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FEDERAL · 20 CFR

Part 725 — Claims for Benefits Under Part C of Title IV of the Federal Mine Safety and Health Act, as Amended

185 sections · Title 20: Employees' Benefits

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