C.F.R. » Title 20 » CHAPTER VI—OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR › SUBCHAPTER B—FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED › PART 725—CLAIMS FOR BENEFITS UNDER PART C OF TITLE IV OF THE FEDERAL MINE SAFETY AND HEALTH ACT, AS AMENDED › Subpart E—Adjudication of Claims by the District Director

20 C.F.R. § 725.406

Medical examinations and tests

Read at: eCFRecfr.gov CornellLII GovInfogovinfo.gov CasesGoogle Scholar

(a) The Act requires the Department to provide each miner who applies for benefits with the opportunity to undergo a complete pulmonary evaluation at no expense to the miner. A complete pulmonary evaluation includes a report of physical examination, a pulmonary function study, a chest radiograph, and, unless medically contraindicated, a blood gas study.

(b) As soon as possible after a miner files an application for benefits, the district director will provide the miner with a list of medical facilities and physicians in the state of the miner's residence and states contiguous to the state of the miner's residence that the Office has authorized to perform complete pulmonary evaluations. The miner must select one of the facilities or physicians on the list, provided that the miner may not select any physician to whom the miner or the miner's spouse is related to the fourth degree of consanguinity, and the miner may not select any physician who has examined or provided medical treatment to the miner within the twelve months preceding the date of the miner's application. The district director will make arrangements for the miner to be given a complete pulmonary evaluation by that facility or physician. The results of the complete pulmonary evaluation must not be counted as evidence submitted by the miner under § 725.414.

(c) If any medical examination or test conducted under paragraph (a) of this section is not administered or reported in substantial compliance with the provisions of part 718 of this subchapter, or does not provide sufficient information to allow the district director to decide whether the miner is eligible for benefits, the district director must schedule the miner for further examination and testing. Where the deficiencies in the report are the result of a lack of effort on the part of the miner, the miner will be afforded one additional opportunity to produce a satisfactory result. In order to determine whether any medical examination or test was administered and reported in substantial compliance with the provisions of part 718 of this subchapter, the district director may have any component of such examination or test reviewed by a physician selected by the district director.

(d) After the physician completes the report authorized by paragraph (a), the district director will inform the miner that he may elect to have the results of the objective testing sent to his treating physician for use in preparing a medical opinion. The district director will also inform the claimant that any medical opinion submitted by his treating physician will count as one of the two medical opinions that the miner may submit under § 725.414 of this part.

(e) The cost of any medical examination or test authorized under this section, including the cost of travel to and from the examination, must be paid by the fund. Reimbursement for overnight accommodations must not be authorized unless the district director determines that an adequate testing facility is unavailable within one day's round trip travel by automobile from the miner's residence. The fund must be reimbursed for such payments by an operator, if any, found liable for the payment of benefits to the claimant. If an operator fails to repay such expenses, with interest, upon request of the Office, the entire amount may be collected in an action brought under section 424 of the Act and § 725.603.

[65 FR 80054, Dec. 20, 2000, as amended at 78 FR 35558, June 13, 2013; 79 FR 21615, Apr. 17, 2014]
Notes of Decisions
Cited in 11 cases (2 in the last 5 years), 2001–2024 · leading case: Dixie Fuel Co. v. Dir., Off. of Workers' Comp. Programs, 820 F.3d 833 (6th Cir. 2016).
Sort: Relevance Newest Treatment
Dixie Fuel Co. v. Dir., Off. of Workers' Comp. Programs, 820 F.3d 833 (6th Cir. 2016). “See 20 C.F.R. § 725.406 (a). Dr. Baker did a full review of Hensley’s occupational, medical, and smoking histories and performed a physical examination, a chest x-ray, a pulmonary function test, an arterial blood-gas study, and an electrocardiogram (EKG).”
E. Associated Coal Corp. v. Dir., Off. of Workers' Comp. Programs, 805 F.3d 502 (4th Cir. 2015). · cites it 2× “See 20 C.F.R. § 725.406 (a). As part of that evaluation, Toler had a chest x-ray, which a radiologist read as positive for simple pneumoconiosis, as well as blood gas and pulmonary function tests, which indicated that Toler was permanently disabled due to a pulmonary impairment.”
Antelope Coal Co./Rio Tinto Energy Am. v. Goodin, 743 F.3d 1331 (10th Cir. 2014). “” 20 C.F.R. § 725.406 . A report from a physical examination submitted with a claim must include results from a chest x-ray that is conducted and interpreted pursuant to the regulations in .”
Sherman Greene v. King James Coal Mining, Inc., 575 F.3d 628 (6th Cir. 2009). “” 20 C.F.R. § 725.406 (a). King James Coal argued that Greene waived this argument by failing to raise it before the district director or the ALJ.”
Nat'l Mining Ass'n v. Dep't of Labor, 292 F.3d 849 (D.C. Cir. 2002). “” 20 C.F.R. § 725.406 (c) (2000). Likewise, the new § 725.”
Nat'l Mining Ass'n v. Chao, 160 F. Supp. 2d 47 (D.D.C. 2001). “20 C.F.R. § 725.406 : This rule requires that all applicants must be afforded a free, complete pulmonary exam.”
Lance Coal Corp./Golden Oak Mining v. Phillip Caudill, 636 F. App'x 355 (6th Cir. 2016). · cites it 2× “§ 923 (b); 20 C.F.R. § 725.406 (a). According to the Director, this DOL-sponsored examination is almost always “the first to be conducted after a claim has been filed,” and it is rare for the physician who administers this initial evaluation to “review[] later-developed evidence.”
Smith v. Martin Cnty. Coal Corp., 233 F. App'x 507 (6th Cir. 2007). · cites it 2× “We additionally find that Claimant-received a “complete pulmonary evaluation” pursuant to 20 C.F.R. § 725.406 (a). We decline to address the *509 issue of the validity of the DOL’s evidencehmiting regulations.”
Consol of Kentucky, Inc. v. DOWCP (4th Cir. 2024). · cites it 2× “See 20 C.F.R. § 725.406 (a) (providing that the DOL must provide the miner with “the opportunity to undergo a complete pulmonary evaluation at no expense to the miner.”
Scalia v. Chevron Mining, Inc. (W.D. Ky. 2021). “20 C.F.R. § 725.406 (e). However, the BLBA dictates that when an eligible miner, or an applicable recipient under 20 C.”
Nat'l Mining Ass'n v. Chao, 145 F. Supp. 2d 1 (D.D.C. 2001). “*2 (b) schedule miners for medical examination and testing pursuant to 20 C.F.R. § 725.406 (as revised). (c) with regard to a survivor’s claims, gather existing medical evidence.”
Annotations are extracted automatically from the opinions in the Syfert caselaw corpus and ranked by authority, recency, and treatment. Dots show Syfertize treatment of the citing case itself.