-
- A.
Miner
-
1. Coal Mine;
Coal Mine Dust
2.
Status/Function/Situs & Situs/Function Tests
- a. Status of the Coal
- b. Function Test
- c. Situs Test
3.
Construction/Transportation Workers
4.
General Case Listings For Covered and Not Covered Coal Mine
Employment [listed in Circuit order]
- a.
Cases: Covered Coal Mine Employment
- b.
Cases: Not Covered Coal Mine Employment
B.
Survivors/Dependents [Digest Headings:
Widow-Subsequent Remarriage; SSA Benefits As Miner's Property;
Impact of State Law; Conveyance of a Home; Disabled Child]
C.
Pneumoconiosis [Digest Headings: Anthracosis in
Lymph Nodes]
D.
Total Disability [Digest Headings: Establishing
Total Disability Under the Act; Age as a Cause of
Disability]
E.
Length of Coal Mine Employment
F.
Usual Coal Mine Work [Digest Headings: Voluntary
Overtime]
G.
Comparable and Gainful Work
H.
Responsible Operator [Digest Headings: Changing Form
of Business Entity; Withdrawal of Controversion; Federal
Government as Operator; Notice to Carrier; Identifying the
Responsible Operator]
PART II PROCEDURAL
ISSUES
- A.
Requirement to File State Workers'
Compensation Claim;
Offset [Digest Headings: Section 725.535(b);
Validity]
- B.
Consequences of Filing a Part B Claim
[Digest
Headings: Converting Part B Claims to Part C; Prior Findings
of Entitlement]
- C. Payment
of Benefits
- 1.
Generally; Assessment of Interest On Past Due Benefit
Installments.
- 2.
Under the 1981 Amendments to the Act
[Digest
Headings: Trust Fund Liability]
- 3.
Overpayments
- a.
Erroneous Information
b. Income
and Expenses
- c.
Defeat the Purpose of the Act
- d.
Changed Position for the Worse
- e.
Miscellaneous
- D.
Applicable Law
[Digest Headings: Application of
Current Law By Appellate Tribunal]
- E.
Viability of Claims
- 1.
Abandonment
[Digest Headings: Distinguishing
Sections 725.409 and 725.410]
- 2.
Merger of Claims/Duplicate Claims
- a.
Tenth Circuit's Duplicate Claim Approach
- b.
Material Change of Conditions
- 1).
Seventh Circuit
- c.
Merging Duplicate Claims
- d.
Duplicate Survivor's Claims
- F.
Modifications
- 1.
Generally
- 2.
Procedural issues
- 3.
Mistake of fact/change in conditions
- G.
Commencement of Benefits
- 1.
Onset of Total Disability Due to Pneumoconiosis
- a.
Section 727.302; Validity
- b.
Generally
- 2. The
Effect of Continued Employment
- H. Scope
of Review
- 1.
Generally; Timeliness
- a.
Thirty Day Notice; Section 725.458
- 2.
Administrative Procedure Act
- 3. Law
of the Case
- 4.
Issues on Appeal
- a.
Board's Authority
- b.
Jurisdiction
[Digest Headings: Jurisdiction on
Interest Cases]
- I.
Policies in General
- 1.
Settlements and Releases
PART III
ADMINISTRATIVE PROCESSING OF CLAIMS
- A. The
Claims Process
- 1.
Filing of Claims/Appeals, Service, Sufficiency of
Pleadings
[Digest Headings: Actual Knowledge of
Service; Sufficiency of Pleadings (Cross-appeals); Timely
Filing of Appeals; Interlocutory Appeals; Validity of
Section 802.206(e)]
- 2. The
District Director's Role and
Representative
[Digest Headings: Deference to the
Director in Interpreting Regulations; Relationship Between
District Director and the Director; Validity of DOL Denial
Letter]
- 3.
Claimants' Rights [Including Criteria for Ordering a
Physical Examination]
- B.
Full and Fair Hearing
- 1.
Right to a Hearing; Waiver
- 2. Due
Process
- 3.
Right to Counsel
- a.
Role of Government Attorney
[Digest Headings:
Absence of Counsel; Acts of Counsel Binding on
Party]
- 4.
Admission of Evidence
- C.
Evaluation and Weighing of Evidence
- 1.
Elements of Entitlement
- a.
Generally; Interpretation of Medical Data
- b.
Disability
[Digest Headings: Date at Which
Disability is Judged; Inferring Total Disability]
- c.
Existence of Pneumoconiosis
- d.
Cause of Disability and Pneumoconiosis
[Digest
Headings: Concurrent Causes of Disability; Silent
Evidence]
- 2.
Specific Evidentiary Principles
- a.
Blevins Test for Admissibility
- b.
Later Evidence
- c.
True Doubt Rule
- d.
Adverse Inferences
-
- 3.
Medical Reports
- a.
Physicians: Qualifications/Treating/Non-Examining
- b.
Hostility
-
- 4.
Miscellaneous
- a.
Lay Testimony
- b.
X-Rays, Readers, Quality Standards
[Digest
Headings: Distinguishing "B" Readers; Section 413(b)
Prohibition]
- c.
Autopsy and Biopsy Evidence, Quality Standards
- d.
Ventilatory and Blood Gas Studies, Quality Standards
- e.
Vocational Experts and Evidence
- f.
Contraindication of Continued Employment
PART
IV ESTABLISHING ENTITLEMENT UNDER 20 C.F.R. PART 718
- A. In
General
- 1.
Applicability
- 2.
Validity
- 3.
Quality Standards
- B.
Existence of Pneumoconiosis
- 1.
Section 718.202(a)(1): X-ray Evidence
- 2.
Section 718.202(a)(2): Biopsy or Autopsy Evidence
- 3.
Section 718.202(a)(3): Presumptions
[NOTE: for
digests and discussion of Sections 718.304, 718.305 and
718.306 please refer to Parts V and VII of this outline]
- 4.
Section 718.202(a)(4): Medical Reports
- C.
Pneumoconiosis Arising Out of Coal Mine Employment
- D. Total
Disability: Section 718.204
- 1.
Generally
- 2.
Section 718.204(c)(1)
- 3.
Section 718.204(c)(2)
- 4.
Section 718.204(c)(3)
- 5.
Section 718.204(c)(4)
- 6.
Section 718.204(c)(5)
- E. Cause
of Disability: Section 718.204(b)
- F.
Survivors' Claims Without Benefit of a Presumption: Section
718.205
[NOTE: for digests and discussion of Section
718.303, please refer to Part VII of this outline]
PART V STATUTORY PRESUMPTIONS IN MINERS'
CLAIMS
- A.
Section 411(c)(1)
- B.
Section 411(c)(3)
- C.
Section 411(c)(4)
PART VI REGULATORY
PRESUMPTIONS
- A. 20
C.F.R. §727.203 Interim Presumption
- 1.
Section 727.203(a)(1)
- 2.
Section 727.203(a)(2)
- 3.
Section 727.203(a)(3)
- 4.
Section 727.203(a)(4)
- 5.
Section 727.203(a)(5)
- B.
Rebuttal of the Interim Presumption
- 1.
Section 727.203(b)(1), (b)(2)
- a.
Total disability is without regard to cause
- b.
Rebuttal can not be established on the basis of no
impairment
- c.
Total disability from a respiratory standpoint
- d.
Comparable and Gainful Work
- 2.
Section 727.203(b)(3)
- a.
Third Circuit
- b.
Fourth Circuit
- c.
Sixth Circuit
- d.
Seventh Circuit
- e.
Eighth Circuit
- f.
Ninth Circuit
- g.
Tenth Circuit
- h.
Eleventh Circuit
- 3.
Section 727.203(b)(4)
- C. 20
C.F.R. §410.490 Interim Presumption
[Claims Filed
Prior to March 31, 1980]
- 1.
Miners with Ten or More Years of Coal Mine
Employment
- 2.
Miners with Less than Ten Years of Coal Mine Employment
PART VII SURVIVORS' CLAIMS
- A.
Derivative Entitlement
- B.
Section 411(c)(1)
- C.
Section 411(c)(2)
- D.
Section 411(c)(3)
- E.
Section 411(c)(4)
- F.
Section 411(c)(5)
PART VIII ATTORNEY FEES
- A. Board
Review of Attorney Fee Awards Made Below
- 1.
General Overview
- 2.
Successful Prosecution of the Claim
- 3.
Jurisdiction
- 4.
Issues on Appeal of Attorney Fee Awards
- a.
Opposition to Attorney Fees
- b.
Counsel's Appeal of Substantial Reductions in the
Requested Fee
- 1).
The Hourly Rate
-
- 5.
Liability for Attorney Fees
-
- 6.
Miscellaneous Issues
-
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