Legislation Authorized Benefits Without Adequate Evidence of Black Lung or Disability

GAO was asked to identify whether legislative changes are needed to ensure that black lung benefits are awarded only to miners totally disabled by black lung or to their survivors.

In December 1981, Congress passed amendments to the Black Lung Benefits Act which should result in the provision of better evidence to support the approval of future black lung benefit claims. GAO found that, for most approved black lung claims, the medical evidence was not adequate to establish disability or death from black lung. However, the approval of the claims was consistent with the Federal Coal Mine Health and Safety Act. The act and regulations authorized approval of black lung claims on the basis of conflicting and inconclusive medical evidence, affidavits, presumptions based on years of coal mine employment, and interim standards. GAO believes that these provisions did not ensure that benefits were awarded only to miners disabled from black lung or to their survivors. In a sample of 205 approved claims, 84 percent had inadequate medical evidence, about half were founded on presumptions based on work history, about an eighth had conflicting medical evidence, and others were supported only by affidavits with no supporting medical evidence. Some claimants were awarded benefits for respiratory conditions which may be aggravated but not caused by coal mine employment. The 1981 amendments, which will affect future claims, address GAO concerns related to the use of presumptions, the rereading of X-rays, and the use of affidavits. However, the amendments do not: (1) change the legislative definition of pneumoconiosis; (2) prohibit all affidavits; or (3) require that disability determinations be based solely on medical test results.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

Director: Franklin A. Curtis Team: General Accounting Office: Human Resources Division Phone: (202) 275-5451