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784, the Bureau is authorized to reim sonable and necessary claims expense burse an employer, carrier, or compen will be made with respect to proper items sation fund for reasonable and nec thereof as established by the claiman: essary claims expense in connection with and approved by the Bureau, or upon cases within the purview of such section, such other equitable basis as may be for which reimbursement is claimed. agreed upon by the Bureau and the

(b) In the adjustment of claims ex claimant. The adjustment of claims es. bense of employers (other than clalms pense arising under other insurance poliexpense arising under insurance poli cies or agreements shall be consisten: cies), reimbursement of reasonable and with the plan or method, if any, provided necessary claims expense will be made for therein in the determination of reon the basis of item reimbursement. imbursable claims expense, if the appliItems of such expense which will be rec cation of such plan or method in relsognized by the Bureau are only those tion to the amount of benefit reimburseitems which can be directly allocated to ment results in reimbursement of reaclaims, when necessary to determine lla sonable and necessary claims expense: bility. If in the adjustment of such otherwise, the manner of determining claims expense, allocation thereof to a such reimbursable expense, as provided specific claim is impracticable, reim above with respect to cases in which no bursement of such expense or part benefit payments have been made, sha! thereof may be made by the Bureau on be applied. the basis of agreement with the claim (d) In the adjustment of claims exant, or on such other equitable basis as pense the Bureau will not in any case will accomplish reimbursement for rea consider as a claims expense any distrisonable and necessary claims expense. bution of administrative, general ofce

(c) The adjustment of claims expense maintenance, rent, insurance, taxes, arising under insurance policies to which or other similar general expenses. Exare attached endorsements under the cept as defined otherwise by an applied comprehensive insurance rating plan, or endorsement, plan or method, the term similar plan, of the Army or Navy De "allocated claims expense", when conpartment, or other department or agency sidered as such by the Bureau, shall inof the United States using the same or clude payments made for reasonable atsimilar plan, shall be consistent with the torneys' fees, court and litigation costs. method provided under such plan for de expenses of witnesses and expert testitermining payment of claims expense. mony, examinations, autopsies and such In addition to reimbursement for allo other items of expense as can be directly cated claims expense, as provided for and allocated to specific claims, when neces. defined in such endorsement the Bu sary to determine liability. The term reau may apply the same factor as is “unallocated claims expense", when concontained in such endorsement for de sidered as such by the Bureau, shall mean termining claims expense, by applying that expense which can properly and such factor to the sum of paid losses aris definitely be allocated to claims, where ing under the policy containing such en necessary to determine liabulty, but cap dorsement, as may be approved for re not be directly allocated to specific imbursement by the Bureau under the claims. particular claim filed under $ 62.2 to (e) No employer, Insurance carrier or which such claims expense relates. In compensation fund shall be entitled to such situations the reimbursement of reimbursement under this section for any claims expense shall be upon the basis of claims expense where it has been paid such allocated claims expense plus the such expense, or has been paid for any application of such factor, as provided. service which included or contemplated If the application of such factor would payment of the expense for which reimnot result in reimbursement of reason bursement hereunder is sought, the cost able and necessary claims expense, the of which has been or will be borne by Bureau may apply such method of deter the United States. Any charge made or mining such claims expense, or may paid, contemplating expenses other than adjust such expense upon such basis with allocated or unallocated claims expense the claimant, as will result in fair and shall not be considered as a claims exequitable reimbursement. In cases in pense within the meaning of this subwhich no benefit payments have been section. Every claimant applying for remade, but claims expense has been neces imbursement of claims expense shall in sarily incurred, reimbursement of rea his claim expressly disclaim and waive

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any right to claim allocated or unallo contained in 62.2 (c), shall apply with
cated claims expense, as defined above respect to claims expense items.
or as defined in any such plan or endorse (C) Where reimbursement for claims
ment, or to claim a service or other expense relates to cases in which pay-
charge which would include or contem ments have been made by an insurance
piate the inclusion of such expense, to the carrier under a policy of insurance to
extent to which reimbursement thereof is which is attached an endorsement under
made under his claim, where such right the comprehensive insurance rating plan,
may arise by reason of any agreement or or similar plan, of the Army or Navy De-
contract with a contractor who has con partment, or other department or agency
tracted with the United States or with of the United States using the same or
the United States directly, under which similar plan, or reimbursement is re-
the United States ultimately would bear quested under an agreement or contract
the cost of such expense.

providing a method for determining re$ 62.6 Claims for reimbursement of

imbursable claims expense, in lieu of claims expense.

listing of items of expense, reference

should be made to the policy of insurance (a) Claims for reimbursement of

and rating plan endorsement, or other reasonable and necessary claims expense agreement as referred to above, under incurred in connection with the adjust which benefit payments have been made, ment of claims by an employer, insur and the amount of reimbursement of ance carrier or compensation fund as claims expense for the cases listed in the provided for in section 104(a) of such schedule may be obtained by applying Public Law No. 784, and $ 62.5, may be the same factor (as is contained in such included in the claim for reimbursement rating plan endorsement for determinof benefit payments, shall be signed and ing claims expense or applying such sworn to by the person entitled to re other factor or method of determining imbursement or his duly authorized rep reimbursement for such expense) to the resentative, and shall be filed with the sum of all paid losses (benefits paid) as Bureau of Employees' Compensation, approved by the Bureau under the United States Department of Labor, claim filed with it for reimbursement of Washington, D.C. 20211. Such claims benefits paid, where such losses have ocshall contain a schedule of cases with curred under policies providing a method respect to which reimbursement of claims of determining claims expense. There expense is sought.

may also be set forth any allowable items (b) Except where relmbursement is to of claims expense not included in such be made by the application of a factor factor. under an endorsement applying a com (d) Claims for reimbursement of prehensive insurance rating plan, or claims expense shall be filed quarterly; similar pian, as provided for in § 62.5, that is, as of the first of January, April, In the schedule of cases there shall be July, and October, unless otherwise aulisted the items of claims expense for thorized by the Bureau. which reimbursement is claimed, sufi (Sec. 104, 56 Stat. 1031; 42 0.8.0. 1704; ciently describing the nature of each 1950 Reorg. Plan No. 19, Sec. 1, 3 CFR, 1949– such item. Only items of claims ex 1953 Comp., p. 1010; 64 Stat. 1271) 18 FR. pense allowable under $ 62.5 will be con.

6811, May 25, 1943, as amended at 25 F.R. sidered. If necessary in specific cases

10795, Nov. 15, 1960)
listed in such schedule (where pay $ 62.7 Same; approval of claims.
ments have been made to numerous

(a) If upon examination and audit of payees), a supplementary sheet identified

a claim for reimbursement of claims exas a case exhibit may be used to show

pense the Bureau finds that insufficient items and payees in the particular case. Each item in excess of $10 with respect

or inadequate information or proof has to which reimbursement is claimed shall

been supplied with the claim, further

information or proof shall be submitted be supported by a suficient receipt signed

as required by the Bureau, and failure to by the payee thereof showing that the

supply available information and proof, amount claimed has been paid and the

upon request, may result in disallowance date of payment and nature of the sery

of items not adequately supported as ice rendered. The regulations govern

justly reimbursable. ing the matter of receipts or other (b) No item shall be approved for evidences of payment applicable to re reimbursement with respect to which imbursement of benefit payments, as there has been failure by the claimant to

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justify any such item as a reasonable (c) The Bureau will not accept such
and necessary claims expense, or where cases for direct payment until such time
the Bureau finds that an item of ex as the rate of compensation or benefit
pense was incurred unnecessarily or and the period of payment have become
without reasonable cause. Claims for relatively fixed and known, unless under
such reimbursement shall be approved the circumstances in a particular case
only to the extent that the Bureau finds the Bureau should determine that the
the claim to be reasonable, and unrea case should be accepted prior thereto.
sonable or excessive items shall be re The transfer of any case to the Bureau
duced accordingly for the purpose of for direct payment may be recommended
such reimbursement. The claimant by an employer, carrier, or fund when-
shall be advised of the action taken upon ever it believes that such transfer prop-
the claim filed and the amount approved erly may be effected within these regula-
for reimbursement. Where a claim has tions. Whenever the Bureau determines
been denied in whole or in part, or where that under these regulations the transfer
reimbursement as to any item has been of a case for direct payment should be ef-
reduced from the amount claimed, the fected, the employer, insurance carrier
claimant shall be advised thereof to or compensation fund shall transfer the
gether with the reasons for the action case to the Bureau at its principal office
taken. Claimants within the United for such purpose, together with the par-
States shall be allowed 60 days and ticular case file of such employer, carrier
claimants outside the United States 6 or fund, or such other records or papers
months, unless unusual circumstances in as may be necessary to enable the Bureau
either case are found to require a longer to complete payments in the case; failure
time, from the date of the Bureau's ac to transfer such case when requested
tion, within which to file objections to may result in denial of further reim-
the disallowance of any claim or part bursement. The file in such transferred
thereof, or reduction in any item of a case shall become part of the official rec-
claim. Such objections, properly filed, ords of the Bureau and shall remain in
will be considered by the Bureau. After its custody.
such period of time objections shall not (d) Medical and other treatment and
be considered, unless the Bureau for rea care with respect to any disabled person
sonable cause shown shall consider such entitled to such treatment, whose case
objections. Where objections are timely is transferred to the Bureau as herein
filed, review of the claim and action

provided, when practicable may be furthereon by the Bureau will be made upon nished in a manner consistent with the the basis of such objections.

regulations in Part 2 of this chapter, gov(c) The provisions of $ 62.4 relating to erning the furnishing of medical treatexamination of records of a claimant and

ment under such Act of September 7, submission of records and papers shall 1916, as amended. In furnishing such apply with respect to claims under this treatment or care the Bureau may use section.

any private facilities, or such Govern$ 62.8 Direct payment of benefits.

ment facilities as may be available.

(e) Whenever it shall appear advisa(a) The Bureau may pay benefits, as ble to the Bureau, any such case may they accrue, directly to any person en be referred to any officer or agent identitled thereto under any applicable work tiñed in § 61.8 of this subchapter for such men's compensation law or agreement as

purpose as the Bureau may direct. referred to in $ 62.1(a), in lieu of reim

(f) Where any person entitled to benbursement of an employer, insurance efits, whose case has been transferred carrier or compensation fund under the under these regulations, has the right provisions of these regulations, under to have his claim for workmen's comsuch indemnity agreement as the Bureau

pensation or other benefits, or continumay provide.

ation of benefits, heard before or con(b) The Bureau will not accept a case sidered or reviewed by any deputy comfor direct payment until such time as missioner, compensation board or agency, the right of the person or persons en or other tribunal, or where the employer, titled to benefits has been established insurance carrier or compensation fund and it finds the case to be one in which has similar rights with respect to furthe employer, carrier, or fund would

ther hearings or adjudicatory processes otherwise be entitled to reimbursement with respect to a claim or case, the transfor benefits thereafter paid.

fer of such case to the Bureau shall not

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affect such rights. · Whenever further adjudicatory processes before such deputy commissioner, board or agency, or tribunal are necessary, the Bureau will retransfer such case to the employer, carrier, or fund for completion of such processes. The Bureau may retransfer any case to an employer, carrier or fund either for the purpose of completion of such adjudicatory processes or for continuation of payments of benefits, whenever the Bureau deems such course advisable or necessary; failure to take necessary steps in the further adjudication of a case, either when necessary, when requested by the Bureau, or pursuant to notice received by the employer, carrier or fund from a person entitled to benefits, his representative, or any party in

interest, or the adjudicating agency concerned, may result in refusal by the Bureau to continue the direct payment of benefits in such case and refusal to reimburse such employer, carrier or fund with respect to any future accruing benefits which it may have liability to pay, unless the circumstances justified such failure.

(g) Claims expense incident to the further handling of such a claim, retransferred to an employer, carrier or fund, will be processed by reimbursement under the provisions of the regulations in this part, or, in lieu of such manner of reimbursement, may be paid pursuant to a contract with an insurance carrier as provided for by § 61.22 of this subchapter. (Sec. 104, 56 Stat. 1931; 42 U.S. C. 1704)



PART 71 -GENERAL PROVISIONS Sec. 71.1 General administrative provisions. 71.2 Computation of benefits. 71.3 Deductions from benefits. 71.4 Limitation upon benefits. 71.5 Payment of benefits. 71.6 Notice of injury or death. 71.7 Claim filing, processing, adjudication

and time limits. AUTHORITY: The provisions of this part 71 issued under sec. 32, 39 Stat. 749, as amended, sec. 106, 56 Stat. 1033, as amended, sec. 5, 62 Stat. 1242, as amended; 5 U.S.C. 8145, 8149, 42 U.S.C. 1706, 50 U.S.C. App., 2004.

SOURCE: The provisions of this Part 71 appear at 16 F.R. 2933, Apr. 4, 1951, unless otherwise noted. $ 71.1 General administrative provisions.

(a) Section 5 (f) of the War Claims Act of 1948 (act of July 3, 1948; Public Law 896, 80th Cong., 62 Stat. 1240) makes provision for the payment of benefits with respect to the injury, disability or death resulting from injury of any civilian American citizen occurring while he was held by or in hiding from the Imperial Japanese Government to the same extent as if such civilian American citizen were an employee within the purview of the act of December 2, 1942 (Public Law 784, 77th Cong., 56 Stat. 1028, 42 U. S. C. 1701, et seq.). Under section 5 (f) of the said War Claims Act

of 1948, the rights of individuals to bene. Ats payable under this subchapter shall accrue from and after December 7, 1941, subject, however, to all of the provisions of said act and the regulations in this subchapter.

(b) The regulations in Part 61 of Subchapter F of this chapter governing the administration of the benefits provided under Titles I and II of the said act of December 2, 1942, as amended, shall, insofar as they are applicable and are not inconsistent with any of the provisions of this subchapter, govern the administration of the benefits payable under this subchapter. Provisions of such regulations relating to benefits for detention by the enemy, reimbursement to an employer or insurance carrier, and limitations on benefits in cases where workmen's compensation is payable are not applicable to the benefits provided in this subchapter nor are they within the purview of this subchapter. The provisions of sections 101 (b), 104 and 105 of such act of December 2, 1942, and the various provisions of Part 61 of this chapter relating to such provisions, accordingly, are not applicable to the payment of benefits under this subchapter.

(c) All rights or benefits under this subchapter which are determinable with reference to other provisions of law other than the said War Claims Act of 1948,

shall be determined with reference to such provisions as they existed and were in force on January 3, 1948.

(d) As used in this subchapter:

(1) The term “Bureau" ineans the Bureau of Employees' Compensation, United States Department of Labor.

(2) The term "civilian American citizen" means any person who, being then a citizen of the United States, was captured by the Imperial Japanese Government on or after December 7, 1941, at Midway, Guam, Wake Island, the Philippine Islands, or any Territory or possession of the United States attacked or invaded by such government or while in transit to or from any such place, or who went into hiding at any such place in order to avoid capture or internment by such government; except (i) a person who at any time voluntarily gave aid to, collaborated with, or in any manner served such government, or (ii) a person who at the time of his capture or entrance into hiding was within the purview of the Federal Employees' Compensation Act of September 7, 1916, as amended and extended, or the said act of December 2, 1942, as amended, or the Missing Persons Act of March 7, 1942 (56 Stat. 143), as amended, or who was a regularly appointed, enrolled, enlisted, or inducted member of any military or naval force.

(3) The terms "held by the Imperial Japanese Government” or “captured by the Imperial Japanese Government" mean a holding of such person as a prisoner, internee, hostage or in any other capacity.

(4) The terms "compensation", "physician" and “medical, surgical and hospital services and supplies" shall be construed and applied as defined in the Federal Employees' Compensation Act of September 7, 1916, as amended.

(5) The term “benefit" is construed as synonymous with the term "compensation".

(6) The terms “disability", "wages", "child", "grandchild", "brother", "sister", "parent", "widow", "widower", "adoption" or "adopted" shall be construed and applied as defined in the Longshoremen's and Harbor Workers' Compensation Act, as amended. 8 71.2 Computation of benefits.

(a) For the purpose of determining the benefits under this subchapter, the average weekly wage of any such civilian

American citizen, whether employed, self-employed, or not employed, shall be deemed to have been $37.50. The provisions of this subchapter are applicable and benefits are payable whether or not such civilian American citizen was employed. Monthly compensation in cases involving partial disability shall be determined by the percentage which the degree of partial disability bears to total disability, and shall not be determined with respect to the extent of loss of wageearning capacity.

(b) Notwithstanding any of the provisions of Part 61 of this chapter, total maximum aggregate compensation for disability payable under this subchapter is limited to $7,500 in case of injury and $7,500 in case of death, such sum being exclusive of medical costs and funeral and burial expenses. § 71.3 Deductions from benefits.

If a civilian American citizen or his dependents receives or has received from the United States any payments on account of the same injury or death, or from his employer in the form of wages or payments in lieu of wages, or in any form of support or compensation (including workmen's compensation) in respect to the same objects, the benefits under this subchapter shall be diminished in the case of an injured person by the amount of payments such injured person received on account of the same injury or disability, or in the case of dependents, by the amount of payments such dependents of the deceased civilian American citizen received on account of the same death, as the case may be. $ 71.4 Limitation upon benefits.

No person, except a widow or a child, shall be entitled to benefits under this subchapter for disability with respect to himself and to death benefits on account of the death of another. $ 71.5 Payment of benefits.

(a) Benefits under this subchapter payable for disability or death shall be paid only to the person entitled thereto, or to his legal or natural guardian if ho has one, and shall not upon death of the person so entitled survive for the benefit of his estate or any other person.

(b) The benefit of a minor or an incompetent person who has no natural or legal guardian may, in the discretion of

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