20 Cfr 725.506

Office of Workers’ Compensation Programs, Labor

rmajette on DSKBCKNHB2PROD with CFR

applicable, shall govern the determination of the date from which benefits
are payable.
(2) Change in conditions. Benefits are
payable to a miner beginning with the
month of onset of total disability due
to pneumoconiosis arising out of coal
mine employment, provided that no
benefits shall be payable for any month
prior to the effective date of the most
recent denial of the claim by a district
director or administrative law judge.
Where the evidence does not establish
the month of onset, benefits shall be
payable to such miner from the month
in which the claimant requested modification.
(e) In the case of a claim filed between July 1, 1973, and December 31,
1973, benefits shall be payable as provided by this section, except to the extent
prohibited
by
§ 727.303
(see
§ 725.4(d)).
(f) No benefits shall be payable with
respect to a claim filed after December
31, 1973 (a part C claim), for any period
of eligibility occurring before January
1, 1974.
(g) Each decision and order awarding
benefits shall indicate the month from
which benefits are payable to the eligible claimant.
§ 725.504 Payments to a claimant employed as a miner.
(a) In the case of a claimant who is
employed as a miner (see § 725.202) at
the time of a final determination of
such miner’s eligibility for benefits, no
benefits shall be payable unless:
(1) The miner’s eligibility is established under section 411(c)(3) of the
Act; or
(2) the miner terminates his or her
coal mine employment within 1 year
from the date of the final determination of the claim.
(b) If the eligibility of a working
miner is established under section
411(c)(3) of the Act, benefits shall be
payable as is otherwise provided in this
part. If eligibility cannot be established under section 411(c)(3), and the
miner continues to be employed as a
miner in any capacity for a period of
less than 1 year after a final determination of the claim, benefits shall be
payable beginning with the month during which the miner ends his or her

§ 725.507

coal mine employment. If the miner’s
employment continues for more than 1
year after a final determination of eligibility, such determination shall be
considered a denial of benefits on the
basis of the miner’s continued employment, and the miner may seek benefits
only as provided in § 725.310, if applicable, or by filing a new claim under this
part. The provisions of Subparts E and
F of this part shall be applicable to
claims considered under this section as
is appropriate.
(c) In any case where the miner returns to coal mine or comparable and
gainful work, the payments to such
miner shall be suspended and no benefits shall be payable (except as provided in section 411(c)(3) of the Act) for
the period during which the miner continues to work. If the miner again terminates employment, the district director may require the miner to submit
to further medical examination before
authorizing the payment of benefits.
§ 725.505

Payees.

Benefits may be paid, as appropriate,
to a beneficiary, to a qualified dependent, or to a representative authorized
under this subpart to receive payments
on behalf of such beneficiary or dependent.
§ 725.506 Payment on behalf of another; ‘‘legal guardian’’ defined.
Benefits are paid only to the beneficiary, his or her representative payee
(see § 725.510) or his or her legal guardian. As used in this section, ‘‘legal
guardian’’ means an individual who has
been appointed by a court of competent
jurisdiction or otherwise appointed
pursuant to law to assume control of
and responsibility for the care of the
beneficiary, the management of his or
her estate, or both.
§ 725.507 Guardian for minor or incompetent.
An adjudication officer may require
that a legal guardian or representative
be appointed to receive benefit payments payable to any person who is
mentally incompetent or a minor and
to exercise the powers granted to, or to
perform the duties otherwise required
of such person under the Act.

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