§ 727.108 - Action by the Office, Department of Labor pending or denied claim.  


Latest version.
  • (a) In the case of a claim filed with the Office under section 415 or part C of title IV of the act which is pending or has been denied as of March 1, 1978, the Office shall follow the procedures set forth in this section.

    (b) The district director shall examine the evidence contained in the file to determine whether the claim may be approved in light of the amendments made by the Black Lung Benefits Reform Act of 1977.

    (c) The district director may: (1) Request up-to-date information from the claimant pertaining to any matter affecting the amount of benefits payable (see subpart G of part 725 of this subchapter); and (2) request any additional information or verification which may be necessary to establish a more detailed and complete history of the miner's employment, for the purpose of determining the identity of any coal mine employer which may be liable for the payment of the claim, and for such other purposes as may be appropriate. Upon receipt of any additional information requested under this paragraph, or if the claimant fails to supply such information, the district director may notify a coal mine employer, if any, of its possible liability for the claim and proceed to adjudicate the claim under §§ 725.409-725.421 of this subchapter.

    (d) If it is determined by the district director that the evidence on file is insufficient to support a finding of entitlement with respect to a claim reviewed under this section, the district director may:

    (1) Assist the claimant in obtaining additional medical evidence or request that such evidence be submitted (see §§ 725.405-725.408 of this subchapter); or (2) request such additional documents or information as may be necessary to establish the amount of benefits which may be payable, or to establish a more detailed and complete history of the nature and duration of the miner's employment. Based upon the evidence developed under this paragraph, if any, and the information contained in the claimant's original file, the district director may make an initial finding with respect to the eligibility of the claimant and shall proceed to adjudicate the claim under §§ 725.409-725.421 of this subchapter.

    (e) Notwithstanding the provisions of paragraphs (a) through (d) of this section, in the case of a claim filed by a part B beneficiary under part C of the act prior to March 1, 1978, for such additional benefits as may be available, the Department shall accept the Social Security Administration's documented finding of entitlement as its initial determination of eligibility.