Li.5. LAB-CIR Uf?te elf Werkers' Campensatien
Divisien ef (Zeal Mine Werlters? {empensatien
L'eritral Niall Realm
PD Bet-t 
Lenden, H?l? dame-330?

 

NI i Pertal: aien ant?eI-es neat-fbl

NUuEH?thl? EDIT Phene: {314} at 
Fi'llrt: [Elli] 

lleNE'ltS yarns: E-ethe Bret}:
CLAIM 
ID 
aetne; 
?1223. Searcreea :?yleaeeyys Head
Wise, 24293

Dear Ereck'

?ms IE, fLthE' refer r?t?e tn ihe as-erba'y'ntent ef black .uhe Eenef-ts tetaline 512.64145:whicnincluees
$11,532.03 :n muritlily benefits and $1,015.45 in rneclieal treatment]. This effice til'S'. intern-led yau at this
eyerpayment 7r" a letter dated Utteber 33,2911

ygu genefitg while yum claim was bef?r'e the Law Juege ?our claim was rayersed ID
a denial. Hayl'eyer. ugh yeu heye List beer" awarded benefits an nteclificetier', you are net entitled te bene?ts
fer the :ieritJ-r'. Ap'il 20011 through May ZEICIS.

FUR DENIAL OF WNUER

We stuchecl ybur ease carefully and cursi?erea? all the eycie'icetsrjustifieatien [fa ".yl suartittee by yea er at year
beha We naye determinac tna: the cir:umstenees cif yeur case an nere?it us be waive the reteyery ef yeur
uyerpaynient because:

iyer?i we rtayE- determined that you are fault' i.i the eyerltlayn?iert, yet. have met
estaelenecl either:

that sL~:h receyery nt Ire cit-erbayntert wecle? defeat the euraese ef the black Lung Act he eL'rter wertls. :nke
away incerne required fe-r era-nary anct necessary liyir?g expenses]. er that wbul-Ll be against EQuity
and enact canscienee [in ether wercls, unfair} aecauseyuu 'fiatl ta giye up a yaluable 'iEHt {such as a jel:
yi-nieh you cannu'. new get back] ar assumed debts as a cellege educatien fer yeur ehilcll ciue tb 'yUuF
acceptance at the cyereai? inneies

Since waiyer ar r'ecayery is {:ienfed and ?u clence in ye-ur Ii uees r??t demenstrate ye-LJr Ir?iahzlity tn matte repayment.
we dire-2t that yet: senel within thirty {3m days a eheca er ercler fer the e'ttire arneiunt ef the e'JerltaymF-nt
Ell-5:11:16. tu the fella-wing aeciress:

b. b. Debaanie-nt e; Lab-:ir
Elack Lut?g Pregrarr

Bat-t 

St. Mt": F31 CIT-QUEE-

Malt: t"e eheel: er erdE? payable le Denartmenl nf earner, Elect tuning
:?renilsess er- the checks

Lh-?l Debt HELCICII 

represeriLs a p'npesed wiln regs-p te your es-erpatrrnern T'rnu disagree the peeisierr are-i. "ta-g
i'eeties: ti meeting with nine er? ISL-F senler esarnirie's te- dis-cuss veer tit-e'paimient. Cir-?tact writir-g within 3U
pas-s- il wish :n has-e an [We ?net: treese net rd an




err rr'rfer??ttl eenference, wiil be git-en t-ie present evidence, eitner ere. er written, te sLIpperl
views regarding the The tenfererree will lse help at a cemenient Etreat en. "Fer. mes? tie
representee he err-Ir persen st: tide in writing. As seen as alter the cenference, Li ridti?ricatpn wr'l

ne mailed :e yeti whinh identifies aii?y issues were and ant.r whieh are centested.

FORMAL 

retr mat.? a se request a fern-rel heaving nefnrn an Administrative Law nude-e, Sud" a re?nes-t IT-LJSE :Je rniaile. i_e
this Where within th rw [30] days ef tne date dt this letter. We. mas! schedule r'i1err'nal conference
we send "your rEnirn fer a fern?al nearing, if we belle-re it help 1e resnlue tne Dh?E?l?pd?fiTiEf?l? ever-i
yen.- reqeested cl leri'nnl hearing.

If we de- detr- t:-l 5 rener, this de1errt?rinatien he made lir?iEl
drad will receive pet fieatien :if the debt ess'ee' to the J5. 

'sint'erely,
. .
. - I 
"Erika-353%: If 
Mare Flni'illa 

Seriipr Cid rris Isani ne'
1 idem-39

E. E'?u rIn. Esriuire

fen can sis-d send s-eur deedrrienIs us eleetrpnicalle. Visit