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he was employed, by reason of the failure disclosed upon a showing that the inforof the United States or its contractor mation will be used exclusively for such to furnish transportation (where the oficial purpose. furnishing of such transportation was an obligation of the United States or
8 61.19 Inspection of records by inter
ested party. such contractor) and where no detention by an enemy is involved, such em
Any party in interest may be permitployee may apply to the Bureau for
ted to examine the record of the case in transportation, subject to the provisions
which he is such party. The Bureau or of this section.
its duly authorized representative shall (Sec. 101, 56 Stat. 1028; 42 U.S.C. 1701)
be the judge of the reasonableness of
any such request, and may, in its or his § 61.18 Confidential nature of records discretion, permit inspection of such
and papers relating to injury, death record or part thereof which will not reor detention of employees.
sult in damage or harm to any person, or (a) All records, medical and other re which will not be inimical to the interports, statements of witnesses, and other ests of the Bureau or the interests or papers relating to the disability, death, safety of the United States. Original or detention of any persons coming
records shall not be removed for such within the purview of Title I of such purpose from the office wherein they are Public Law, are the official records of the kept. Bureau and are not records of the
§ 61.20 Approval of claims for legal and agency, establishment, Government de
other services. partment, employer, or any individual
(a) No claim for legal services or for making or having the care of such rec
any other services rendered in respect of ords. Such records and papers pertain
a claim or award for compensation ing to any such injury, death, or de
under Title I, of such Public Law, to or tention are confidential and no official
on account of any person shall be valid or employee of the United States, or other
unless approved by the Bureau or its person, who has investigated or secured
duly authorized representative; and any statements from witnesses and others
claim so approved shall in the manner pertaining to any case within the purview
and to the extent fixed by the Bureau or of Title I of such Public Law, or any per its duly authorized representative, be son having the care or use of such records
paid out of the compensation payable to and papers, shall disclose information
the claimant; and any person who refrom or pertaining to such records to any
ceives any fee, other consideration, or person, except upon written approval of
any gratuity on account of services so the Bureau, or except as otherwise pro
rendered, unless such consideration or vided for by these regulations.
gratuity is so approved, or who solicits (b) Any person having any such rec
employment for another person or for ord or paper shall assume no control
himself in respect of any claim or award over same nor shall such person be vested
for compensation under such Title I with any discretion relative to the pro
shall be liable upon conviction for such duction of same in court, as such discre
offense to the penalty provided in section tion shall remain in the Bureau to whose
204, Title II, of such Public Law. business such records appertain. Any
(b) Persons representing the Bureau, such person is prohibited from presenting
who are authorized to process claims unsuch records or information in court,
der clauses 1 to 7, inclusive, of the term whether in answer to a subpoena duces tecum or otherwise. When a subpoena
“processed" as defined in g 61.9, are with
out further authorization, authorized to shall have been served upon such person,
approve reasonable fees for services unhe shall appear in court and respectfully
der this section. decline to present such records or papers
(c) No contract for a stipulated fee or or to divulge the information called for,
for a fee on a contingent basis will be basing his refusal upon this regulation
recognized, and no fee for services shall and upon the fact that such person is
be approved except upon application for not the custodian of such records or such approval, supported by a suficient papers.
statement of the extent and character of (c) Information with respect to any the necessary work done on behalf of the matter necessary for the official purpose beneficiary. Except where the beneof any department, agency, or other es ficiary was advised that such representatablishment of the United States may be tion would be rendered on a gratuitous
basis, the fee approved shall be reason Sec. abiy commensurate with the actual ne
62.3 Approval of claims. cessary work performed by such repre
62.4 Examination of records of claimant.
62.5 Reimbursement of claims expense. sentative, with due regard to the capacity
62.6 Claims for relmbursement of claims in which the representative appeared, the
expense. amount of compensation involved, and 62.7 Same; approval of claims. the circumstances of the beneficiary. 62.8 Direct payment of benefits. 8 61.21 Assignments; creditors.
AUTHORITY: The provisions of this part The right of any person to benefits
62 Issued under sec. 106, 56 Stat. 1033; 42
U.S.C. 1706, unless otherwise noted. under this subchapter and the applicable provisions of Title I of such Public SOURCE: The provisions of this Part 62 Law, pursuant to section 207 thereof, appear at 8 F.R. 6811, May 25, 1943, unless is not transferable or assignable at law
otherwise noted. or in equity except to the United States, § 62.1 General reimbursement proviand none of the moneys paid or payable sions. (except money paid as reimbursement
(a) Where any employer or his insurfor funeral expenses), or rights existing under such title, are subject to execu
ance carrier or compensation fund pays
or is required to pay benefits: tion, levy, attachment, garnishment, or
(1) To any person or fund on account other legal process or to the operation
of injury or death of any person coming of any bankruptcy or insolvency law.
within the purview of Title I of Public 8 61.22 Contracts for service facilities Law No. 784, 77th Congress, entitled "An of insurance carriers.
Act to provide benefits for the injury. (a) Under the provisions of section
disability, death, or enemy detention of 106(a) of such Public Law the Bureau
employees of contractors with the United is authorized to contract with insurance
States, and for other purposes," approved carriers for the use of the service facili
December 2, 1942, or of Public Law ties of such carriers for the purpose of
No. 208. 77th Congress, extending the facilitating administration. The Bureau
Longshoremen's and Harbor Workers' under this authority may enter into con
Compensation Act to certain persons tracts for the use of service facilities
employed at military, air, and naval which may be available and can be util
bases, and upon Federal public works. ized in the processing of claims arising
outside the continental United States. directly under section 101 and under
approved August 16, 1941, as amended, 11 section 104, Title I of such Public Law.
such injury or death arose from a war (b) Contracts for the use of service
risk hazard (as defined in section 201
(b), Title II of such Public Law No. 784). facilities will be arranged directly with insurance carriers or carrier groups as
which are payable under any workmen's the Bureau finds to be necessary to fa
compensation law of the United States cilitate administration.
or of any State, Territory, or possession (c) Compensation for the use of sery.
of the United States, or other jurisdic
tion. ice facilities shall be based upon the services rendered for the Bureau with
(2) To any person by reason of any reimbursement for such items of claims
agreement outstanding on the date of expense (see $ 62.6 of this subchapter)
enactment of such Public Law No. 784 as may be necessarily incurred or au
(such date being December 2, 1942) thorized by the Bureau, unless the serv
made in accordance with a contract beice charge agreed upon includes all items
tween the United States and any conof the carriers expense. The compensa
tractor therewith (including any subtion for services shall be such amount
contractor or subordinate contractor as the Bureau and the carrier shall
with respect to the contract of such conagree upon as reasonable for services
tractor), (i) to pay benefits with respect rendered.
to the death of any employee of suca contractor occurring under circum
stances not entitling such person to PART 62-REIMBURSEMENT OF EM
benefits under any workmen's compenPLOYERS, INSURANCE CARRIERS, sation law, or (11) to pay benefits with OR COMPENSATION FUNDS
respect to the failure of the United States Sec.
or its contractor to furnish transporta62.1 General reimbursement provisions. tion, upon the completion of the employ62.2 Claims for reimbursement.
ment of any employee of such contractor,
lis home or to the place where he was ployed 3) To any person by reason of an eement approved or authorized by
United States under which a con
ctor with the United States has 112 eed to pay workmen's compensation
nefits or benefits in the nature of Erkmen's compensation benefits to an jured employee or his dependents on count of detention by the enemy or on count of injury or death arising from
war-risk hazard; ch employer, carrier, or fund shall be ntitled to be reimbursed for all benefits
paid or payable, including funeral and Lozoirial expenses, medical, hospital, or Isa her similar costs for treatment and Et ire; and reasonable and necessary fed claims expense in connection there. y pec'ith. Titel: (b) No reimbursement shall be made S5, en any
case in which the Bureau for finds that the benefits paid or payable 17 dezvere on account of injury, detention, or with leath which arose from a war-risk ises," azard for which a premium (which in
Par luded an additional charge or loading ster for such hazard) was charged; or where bor Tan insurance carrier has been compentain sated by its premium charge for the risk
ard:which it has assumed; or where the ublic Eclaimant has been reimbursed, paid, or ited scompensated for the loss for which rezamena imbursement is claimed. rom i (c) Reimbursement under this secsectior tion, with respect to benefits, shall be » No.2 made only of amounts which will disworkm: charge such liability or obligation as ed Si arises under applicable workmen's comossesi pensation law or pursuant to the terms jurise of the applicable contract. § 62.2 Claims for reimbursement.
(a) Claims for reimbursement of No. benefits and expense shall be made upon 1949 a form which the Bureau has prescribed,
shall be signed and sworn to by the per
son, firm, or corporation entitled to resi imbursement or the duly authorized rep
resentative of such person, firm, or corporation, and shall be filed with the Buaqu of Employees' Compensation, United
tes Department of Labor, Washing25, D.C. Where the claimant is a pration, or an agency authorized by w of a State or other political jurissuch corporation or agency shall
u of the name and desigr or officers authorized ims.
(b) Such claims shall contain schedule showing the names and addresses of the persons to whom or on whose account benefits, payments, or expenses have been paid. In such schedule with respect to such persons there shall be stated the nature of the payment made; that is, whether for workmen's compensation benefits paid under any applicable law or for benefits under such agreements as are referred to in $ 62.1. In the cases of such persons as are named in such schedule, the purpose of such payments shall be stated; that is, whether for compensation or benefits for disability or death, for medical, hospital or other similar costs for treatment and care, for funeral and burial expenses, for failure of the United States or the contractor to furnish transportation, for detention of an employee by the enemy, or for such other purpose within the purview of § 62.1. Expenses classed as reasonable and necessary claims expense in connection with the handling of such cases may be included in such claim, as provided for by $ 62.5. With respect to each case listed in such schedule, where injury or death is involved, the cause thereof shall be stated; if payment is on account of detention or failure to furnish such transportation, the facts in relation thereto shall be stated.
(c) All payments as listed in such schedule shall be itemized, with identity of the payee shown. If necessary in specific cases listed in such schedule, where payments have been made to numerous payees, a supplementary sheet, properly identified, as an exhibit to th case or cases, may be used to show items and payees. Each item in excess of $10, with respect to which reimbursement is claimed in any claim shall be supported by a suficient receipt signed by the payee showing that the amount claimed has been paid and the date thereof and the purpose of payment. Where a payee fails or refuses to furnish such receipt upon request therefor, in lieu of such receipt the Bureau may accept the certificate of the person claiming reimbursement that the item has been paid as claimed (such certificate identifying the payee and service rendered or benefit paid) and that receipt has been requested, but that the payee has falled or refused to furnish same, and that a canceled check covering the payment is in the claimant's possession. The Bureau may also accept such certificate where
of & date :
for other satisfactory reason such receipt shall attach as a case exhibit a copy of can not be obtained; or the Bureau the insurance contract under which its may accept other satisfactory evidence liability obligation has accrued. of payment. The Bureau reserves the Where payment was made pursuant to right, when satisfactory receipts have 4 contract or agreement between the not been furnished, to examine the vou United States and the contractor, a copy chers, canceled checks, and other evi of such contract, or a sufficient excerpt dence of payment in the possession of therefrom or information suficient to the claimant. All supplementary sheets, enable the Bureau to obtain a copy or as above referred to, receipts for items excerpt thereof, including a copy of paid, and certificates in lieu of receipts, the applicable insurance contract issued or other evidence, shall be marked with thereunder, if any, shall be furnished as the case number appearing in the sched a case exhibit to the case or cases to ule (as provided in paragraph (d) of which it applies. Such contract or exthis section), the case name, as listed in cerpt should be supplemented by an exsuch schedule, and identified as exhibits planatory statement of the claimant, or to the respective cases and lettered al by other supporting papers, if the 11phabetically with respect to each case. ability of the claimant for the payment
(d) Where claim for reimbursement with respect to which reimbursement is includes more than one case, the sched. claimed is not otherwise clearly apparule attached thereto (referred to in par ent. Where liability of an employer, inagraph (b) of this section) shall be surance carrier or compensation fund arranged alphabetically and cases shall has accrued in more than one case, copbe numbered consecutively in the sched ies of insurance contracts, awards or ule. Each separate claim of an employ settlement agreements, or other agreeer, insurance carrier, or compensation ments or contracts (or excerpts) relied fund shall be numbered consecutively upon as basis for reimbursement need be for prompt identification. Claimants furnished to the Bureau only once as shall make and retain a copy of the claim a case exhibit; thereafter, in other cases and accompanying schedule.
in the same reimbursement claim, or in (e) In the schedule provided for in future reimbursement claims, reference paragraph (b) of this section, there shall thereto may be made suficiently identibe set forth, in relation to each case as fying the case name, number upon claim listed, a reference to the workmen's com schedule, and number and date of the pensation law or agreement under which claim (if the exhibit accompanied an payment was made, sufficiently identify earlier claim). ing the applicable law and section there. (f) Claims for reimbursement shall of pertaining to the separate amounts be filed quarterly; that is, as of the first listed for reimbursement. Where pay of January, April, July, and October, ment was made pursuant to an award or unless otherwise authorized by the settlement agreement under such appli Bureau. cable law, a copy of the award or agree (Sec. 104, 56 Stat. 1031; 42 U.S.C. 1704; 1950 ment shall be attached as an exhibit to Reorg. Plan No. 19, § 1, 3 CFR, 1949–1953 the case. Where continued payments Comp., p. 1010; 64 Stat, 1271) (8 F.R. 6811, have been made under an award or
May 25, 1943, as amended at 25 F.R. 10795,
Nov. 15, 1960] agreement, copy of which has been furnished by the claimant in connection § 62.3 Approval of claims. with a prior claim, further copy thereof
(a) If upon examination and audit of need not be furnished in connection with
a claim under this part the Bureau finds a later claim for reimbursement involv
that insufficient or inadequate informaing the same case. Suficient reference thereto should be given to facilitate
tion or proof has been supplied with the identification.
claim, further information or proof shall Where an award or
be submitted as required by the Bureau, agreement has been modified, evidence of such modification should be submitted
and failure to supply available informain applicable cases. Copies of awards
tion and proof, upon request, may result under any law administered by the Bu
in disallowance of items not adequately reau need not be attached, but ref
supported as justly reimbursable. erence thereto may be made in the
(b) No item shall be approved for reschedule or in a separate sheet marked imbursement with respect to which there as a case exhibit. In all cases where has been failure by the claimant to jusan insurance carrier is a claimant, it tify such item as a liability or obligation
of such claimant arising under the provisions of applicable workmen's compensation law or under the provisions of an agreement or contract relied upon as basis for such liability. Claims for reimbursement for funeral and burial expenses, medical, hospital, or other similar costs for treatment and care, or other necessary expenses, shall be approved only to the extent that they have been shown to be reasonable, and unreasonable or excessive items shall be reduced accordingly for purpose of such reimbursement. The Bureau will not withhold payment of any part of a claim approved, because of denial of any part of such claim. The Bureau will regard awards, decisions, and approved settlement agreements of workmen's compensation jurisdictions, which have become final in the cases to which they pertain, as establishing, prima facie, the right of the beneficiary named therein to the payment awarded or provided for.
(c) The claimant shall be advised or the action taken upon the claim filed and the amount approved for reimbursement. Where the claim has been denied in whole or in part, or where reimbursement as to any item has been reduced from the amount claimed, the claimant shall be advised thereof together with the reasons for the action taken. Claimants within the United States shall be allowed sixty days, and claimants outside the United States six months, unless unusual circumstances in either case are found to require a longer time, from date of the Bureau's action, within which to file objections to the disallowance of any claim or part thereof, or reduction in any item of a claim. Such objections properly filed will be considered by the Bureau. After such period of time, objections shall not be considered, unless the Bureau for reasonable cause shown shall consider such objections.
(d) A part or an item of a claim may be disapproved if the Bureau should find that the claimant or those whom he represented or those who represent him by contract or otherwise (1) failed to contest, reasonably questionable liability; or (2) failed to take advantage of set-off against the claim of any person whose case is referred to in such schedule; or (3) failed to take advantage of any right accruing by assignment, subrogation or otherwise (except as against the United States, directly or indirectly, its employees, or members of its armed
forces) because of the liability of a third party, unless the Unancial condition of such third party or facts and circumstances in respect of such liability justified such failure; or (4) failed to take reasonable measures to reduce or termi. nate his liability by appropriate available procedures under workmen's compensation law or otherwise; or (5) failed to make reasonable and adequate investigation or inquiry as to the right of any person to any benefit or payment, or the continuation thereof. In considering whether there has been a failure to do any of the foregoing things, the Bureau will have regard for and weigh such matters as bona fides, good judgment, unusual circumstances, reasonable cause, or such similar basis for justification as may be relied upon to avoid the effect of any such failure. Claimants will be held to the same degree of care and prudence in respect of the matters set forth in this paragraph, as under the law any individual or corporation in the protection of its interests or the handling of its affairs would be expected to exercise under similar circumstances. & 62.4 Examination of records of
claimant. (a) Whenever it shall be deemed necessary, the Bureau or its representative may request submission of case records or may inspect the records and accounts of a claimant (or any party whom he represents or who represents him, by contract or otherwise) for the purpose of verifying any allegation, fact or payment stated in his claim or papers in support thereof, and such ciaimant shall furnish such record and permit or authorize any such inspection as the Bureau shall require. Such right of inspection shall also relate to records and data used for rate making or premium establishing purposes kept by a claimant or supplied by him to any rate making or similar agency or authority to determine whether any premium or other charge has been made with respect to the reimbursement claimed.
(b) If required by the Bureau, a claimant shall furnish copies of drafts, vouchers, releases, or other instruments relating to payments on account of which reimbursement is claimed, by photostat or other means of facsimile reproduction. § 62.5 Reimbursement of claims
pense. (a) Under the provisions of section 104(a) Title I, of such Public Law No.
IHE UNIVERSITY OF MICHIGAN LIURARIES