S. 3491 — Black Lung Benefits Improvement Act of 2025

This section expands the authorized purposes of contracts and grants by the Secretary of Health and Human Services for fixed-site and mobile clinical facilities under the Black Lung Benefits Act (i.e., facilities for analysis, examination, and treatment of respiratory and pulmonary impairments in active and inactive coal miners) to also include assistance on behalf of miners, spouses, dependents, and other family members with claims arising under that Act. (Thus, these facilities may now support the claims process for black lung benefits, which provide workers' compensation to coal miners disabled by pneumoconiosis and their survivors.)

This section revises the irrebuttable presumption of total disability due to pneumoconiosis (black lung disease), or death due to pneumoconiosis (or total disability at time of death), for miners under the Black Lung Benefits Act. (As background, the act provides monthly benefits to coal miners totally disabled by pneumoconiosis arising from coal mine employment, and to survivors of deceased miners.) The revision expands qualifying diagnostic evidence for complicated pneumoconiosis or progressive massive fibrosis beyond chest roentgenograms (x-rays) and biopsies or autopsies to also include chest CT scans or other medically accepted tests or procedures evidencing one or more large opacities greater than 1 centimeter in diameter (classified as category A, B, or C under International Labour Organization standards for x-rays, or equivalent for other tests), absent more probative evidence of non-pneumoconiosis etiology.

This section establishes requirements under a new section 435 of part C of the Black Lung Benefits Act (BLBA) for the Secretary of Labor, upon a claimant's request, to provide a complete pulmonary evaluation for black lung benefits claims (i.e., BLBA claims against coal mine operators for miners disabled by pneumoconiosis). The evaluation includes (1) an initial report by a qualified physician from a Secretary-maintained public list, conducted per specified standards; and (2) supplemental medical evidence if the Secretary recommends an award and an opposing party submits contrary evidence, or in an administrative law judge proceeding where the Secretary awarded benefits, an opposing party submits new contrary evidence, and the claimant or attorney consents. The Secretary must authorize a high-quality computerized tomography scan for diagnosing complicated pneumoconiosis if a certified B reader finds pneumoconiosis (ILO category 2/1 or greater) or coalescence of small opacities on a chest radiograph. For supplemental evidence, the Secretary requests the initial physician (or an alternative from the list if unavailable) to review new evidence and update the opinion. The Secretary must annually review the public list of qualified physicians for suitability (e.g., licensed without revocation or suspension, per National Practitioner Data Bank review) and implement conflict-of-interest policies barring physicians employed by, contracted to, or retained by opposing parties (including insurers) in the prior 24 months. All reports are entered into the record and shared with parties, with expenses paid by the Black Lung Disability Trust Fund.

This section revises penalties for false statements and misrepresentations under the Black Lung Benefits Act (30 U.S.C. 941) by (1) expanding prohibited conduct to include knowingly and willfully making false statements to obtain, increase, reduce, deny, or terminate benefits, or threatening, coercing, intimidating, deceiving, or misleading participants in proceedings; (2) broadening applicability to claimants, physicians, operators, their agents, and insurance carrier employees; and (3) increasing criminal penalties to a fine under 18 U.S.C., imprisonment for up to 5 years (from a $1,000 fine or 1 year imprisonment for a misdemeanor), or both. It further requires the U.S. Attorney to promptly investigate complaints; permanently disqualifies violating attorneys and expert witnesses from proceedings under the act (with the Secretary able to additionally disqualify attorneys for prejudicial conduct or suspension/disbarment); authorizes administrative law judges to impose discovery sanctions (i.e., adverse inferences, limits on claims or evidence, or default decisions); and directs the Secretary to issue implementing regulations (proposed rule within 180 days of enactment; final rule within 18 months). (As background, the Black Lung Benefits Act provides workers' compensation benefits to coal miners disabled by pneumoconiosis.)

This section establishes procedures under the Black Lung Benefits Act for covered individuals (i.e., miners) or covered survivors to file new claims for previously denied benefits where the record included a covered chest radiograph—i.e., one interpreted as negative for pneumoconiosis by a physician whose negative interpretations the Secretary of Labor has discredited in writing. New claims are adjudicated on the merits without considering covered chest radiographs (or as a miner's or survivor's claim, for covered survivors, based on the type pending at the miner's death); if awarded, benefits are payable from the month of the original denied claim's filing (miner's claims) or the miner's death (survivor's claims). The Secretary may deny a new claim if the opposing party proves by clear and convincing evidence that the covered chest radiograph did not contribute to the prior denial, and new claims are available only after final denial by a district director, administrative law judge, or Benefits Review Board.

This section establishes a program, to be implemented by the Secretary within 180 days of enactment, to pay from the Black Lung Disability Trust Fund attorneys’ fees up to $4,500 total and reasonable unreimbursed medical expenses up to $3,000 total per qualifying claim (i.e., a contested black lung benefits claim without a final order within two years of filing). For such claims with an award from a district director, that director may approve up to $1,500 in attorneys’ fees and $1,500 in medical expenses for work before the director; an administrative law judge may approve up to $3,000 in attorneys’ fees and $1,500 in medical expenses for work before the judge. If a final order awards compensation, the liable operator reimburses the fund (enforced as under 33 U.S.C. 921(d)); the program does not limit operator liability for other fees or expenses, nor the Secretary’s authority to pay them from the fund if the operator cannot or will not, and no payments are recouped from the claimant or attorney.

This section revises the basic monthly benefit rate for coal miners totally disabled by pneumoconiosis under the Black Lung Benefits Act from 37½% of the GS-2, step 1 monthly pay rate (with no further specification) to a tiered schedule: (1) retaining that rate for calendar years through 2025; (2) setting it at $9,627.60 per year, payable in 12 equal monthly payments, for 2026; and (3) indexing it for each year thereafter to the prior year's rate multiplied by the CPI-U ratio (not less than 1). (This rate serves as the base for benefits to eligible widows under subsection (a)(2) and to children under subsection (a)(3), which add specified percentages for multiple children.)

This section authorizes the Commissioner of Social Security to disclose, upon written request, an individual's return information on net earnings from self-employment and wages to the Department of Labor (DOL) for administering the Black Lung Benefits Act (BLBA, 30 U.S.C. 901 et seq.), which provides disability benefits, medical benefits, and survivor benefits to coal miners affected by black lung disease (pneumoconiosis). It further requires the Commissioner, notwithstanding the Privacy Act (5 U.S.C. 552a) or other federal or state law, to provide DOL with Social Security earnings information for living or deceased BLBA claimants, in electronic form.

This section directs the Secretary of Labor, not later than 90 days after enactment, to submit to the Senate Committees on Health, Education, Labor, and Pensions and Appropriations and the House Committees on Education and Workforce and Appropriations a comprehensive strategy to reduce the backlog of cases pending, as of enactment, before the Department of Labor's Office of Administrative Law Judges (OALJ). The strategy must address (1) current and targeted pendency for each category of OALJ cases; (2) necessary numbers of administrative law judges, attorney advisors, support staff, and other resources to achieve targeted pendency; (3) resources to improve efficiency, such as video conference equipment, training, reemployed annuitants, and administrative reforms; and (4) for claims under the Black Lung Benefits Act (i.e., benefits for coal miners disabled by pneumoconiosis), resources needed to reduce average pendency to less than 12 months from receipt to disposition.

This section directs the Secretary of Labor to publish an interim final rule within 60 days of enactment and a final rule within 12 months establishing requirements for coal mine operators to qualify as self-insurers for liabilities under the Black Lung Benefits Act (BLBA, which provides workers' compensation to coal miners disabled by pneumoconiosis and their survivors). Such requirements must include (1) criteria based on the operator's financial health (i.e., creditworthiness, long-term viability, and other liabilities) for initial and ongoing eligibility; (2) procedures for annually (or more frequently) determining minimum security amounts sufficient for current and projected liabilities; and (3) procedures for Secretary review of operator appeals. The section further amends BLBA civil penalties for failure to secure benefit payments (30 U.S.C. 933(d)(1)) by (1) increasing the daily penalty to $25,000 (from $1,000); (2) expanding covered corporate officers to include the chief executive officer and chief operating officer, in addition to the president and treasurer, and adding "other responsible party"; and (3) revising penalty scope to cover benefits accruing due to such failure or, upon operator bankruptcy or abandonment, the shortfall between the Black Lung Disability Trust Fund's projected actuarial liability and recovered security (with interest). Finally, the section adds a definition of "other responsible party" to BLBA section 402 (30 U.S.C. 902(j)) as any entity with power to direct an operator's management or policies or under common control with the operator.