You fill out DOL Form CM-913 by giving the U.S. Department of Labor’s Division of Coal Mine Workers’ Compensation the clarifying employment, medical, and dependency information it needs to decide a federal Black Lung benefits claim. The form is a follow-up questionnaire, not the original claim, and the Office of Workers’ Compensation Programs sends it after reviewing your initial application under the Black Lung Benefits Act.
Missing or wrong answers on CM-913 can cause a denial, a delay, or the wrong coal company being named the responsible operator under 20 C.F.R. § 725.495. About 25,000 federal Black Lung claims were active or pending in fiscal year 2025, according to the DOL DCMWC annual report, and clarification forms like CM-913 touch a large share of them.
This guide walks coal miners, surviving spouses, dependents, attorneys, employers, insurers, and HR teams through every field of CM-913, plus the federal rules and state nuances that shape each answer. Here is what you will learn:
- 📝 How to complete each line of CM-913 without triggering a denial
- ⚖️ Which statutes, regulations, and cases drive each question
- 🏥 How medical evidence and the 15-year presumption interact with your answers
- 🏭 How responsible operator designation works and how to rebut it
- 🗂️ The most common mistakes, do’s and don’ts, and FAQs from real claims
What DOL Form CM-913 Is and Why It Exists
DOL Form CM-913, titled Clarification of Employment Information in the Black Lung program, is a supplemental questionnaire issued by the DCMWC district office after a miner, surviving spouse, child, parent, brother, or sister files a claim on Form CM-911 or CM-912. The form exists because the agency must build a complete factual record before it issues a Proposed Decision and Order under 20 C.F.R. § 725.418.
The Black Lung Benefits Act, codified at 30 U.S.C. §§ 901–945, entitles totally disabled coal miners and certain survivors to monthly cash benefits and medical care for pneumoconiosis arising out of coal mine employment. To pay those benefits, the Department of Labor must identify the last responsible coal mine operator that employed the miner for at least one cumulative year, as defined in 20 C.F.R. § 725.494. CM-913 is how the agency closes gaps in employment dates, job duties, dust exposure, and dependency that the original claim form left open.
The plain-English version is simple: the DOL is asking you to clear up something it could not figure out from your first filing. The consequence of ignoring CM-913 is severe, because under 20 C.F.R. § 725.409 a claim can be denied by reason of abandonment if the claimant fails to provide requested information within 60 days. A real-world example: Marvin, a retired Kentucky miner, ignored a CM-913 request for missing 1986–1989 employment dates, and his claim was denied by abandonment even though his medical evidence was strong. A common misconception is that CM-913 is optional because it is not the original claim form, but the regulations treat the request as mandatory once issued.
The Form’s Place in the Claims Process
CM-913 sits between the initial claim filing and the Proposed Decision and Order. After you file Form CM-911 (miner) or Form CM-912 (survivor), the district office orders a complete pulmonary evaluation under 20 C.F.R. § 725.406 and develops the employment history. CM-913 is sent when the Employment History (Form CM-911a) is unclear, contradicts Social Security earnings records, or fails to establish 15 years of qualifying coal mine employment for the Section 411(c)(4) presumption.
The consequence of a sloppy CM-913 reply is that the district director may not invoke the 15-year presumption, which shifts the burden to the operator to disprove pneumoconiosis once the miner shows 15 years of qualifying employment and a totally disabling respiratory impairment. A scenario: Brenda, a widow in West Virginia, returned a CM-913 listing only 12 years of underground work because she forgot two surface jobs, and the district director declined to apply the presumption. A common misconception is that any coal job counts toward the 15 years, but 20 C.F.R. § 718.305 requires the work to be substantially similar to underground conditions for surface miners.
Who Receives CM-913 and Who Must Respond
CM-913 is issued to claimants, named responsible operators, and sometimes carriers and third-party employers. Each recipient has a different duty under the regulations, and confusing the duties is one of the top reasons claims are derailed. The form’s instructions, available on the DOL Forms page, explain that the recipient must answer every applicable question and sign under penalty of perjury under 18 U.S.C. § 1001.
Claimants must respond because the Black Lung Benefits Act places the initial burden of production on them under 20 C.F.R. § 725.103. Operators must respond because 20 C.F.R. § 725.408 requires a designated responsible operator to file a response within 30 days of notification, including any controverting evidence about employment dates, dust exposure, or insurance coverage. The consequence of an operator’s silence is that the agency may treat the employment facts as admitted, which the Benefits Review Board affirmed in Big Branch Resources v. Ogle.
A common misconception is that only the named operator must answer, but prior operators can also be served if the named operator is financially incapable, under the cascade rules in 20 C.F.R. § 725.495(a)(4). For example, Harlan Coal Co. was named first, but after it proved insolvency, the DOL served CM-913 on Cumberland Mining LLC, the prior operator, which then had 30 days to respond. The plain-English explanation is that the agency keeps moving up the chain until it finds a solvent, properly insured operator.
Survivors, Dependents, and Representatives
Surviving spouses, children, parents, and siblings can each receive CM-913 when their dependency or relationship facts are unclear. 20 C.F.R. § 725.204 defines a surviving spouse and requires proof of marriage, cohabitation or support, and absence of remarriage that terminated benefits. A surviving child must show full-time student status between ages 18 and 23 under 20 C.F.R. § 725.209, and CM-913 often asks for school enrollment letters.
Authorized representatives, including attorneys admitted under 20 C.F.R. § 725.363, can sign CM-913 on the claimant’s behalf if a Form CM-972 fee agreement and authorization is on file. The consequence of an unauthorized representative signing is rejection of the response and potential referral for unauthorized practice. A real example: Attorney Diaz signed CM-913 for client Roy without filing a current CM-972, and the district office returned the form unprocessed, costing 21 days of development time.
Section-by-Section Walkthrough of CM-913
CM-913 has identifying information at the top, then numbered sections covering employment, medical, dependency, and certification. The current OMB-approved version, listed under OMB Control No. 1240-0002, follows the same structure across recent revisions. Always verify you are using the latest edition from the DOL DCMWC forms library before signing.
The form must be completed in blue or black ink if filled by hand, or typed into the fillable PDF. The plain-English rule is that every blank must be addressed, even if the answer is not applicable or unknown. The consequence of leaving a blank truly empty is that the district director may treat the question as unanswered and issue another CM-913, which restarts the 60-day clock and delays your benefits.
Top of the Form: Identifying Information
The header collects the miner’s full legal name, Social Security Number, claim number, and date of birth. The claim number is the OWCP-assigned number that begins with a state-coded prefix and appears on every letter from the district office. The consequence of a mismatched SSN is that the agency cannot pull the SSA earnings record used to verify employment quarters under the coal mine employment table.
A real example: Jefferson, a miner in Virginia, transposed two digits of his SSN on CM-913, and the agency could not match his 1978–1992 earnings, which delayed the 15-year presumption finding by four months. A common misconception is that the claim number and case number are the same, but the case number is internal and the claim number is what you must use on every form. Always copy the claim number directly from the DOL letter that came with CM-913.
Section A: Employment History Clarification
This section asks for a line-by-line list of every coal mine employer, with start and end dates, job titles, employer addresses, and whether the work was underground, surface, or mixed. The agency cross-checks these entries against SSA earnings, MSHA mine ID records, and operator filings. The plain-English rule is that every coal job counts, even part-time, seasonal, contractor, and out-of-state work.
The consequence of omitting a job is that you may fall under 15 years and lose the Section 411(c)(4) presumption. A scenario: Walter worked 14 years underground in Pennsylvania and one year as a coal truck driver hauling from a tipple, but he left the trucking job off CM-913 because he thought it did not count, and the presumption was denied. Under 20 C.F.R. § 725.202, transportation of coal from the mine site can qualify if the duties are integral to extraction.
A common misconception is that contractor work for a coal operator is not coal mine employment, but 20 C.F.R. § 725.493 defines an operator broadly to include independent contractors performing services or construction at a mine. List the contractor and the mine where you worked, with both addresses if known.
Section B: Dust Exposure and Job Duties
Section B asks you to describe the dusty conditions of each job, the equipment you operated, and the protective equipment provided. This information matters for surface miners who must show substantially similar exposure to qualify for the 15-year presumption under 20 C.F.R. § 718.305(b)(2). The Supreme Court’s reasoning in Usery v. Turner Elkhorn Mining, upholding the Act’s presumptions, makes clear the exposure facts must be detailed.
The consequence of vague answers like dusty all the time is that the administrative law judge may reject the comparison to underground conditions. A better answer names the equipment, the respirable dust levels if known from MSHA inspections, and the duration. Edith, a surface drill operator in Wyoming, won her presumption by listing the specific drill model, the lack of dust suppression water, and the 12-hour shifts in open pits.
A common misconception is that wearing a respirator means you cannot claim heavy dust exposure, but the regulation focuses on the environment, not the personal protective equipment. List the PPE honestly but emphasize the ambient dust.
Section C: Medical Information and Treating Physicians
Section C collects names and addresses of treating physicians, hospitals, pulmonologists, and any prior chest X-rays, pulmonary function tests, arterial blood gas studies, or biopsy reports. The DOL pays for one complete pulmonary evaluation under 20 C.F.R. § 725.406, but it also weighs all medical evidence in the record under the quality standards in 20 C.F.R. Part 718.
The consequence of leaving out a treating physician is that favorable evidence may never reach the file, while the operator’s experts dominate. A real example: Curtis forgot to list his VA pulmonologist on CM-913, and the operator’s B-reader radiologist’s negative X-ray reading went uncontested until appeal. Under the B-reader certification program run by NIOSH, only certified readers can interpret X-rays for Black Lung purposes.
A common misconception is that you must already have positive medical evidence to list a doctor, but you should list every provider who treated your lungs, heart, or related conditions. The agency will request records directly using the signed authorization on CM-913.
Section D: Dependency and Family Information
Section D asks about your spouse, children, stepchildren, parents, and siblings who might qualify as augmentees or survivors. Augmented benefits under 20 C.F.R. § 725.520 increase the monthly benefit by a set percentage for each qualifying dependent, with the 2026 base benefit rate at $816.40 per month for a miner with no dependents, per the DCMWC benefit rate table.
The consequence of failing to list a dependent is underpayment of monthly benefits, which can be corrected only prospectively in many cases. A scenario: Lila, a miner’s wife, was not listed on CM-913 because the miner thought common-law marriage did not count, but 20 C.F.R. § 725.214 recognizes common-law marriage where the state of celebration recognizes it, including in Pennsylvania for marriages before 2005.
A common misconception is that adult children never qualify, but a child under 18, a full-time student under 23, or a child disabled before 22 can be a dependent under 20 C.F.R. § 725.209. List every potentially qualifying dependent and let the agency rule.
Section E: Other Benefits and Offsets
Section E asks about state workers’ compensation, Social Security Disability, VA pensions, and private disability insurance. Federal Black Lung benefits can be reduced by state workers’ compensation paid for pneumoconiosis under 20 C.F.R. § 725.535. The reduction prevents double recovery for the same condition.
The consequence of hiding a state award is overpayment and a recovery action under the Federal Claims Collection Standards. Norman, a Virginia miner, did not disclose his state pneumoconiosis award and faced a $19,400 recoupment three years later, plus interest. A common misconception is that all benefits offset, but Social Security retirement, VA service-connected compensation, and private insurance generally do not reduce federal Black Lung benefits.
Section F: Certification and Signature
The certification block requires the claimant or authorized representative to sign and date under penalty of perjury. False statements expose the signer to criminal penalties under 18 U.S.C. § 1001 and civil penalties under the Program Fraud Civil Remedies Act. The plain-English rule is do not guess — write unknown if you do not know.
The consequence of a false answer can be a denial of the claim, prosecution, and forfeiture of benefits paid. A scenario: Theodore claimed 18 years of underground work but SSA records showed only 9, and the U.S. Attorney’s Office in the Eastern District of Kentucky pursued a misdemeanor under § 1001. A common misconception is that an honest mistake is fraud, but the statute requires knowing and willful falsity, so disclose corrections promptly to avoid that risk.
Three Common CM-913 Scenarios
Below are the three most frequent fact patterns that drive CM-913 outcomes, drawn from published Benefits Review Board decisions and DCMWC guidance.
Scenario 1: The Surface Miner Seeking the 15-Year Presumption
| Claimant Action | Regulatory Outcome |
|---|---|
| Lists 16 years of strip-mine drill operator work with detailed dust exposure | District director invokes Section 411(c)(4) presumption and shifts burden to operator |
| Lists 16 years but writes only general labor, dusty | Presumption denied for failure to show substantially similar exposure under 20 C.F.R. § 718.305 |
| Lists 14 years and forgets a 13-month coal-prep plant job | Falls below 15-year threshold; presumption unavailable; case proceeds on direct evidence only |
Scenario 2: The Surviving Spouse Filing a Survivor’s Claim
| Survivor Action | Regulatory Outcome |
|---|---|
| Provides marriage certificate, death certificate, and proof of cohabitation through CM-913 | Eligibility under 20 C.F.R. § 725.212 established; benefits begin month of miner’s death |
| Omits prior divorce decree and remarriage termination | Agency cannot confirm current marital status; CM-913 returned for missing documents and 60-day clock restarts |
| Reports the miner was already receiving federal benefits at death | Automatic entitlement under Byrd Amendment of the Affordable Care Act, no need to relitigate disease |
Scenario 3: The Operator Disputing Responsibility
| Operator Action | Regulatory Outcome |
|---|---|
| Returns CM-913 with payroll records showing miner worked under 1 cumulative year | Operator dismissed under 20 C.F.R. § 725.494(c); next prior operator named |
| Ignores CM-913 for 30+ days | Agency treats employment facts as admitted, per Big Branch Resources v. Ogle reasoning |
| Returns CM-913 disputing insurance coverage on the exposure date | Carrier joinder triggered under 20 C.F.R. § 725.493(b) |
Named Examples That Illustrate the Rules
Example 1 — Earl, a Retired West Virginia Underground Miner. Earl worked 22 years for Pocahontas Coal Co. and 3 years for Beckley Mining LLC. CM-913 asked him to clarify a two-year gap in 1994–1996. Earl produced union dues records from the United Mine Workers of America showing continuous membership and a layoff letter, which closed the gap. The district director invoked the 15-year presumption, and Earl began receiving the 2026 augmented rate of $1,224.60 per month for a miner with one dependent.
Example 2 — Roberta, a Surviving Spouse in Kentucky. Roberta’s late husband, Henry, was already receiving federal Black Lung benefits when he died in 2025. CM-913 asked Roberta to verify cohabitation and dependency. Because Henry was an awarded miner at death, Roberta qualified automatically under the Byrd Amendment without proving the disease caused his death. Her benefits began the month after his death.
Example 3 — Pioneer Mining Inc., a Named Responsible Operator in Virginia. Pioneer was named as the responsible operator for Lawrence, a miner with 11 months at Pioneer and 14 years at Clinch Valley Coal. Pioneer’s CM-913 response attached payroll showing under 1 cumulative year, and the district director reassigned responsibility to Clinch Valley under 20 C.F.R. § 725.495. Pioneer was dismissed and saved an estimated $340,000 in lifetime liability.
Mistakes to Avoid on CM-913
The most damaging errors on CM-913 are the ones that look harmless. The DOL’s own compliance bulletins flag the same issues year after year, and the Benefits Review Board has affirmed denials based on each. Below are the seven most frequent mistakes plus their consequences under the regulations.
- Leaving a field blank instead of writing unknown or N/A, which causes the agency to reissue CM-913 and restart the 60-day abandonment clock.
- Underreporting coal mine years by skipping contractor or transportation work, which can sink the 15-year presumption under 20 C.F.R. § 725.202.
- Vague dust descriptions like dusty job without equipment, location, or duration, which sinks the surface-miner substantially similar showing.
- Not listing every treating physician, which lets the operator’s experts dominate the medical record under 20 C.F.R. Part 718.
- Omitting dependents like full-time student children or disabled adult children, which causes underpayment of augmented benefits under 20 C.F.R. § 725.520.
- Failing to disclose a state workers’ compensation award, which leads to overpayment recovery under 20 C.F.R. § 725.535.
- Signing without authority, where a relative or friend signs for the miner without a power of attorney or CM-972, causing the form to be rejected.
- Mailing CM-913 to the wrong district office, since each state is assigned to a specific DCMWC district, and misrouted forms add weeks of delay.
- Missing the 30-day operator response deadline, which the agency treats as an admission of employment facts under 20 C.F.R. § 725.408.
Federal Rules That Drive Each Answer
Federal law sets the spine of every CM-913 answer. The Black Lung Benefits Act creates the entitlement, and 20 C.F.R. Parts 718, 725, and 727 implement it. Understanding the why behind each section of CM-913 helps you give answers that survive operator challenge and ALJ review.
The 15-year presumption in Section 411(c)(4) is the single most powerful tool a claimant has. It says that if a miner worked at least 15 years in qualifying coal mine employment and has a totally disabling respiratory or pulmonary impairment, then pneumoconiosis is presumed and the operator must rebut by ruling out coal dust as a cause. The Supreme Court in Mullins Coal Co. v. Director, OWCP discussed the evidentiary structure of these presumptions and the burden-shifting framework.
The consequence of giving up the presumption through sloppy CM-913 answers is enormous, because direct proof of legal pneumoconiosis under 20 C.F.R. § 718.201 is medically demanding. A common misconception is that the presumption guarantees benefits, but operators routinely rebut it with negative B-reader X-rays, normal pulmonary function studies, and physician opinions excluding coal dust as a substantial contributing cause.
Responsible Operator Designation
Under 20 C.F.R. § 725.495, the responsible operator is the most recent operator that employed the miner for at least one cumulative year, was an operator after June 30, 1973, and is financially capable of paying benefits, usually proven by black lung insurance or self-insurance authorization. CM-913 forces both claimant and operator to put their employment facts on the table.
The consequence of a wrong designation is years of litigation and possible payment from the Black Lung Disability Trust Fund, which is funded by an excise tax on coal at $1.10 per ton underground and $0.55 per ton surface, capped at 4.4% of sales price, under 26 U.S.C. § 4121. A common misconception is that the current employer is always responsible, but the rules look at the last qualifying operator before the claim, even if decades passed.
State Nuances After the Federal Rules
Federal law governs CM-913, but state black lung programs run in parallel and can affect offsets, evidence, and dependency proof. Always start with federal answers, then layer in state facts where the form asks about state benefits.
Pennsylvania has a robust state black lung program under the Pennsylvania Workers’ Compensation Act, and a state award offsets federal benefits under 20 C.F.R. § 725.535. Pennsylvania also recognized common-law marriage entered before January 1, 2005, which can affect Section D of CM-913.
West Virginia runs occupational pneumoconiosis claims through the Workers’ Compensation Office of Judges, and CM-913 should disclose any West Virginia award. Kentucky uses the Department of Workers’ Claims and requires specific medical evidence that often parallels federal CM-988 reports. Virginia processes claims through the Workers’ Compensation Commission and offsets too.
The consequence of failing to disclose a state award is a federal overpayment and recoupment under the Debt Collection Improvement Act. A common misconception is that settlements in state cases are not offsets, but lump-sum settlements are prorated over the miner’s life expectancy under 20 C.F.R. § 725.535(b).
Do’s and Don’ts for Filing CM-913
- Do read the cover letter that came with CM-913 and answer every item it lists, because the district director uses that letter as a checklist.
- Do attach Social Security earnings printouts, MSHA mine ID lookups, union dues records, and W-2s to back up employment dates, since corroboration beats memory.
- Do list every treating physician, even VA and county clinic doctors, because favorable evidence cannot enter the record if the agency does not know about it.
- Do keep a full copy of the completed CM-913 and every attachment, because the agency may lose mail and you may need to refile.
- Do mail CM-913 by certified mail, return receipt, to the assigned DCMWC district office, so you have proof of timely filing.
- Don’t guess on dates; write approximately and the best estimate, then attach what records you have.
- Don’t sign for someone else without a power of attorney or CM-972, because unauthorized signatures void the form.
- Don’t ignore CM-913 if you plan to withdraw the claim; file a written withdrawal under 20 C.F.R. § 725.306 instead.
- Don’t lie about a state award, because the DOL will find it through interagency data matching.
- Don’t miss the 60-day deadline; ask in writing for an extension before day 60 if you need more time.
Pros and Cons of Responding to CM-913
- Pro: A complete CM-913 unlocks the 15-year presumption and accelerates the Proposed Decision and Order under 20 C.F.R. § 725.418.
- Pro: Listing all dependents maximizes the augmented monthly rate, which in 2026 ranges from $816.40 to over $1,632.80 for a miner with three or more dependents per the DCMWC rate table.
- Pro: Disclosing every treating physician forces the operator to confront favorable medical evidence, narrowing the litigation window.
- Pro: Operators who respond with payroll detail can shed responsibility quickly under 20 C.F.R. § 725.495.
- Pro: A signed CM-913 with authorizations lets the agency gather records on your behalf, which is faster than self-collection.
- Con: Detailed answers create a paper record that the operator can use to attack credibility if later testimony differs.
- Con: Disclosing a state award triggers offset and lowers the federal monthly check.
- Con: Listing prior employers can expand the universe of potentially responsible operators and complicate carrier joinder.
- Con: Naming every physician opens the door to the operator subpoenaing each chart, which can surface unrelated negative findings.
- Con: A signed certification under 18 U.S.C. § 1001 creates personal criminal exposure if any answer is knowingly false.
How CM-913 Connects to Other DOL Forms
CM-913 is one piece of a paper trail that includes Form CM-911 (miner’s claim), Form CM-912 (survivor’s claim), Form CM-911a (employment history), Form CM-988 (medical evaluation report), and Form CM-972 (representative authorization). The agency uses CM-913 to fill the holes the other forms left.
The consequence of inconsistency among these forms is fatal to credibility. A scenario: Phyllis listed 17 coal-mine years on CM-911a but only 14 on CM-913 because she dropped a contractor stint, and the ALJ found the contradiction undermined her testimony in Black Lung benefits hearings. A common misconception is that you cannot amend earlier forms, but 20 C.F.R. § 725.310 allows modification of a claim within one year of denial.
Coordination with the Pulmonary Evaluation
The complete pulmonary evaluation paid for by the DOL under 20 C.F.R. § 725.406 is documented on Form CM-988 by an authorized physician. CM-913 may ask whether you have completed your CM-988 exam, who performed it, and where the records are. The plain-English rule is that you must submit to the exam or risk dismissal under 20 C.F.R. § 725.405.
The consequence of refusing the CM-988 exam without good cause is denial. Stuart skipped his exam because he disliked the assigned physician, and his claim was dismissed; on remand he had to re-establish his employment history through a fresh CM-913 cycle. A common misconception is that you can pick any pulmonologist, but the DOL-paid exam must be done by a DCMWC-authorized physician from the agency’s panel.
Recap of Key Court Rulings
The Supreme Court in Usery v. Turner Elkhorn Mining upheld the constitutionality of the Black Lung Benefits Act and its presumptions, giving the framework that supports CM-913’s evidence-gathering function. The Court in Mullins Coal Co. v. Director, OWCP addressed the true doubt rule and the burden of proof in pneumoconiosis cases.
The Fourth Circuit in Island Creek Coal Co. v. Compton explained how administrative law judges must weigh conflicting medical evidence, which is why CM-913’s medical disclosures matter. The Sixth Circuit in Cumberland River Coal Co. v. Banks reinforced that surface miners may invoke the 15-year presumption with proof of substantially similar exposure, which is exactly what Section B of CM-913 captures.
FAQs About DOL Form CM-913
Is DOL Form CM-913 the same as the original Black Lung claim?
No. CM-913 is a clarification questionnaire sent after you file the original claim on Form CM-911 or CM-912 to fill gaps in employment, medical, or dependency facts the agency needs to decide your case.
Do I have to return CM-913 if I do not want benefits anymore?
No. You should file a written withdrawal of your claim under 20 C.F.R. § 725.306 instead, which formally closes the claim and stops further development.
Can my lawyer sign CM-913 for me?
Yes. A representative admitted under 20 C.F.R. § 725.363 with a current Form CM-972 on file may sign CM-913 on your behalf.
Will the agency accept CM-913 by email?
No. The DCMWC requires mailed or hand-delivered originals to the assigned district office, though some district offices accept secure fax for time-sensitive items.
Does part-time coal work count on CM-913 employment history?
Yes. Part-time, seasonal, and contractor coal mine work all count toward total cumulative coal mine employment under 20 C.F.R. § 725.493.
Can I amend CM-913 after I send it?
Yes. Send a signed corrected version to the same district office and reference the original submission date so the agency replaces the prior answers.
Does a state black lung award reduce my federal benefit?
Yes. A state workers’ compensation award for pneumoconiosis offsets federal benefits under 20 C.F.R. § 725.535 to prevent double recovery.
Can the operator see my CM-913 answers?
Yes. The named responsible operator is a party under 20 C.F.R. § 725.360 and gets copies of CM-913 as part of the record.
Will I lose my claim if I miss the 60-day deadline?
Yes. Failure to respond within 60 days can lead to denial by abandonment under 20 C.F.R. § 725.409, though good-cause extensions may be granted.
Is medical evidence I list on CM-913 free?
Yes. The DOL pays for the complete pulmonary evaluation under 20 C.F.R. § 725.406, and treating physician records are typically obtained at no cost to the claimant.
Does CM-913 ask about Social Security Disability?
Yes. Section E asks about other federal and state benefits, including SSDI, though SSDI does not offset federal Black Lung benefits.
Can a surviving child receive benefits if listed on CM-913?
Yes. A child under 18, a full-time student under 23, or a disabled-before-22 child can qualify under 20 C.F.R. § 725.209 when properly listed.
Related reading
- How to Fill Out DOL Form AB-1 (w/Examples) + FAQs
- How to Fill Out DOL Form CM-2970 (w/Examples) + FAQs
- How to Fill Out DOL Form CM-787 (w/Examples) + FAQs
- How to Fill Out DOL Form CM-908 (w/Examples) + FAQs
- How to Fill Out DOL Form CM-981 (w/Examples) + FAQs
- How to Fill Out DOL Form CM-988 (w/Examples) + FAQs
- How to Fill Out DOL Form OWCP-16 (w/Examples) + FAQs