Black Lung Benefits Program
The Black Lung Benefits Act (BLBA) is a type of federal workers' compensation benefits program that provides monthly payments and medical benefits to coal miners totally disabled from pneumoconiosis (black lung disease) arising from employment in or around the nation's coal mines. The Act also provides monthly benefits to a miner's dependent survivors if pneumoconiosis caused or hastened the miner's death.
What Is Covered Under BLBA?
BLBA covers the cost of medical treatment services and associated travel for the treatment of black lung condition. Payment for medical treatment services is subject to a maximum allowable fee, but the patient is not required to pay a copayment. Payment for travel is limited to reasonable costs.
Do I Have to Have a Physical Exam?
After you submit your benefits application, you will be required to complete a "pulmonary evaluation." This is a medical examination to determine whether you are totally disabled by black lung disease. The Department of Labor is required by law to offer you a free examination to prove that you may be entitled to black lung benefits.
The examination consists of:
- a physical examination by a physician;
- a chest X-ray;
- a pulmonary function test; and
- an arterial blood gas test.
What Services Are Typically Covered Under the BLBA?
Present and former coal miners, other workers who have been exposed to coal dust, and their surviving dependents may apply for medical and monthly financial benefits under the Act. The program provides for diagnostic testing to verify the presence of black lung disease and degree of associated disability. Benefits may include a monthly stipend, as well as such medical services as prescription drug coverage, hospitalization coverage, durable medical equipment, and outpatient therapy.
The following is a list of services that would likely be covered for treatment of a black lung-related condition:
- Doctor's office calls, hospital visits, and consultations;
- Inpatient and outpatient hospital charges, including emergency room
visits for ACUTE black lung related conditions, diagnostic laboratory testing and chest x-rays;
- Federal Black Lung Program approved prescription drugs, both
brand name and generic;
- Ambulance services limited to transportation to the hospital for emergency acute black lung related care; and,
- Travel to the doctor, hospital, clinic, or other medical facility for round trips of 200 miles or less.
Costs That Aren't Covered by the BLBA
The following are among the costs not covered under the Federal Black Lung Program:
- Treatment of medical problems NOT related to black lung condition-for example, arthritis, diabetes, and most heart conditions;
- Medical treatment for the patient's spouse or other family members;
- Dental or eye care, and X-rays other than chest X-rays;
- Nurse's aid (non-skilled nursing care) services in the home;
- Home health aides
- Medicine that you can buy without a doctor's prescription;
- Medicine for problems other than your black lung condition;
- Personal services in the hospital, such as TV or telephone;
- Rental or purchase of an Intermittent Positive Pressure Breathing (IPPB) machine for home use;
- Travel to and from your drugstore;
- Residence costs (room and board) for nursing homes or skilled nursing facilities; and,
- Home medical equipment not authorized for coverage.
Who Handles the Claims Process?
The Division of Coal Mine Workers' Compensation (DCMWC), within the U.S. Department of Labor Employment Standards Administration's Office of Workers' Compensation Programs (OWCP), adjudicates and processes claims filed by coal miners and their survivors under the BLBA.
Speak with an Attorney About Your Black Lung Benefits Claim
Even the simplest injury can lead to considerable obstacles, such as proving that the injury was in fact work-related or covered by insurance. In any event, your employer is required by law to provide fair compensation in the event of a workplace injury or illness. If you have questions about your claim, or want to find out whether you should sue your employer, you should speak with a workers' compensation attorney.
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Contact a qualified workers' compensation attorney to make sure your rights are protected.