First, potentially eligible claimants needed to be told about the program and urged to file application as promptly as possible to avoid possible loss of benefits.

Second, we had to develop a body of administrative regulations and policy criteria for determining when a person should be considered disabled due to coal workers' pneumoconiosis and when death could be found to be due to that disease.

Third, we had to devise administrative procedures and other mechanisms for taking applications, developing necessary evidence, determining all necessary factors of entitlement, and establishing and continuing benefit payments.

It was necessary to gear up and take action on all of these fronts simultaneously if we hoped to process claims within a reasonable time and help claimants avoid loss of benefits. As an example of our response to these needs, on the day the act was signed, every Social Security district office in the Nation was provided by teletype with informational material for release to the press, television, and radio. and given emergency instructions on the acceptance of applications under the new law.

As a result of this action and other publicity given to the new program, 18,000 applications for benefits were filed in the first week after enactment. And in the first month of enactment, almost 100,000 applications had been filed by coal miners and widows. I do want to acknowledge, however, the valuable assistance and cooperation we received in this informational effort from Members of Congress, the United States Mine Workers of America, the United Mine Workers Retirement Welfare Fund, and many others.

Senator WILLIAMS. We accept your statement of appreciation. Mr. POPICK. We also immediately began to develop the necessary substantative rules for determining who would be eligible for benefits under the program, including the medical criteria for determining when a miner is totally disabled due to pneumoconiosis, or when his death could be attributed to this disease.

This was done in very close consultation with a number of groups and individuals whose experience and interest we found to be most. relevant and helpful, starting primarily with our colleagues in the Public Health Service, Dr. Key and his staff, as well as representatives of the UMWA and the fund, workman's compensation agencies, our own Social Security Medical Advisory Committee, coal mine operators, and a wide range of professional and technical specialists in the field.

To date, over 180,000 miners' and widows' claims for benefits have been filed, with over 80 percent of these from Pennsylvania, Kentucky, and West Virginia. New claims are being filed at the rate of about 3,000 per week. The first benefit awards were made at the end of April, 4 months after enactment, and we have now progressed to the point of having approved a total of 30,000 claims for payment.

While we were limited at the start in what we could do by way of processing claims before we had time to catch up on the many legal and policy issues that needed to be resolved, we did use the time while we were working on these problems to good advantage. We did a tremendous amount of work in gathering evidence pertinent to these claims that was available from existing sources.

Because 80 percent of these claimants for black lung benefits had previously filed claims for social security benefits, we were able to utilize a good deal of evidence in our own files. In addition, we worked out arrangements to tap other valuable sources of evidence. For example, we sent social security personnel to Pennsylvania to screen and excerpt pertinent records in over 30,000 claims in the files of the Pennsylvania occupational disease program. Workmen's compensation files in other States were also screened.

Arrangements were made to receive death certificates en masse from the larger coal mine States at our expense, as well as to tap UMWA and Retirement and Welfare Fund reports. As a result of this type of activity, in a large number of the claims thus far allowed, we did not have to go back to the applicant at all for any additional information or evidence after he had filed his application.

At the present time we are working with the greatest speed and vigor on the big backlog of cases remaining to be processed. We have placed additional temporary staff in our district offices in the coal mining areas to provide maximum assistance to applicants in filing claims and securing necessary evidence. Our offices with peak claims loads are remaining open on evenings and Saturdays, and a considerable amount of overtime is being worked by the staff throughout the operation as part of a massive effort to expedite the completion of the heavy volume of claims.

Many cases require medical evidence beyond that available from existing records in order to assure proper consideration of the applicant's benefit rights. To obtain this evidence, we have enlisted the assistance of the State agencies which work with us under special agreement in our regular disability program. These agencies are now very intensively engaged in arranging for necessary medical examinations in coal miners' claims involving primarily X-rays and pulmonary function studies as needed. These examinations are performed by qualified local physicians and medical facilities convenient to the applicant, and at no cost to him.

Of course, with the volume and concentration of these claims and the limitations on medical resources, securing the necessary medical evidence is posing a major challenge for some of these agencies and for the prompt handling of claims. We have been working very closely with the State agencies with major work loads to enlarge the availability of medical resources in their areas, and we have also deployed technical and specialist claims staff from our headquarters disability operation at key points throughout the States to reinforce this all-out effort to expedite these claims.

While we are providing every assistance we can to applicants in establishing their entitlement to these new benefits, a very substantial number of claims can be expected to be denied because we will find that one or more requirements of the law are not met. But denied applicants have a right to challenge the decision, as do applicants for social security benefits. They may request administrative reconsideration and, if still dissatisfied, may ask for a hearing before a hearing examiner. There are also further appeal rights to the appeals council and to the Federal courts.

As we notify individuals of the disallowance of their claims and many of them exercise their right to request reconsideration, we can

expect a substantial workload to develop for us in taking the necessary action to thoroughly reconsider and, in some cases, supplement the evidence in their claim and make a new decision in each appealed case.

Title IV of the act provides two basic benefits. First, benefits to coal miners totally disabled due to pneumoconiosis arising out of employment in underground coal mines; and, two, benefits to widows of coal miners who died due to pneumoconiosis arising out of employment in an underground coal mine. It is immaterial how long ago the disability began, when the miner died, or the age of the miner or the widow.

At present, the basic benefit for miners and widows in $144.50 per month. Benefits are not paid directly to wives and children. However, the amount of the benefits payable to a miner or widow is increased where there are qualified dependents. The maximum amount per family is $288.90 per month.

Since the basic benefit amounts are tied to the civil service benefits retirement levels, the benefit amount is increased as Federal salaries and retirement benefits are increased, and one such upward adjustment has already been made.

The payments to the 30,000 miners and widows whose claims have already been approved include payments for additional 20,000 dependent wives and children, making a total of 50,000 beneficiaries thus far. The amount of cumulative benefits paid back to January 1970, now totals about $25 million.

It should be noted that our responsibility under this program is limited generally to claims filed through December 1972. For claims filed in 1970 and 1971, we will handle benefit payments as long as the beneficiary remains eligible during his or her lifetime. For claims filed in 1972, we handle them only to the end of that year. In 1973, administrative responsibility for new claims will shift to the Department of Labor and will be handled through workman's compensation agencies in States which have enacted appropriate legislation to provide comparable benefit payments.

It may be of interest to offer a comment on the difference in concepts underlying these coal workers' pneumoconiosis benefits and those provided under our regular disability program. Social security disability benefits are payable to insured workers who are disabled within the meaning of the law, regardless of the nature of the medically determinable impairment or disease that causes the disability and regardless of whether there was a causal connection with employment.

Under the Federal Coal Mine Health and Safety Act, benefits are payable to a miner who is totally disabled due to pneumoconiosis, provided the disease was caused by underground coal mine work. Thus, these two requirements-disability must be due to the specific disease, pneumoconiosis, and the requirement of causal connection with underground coal mine work-are quite different from anything in our regular program.

Fortunately, the problem of establishing causality is facilitated for us by the provision in the law which permits a presumption that pneumoconiosis was due to work in the mine when the miner worked 10 or more years in an underground mine. However, the problem remains if the applicant is disabled by pneumoconiosis and did not work in an underground coal mine for this length of time. On the basis of

case experience, we are developing additional criteria for making decisions on this issue.

With respect to the requirement that the miner be totally disabled due to pneumoconiosis, we had to establish diagnostic criteria for determining the presence of the disease, criteria for measuring its severity in terms of its effect on the applicant's ability to work, and criteria establishing the level of severity that would be considered totally disabling within the meaning of the law. The act, of course. prescribes that the term "total disability" shall have the meaning given by regulations of the Secretary of Health, Education, and Welfare. But such regulation shall not provide more restrictive criteria than those applicable under the Social Security Act, which defines "disability" under our regular program.

There is clearly expressed congressional intent that initially the criteria should be those now applied under the Social Security law and the President, in signing the act into law, expressly suggested such application. Accordingly, in addition to the specific presumptions provided by law, the regulations reflect the basic evaluation principles and criteria followed under our regular disability program to the extent that they are applicable to cases in which pneumoconiosis is the disabling impairment.

Under these regulations, the miner is found to be disabled if he meets a presumptive test described in the law, which means that the X-ray or pathological findings show that he has what is commonly referred to as complicated pneumoconiosis. Alternatively, as under our regular program, he can be found to be disabled if he meets certain medical criteria showing severe breathing impairment due to pneumoconiosis or has another serious condition resulting from that disease, for example, cor pulmonale.

If he is not disabled by any of these prescribed medical standards, he may nevertheless be found to be disabled if he has pneumoconiosis and such functional breathing limitation as to prevent him from doing coal mining work, and if he cannot engage in any other type of substantial gainful activity consistent with his vocational competence. Thus, the older, longtime miner with limited education and skills, who is shown to be unable to do heavy work because of pneumoconiosis, will ordinarily be found to be disabled. These criteria follow closely the evaluation guides under our regular disability program.

For a widow to qualify for benefits under the program, her husband must have been drawing benefits under the act, or it must be established that he died from pneumoconiosis growing out of underground coal mine work. The law provides an irrebuttable presumption that death was due to pneumoconiosis, if the miner had the disease in its complicated stage. It provides a rebuttable presumption that a miner's death was due to pneumoconiosis, if he had at least 10 years of work in an underground coal mine and died of a respirable disease.

Our regulations provide that death will be found due to pneumoconiosis when, in the absence of evidence to the contrary, death is ascribed to chronic dust disease or other chronic disease of the lung, with certain specified exceptions.

One requirement for payment of benefits is that the coal miner's pneumoconiosis be due to work in an underground coal mine. Our regulations reflect a liberal interpretation that work in an underground

coal mine includes not only work under the surface but also work above the surface in processing coal.

Reimbursement to applicants for necessary medical expenses in establishing their claims is specifically provided in the law. We have interpreted this to permit reimbursement or direct payment for medical evidence in miners' claims, as well as for death certificates as evidence of cause of death in widows' claims. Of course, any such special examinations or tests required of the applicant are also paid for by the Government.

Another significant provision unique to the coal miners' benefit program is a statutory requirement that no claim be considered until a State workman's compensation claim has also been filed, unless such filing would be futile. We have interpreted this provision in such a way that we will accept and adjudicate coal miners' claims prior to filing the required workman's compensation claim, but withholding actual payment until the workman's compensation filing requirement is met.

We are also making every effort to advise applicants about when such filing will be unnecessary because it would be futile as, for example, when the time period for filing under the State law has expired.

As I previously indicated, the law provides no retroactivity in benefit payments. In fact, it provides that no benefits can be paid for any period before the date the claim is filed. Taken literally, this could mean, for example, that a widow would lose benefits if she did not file her claim on the day her husband died. However, through regulatory interpretation we found it possible to pay benefits for the entire month in which the claim was filed and for assuring that no interruption in benefit payments for the wife in the event of her husband's death would take place, even though there might be delay in filing the claim.

Many of the people who have filed application for Federal coal miners' benefits are already receiving social security benefits or workman's compensation or occupational disability benefits under a State program. Both the Social Security Act and the Federal Coal Mine Health and Safety Act contain provisions which are designed to reduce the extent of overlapping and duplication of benefits.

The Social Security Act has, since 1965, contained what we call a workman's compensation offset provision. For people below age 62 and who become disabled after June 1, 1965, the law limits the amount of combined income from social security disability benefits and workmen's compensation benefits to 80 percent of the worker's average current earnings before he becomes disabled. If the combined benefits were to exceed this amount, the social security benefits are reduced by the amount of the excess. This is not a dollar-for-dollar offset. As a result of this, some current social security disability beneficiaries will have these benefits reduced when they become entitled to coal miners' benefits. However, we estimate that only about 5 percent will be so affected. Most miner applicants are age 62 or older and the offset would therefore not apply at all. Incidentally, there is proposed social security legislation in H.R. 175502 which has passed the House and is now pending in the Senate, containing a provision which would raise the ceiling on combined benefits from 80 to 100 percent.