725.406

§725.406 Medical examinations and tests.
(a) The Act requires the Department to provide each miner who applies for benefits with the opportunity to undergo a
complete pulmonary evaluation at no expense to the miner. A complete pulmonary evaluation includes a report of physical
examination, a pulmonary function study, a chest radiograph, and, unless medically contraindicated, a blood gas study.
(b) As soon as possible after a miner files an application for benefits, the district director will provide the miner with a
list of medical facilities and physicians in the state of the miner's residence and states contiguous to the state of the miner's
residence that the Office has authorized to perform complete pulmonary evaluations. The miner must select one of the
facilities or physicians on the list, provided that the miner may not select any physician to whom the miner or the miner's
spouse is related to the fourth degree of consanguinity, and the miner may not select any physician who has examined or
provided medical treatment to the miner within the twelve months preceding the date of the miner's application. The district
director will make arrangements for the miner to be given a complete pulmonary evaluation by that facility or physician.
The results of the complete pulmonary evaluation must not be counted as evidence submitted by the miner under §725.414.
(c) If any medical examination or test conducted under paragraph (a) of this section is not administered or reported in
substantial compliance with the provisions of part 718 of this subchapter, or does not provide sufficient information to
allow the district director to decide whether the miner is eligible for benefits, the district director must schedule the miner
for further examination and testing. Where the deficiencies in the report are the result of a lack of effort on the part of the
miner, the miner will be afforded one additional opportunity to produce a satisfactory result. In order to determine whether
any medical examination or test was administered and reported in substantial compliance with the provisions of part 718 of
this subchapter, the district director may have any component of such examination or test reviewed by a physician selected
by the district director.
(d) After the physician completes the report authorized by paragraph (a), the district director will inform the miner
that he may elect to have the results of the objective testing sent to his treating physician for use in preparing a medical
opinion. The district director will also inform the claimant that any medical opinion submitted by his treating physician will
count as one of the two medical opinions that the miner may submit under §725.414 of this part.
(e) The cost of any medical examination or test authorized under this section, including the cost of travel to and from
the examination, must be paid by the fund. Reimbursement for overnight accommodations must not be authorized unless
the district director determines that an adequate testing facility is unavailable within one day's round trip travel by
automobile from the miner's residence. The fund must be reimbursed for such payments by an operator, if any, found liable
for the payment of benefits to the claimant. If an operator fails to repay such expenses, with interest, upon request of the
Office, the entire amount may be collected in an action brought under section 424 of the Act and §725.603.

[65 FR 80054, Dec. 20, 2000, as amended at 78 FR 35558, June 13, 2013; 79 FR 21615, Apr. 17, 2014]