20cfr725.407-408

20CFR725.407-408.pdf

Operator Controversion, Operator Response, Operator Response to Schedule for Submission of Additional Evidence, and Operator Response to Notice of Claim

20CFR725.407-408

OMB: 1215-0058

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Federal Register / Vol. 65, No. 245 / Wednesday, December 20, 2000 / Rules and Regulations
an action brought under section 424 of
the Act and § 725.603 of this part.
§ 725.407 Identification and notification of
responsible operator.

(a) Upon receipt of the miner’s
employment history, the district
director shall investigate whether any
operator may be held liable for the
payment of benefits as a responsible
operator in accordance with the criteria
contained in Subpart G of this part.
(b) The district director may identify
one or more operators potentially liable
for the payment of benefits in
accordance with the criteria set forth in
§ 725.495 of this part. The district
director shall notify each such operator
of the existence of the claim. Where the
records maintained by the Office
pursuant to part 726 of this subchapter
indicate that the operator had obtained
a policy of insurance, and the claim falls
within such policy, the notice provided
pursuant to this section shall also be
sent to the operator’s carrier. Any
operator or carrier notified of the claim
shall thereafter be considered a party to
the claim in accordance with § 725.360
of this part unless it is dismissed by an
adjudication officer and is not thereafter
notified again of its potential liability.
(c) The notification issued pursuant to
this section shall include a copy of the
claimant’s application and a copy of all
evidence obtained by the district
director relating to the miner’s
employment. The district director may
request the operator to answer specific
questions, including, but not limited to,
questions related to the nature of its
operations, its relationship with the
miner, its financial status, including any
insurance obtained to secure its
obligations under the Act, and its
relationship with other potentially
liable operators. A copy of any
notification issued pursuant to this
section shall be sent to the claimant by
regular mail.
(d) If at any time before a case is
referred to the Office of Administrative
Law Judges, the district director
determines that an operator which may
be liable for the payment of benefits has
not been notified under this section or
has been incorrectly dismissed pursuant
to § 725.410(a)(3), the district director
shall give such operator notice of its
potential liability in accordance with
this section. The adjudication officer
shall then take such further action on
the claim as may be appropriate. There
shall be no time limit applicable to a
later identification of an operator under
this paragraph if the operator
fraudulently concealed its identity as an
employer of the miner. The district
director may not notify additional

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operators of their potential liability after
a case has been referred to the Office of
Administrative Law Judges, unless the
case was referred for a hearing to
determine whether the claim was
properly denied as abandoned pursuant
to § 725.409.
§ 725.408 Operator’s response to
notification.

(a)(1) An operator which receives
notification under § 725.407 shall,
within 30 days of receipt, file a response
indicating its intent to accept or contest
its identification as a potentially liable
operator. The operator’s response shall
also be sent to the claimant by regular
mail.
(2) If the operator contests its
identification, it shall, on a form
supplied by the district director, state
the precise nature of its disagreement by
admitting or denying each of the
following assertions. In answering these
assertions, the term ‘‘operator’’ shall
include any operator for which the
identified operator may be considered a
successor operator pursuant to
§ 725.492.
(i) That the named operator was an
operator for any period after June 30,
1973;
(ii) That the operator employed the
miner as a miner for a cumulative
period of not less than one year;
(iii) That the miner was exposed to
coal mine dust while working for the
operator;
(iv) That the miner’s employment
with the operator included at least one
working day after December 31, 1969;
and
(v) That the operator is capable of
assuming liability for the payment of
benefits.
(3) An operator which receives
notification under § 725.407, and which
fails to file a response within the time
limit provided by this section, shall not
be allowed to contest its liability for the
payment of benefits on any of the
grounds set forth in paragraph (a)(2).
(b)(1) Within 90 days of the date on
which it receives notification under
§ 725.407, an operator may submit
documentary evidence in support of its
position.
(2) No documentary evidence relevant
to the grounds set forth in paragraph
(a)(2) may be admitted in any further
proceedings unless it is submitted
within the time limits set forth in this
section.
§ 725.409 Denial of a claim by reason of
abandonment.

(a) A claim may be denied at any time
by the district director by reason of
abandonment where the claimant fails:

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(1) To undergo a required medical
examination without good cause; or,
(2) To submit evidence sufficient to
make a determination of the claim; or,
(3) To pursue the claim with
reasonable diligence; or,
(4) To attend an informal conference
without good cause.
(b)(1) If the district director
determines that a denial by reason of
abandonment under paragraphs (a)(1)
through (3) of this section is
appropriate, he or she shall notify the
claimant of the reasons for such denial
and of the action which must be taken
to avoid a denial by reason of
abandonment. If the claimant completes
the action requested within the time
allowed, the claim shall be developed,
processed and adjudicated as specified
in this part. If the claimant does not
fully comply with the action requested
by the district director, the district
director shall notify the claimant that
the claim has been denied by reason of
abandonment. Such notification shall be
served on the claimant and all other
parties to the claim by certified mail.
(2) In any case in which a claimant
has failed to attend an informal
conference and has not provided the
district director with his reasons for
failing to attend, the district director
shall ask the claimant to explain his
absence. In considering whether the
claimant had good cause for his failure
to attend the conference, the district
director shall consider all relevant
circumstances, including the age,
education, and health of the claimant, as
well as the distance between the
claimant’s residence and the location of
the conference. If the district director
concludes that the claimant had good
cause for failing to attend the
conference, he may continue processing
the claim, including, where appropriate
under § 725.416, the scheduling of an
informal conference. If the claimant
does not supply the district director
with his reasons for failing to attend the
conference within 30 days of the date of
the district director’s request, or the
district director concludes that the
reasons supplied by the claimant do not
establish good cause, the district
director shall notify the claimant that
the claim has been denied by reason of
abandonment. Such notification shall be
served on the claimant and all other
parties to the claim by certified mail.
(c) The denial of a claim by reason of
abandonment shall become effective
and final unless, within 30 days after
the denial is issued, the claimant
requests a hearing. Following the
expiration of the 30-day period, a new
claim may be filed at any time pursuant
to § 725.309. For purposes of § 725.309,

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