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. § 725.410

Submission of additional evidence

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(a) After the district director completes the development of medical evidence under § 725.405 of this part, including the complete pulmonary evaluation authorized by § 725.406, and receives the responses and evidence submitted pursuant to § 725.408, he shall issue a schedule for the submission of additional evidence. The schedule shall contain the following information:

(1) If the claim was filed by, or on behalf of, a miner, the schedule shall contain a summary of the complete pulmonary evaluation administered pursuant to § 725.406. If the claim was filed by, or on behalf of, a survivor, the schedule shall contain a summary of any medical evidence developed by the district director pursuant to § 725.405(c).

(2) The schedule shall contain the district director's preliminary analysis of the medical evidence. If the district director believes that the evidence fails to establish any necessary element of entitlement, he shall inform the claimant of the element of entitlement not established and the reasons for his conclusions and advise the claimant that, unless he submits additional evidence, the district director will issue a proposed decision and order denying the claim.

(3) The schedule shall contain the district director's designation of a responsible operator liable for the payment of benefits. In the event that the district director has designated as the responsible operator an employer other than the employer who last employed the claimant as a miner, the district director shall include, with the schedule, a copy of the statements required by § 725.495(d) of this part. The district director may, in his discretion, dismiss as parties any of the operators notified of their potential liability pursuant to § 725.407. If the district director thereafter determines that the participation of a party dismissed pursuant to this section is required, he may once again notify the operator in accordance with § 725.407(d).

(4) The schedule shall notify the claimant and the designated responsible operator that they have the right to obtain further adjudication of the claim in accordance with this subpart, and that they have the right to submit additional evidence in accordance with this subpart. The schedule shall also notify the claimant that he has the right to obtain representation, under the terms set forth in subpart D, in order to assist him. In a case in which the district director has designated a responsible operator pursuant to paragraph (a)(3), the schedule shall further notify the claimant that if the operator fails to accept the claimant's entitlement to benefits within the time limit provided by § 725.412, the cost of obtaining additional medical and other necessary evidence, along with a reasonable attorney's fee, shall be reimbursed by the responsible operator in the event that the claimant establishes his entitlement to benefits payable by that operator. In a case in which there is no operator liable for the payment of benefits, the schedule shall notify the claimant that the cost of obtaining additional medical and other necessary evidence, along with a reasonable attorney's fee, shall be reimbursed by the fund.

(b) The schedule shall allow all parties not less than 60 days within which to submit additional evidence, including evidence relevant to the claimant's eligibility for benefits and evidence relevant to the liability of the designated responsible operator, and shall provide not less than an additional 30 days within which the parties may respond to evidence submitted by other parties. Any such evidence must meet the requirements set forth in § 725.414 in order to be admitted into the record.

(c) The district director shall serve a copy of the schedule, together with a copy of all of the evidence developed, on the claimant, the designated responsible operator, and all other operators which received notification pursuant to § 725.407. The schedule shall be served on each party by certified mail.

Notes of Decisions
Cited in 42 cases (5 in the last 5 years), 1981–2026 · leading case: United States Dep't of Labor v. Triplett, 494 U.S. 715 (1990).
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United States Dep't of Labor v. Triplett, 494 U.S. 715 (1990). · cites it 2× “20 CFR §§ 725.410 , 725.419(a), 725.481 (1989); 30 U.”
Arch Coal, Inc. v. R. Alexander Acosta, 888 F.3d 493 (D.C. Cir. 2018). “A mine operator may introduce "evidence relevant to [its] liability" in the BLBA proceedings, 20 C.F.R. § 725.410 (b) ; see also id. §§ 725.”
Edmonds v. Illinois Workers'Comp., 968 N.E.2d 775 (Ill. App. Ct. 2012). · cites it 3× “20 C.F.R. § 725.410 (2002). ¶ 25 Where the district director believes that the evidence fails to establish any necessary elements of entitlement, he advises the claimant that, unless additional evidence is submitted within the allotted time frame, a proposed decision and order…”
Kentland Elkhorn Coal Corp. v. Noah Hall Dir., Off. of Workers' Comp. Programs, United States Dep't of Labor, 287 F.3d 555 (6th Cir. 2002). · cites it 2× “See 20 C.F.R. §§ 725.410 (b), 725.412 (1999).”
Marfork Coal Co. v. Weis, 251 F. App'x 229 (4th Cir. 2007). · cites it 6× “20 C.F.R. § 725.410 (2007). The schedule must allow the parties “not less than sixty days within which to submit additional evidence, including evidence .”
Lisa Lee Mines (Terrilynne Coal Co.) v. Dir., Off. of Workers' Comp. Programs, United States Dep't of Labor Alva Rutter, 86 F.3d 1358 (4th Cir. 1996). “He may either appeal the erroneous decision, 20 C.F.R. § 725.410 (c), or seek modification of that decision, for up to a year after the initial denial, id.”
Joseph P. Connors, Sr. v. Amax Coal Co., Inc., 858 F.2d 1226 (7th Cir. 1988). “1 Claims for compensation for black lung related medical expenses are subject to three levels of administrative review: an initial determination by the Deputy Commissioner of the Division of Coal Mine Workers’ Compensation, Office of Workers Compensation Programs, 20 C.F.R. §§…”
Consolidation Coal Co. v. Albert A. Borda Dir., Off. of Workers' Comp. Programs, United States Dep't of Labor, 171 F.3d 175 (4th Cir. 1999). “412 , or the claimant requests a formal hearing after the initial denial of his claim, see 20 C.F.R. § 725.410 (d), cannot insulate the Department from the independent, constitutional requirements of due process.”
Dir., Off. of Workers' Comp. Programs, United States Dep't of Labor v. Albert Brodka, 643 F.2d 159 (3rd Cir. 1981). “20 C.F.R. § 725.410 (a) (1980). The proposed decision and order of the deputy commissioner will become final unless a party requests a revision of the order or a hearing before an administrative law judge.”
Myrtle Clark v. Dir., Off. of Workers' Comp. Programs, United States Dep't of Labor, 838 F.2d 197 (6th Cir. 1988). · cites it 2× “To quote from the Director’s brief, “[t]he parenthetical cross-reference merely specifies that the effect of a denial by reason of abandonment under 20 CFR 725.410 is the same as under 20 CFR 725.”
Robert West v. Dir., Off. of Workers' Comp. Programs, United States Dep't of Labor, 896 F.2d 308 (8th Cir. 1990). · cites it 3× “The May 21, 1979, letter complies with 20 C.F.R. § 725.410 (c), and as such West’s failure to respond to it within 60 days constitutes an abandonment of his claim.”
Armand Pavesi v. Dir., Off. of Workers' Comp. Programs, United States Dep't of Labor, 758 F.2d 956 (3rd Cir. 1985). “20 C.F.R. § 725.410 (a) (1980). The proposed decision and order of the deputy commissioner will become final unless a party requests a revision of the order or a hearing before an administrative law judge.”
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— 20 C.F.R. § 725.410(c) — 1 case
Myrtle Clark v. Dir., Off. of Workers' Comp. Programs, United States Dep't of Labor, 838 F.2d 197 (6th Cir. 1988). “To quote from the Director’s brief, “[t]he parenthetical cross-reference merely specifies that the effect of a denial by reason of abandonment under 20 CFR 725.410 is the same as under 20 CFR 725.”
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