H.R. 4415 (103rd): Black Lung Benefits Restoration Act of 1994

103rd Congress, 1993–1994. Text as of May 12, 1994 (Introduced).

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HR 4415 IH

103d CONGRESS

2d Session

H. R. 4415

To make improvements in the Black Lung Benefits Act.

IN THE HOUSE OF REPRESENTATIVES

MAY 12, 1994

Mr. MURPHY introduced the following bill; which was referred to the Committee on Education and Labor


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 1994’.

    (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. DEFINITIONS.

    (a) COKE OVENS-

      (1) FEDERAL MINE SAFETY AND HEALTH ACT OF 1977- Section 3 of the Federal Mine Safety and Health Act of 1977 (30 U.S.C. 802) is amended--

        (A) in paragraph (d), by inserting before the semicolon the following: ‘or who operates a coke oven or any machine shop or other operation reasonably related to the coke oven’,

        (B) in paragraph (g), by inserting before the semicolon the following: ‘or working at a coke oven or in any other operation reasonably related to the operation of a coke oven’, and

        (C) in paragraph (h)(2), by inserting before the semicolon the following: ‘and includes a coke oven and any operation, structure, or area of land reasonably related to the operation of a coke oven’.

      (2) BLACK LUNG BENEFITS ACT- The first sentence of section 402(d) (30 U.S.C. 902(d)) is amended by inserting before the period the following: ‘or who works or has worked at a coke oven or in any other operation reasonably related to the operation of a coke oven’.

    (b) PNEUMOCONIOSIS- Section 402(b) (30 U.S.C. 902(b)) is amended--

      (1) by adding after ‘sequelae’ the following: ‘which disease or sequelae is restrictive or obstructive or both’, and

      (2) by striking out ‘coal mine’ and inserting in lieu thereof ‘coal mine or coke oven’.

SEC. 10. 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. 11. 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.