20 CFR 410.101 et seq.

SSR 72-41

Where an amount of benefits under a State workmen's compensation law accrues to a miner on account of his disability for a period prior to his death, but after his death is paid, under appropriate State law or practice, to his widow as his legal representative, held, such payment requires a reduction, under section 412(b) of Federal Coal Mine Health and Safety Act, of Federal "black lung" benefits, if any, which belonged to the miner for the period for which the State benefits are paid but further held, such State payment doe not require a reduction of "black lung" benefits due the widow in her own right because of, and for the period subsequent to, the miner's death.

A question has been raised as to whether the residual Pennsylvania occupational disease benefit for the month of death, which is automatically paid to the miner's widow, constitutes a payment "on account of the disability of the miner" and thus cause for reduction of her "black lung" benefits for that month, under section 412(b) of the Federal Coal Mine Health and Safety Act of 1969. If the State compensation due a disabled miner but paid to his spouse is a payment to her "on account of the disability of such miner" with respect to a periodic benefit she receives entirely in her own right after his death, such payment would require a reduction of her monthly "black lung" widow's benefit. If, however, such payment constitutes a payment to her on account of the miner's death, there would be no cause for such reduction.

Section 410 of the Pennsylvania Occupational Disease Act, 77 P.S. 1510, provides, in pertinent part, that:

In any case any claimant shall die before the final adjudication of his claim, the amount of compensation due such claimant to the date of death shall be paid to the dependents entitled to compensation, or, if there be no dependents, then to the estate of the decedent.

An identical provision is contained in section 410 of the Pennsylvania Workmen's Compensation Act, 77 P.S. 751.

While Pennsylvania law thus makes provision in some cases for compensation due a disabled employee to be paid to his widow when the employee's claim is not adjudicated until after his death, comparable statutory provisions do not appear to have been enacted with respect to compensation payments due for the period immediately prior to the death of an employee who had before his death established his entitlement to compensation payments. However, it appears that the Bureau of Workmen's Compensation of the Pennsylvania Department of Labor and Industry automatically pays any such benefit to the employee's widow even when there is a legally administered estate. In either case, a State benefit due a disabled employee in his own right for a period of entitlement preceding his death is not paid until after his death.

Section 412(b) of the Federal Act provides, in pertinent part, that:

* * * benefit payments under this section to a miner or his widow shall be reduced, on a monthly or other appropriate basis, by an amount equal to any payment received by such miner or his widow under the workmen's compensation * * * laws of his State on account of the disability of such miner * * *.

It is conceded that the Pennsylvania payment in question would not be made unless the miner had been disabled. It is equally true that the establishment or continuation of benefit entitlement under State law, as well as the amount due, does not require the miner's death. The issue then is does death change the nature of the payment or, to state it another way, is a compensation payment made to the miner's widow on account of his death, a derivative payment or a wholly independent payment. Under Pennsylvania law, it is clear that workmen's compensation death claims are independent of, and not derivative from, workmen's compensation disability claims. Segal v. Segal, 191 A.2d 858, 861 (Pa. Super., 1963); Moore v. Dodge Steel Co., 213 A.2d 130, 132f. (Pa. Super., 1965); Wilson v. United News Transportation Co., 261 A.2d 338, 341f. (Pa. Super., 1969).

Since the Federal Coal Mine Health and Safety Act does not have a provision such as section 410 of the Pennsylvania Occupational Disease Act, supra (which is analogous to the underpayment provisions in section 204(d) of the Social Security Act, 42 U.S.C. 404(d)), the unpaid amount of "black lung" payments due a deceased miner would become an asset of his estate. Whether the assets of the estate of a miner leaving a spouse are distributed by will, by intestacy, or under a "small estate" statute, some part of them is likely to devolve upon his surviving widow. That part of such assets might be the amount of an "underpayment" of State workmen's compensation benefits to which the miner had established entitlement on account of his disability, patently should not require a reduction in the survivor benefits to which his widow was entitled in her own right under the provisions of section 412(b) of the Federal "black lung" Act. The "residual" payment provisions operate, in effect, to dispose only of what would otherwise be a part of the deceased worker's estate.

This would appear also to be the view of the Supreme Court of Pennsylvania, which had occasion to describe section 410 of the Pennsylvania statute as follows:

Thus, the statute clearly sets forth those parties in interest in their order upon the death of the claimant and obviates the necessity of any costly legal proceeding to bring a new party on the record.

* * * * * * *

The Court further indicated that:

* * * it was the intent of the legislature to obviate the necessity of further costs or legal proceedings in a compensation case, in keeping with the humane provisions of the legislation. Troxel v. Troxel Ins. Agency, Inc., 156 Pa. Super. 402, 40 A.2d 862 (1945). Fehr v. Y.M.C.A., 192 A.2d 143, 148 (Pa., 1963).

It would follow, then, that the transfer to the widow of such an accrued amount which would have been paid to the miner had he liver is, at the least, part of the settlement of the miner's estate; at most, it is in the nature of a workmen's compensation payment to the widow on account of the miner's death.

Furthermore, a reduction in a widow's periodic "black lung" benefit because of this type of payment would not appear to serve the underlying purposes of the reduction provisions in section 412(b) of the Act. Those provisions are analogous to the workmen's compensation offset provisions in section 224 of the Social Security Act, 42 U.S.C. 424a, just as the excess earnings reduction provisions in the Federal "black lung" Act are analogous to (in fact, expressly incorporate) the excess earnings provisions in section 203 of the Social Security Act, 42 U.S.C. 403. While neither Title IV nor its legislative history spell out why Congress included these reduction provisions in the "black lung" benefits program, it is reasonable to assume that their purposes are the same as those underlying the comparable social security provisions, i.e., that prescribed levels of income be maintained without producing "windfalls" by the payment of duplicate Federal benefits or the payment of Federal benefits not needed to maintain such levels of income.

Nor would a reduction of the "black lung" death benefit due a widow in her own right comport with the monthly character of benefit entitlement and payments under the Federal Act. As noted above, section 412(b) provides for reductions "on a monthly or other appropriate basis." This is one of several statutory indications that the "black lung" benefits program be administered on a monthly basis. (For a discussion of these provisions, see SSR 71-30, C.B. 1971, p. 114). Under such a scheme, as under Title II of the Social Security Act, a reduction against a monthly benefit is imposed with respect to the benefit for the month in which the reduction event occurs. If the event in question is some payment, such as a State workmen's compensation payment, the reduction is imposed against the benefit for the month in which the right to the State payment accrues, regardless of when it is paid. (Also see 20 CFR 404.408(c)). On this basis, a current reduction of a widow's "black lung" benefit because of payments due a disabled miner in the past (even though being paid to the miner's widow currently because of his death) would be contrary to the statutory scheme. Only where a miner is entitled to State workmen's compensation and Federal "black lung" benefits for the same month is there a duplication of benefits for that month regardless of when these respective benefits are actually paid -- whether before or after the miner's death. The avoidance of such duplication would support the reduction of the Federal "black lung" benefits of the miner even where paid as an underpayment to the legal representative of the miner's estate, e.g., his widow, after his death, but where there is no such duplication of benefits for a given month, there should be no reduction of "black lung" benefits.

In this sense, a State disability payment due the miner on account of his disability (and to which he was determined to be entitled before he died) is not related to the payment of benefits due his widow in her own right because of his death. The nature of this situation is not essentially changed merely because a reduction is avoided where the miner was not entitled to Federal "black lung" benefits before his death, e.g., he never filed for such benefits. Where the miner himself never became entitled to Federal "black lung" benefits so that ny State benefits due him could not have resulted in a reduction of his "black lung" benefits, no statutory provision is offended by paying the widow the "black lung" benefit to which she is entitled in her own right, without any reduction under section 412(b) of the Act.

Accordingly, it is held that payment of a benefit under a State workmen's compensation law on account of the disability of a miner must reduce an "underpayment" of Federal "black lung" benefits due the miner but paid to his widow as his legal representative after his death, but further held, such State payment, payable to the miner's spouse on account of his death, will not, under section 412(b), supra, reduce any "black lung" benefits to which she is entitled in her own right as a widow under section 412(a)(2) of such Act, supra.

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