Information about filing a claim for benefits under the Black Lung Benefits Act

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grid-row grid-gap-5"> <div class="desktop:grid-col-3 margin-bottom-2 desktop:padding-top-2 first-sidebar" role="complementary"> <div class="dol-subnav-wrapper"> <input data-function='swipe' id='swipe' type='checkbox'> <label data-function='swipe' for='swipe'>More in This Section <i class="fa fa-chevron-right"></i></label> <div class="dol-sidebar"> <li class="sub-menu-close"><a href="#"><i class="fa fa-chevron-left"></i><span>Close</span></a></li> <div id="block-dol-booknavigation"> <ul region="sidebar_first" block="block-dol-booknavigation" class="site-sidenav usa-sidenav dol-sidenav book_heading"> <li class="usa-sidenav__item dol-sidenav__item dol-sub-menu-item--expanded is-current"> <a href="/agencies/owcp/dcmwc/filing_a_claim" class="usa-sidenav__item dol-sidenav__item dol-sub-menu-item--expanded is-current usa-current" hreflang="en">Information about filing a claim for benefits under the Black Lung Benefits Act</a> <ul class="site-sidenav usa-sidenav__sublist dol-sidenav "> <li 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Mine Electronic Document Submission Portal</a> </li> <li class="usa-sidenav__item dol-sidenav__item"> <a href="/agencies/owcp/dcmwc/QAMedicalBenefits" class="usa-sidenav__item dol-sidenav__item" hreflang="en">Q&A About Medical Benefits</a> </li> <li class="usa-sidenav__item dol-sidenav__item dol-sub-menu-item--collapsed"> <a href="/agencies/owcp/dcmwc/regs/compliance/blbene" class="usa-sidenav__item dol-sidenav__item dol-sub-menu-item--collapsed" hreflang="en">Black Lung Monthly Benefit Rates for 2025</a> </li> <li class="usa-sidenav__item dol-sidenav__item"> <a href="/agencies/owcp/dcmwc/regs/compliance/bltaxanouncement" class="usa-sidenav__item dol-sidenav__item" hreflang="en">Benefits and Taxes</a> </li> <li class="usa-sidenav__item dol-sidenav__item"> <a href="/agencies/owcp/dcmwc/representative_payees_info" class="usa-sidenav__item dol-sidenav__item" hreflang="en">Representative Payee Notice</a> </li> </ul> </li> <li class="usa-sidenav__item dol-sidenav__item dol-sub-menu-item--collapsed"> <a href="/agencies/owcp/dcmwc/medical_providers" class="usa-sidenav__item dol-sidenav__item dol-sub-menu-item--collapsed" hreflang="en">Medical Providers</a> </li> <li class="usa-sidenav__item dol-sidenav__item"> <a href="/agencies/owcp/dcmwc/operators-insurers" class="usa-sidenav__item dol-sidenav__item" hreflang="en">Coal Mine Operators and Insurance Carriers</a> </li> <li class="usa-sidenav__item dol-sidenav__item dol-sub-menu-item--collapsed"> <a href="/agencies/owcp/dcmwc/mission" class="usa-sidenav__item dol-sidenav__item dol-sub-menu-item--collapsed" hreflang="en">About the Federal Black Lung Program</a> </li> <li class="usa-sidenav__item dol-sidenav__item"> <a href="/agencies/owcp/dcmwc/es" class="usa-sidenav__item dol-sidenav__item" hreflang="en">En Español</a> </li> <li class="usa-sidenav__item dol-sidenav__item"> <a href="/agencies/owcp/dcmwc/navajo" class="usa-sidenav__item dol-sidenav__item" hreflang="en">In Navajo/Diné bízaad</a> </li> <li class="usa-sidenav__item dol-sidenav__item"> <a href="/agencies/owcp/dcmwc/announcementsarchive" class="usa-sidenav__item dol-sidenav__item" hreflang="en">Announcements Archive</a> </li> <li class="usa-sidenav__item dol-sidenav__item"> <a href="/agencies/owcp/dcmwc/coronavirusfaqs" class="usa-sidenav__item dol-sidenav__item" hreflang="en">COVID-19 DCMWC FAQs</a> </li> <li class="usa-sidenav__item dol-sidenav__item"> <a href="/agencies/owcp/dcmwc/lawsandprogramguidance" class="usa-sidenav__item dol-sidenav__item" hreflang="en">Laws and Program Guidance</a> </li> </ul> </div> </div> </div> </div> <div class="usa-layout-docs__main desktop:grid-col-9 usa-prose usa-layout-docs"> <div id="block-opa-theme-content"> <article data-history-node-id="143909" about="/agencies/owcp/dcmwc/filing_a_claim"> <div> <div class="field field--name-field-row field--type-entity-reference-revisions field--label-hidden clearfix"> <div> <div class="paragraph paragraph--type--row paragraph--view-mode--default row" style="background-color:;"> <div class="field field--name-field-bundles field--type-entity-reference-revisions field--label-hidden clearfix"> <div> <div class="paragraph paragraph--type--text-block paragraph--view-mode--default"> <div class="field field--name-field-p-text field--type-text-long field--label-hidden clearfix"><div id="Main"> <div id="Body"> <div id="content"> <h2>Division of Coal Mine Workers' Compensation (DCMWC)</h2> <h3>Are you filing a claim as an active or retired miner?</h3> <p>If you are filing on your record of employment in the coal mining industry, you must complete a CM-911, Miner's Claim for Benefits, and related forms.</p> <ul> <li><a href="/agencies/owcp/dcmwc/guidefilingbenefits">Step-by-step guide to filing for benefits</a></li> <li>Learn more about <a href="/agencies/owcp/dcmwc/filing_guide_miner">filing a claim as an active or retired miner</a>.</li> </ul> <h3>Are you filing a claim as the survivor of a miner?</h3> <p>If you are filing on the employment record of a deceased miner, you must complete a CM-912, Survivor's Claim for Benefits, and related forms.</p> <ul> <li>Learn more about <a href="/agencies/owcp/dcmwc/filing_guide_survivor">filing a claim as the survivor of a miner</a>.</li> </ul> <h3>Are you filing a claim on behalf of another person?</h3> <p>If you are filing a claim on behalf of a minor child or on behalf of someone under a legal or physical impairment, please consult <a href="https://www.ecfr.gov/cgi-bin/text-idx?SID=bbb7f10f73900aa17cc292a42ed32905&mc=true&node=pt20.4.725&rgn=div5#se20.4.725_1301">20 CFR 725.301</a> to make sure that you are eligible to file. Benefits are payable only to the beneficiary, his or her representative payee, or his or her legal guardian.</p> <ul> <li>Learn more about <a href="/agencies/owcp/dcmwc/representative_payees_info">acting as a representative payee</a>.</li> </ul> <h3>Are you assisting a claimant?</h3> <p>If you are acting as a <strong>lay representative</strong> for a miner or a survivor, you must submit a written statement to that effect and signed by the claimant in addition to the claim forms. Lay representatives may be benefits counselors, family members, or any other non-attorney approved by the appropriate adjudication official, usually the District Director at the time a claim is filed. If you are an <strong>attorney</strong> representing the claimant, your written declaration of representation must be submitted but the claimant's written appointment is not required. 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Information about filing a claim for benefits under the Black Lung Benefits Act | U.S. Department of Labor