20 CFR Part 725
PART 725—CLAIMS FOR BENEFITS UNDER PART C OF TITLE IV OF THE FEDERAL MINE SAFETY AND HEALTH ACT, AS AMENDED
- PART 725—CLAIMS FOR BENEFITS UNDER PART C OF TITLE IV OF THE FEDERAL MINE SAFETY AND HEALTH ACT, AS AMENDED
- Chapter VI—Office of Workers' Compensation Programs, Department of Labor › Subchapter B—Federal Coal Mine Health and Safety Act of 1969, as Amended
- Subpart A—General
- § 725.1 Statutory provisions.
- § 725.2 Purpose and applicability of this part.
- § 725.3 Contents of this part.
- § 725.4 Applicability of other parts in this title.
- § 725.101 Definition and use of terms.
- § 725.102 Disclosure of program information.
- § 725.103 Burden of proof.
- Subpart B—Persons Entitled to Benefits, Conditions, and Duration of Entitlement
- § 725.201 Who is entitled to benefits; contents of this subpart.
- Conditions and Duration of Entitlement: Miner
- § 725.202 Miner defined; condition of entitlement, miner.
- § 725.203 Duration and cessation of entitlement; miner.
- Conditions and Duration of Entitlement: Miner's Dependents (Augmented Benefits)
- § 725.204 Determination of relationship; spouse.
- § 725.205 Determination of dependency; spouse.
- § 725.206 Determination of relationship; divorced spouse.
- § 725.207 Determination of dependency; divorced spouse.
- § 725.208 Determination of relationship; child.
- § 725.209 Determination of dependency; child.
- § 725.210 Duration of augmented benefits.
- § 725.211 Time of determination of relationship and dependency of spouse or child for purposes of augmentation of benefits.
- § 725.212 Conditions of entitlement; surviving spouse or surviving divorced spouse.
- § 725.213 Duration of entitlement; surviving spouse or surviving divorced spouse.
- § 725.214 Determination of relationship; surviving spouse.
- § 725.215 Determination of dependency; surviving spouse.
- § 725.216 Determination of relationship; surviving divorced spouse.
- § 725.217 Determination of dependency; surviving divorced spouse.
- § 725.218 Conditions of entitlement; child.
- § 725.219 Duration of entitlement; child.
- § 725.220 Determination of relationship; child.
- § 725.221 Determination of dependency; child.
- § 725.222 Conditions of entitlement; parent, brother, or sister.
- § 725.223 Duration of entitlement; parent, brother, or sister.
- § 725.224 Determination of relationship; parent, brother, or sister.
- § 725.225 Determination of dependency; parent, brother, or sister.
- § 725.226 “Good cause” for delayed filing of proof of support.
- § 725.227 Time of determination of relationship and dependency of survivors.
- § 725.228 Effect of conviction of felonious and intentional homicide on entitlement to benefits.
- § 725.229 Intestate personal property.
- § 725.230 Legal impediment.
- § 725.231 Domicile.
- § 725.232 Member of the same household—“living with,” “living in the same household,” and “living in the miner's household,” defined.
- § 725.233 Support and contributions.
- Subpart C—Filing of Claims
- § 725.301 Who may file a claim.
- § 725.302 Evidence of authority to file a claim on behalf of another.
- § 725.303 Date and place of filing of claims.
- § 725.304 Forms and initial processing.
- § 725.305 When a written statement is considered a claim.
- § 725.306 Withdrawal of a claim.
- § 725.307 Cancellation of a request for withdrawal.
- § 725.308 Time limits for filing claims.
- § 725.309 Additional claims; effect of prior denial of benefits.
- § 725.310 Modification of awards and denials.
- § 725.311 Communications with respect to claims; time computations.
- Subpart D—Adjudication Officers; Parties and Representatives
- § 725.350 Who are the adjudication officers?
- § 725.351 Powers of adjudication officers.
- § 725.352 Disqualification of adjudication officer.
- § 725.360 Parties to proceedings.
- § 725.361 Party amicus curiae.
- § 725.362 Representation of parties.
- § 725.363 Qualification of representative.
- § 725.364 Authority of representative.
- § 725.365 Approval of representative's fees; lien against benefits.
- § 725.366 Fees for representatives.
- § 725.367 Payment of a claimant's attorney's fee by responsible operator or fund.
- Subpart E—Adjudication of Claims by the District Director
- § 725.401 Claims development—general.
- § 725.402 Approved State workers' compensation law.
- § 725.403 [Reserved]
- § 725.404 Development of evidence—general.
- § 725.405 Development of medical evidence; scheduling of medical examinations and tests.
- § 725.406 Medical examinations and tests.
- § 725.407 Identification and notification of responsible operator.
- § 725.408 Operator's response to notification.
- § 725.409 Denial of a claim by reason of abandonment.
- § 725.410 Submission of additional evidence.
- § 725.411 Initial adjudication in Trust Fund cases.
- § 725.412 Operator's response.
- § 725.413 Disclosure of medical information.
- § 725.414 Development of evidence.
- § 725.415 Action by the district director after development of evidence.
- § 725.416 Conferences.
- § 725.417 Action at the conclusion of conference.
- § 725.418 Proposed decision and order.
- § 725.419 Response to proposed decision and order.
- § 725.420 Initial determinations.
- § 725.421 Referral of a claim to the Office of Administrative Law Judges.
- § 725.422 Legal assistance.
- § 725.423 Extensions of time.
- Subpart F—Hearings
- § 725.450 Right to a hearing.
- § 725.451 Request for hearing.
- § 725.452 Type of hearing; parties.
- § 725.453 Notice of hearing.
- § 725.454 Time and place of hearing; transfer of cases.
- § 725.455 Hearing procedures; generally.
- § 725.456 Introduction of documentary evidence.
- § 725.457 Witnesses.
- § 725.458 Depositions; interrogatories.
- § 725.459 Witness fees.
- § 725.460 Consolidated hearings.
- § 725.461 Waiver of right to appear and present evidence.
- § 725.462 Withdrawal of controversion of issues set for formal hearing; effect.
- § 725.463 Issues to be resolved at hearing; new issues.
- § 725.464 Record of hearing.
- § 725.465 Dismissals for cause.
- § 725.466 Order of dismissal.
- § 725.475 Termination of hearings.
- § 725.476 Issuance of decision and order.
- § 725.477 Form and contents of decision and order.
- § 725.478 Filing and service of decision and order.
- § 725.479 Finality of decisions and orders.
- § 725.480 Modification of decisions and orders.
- § 725.481 Right to appeal to the Benefits Review Board.
- § 725.482 Judicial review.
- § 725.483 Costs in proceedings brought without reasonable grounds.
- Subpart G—Responsible Coal Mine Operators
- § 725.490 Statutory provisions and scope.
- § 725.491 Operator defined.
- § 725.492 Successor operator defined.
- § 725.493 Employment relationship defined.
- § 725.494 Potentially liable operators.
- § 725.495 Criteria for determining a responsible operator.
- § 725.496 Special claims transferred to the fund.
- § 725.497 Procedures in special claims transferred to the fund.
- Subpart H—Payment of Benefits
- General Provisions
- § 725.501 Payment provisions generally.
- § 725.502 When benefit payments are due; manner of payment.
- § 725.503 Date from which benefits are payable.
- § 725.504 Payments to a claimant employed as a miner.
- § 725.505 Payees.
- § 725.506 Payment on behalf of another; “legal guardian” defined.
- § 725.507 Guardian for minor or incompetent.
- § 725.510 Representative payee.
- § 725.511 Use and benefit defined.
- § 725.512 Support of legally dependent spouse, child, or parent.
- § 725.513 Accountability; transfer.
- § 725.514 Certification to dependent of augmentation portion of benefit.
- § 725.515 Assignment and exemption from claims of creditors.
- Benefit Rates
- § 725.520 Computation of benefits.
- § 725.521 Commutation of payments; lump sum awards.
- § 725.522 Payments prior to final adjudication.
- Special Provisions for Operator Payments
- § 725.530 Operator payments; generally.
- § 725.531 Receipt for payment.
- § 725.532 Suspension, reduction, or termination of payments.
- Increases and Reductions of Benefits
- § 725.533 Modification of benefits amounts; general.
- § 725.534 Reduction of State benefits.
- § 725.535 Reductions; receipt of State or Federal benefit.
- § 725.536 Reductions; excess earnings.
- § 725.537 Reductions; retroactive effect of an additional claim for benefits.
- § 725.538 Reductions; effect of augmentation of benefits based on subsequent qualification of individual.
- § 725.539 More than one reduction event.
- Overpayments; Underpayments
- § 725.540 Overpayments.
- § 725.541 Notice of waiver of adjustment or recovery of overpayment.
- § 725.542 When waiver of adjustment or recovery may be applied.
- § 725.543 Standards for waiver of adjustment or recovery.
- § 725.544 Collection and compromise of claims for overpayment.
- § 725.545 Underpayments.
- § 725.546 Relation to provisions for reductions or increases.
- § 725.547 Applicability of overpayment and underpayment provisions to operator or carrier.
- § 725.548 Procedures applicable to overpayments and underpayments.
- Subpart I—Enforcement of Liability; Reports
- § 725.601 Enforcement generally.
- § 725.602 Reimbursement of the fund.
- § 725.603 Payments by the fund on behalf of an operator; liens.
- § 725.604 Enforcement of final awards.
- § 725.605 Defaults.
- § 725.606 Security for the payment of benefits.
- § 725.607 Payments of additional compensation.
- § 725.608 Interest.
- § 725.609 Enforcement against other persons.
- § 725.620 Failure to secure benefits; other penalties.
- § 725.621 Reports.
- Subpart J—Medical Benefits and Vocational Rehabilitation
- § 725.701 What medical benefits are available?
- § 725.702 Who is considered a physician?
- § 725.703 How is treatment authorized?
- § 725.704 How are arrangements for medical care made?
- § 725.705 Is prior authorization for medical services required?
- § 725.706 What reports must a medical provider give to OWCP?
- § 725.707 At what rate will fees for medical services and treatments be paid?
- § 725.708 How are payments for professional medical services and medical equipment determined?
- § 725.709 How are payments for prescription drugs determined?
- § 725.710 How are payments for outpatient medical services determined?
- § 725.711 How are payments for inpatient medical services determined?
- § 725.712 When and how are fees reduced?
- § 725.713 If a fee is reduced, may a provider bill the claimant for the balance?
- § 725.714 How do providers enroll with OWCP for authorizations and billing?
- § 725.715 How do providers submit medical bills?
- § 725.716 How should a miner prepare and submit requests for reimbursement for covered medical expenses and transportation costs?
- § 725.717 What are the time limitations for requesting payment or reimbursement for covered medical services or treatments?
- § 725.718 How are disputes concerning medical benefits resolved?
- § 725.719 What is the objective of vocational rehabilitation?
- § 725.720 How does a miner request vocational rehabilitation assistance?
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