20 CFR 725.704 and 725.705 BLBA

20 CFR 725.704 and 705 BLBA Supporting Reg.pdf

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20 CFR 725.704 and 725.705 BLBA

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BLBA: 20 CFR § 725.704 Notification of right to medical benefits; authorization of
(a) Upon notification to a miner of such miner's entitlement to benefits, the Office shall provide
the miner with a list of authorized treating physicians and medical facilities in the area of the
miner's residence. The miner may select a physician from this list or may select another
physician with approval of the Office. Where emergency services are necessary and appropriate,
authorization by the Office shall not be required.
(b) The Office may, on its own initiative, or at the request of a responsible operator, order a
change of physicians or facilities, but only where it has been determined that the change is
desirable or necessary in the best interest of the miner. The miner may change physicians or
facilities subject to the approval of the Office.
(c) If adequate treatment cannot be obtained in the area of the claimant's residence, the Office
may authorize the use of physicians or medical facilities outside such area as well as
reimbursement for travel expenses and overnight accommodations.
BLBA: 20 CFR § 725.705 Arrangements for medical care.
(a) Operator liability. If an operator has been determined liable for the payment of benefits to a
miner, the Office shall notify such operator or insurer of the names, addresses, and telephone
numbers of the authorized providers of medical benefits chosen by an entitled miner, and shall
require the operator or insurer to:
(1) Notify the miner and the providers chosen that such operator will be responsible for the cost
of medical services provided to the miner on account of the miner's total disability due to
(2) Designate a person or persons with decision making authority with whom the Office, the
miner and authorized providers may communicate on matters involving medical benefits
provided under this subpart and notify the Office, miner and providers of such designation;
(3) Make arrangements for the direct reimbursement of providers for their services.
(b) Fund liability. If there is no operator found liable for the payment of benefits, the Office shall
make necessary arrangements to provide medical care to the miner, notify the miner and medical
care facility selected of the liability of the fund, designate a person or persons with whom the
miner or provider may communicate on matters relating to medical care, and make arrangements
for the direct reimbursement of the medical provider.

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