eligible, the type of State agency will be indicated (State welfare agency or State agency on aging) and the criteria that they
Certain federal programs (e.g., the Pell Grant program which provides grants to students) involve intermediate levels of application processing, i.e., applications
are transmitted through colleges or universities that are neither the direct applicant nor the ultimate beneficiary. For these programs,
the criteria that the intermediaries must satisfy are also indicated, along with intermediaries who are not eligible.
How to apply...
Telephone, write-in, or visit the local Social Security Administration or local Division of Coal Mine Workers' Compensation district or local office listed in Additional Contact Information - FMR Help.
Note: Each program will indicate whether applications are to be submitted to the Federal headquarters, regional or local office, or to a State or local government office.
After review of the application is completed, the applicant will be notified by mail.
Note: Grant payments may be made by a letter of credit, advance by Treasury check, or reimbursement by Treasury check.
Awards may be made by the headquarters office directly to the applicant, an agency field office, a regional office,
or by an authorized county office. The assistance may pass through the initial applicant for further distribution by
intermediate level applicants to groups or individuals in the private sector.
Deadlines and process...
A miner must file a claim for benefits within 3 years after a medical determination of total disability due to pneumoconiosis or within 3 years after the date of enactment of Public Law 95-239, whichever comes later, (Black Lung Benefits Reform Act of 1977). There are no time limitations for dependent survivors to file claims.
When available, this section indicates the deadlines for applications to the funding agency which will
be stated in terms of the date(s) or between what dates the application should be received.
When not available, applicants should contact the funding agency for deadline information.
Range of Approval/Disapproval Time
From 2 months to 8 months for initial findings depending on availability of supporting evidence.
Applicants are required to state on the claim form whether a claim for disability benefits due to the same condition has been filed under any State or other Federal workers' compensation law. Benefits received as a result of such a claim could be offset against Federal benefits. This program is excluded from coverage under E.O. 12372.
This section indicates whether any prior coordination or approval is required with governmental or nongovernmental units
prior to the submission of a formal application to the federal funding agency.
Notify Office of Workers' Compensation Programs (OWCP), Employment Standards Administration. The appeal process includes formal hearings, Benefits Review Board consideration, and review by Federal courts, as appropriate.
In some cases, there are no provisions for appeal. Where applicable, this section discusses appeal procedures or allowable rework time for resubmission
of applications to be processed by the funding agency. Appeal procedures vary with individual programs and are either listed in this section or
applicants are referred to appeal procedures documented in the relevant Code of Federal Regulations (CFR).
In some instances, renewal procedures may be the same as for the application procedure, e.g., for projects of a non-continuing nature renewals will be treated as new, competing applications; for projects of an ongoing nature, renewals may be given annually.
Who can benefit...
Disabled coal miners, widows and other surviving dependents of the deceased.
About this section:
This section lists the ultimate beneficiaries of a program, the criteria they must satisfy and who specifically is not eligible. The applicant and beneficiary will generally be the same for programs that provide assistance directly from a Federal agency. However, financial assistance that passes through State or local governments will have different applicants and beneficiaries since the assistance is transmitted to private sector beneficiaries who are not obligated to request or apply for the assistance.
What types of assistance...
Direct Payments with Unrestricted Use
Financial assistance from the Federal government provided directly to beneficiaries who satisfy Federal eligibility requirements with no restrictions being imposed on the recipient as to how the money is spent. Included are payments under retirement, pension, and compensatory programs.
How much financial aid...
Range and Average of Financial Assistance
Basic monthly rate: $518.50 (claimant only). For three or more dependents: $1,037.00 maximum effective January 2002 (this does not include medical services). Average monthly benefits payment: $574.30 for February, 2002.
This section lists the representative range (smallest to largest) of the amount of financial assistance available. These figures are based upon funds awarded in the past fiscal year and the current fiscal year to date. Also indicated is an approximate average amount of awards which were made in the past and current fiscal years.
(Benefits) FY 03 $426,014,000; FY 04 enacted $390,848,000; and FY 05 est $358,806,000.
The dollar amounts listed in this section represent obligations for the past fiscal year (PY), estimates for the current fiscal year (CY), and estimates for the budget fiscal year (BY) as reported by the Federal agencies. Obligations for non-financial assistance programs indicate the administrative expenses involved in the operation of a program.
Note: This 11-digit budget account identification code represents the account which funds a particular program.
This code should be consistent with the code given for the program area as specified in Appendix III of the Budget of the United States Government.
Examples of funded projects...
About this section
This section indicates the different types of projects which have been funded in the past. Only projects funded under Project Grants or Direct Payments for Specified Use should be listed here. The examples give potential applicants an idea of the types of projects that may be accepted for funding. The agency should list at least five examples of the most recently funded projects.
In fiscal year 2003 over 6,200 claims for benefits were received. At the end of FY 2003 the program was disbursing monthly cash and medical treatment benefit outlays of approximately $370,000,000 to almost 48,000 recipients under Part C and approximately $417,000,000 to 59,000 recipients under Part B.
Criteria for selecting proposals...
Length and Time Phasing of Assistance
The period of total disability with no monetary limit. Death: Spouse - until death or remarriage; children - until age 18 or to age 23 if qualified as a student as defined by the Act unless under a disability as defined in Section 223(d) of the Social Security Act, 42 U.S.C. 423(d). Employers or their insurance carriers are required to begin compensation within 30 days of the initial determination of eligibility. Payments are disbursed on a monthly basis.
Formula and Matching Requirements
A formula may be based on population, per capita income, and other statistical factors. Applicants are informed whether there are any matching requirements to be met when participating in the cost of a project. In general, the matching share represents that portion of the project costs not borne by the Federal government. Attachment F of OMB Circular No. A-102 (Office of Management and Budget) sets forth the criteria and procedures for the evaluation of matching share requirements which may be cash or in-kind contributions made by State and local governments or other agencies, institutions, private organizations, or individuals to satisfy matching requirements of Federal grants or loans.
Cash contributions represent the grantees' cash outlay, including the outlay of money contributed to the grantee by other public agencies, institutions, private organizations, or individuals. When authorized by Federal regulation, Federal funds received from other grants may be considered as the grantees' cash contribution.
In-kind contributions represent the value of noncash contributions provided by the grantee, other public agencies and institutions, private organizations or individuals. In-kind contributions may consist of charges for real property and equipment, and value of goods and services directly benefiting and specifically identifiable to the grant program. When authorized by Federal legislation, property purchased with Federal funds may be considered as grantees' in-kind contribution.
Maintenance of effort (MOE) is a requirement contained in certain legislation, regulations, or administrative policies stating that a grantee must maintain a specified level of financial effort in a specific area in order to receive Federal grant funds, and that the Federal grant funds may be used only to supplement, not supplant, the level of grantee funds.
Post assistance requirements...
Any change in an eligibility requirement or in a factor affecting the amount of benefits, such as, State workers' compensation awards, or change in status of a dependent, must be reported to the Office of Workers' Compensation Programs when it occurs.
This section indicates whether program reports, expenditure reports, cash reports or performance monitoring are required by the Federal funding agency, and specifies at what time intervals (monthly, annually, etc.) this must be accomplished.
This section discusses audits required by the Federal agency.
The procedures and requirements for State and local governments and nonprofit entities are set forth in OMB Circular No. A-133.
These requirements pertain to awards made within the respective State's fiscal year - not the Federal fiscal year,
as some State and local governments may use the calendar year or other variation of time span designated as the fiscal year period,
rather than that commonly known as the Federal fiscal year (from October 1st through September 30th).
This section indicates the record retention requirements and the type of records the Federal agency may require.
Not included are the normally imposed requirements of the General Accounting Office.
For programs falling under the purview of OMB Circular No. A-102, record retention is set forth in Attachment C.
For other programs, record retention is governed by the funding agency's requirements.
Federal Mine Safety and Health Amendments Act of 1977, as amended, Public Laws 91-173, 92-303, 95-239, and 97-119.
This section lists the legal authority upon which a program is based (acts, amendments to acts, Public Law numbers, titles, sections, Statute Codes, citations to the U.S. Code, Executive Orders, Presidential Reorganization Plans, and Memoranda from an agency head).
Regulations, Guidelines, And Literature
Code of Federal Regulations, Title 20, Parts 410.401 et seq., 718, 722, 725, 726, and 727. Also, Black Lung Amendments of 1981, 30 U.S.C. 901 et seq. "Black Lung Benefits," Fact Sheet No. ESA 91-14.