Federal Black Lung Claims: The Real Cost of Coal

The Black Lung Benefits Act (BLBA) was passed by Congress in 1969 to fill the gaps left by state Workers’ Compensation programs. It provides financial and medical support to miners suffering from black lung and compensates their surviving dependents. Employers and insurers typically cover these costs, but if a company goes out of business, the Federal Black Lung Program steps in so workers don’t go untreated. Since its inception, this program has paid out over $47 billion in benefits.

The big question is, why are black lung cases rising while benefit payments are declining? The decline in the coal mining workforce is a major factor due to employment dropping from 170,000 miners in 1985 to just 47,000 in 2020. Many miners who originally enrolled in the program have since passed away, reducing the number of active claims. However, black lung rates among current and former miners are increasing in severity, which could lead to more costly claims in the future. Additionally, mine operators frequently contest claims, delaying benefits—sometimes until after the miner has died.

With rising black lung cases and persistent program weaknesses, there’s a clear need for further research, policy improvements, and proactive risk management. The future of black lung benefits will depend on how well these challenges are addressed.

Federal Black Lung Act: A Quick History

The world of workers’ compensation is already complex, and federal black lung claims add another layer of nuance. If you’re a claims adjuster or risk manager handling cases related to coal workers’ pneumoconiosis (CWP), understanding the ins and outs of these claims is critical. This guide will break down everything you need to know, from the history of black lung benefits to the claims process and risk management strategies.

What Are Federal Black Lung Claims?

Federal black lung claims stem from the Black Lung Benefits Act (BLBA), a law established in 1969 to provide compensation to coal miners suffering from pneumoconiosis, commonly known as black lung disease. This condition is caused by prolonged exposure to coal dust, leading to serious respiratory issues and, in severe cases, disability or death.

The U.S. Department of Labor (DOL) administers these claims through the Division of Coal Mine Workers’ Compensation (DCMWC). Unlike standard workers’ compensation claims, federal black lung claims are processed separately under federal law, making them unique in the insurance landscape.

Who Can File an Eligible Claim?

Understanding who qualifies for federal black lung benefits is crucial for adjusters managing these claims. The following groups are eligible:

• Current or former coal miners who can prove they have pneumoconiosis due to their work in the coal industry.
• Surviving dependents (such as spouses or children) of miners who passed away due to black lung disease.

The burden of proof often falls on claimants, requiring extensive medical evidence and employment history records.

The Claims Process: What Adjusters Need to Know

Handling a black lung claim requires a firm grasp of the claims process. Here’s a breakdown of what to expect:

Filing the Claim

Claimants must submit Form CM-911 (for miners) or Form CM-912 (for survivors) to the U.S. Department of Labor. These forms require a detailed employment history and medical records demonstrating the presence of black lung disease.

Medical Evidence & Evaluation

The claimant must undergo a medical examination, including:
• Chest X-rays to detect lung abnormalities.
• Pulmonary function tests to assess respiratory impairment.
• Arterial blood gas tests to measure oxygen levels.
Employers and insurers can also require independent medical examinations (IMEs) to verify claims.

Determining Eligibility

The DOL reviews all evidence and decides whether the miner or their dependents qualify for benefits. Key factors include:
• Length of employment in coal mining.
• Severity of lung impairment.
• Medical documentation linking pneumoconiosis to coal dust exposure.

Benefit Payments & Liability

If approved, benefits cover monthly compensation and medical expenses for black lung treatment. Employers or their insurance carriers are responsible for payments unless the employer is no longer in business, in which case the Black Lung Disability Trust Fund (BLDTF) covers costs.

Black Lung Claim Challenges

Federal black lung claims present unique challenges that adjusters must navigate, including:

1. Establishing Work History
Miners often work for multiple employers over decades. Verifying their complete employment history is crucial for determining liability.

2. Medical Disputes
Because black lung symptoms can overlap with other lung diseases (such as COPD or emphysema), medical disputes frequently arise. Having independent medical experts review cases can help resolve conflicts.

3. Fraud Prevention
While most claims are legitimate, fraud can occur in cases where claimants exaggerate symptoms or misrepresent work history. Surveillance, medical reviews, and thorough background checks are key fraud prevention strategies.

4. Long-Tail Exposure & Costs
Black lung claims can remain open for decades, leading to ongoing financial exposure for employers and insurers. Understanding long-term cost projections is essential for risk management.

NIOSH April 2025 Updates

Recent layoffs at the U.S. Health and Human Services Department are raising concerns about the future of worker safety—especially for coal miners. Hundreds of employees, including those at the National Institute for Occupational Safety and Health (NIOSH), have received layoff notices, potentially shutting down black lung disease monitoring programs. Anita Wolfe, a former director of the Coal Workers’ Health Surveillance Program, warns that these cuts could leave miners without critical health screenings, a program that has protected workers since the Coal Mine Health and Safety Act of 1969. Additionally, the Mine Safety and Health Administration (MSHA) is set to lose multiple field offices, further weakening oversight. With safety programs at risk, miner advocates and unions are demanding answers about why these critical protections are being dismantled.

Due to recent restructuring and layoffs led by Robert F. Kennedy Jr. under President Trump’s orders, departments like the NIOSH (National Institute for Occupational Safety and Health) are facing massive layoffs. As of April 1st, 2024, at least 400 NIOSH workers that helped conduct mine research and ensure the safety of American mine workers have been laid off due to a “reduction in force.”

Some of the projects and research this branch was working on are helpful for coal miners and employers that provide Workers’ Comp. It is also important to adjusters, like yourself, to be armed with the medical information needed to diagnose and properly coordinate benefits for black lung patients.

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Check out our sources:

LPM. (2025, April 1). Black lung researchers among hundreds laid off from federal health agency. LPM News. https://www.lpm.org/news/2025-04-01/black-lung-researchers-among-hundreds-laid-off-from-federal-health-agency

Congressional Research Service. (n.d.). Black lung benefits program: An overview (Report No. R45261). U.S. Congress. Retrieved from https://www.congress.gov/crs-product/R45261