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The Funds and the Department of Labor
Black Lung Program
The Federal Black Lung program is a workers compensation program for individuals with a condition attributable to lung diseases and conditions caused by coal mining. Some Funds' beneficiaries have medical coverage under the Black Lung program. These beneficiaries' claims may be paid by the Funds, Department of Labor (DOL) or Responsible Mine Operator (RMO), depending upon the service and DOL beneficiary assignment.
- Black Lung Claims Submission
- For some beneficiaries, the DOL has assigned responsibility for payment of health benefits meeting specific criteria to the coal company where the beneficiary was last employed, known as a Responsible Mine Operator. All claims for these beneficiaries must first be submitted to the coal company or its carrier. If the entire claim or a portion of the claim is denied for a valid reason, the denial must be attached to the claim submitted to the Funds. Claims denied by the RMO for lack of information should be corrected and resubmitted to the RMO.
The Funds provides coverage for Federal Black Lung beneficiaries who are not assigned to RMOs. Claims for DME, oxygen, and respiratory equipment for Funds' beneficiaries assigned to the Federal Black Lung Trust Fund must be submitted to the U.S. Department of Labor before submission to the Funds. Claims denied by the DOL for lack of information should be corrected and resubmitted to the DOL; other claims denied by the Department of Labor may be submitted to the Funds for benefit consideration with a copy of the denial. Claims for Funds Black Lung beneficiaries for all other covered services should be submitted to the Funds for payment.
Contact the Call Center or the beneficiary's Field Service Office for questions about the beneficiary's Black Lung program eligibility or RMO assignment. For general questions about the Black Lung Program, contact your regional Department of Labor office.
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