Black Lung Benefits Restoration Act of 1995 - Amends the Black Lung Benefits Act (the Act) to provide that, when black lung benefits are paid after an initial determination of eligibility, repayment of an overpayment will not be required even upon a final determination of ineligibility, if there was no fraud or deception by the claimant. Provides for refunds to claimants of any such repayments required before this Act. Provides for reimbursement by the Black Lung Disability Trust Fund to operators who made such benefit overpayments.
(Sec. 3) Revises evidence requirements. Prohibits the responsible operator or the Trust Fund from requiring more than one medical examination to controvert medical evidence presented by a claimant on the basis of a medical examination. Prohibits any claimant from offering more than three medical examinations; but authorizes the administrative law judge to require the claimant to submit to an additional medical examination.
(Sec. 4) Revises requirements for survivor benefits. Provides that a miner's death shall be considered to have occurred as a result of the pneumoconiosis if the miner was receiving benefits for, or was disabled by, pneumoconiosis at the time of death. Qualifies to receive survivor benefits any widow or widower of a miner who was married to the miner for at least nine months preceding the miner's death, or who had children as a result of such a marriage. Provides that widows or widowers of miners are not disqualified to receive survivor benefits if they remarry after attaining age 50; but prohibits them from receiving an augmentation in survivor benefits on any basis arising out of a subsequent marriage.
(Sec. 5) Provides for notice and an opportunity for a hearing to appeal to the Secretary any designation of liability as the responsible operator. Authorizes assessment of proceeding costs against any operator who does not have reasonable grounds to contest the designation.
(Sec. 6) Requires that all reasonable legal costs and expenses incurred by the claimant be paid by the responsible operator, or the Trust Fund, after an administrative or judicial determination that the claimant is entitled to black lung benefits. Requires the Secretary or court to take action to assure that they are paid within 45 days after such determination.
Requires the Trust Fund to pay any operator the legal costs the operator paid to a claimant determined in a later proceeding to be ineligible for benefits.
(Sec. 7) Prohibits a claimant or respondent from appealing to the Benefits Review Board any order unless it has been made by an administrative law judge.
(Sec. 8) Allows any claim filed under the Act after January 1, 1982, but before enactment of this Act, to be refiled after enactment of this Act for a de novo review on the merits.
(Sec. 9) Requires that the legislative history accompanying this Act be considered controlling if a term in any amendment made by this Act is considered ambiguous in any legal proceeding.
(Sec. 10) Makes attorney fees provisions of this Act applicable only to new claims filed after October 1, 1994.
[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 754 Introduced in House (IH)]
104th CONGRESS
1st Session
H. R. 754
To make improvements in the Black Lung Benefits Act.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 31, 1995
Mr. Holden (for himself, Mr. Boucher, Mr. Kanjorski, Mr. Klink, Mr.
Mascara, Mr. Murtha, Mr. Rahall and, Mr. Wise) introduced the following
bill; which was referred to the Committee on Economic and Educational
Opportunities
_______________________________________________________________________
A BILL
To make improvements in the Black Lung Benefits Act.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; REFERENCE.
(a) Short Title.--This Act may be cited as the ``Black Lung
Benefits Restoration Act of 1995''.
(b) Reference.--Whenever in this Act (other than section 9(a)(1))
an amendment or repeal is expressed in terms of an amendment to, or
repeal of, a section or other provision, the reference shall be
considered to be made to a section or other provision of the Black Lung
Benefits Act.
SEC. 2. BENEFIT OVERPAYMENT.
Part C is amended by adding at the end the following:
``Sec. 436 (a) The repayment of benefits paid on a claim filed
under this part before the final adjudication of the claim shall not be
required if the claim was finally denied, unless fraud or deception was
used to procure the payment of such benefits.
``(b) The trust fund shall refund any payments made to it as a
reimbursement of benefits paid on a claim filed under this part before
the final adjudication of the claim, unless fraud or deception was used
to procure the payment of such benefits.
``(c) The trust fund shall reimburse an operator for any benefits
paid on a claim filed under this part before the final adjudication of
the claim if the claim was finally denied.
``(d) If on a claim for benefits filed under this part--
``(1) the Secretary makes an initial determination--
``(A) of eligibility, or
``(B) that particular medical benefits are payable,
or
``(2) an award of benefits is made,
the operator found to be the responsible operator under section 422(h)
shall, within 30 days of the date of such determination or award,
commence the payment of monthly benefits accruing thereafter and of
medical benefits that have been found payable. If an operator fails to
timely make any payment required by an initial determination or by an
award, such determination or award shall be considered final as of the
date of its issuance.''.
SEC. 3. EVIDENCE.
Section 422 (30 U.S.C. 932) is amended by adding at the end the
following:
``(m)(1)(A) During the course of all proceedings on a claim for
benefits under this part, the results of not more than 3 medical
examinations offered by the claimant may be received as evidence to
support eligibility for benefits.
``(B) During the course of all proceedings on a claim for benefits
under this part, the responsible operator and the trust fund--
``(i) may each require, at no expense to the claimant, not
more than one medical examination of the miner, and
``(ii) may not each offer as evidence the results of more
than one medical examination of the miner.
``(C) An administrative law judge may require the miner to submit
to a medical examination by a physician assigned by the District
Director if the administrative law judge determines that, at any time,
there is good cause for requiring such examination. For purposes of
this subparagraph, good cause shall exist only when the administrative
law judge is unable to determine from existing evidence whether the
claimant is entitled to benefits.
``(D) The complete pulmonary evaluation provided each miner under
section 413(b) and any consultive evaluation developed by the District
Director shall be received into evidence notwithstanding subparagraph
(A) or (B).
``(E) Any record of--
``(i) hospitalization for a pulmonary or related disease,
``(ii) medical treatment for a pulmonary or related
disease, and
``(iii) a biopsy or an autopsy,
may be received into evidence notwithstanding subparagraph (A) or (B).
``(2) In addition to the medical examinations authorized by
paragraph (1), each party may submit one interpretive medical opinion
(whether presented as documentary evidence or in oral testimony)
reviewing each clinical study or physical examination (including a
consultive reading of a chest roentgenogram, an evaluation of a blood
gas study, and an evaluation of a pulmonary function study) derived
from any medical examination or contained in a record referred to in
paragraph (1)(E).
``(3) A request for modification of a denied claim under section 22
of the Longshore and Harbor Workers' Compensation Act, as made
applicable to this Act by subsection (a) of this section, shall be
considered as if it were a new claim for the purpose of applying the
limitations prescribed by paragraphs (1) and (2).
``(4) The opinion of a miner's treating physician, if offered in
accordance with paragraph (1)(A), shall be given substantial weight
over the opinion of other physicians in determining the claimant's
eligibility for benefits if the treating physician is board-certified
in a specialty relevant to the diagnosis of total disability or death
due to pneumoconiosis.
``(5) For purposes of this subsection, a medical examination
consists of a physical examination and all appropriate clinical studies
(not including a biopsy or an autopsy) related to the diagnosis of
total disability or death due to pneumoconiosis.''.
SEC. 4. SURVIVOR BENEFITS.
(a) Death.--Section 422 (30 U.S.C. 932), as amended by section 3,
is amended by adding at the end the following:
``(n) If an eligible survivor files a claim for benefits under this
part and if the miner--
``(1) was receiving benefits for pneumoconiosis pursuant to
a final adjudication under this part, or
``(2) was totally disabled by pneumoconiosis at the time of
the miner's death,
the miner's death shall be considered to have occurred as a result of
the pneumoconiosis.''.
(b) Rules for Widows and Widowers.--Section 422 (30 U.S.C. 932), as
amended by subsection (a), is amended by adding at the end the
following:
``(o)(1) A widow or widower of a miner who was married to the miner
for less than 9 months at any time preceding the miner's death is not
qualified to receive survivor benefits under this part unless the widow
or widower was the natural or adoptive parent of the miner's child.
``(2) The widow or widower of a miner is disqualified to receive
survivor benefits under this part if the widow or widower remarries
before attaining the age of 50.
``(3) A widow or widower may not receive an augmentation in
survivor benefits on any basis arising out of a remarriage of the widow
or widower.''.
SEC. 5. RESPONSIBLE OPERATOR.
Section 422(h) (30 U.S.C. 932(h)) is amended by inserting ``(1)''
after ``(h)'' and by adding at the end the following:
``(2)(A) Prior to issuing an initial determination of eligibility,
the Secretary shall, after investigation, notice, and a hearing as
provided in section 19 of the Longshore and Harbor Workers'
Compensation Act, as made applicable to this Act by subsection (a) of
this section, determine whether any operator meets the Secretary's
criteria for liability as a responsible operator under this Act. If a
hearing is timely requested on the liability issue, the decision of the
administrative law judge conducting the hearing shall be issued not
later than 120 days after such request and shall not be subject to
further appellate review.
``(B) If the administrative law judge determines that an operator's
request for a hearing on the liability issue was made without
reasonable grounds, the administrative law judge may assess the
operator for the costs of the proceeding (not to exceed $750).''.
SEC. 6. ATTORNEY FEES.
Section 422 (30 U.S.C. 932), as amended by section 4(b), is amended
by adding at the end the following:
``(p)(1) If in any administrative or judicial proceeding on a claim
for benefits a determination is made that a claimant is entitled to
such benefits, the claimant shall be entitled to receive all reasonable
costs and expenses (including expert witness and attorney's fees)
incurred by the claimant in such proceeding and in any other
administrative or judicial proceeding on such claim occurring before
such proceeding.
``(2) In the case of a proceeding held with respect to such claim--
``(A) the person or Board which made the determination that
the claimant is entitled to benefits in an administrative
proceeding and any other person or Board which made a prior
determination in an administrative proceeding on such claim, or
``(B) the court in the case of a judicial proceeding,
shall determine the amount of all costs and expenses (including expert
witness and attorney's fees) incurred by the claimant in connection
with any such proceeding and shall assess the operator responsible to
the claimant for such costs and expenses which are reasonable or if
there is not an operator responsible to the claimant, shall assess the
fund for such costs and expenses.
``(3) The determination of such costs and expenses shall be made
within 60 days of the date the claimant submits a petition for the
payment of such costs and expenses to a person, the Board, or court
which made a determination on the claimant's claim. The person, Board,
or court receiving such petition shall take such action as may be
necessary to assure that such costs and expenses are paid within 45
days of the date of the determination of such costs and expenses unless
a motion to reconsider--
``(A) the amount of such costs and expenses, or
``(B) the person liable for the payment of such amount,
is pending.
``(4) If an operator pays costs and expenses assessed under
paragraph (1) and if the claimant for whom such costs and expenses were
paid is determined in a later proceeding not to be eligible for
benefits under this part, the fund shall pay the operator the amount
paid for such costs and expenses.
``(5) Section 28(e) of the Longshore and Harbor Workers'
Compensation Act shall apply with respect to any person who receives
costs and expenses which are paid under this subsection on account of
services rendered a claimant.''.
SEC. 7. ADMINISTRATION.
(a) Appeals to the Benefits Review Board.--No appeal of an order in
a proceeding under the Black Lung Benefits Act may be made by a
claimant or respondent to the Benefits Review Board unless such order
has been made by an administrative law judge.
(b) Acquiescence.--The Secretary of Labor may not delegate to the
Benefits Review Board the authority to refuse to acquiesce in a
decision of a Federal court.
SEC. 8. REFILING.
Any claim filed under the Black Lung Benefits Act after January 1,
1982, but before the effective date of this Act prescribed by section
11(a), may be refiled under such Act after such effective date for a de
novo review on the merits.
SEC. 9. CONSTRUCTION.
If in any legal proceeding a term in any amendment made by this Act
is considered to be ambiguous, the legislative history accompanying
this Act shall be considered controlling.
SEC. 10. EFFECTIVE DATES.
(a) General Rule.--Except as provided in subsection (b), this Act
and the amendments made by this Act shall take effect October 1, 1994.
(b) Section 6.--The amendment made by section 6 shall apply only
with respect to claims which are filed for the first time after October
1, 1994, and shall not apply with respect to any claim which is filed
before such date and which is refiled under section 8 of this Act after
such date.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Economic and Educational Opportunities. Relations, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Workforce Protections.
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