20 C.F.R. § 725.533

Modification of benefits amounts; general

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(a) Under certain circumstances, the amount of monthly benefits as computed in § 725.520 or lump-sum award (§ 725.521) shall be modified to determine the amount actually to be paid to a beneficiary. With respect to any benefits payable for all periods of eligibility after January 1, 1974, a reduction of the amount of benefits payable shall be required on account of:

(1) Any compensation or benefits received under any State workers' compensation law because of death or partial or total disability due to pneumoconiosis; or

(2) Any compensation or benefits received under or pursuant to any Federal law including part B of title IV of the Act because of death or partial or total disability due to pneumoconiosis; or

(3) In the case of benefits to a parent, brother, or sister as a result of a claim filed at any time or benefits payable on a miner's claim which was filed on or after January 1, 1982, the excess earnings from wages and from net earnings from self-employment (see § 410.530 of this title) of such parent, brother, sister, or miner, respectively; or

(4) The fact that a claim for benefits from an additional beneficiary is filed, or that such claim is effective for a payment during the month of filing, or a dependent qualifies under this part for an augmentation portion of a benefit of a miner or widow for a period in which another dependent has previously qualified for an augmentation.

(b) An adjustment in a beneficiary's monthly benefit may be required because an overpayment or underpayment has been made to such beneficiary (see §§ 725.540-725.546).

(c) A suspension of a beneficiary's monthly benefits may be required when the Office has information indicating that reductions on account of excess earnings may reasonably be expected.

(d) Monthly benefit rates are payable in multiples of 10 cents. Any monthly benefit rate which, after the applicable computations, augmentations, and reductions is not a multiple of 10 cents, is increased to the next higher multiple of 10 cents. Since a fraction of a cent is not a multiple of 10 cents, a benefit rate which contains such a fraction in the third decimal is raised to the next higher multiple of 10 cents.

(e) Any individual entitled to a benefit, who is aware of any circumstances which could affect entitlement to benefits, eligibility for payment, or the amount of benefits, or result in the termination, suspension, or reduction of benefits, shall promptly report these circumstances to the Office. The Office may at any time require an individual receiving, or claiming entitlement to, benefits, either on his or her own behalf or on behalf of another, to submit a written statement giving pertinent information bearing upon the issue of whether or not an event has occurred which would cause such benefit to be terminated, or which would subject such benefit to reductions or suspension under the provisions of the Act. The failure of an individual to submit any such report or statement, properly executed, to the Office shall subject such benefit to reductions, suspension, or termination as the case may be.

Notes of Decisions

Cited in 5 cases, 1987–1999 · leading case: Piney Mountain Coal Co. v. Mays, 176 F.3d 753 (4th Cir. 1999).

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Piney Mountain Coal Co. v. Mays, 176 F.3d 753 (4th Cir. 1999). “In support of its view Piney Mountain cites 20 C.F.R. §§ 725.533 (a)(4) and 725.537. 16 The Director counters that these regulations merely describe the manner in which benefit reductions are implemented, but they do not establish when reductions are warranted.”

Dir., Off. of Workers' Comp. Programs, United States Dep't of Labor v. Aleen E. Ball, 826 F.2d 603 (7th Cir. 1987). “§ 932 (g) (1982); 20 C.F.R. §§ 725.533 -.535 (1986). Mrs. Ball was receiving her sole support from social security benefits.”

Canada Coal Co. v. Stiltner, 866 F.2d 153 (6th Cir. 1989). “See 20 C.F.R. §§ 725.533 (a)(1); 725.535(b). In many cases, Kentucky Workers’ Compensation benefits totally offset benefit payments under the federal act.”

Nat'l Mines Corp. v. Carroll, 64 F.3d 135 (3rd Cir. 1995). “§ 932 (g); 20 C.F.R. § 725.533 (a)(1). Moreover, because Carroll's widow was awarded state benefits as a result of Carroll’s pneumoconiosis, the Fund has not paid her interim benefits.”

Dir., Off. of Workers' Comp. Programs v. E. Associated Coal Corp., 54 F.3d 141 (3rd Cir. 1995). “20 C.F.R. § 725.533 (a)(1). The regulations define a “workers’ compensation law” for the purposes of Part C as follows: For the purposes of this subchapter, except where the content clearly indicates otherwise, the following definitions apply: .”

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