The mission of the Division of Coal Mine Workers’ Compensation, or Federal Black Lung Program, is to administer claims filed under the Black Lung Benefits Act. The Act provides compensation to coal miners who are totally disabled by pneumoconiosis arising out of coal mine employment, and to survivors of coal miners whose deaths are attributable to the disease. We administer benefits paid from the Black Lung Disability Trust Fund and by responsible coal mine operators under Part C of the Act, and benefits paid under Part B of the Act, to ensure that all payments are accurate and timely. In addition to monthly compensation, we provide eligible miners with medical coverage for the treatment of lung diseases related to pneumoconiosis. We identify and work with coal mine operators and insurers so that liability for payment of benefits is properly assigned.
The Program provides medical treatment for respiratory conditions related to treatment for black lung disease. Medical treatment bills are monitored and subject to audit to ensure that the requested treatments are necessary and that payments are correct.
If you are filing on the employment record of a deceased miner, you must complete a CM-912, Survivor’s Claim for Benefits, and related forms.
If you are filing a claim on behalf of a minor child or on behalf of someone under a legal or physical impairment, please consult 20 CFR 725.301 to make sure that you are eligible to file. Benefits are payable only to the beneficiary, his or her representative payee, or his or her legal guardian.
Per: U.S. Department Of Labor https://www.dol.gov/agencies/owcp/dcmwc/guidefilingbenefits
The steps outlined here are intended as a “quick-start” guide for active or retired miners. More detailed information about filing a claim as an active or retired miner is available on our website. Should you have any questions, please contact the District Office that has jurisdiction over your claim.
Step 1: Complete the application form entitled, “Miner’s Claim for Benefits under the Black Lung Act” (form CM-911)
Step 2: Complete the form entitled, “Employment History” (form CM-911a)
Step 3: Review SSA-581 instructions and complete two copies of the form entitled, “Authorization to Obtain Earnings Data from the Social Security Administration” (SSA-581)
Step 4: Review “Selection of Examining Provider” instructions and complete the “Selection of Examining Provider” form. Please note, you should select a provider in your home state or a contiguous state. A list of approved providers is available.