Legislation Authorized Benefits Without Adequate Evidence of Black Lung or Disability

HRD-82-26: Published: Jan 19, 1982. Publicly Released: Jan 19, 1982.

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GAO was asked to identify whether legislative changes are needed to ensure that black lung benefits are awarded only to miners totally disabled by black lung or to their survivors.

In December 1981, Congress passed amendments to the Black Lung Benefits Act which should result in the provision of better evidence to support the approval of future black lung benefit claims. GAO found that, for most approved black lung claims, the medical evidence was not adequate to establish disability or death from black lung. However, the approval of the claims was consistent with the Federal Coal Mine Health and Safety Act. The act and regulations authorized approval of black lung claims on the basis of conflicting and inconclusive medical evidence, affidavits, presumptions based on years of coal mine employment, and interim standards. GAO believes that these provisions did not ensure that benefits were awarded only to miners disabled from black lung or to their survivors. In a sample of 205 approved claims, 84 percent had inadequate medical evidence, about half were founded on presumptions based on work history, about an eighth had conflicting medical evidence, and others were supported only by affidavits with no supporting medical evidence. Some claimants were awarded benefits for respiratory conditions which may be aggravated but not caused by coal mine employment. The 1981 amendments, which will affect future claims, address GAO concerns related to the use of presumptions, the rereading of X-rays, and the use of affidavits. However, the amendments do not: (1) change the legislative definition of pneumoconiosis; (2) prohibit all affidavits; or (3) require that disability determinations be based solely on medical test results.

Matters for Congressional Consideration

  1. Status: Closed - Not Implemented

    Comments: The study on the medical aspects of pneumoconiosis was completed in 1984. Neither DOL nor Congress appears to be interested in changing the black lung eligibility criteria at this time.

    Matter: Congress should consider amending the black lung legislation to redefine black lung as coal workers' pneumoconiosis, a chronic dust disease arising out of coal mine employment that permanently damages the lungs.

  2. Status: Closed - Not Implemented

    Comments: The study on the medical aspects of pneumoconiosis was completed in 1984. Neither DOL nor Congress appears to be interested in changing the black lung eligibility criteria at this time.

    Matter: Congress should consider amending the black lung legislation to require that medical evidence be the basis for establishing the presence of pneumoconiosis and disability due to black lung.

  3. Status: Closed - Not Implemented

    Comments: Neither DOL nor Congress appears to be interested in changing the black lung eligibility criteria at this time.

    Matter: Congress should consider amending the black lung legislation to eliminate the use of affidavits to establish death or disability from pneumoconiosis.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: The Secretary of Labor should establish additional procedures to resolve conflicting medical evidence.

    Agency Affected: Department of Labor

  2. Status: Closed - Implemented

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: The Secretary of Labor should provide guidance on the quantity and quality of evidence needed to rebut certain presumptions for claims filed before the effective date of the 1981 amendments.

    Agency Affected: Department of Labor

 

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