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any right to claim allocated or unallocated claims expense, as defined above or as defined in any such plan or endorsement, or to claim a service or other charge which would include or contemplate the inclusion of such expense, to the extent to which reimbursement thereof is made under his claim, where such right may arise by reason of any agreement or contract with a contractor who has contracted with the United States or with the United States directly, under which the United States ultimately would bear the cost of such expense.

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(a) Claims for reimbursement reasonable and necessary claims expense incurred in connection with the adjustment of claims by an employer, insurance carrier or compensation fund as provided for in section 104(a) of such Public Law No. 784, and § 62.5, may be included in the claim for reimbursement of benefit payments, shall be signed and sworn to by the person entitled to reimbursement or his duly authorized representative, and shall be filed with the Bureau of Employees' Compensation, United States Department of Labor, Washington, D.C. 20211. Such claims shall contain a schedule of cases with respect to which reimbursement of claims expense is sought.

(b) Except where reimbursement is to be made by the application of a factor under an endorsement applying a comprehensive insurance rating plan, or similar plan, as provided for in § 62.5, In the schedule of cases there shall be listed the items of claims expense for which reimbursement is claimed, sufficiently describing the nature of each such item. Only items of claims expense allowable under § 62.5 will be considered. If necessary in specific cases listed in such schedule (where payments have been made to numerous payees), a supplementary sheet identified as a case exhibit may be used to show items and payees in the particular case. Each item in excess of $10 with respect to which reimbursement is claimed shall be supported by a sufficient receipt signed by the payee thereof showing that the amount claimed has been paid and the date of payment and nature of the service rendered. The regulations governing the matter of receipts or other evidences of payment applicable to reimbursement of benefit payments, as

contained in § 62.2 (c), shall apply with respect to claims expense items.

(c) Where reimbursement for claims expense relates to cases in which payments have been made by an insurance carrier under a policy of insurance to which is attached an endorsement under the comprehensive insurance rating plan, or similar plan, of the Army or Navy Department, or other department or agency of the United States using the same or similar plan, or reimbursement is requested under an agreement or contract providing a method for determining reimbursable claims expense, in lieu of listing of items of expense, reference should be made to the policy of insurance and rating plan endorsement, or other agreement as referred to above, under which benefit payments have been made, and the amount of reimbursement of claims expense for the cases listed in the schedule may be obtained by applying the same factor (as is contained in such rating plan endorsement for determining claims expense or applying such other factor or method of determining reimbursement for such expense) to the sum of all paid losses (benefits paid) as approved by the Bureau under the claim filed with it for reimbursement of benefits paid, where such losses have occurred under policies providing a method of determining claims expense. may also be set forth any allowable items of claims expense not included in such factor.

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(d) Claims for reimbursement of claims expense shall be filed quarterly; that is, as of the first of January, April, July, and October, unless otherwise authorized by the Bureau.

(Sec. 104, 56 Stat. 1031; 42 U.S.C. 1704; 1950 Reorg. Plan No. 19, Sec. 1, 3 CFR, 19491953 Comp., p. 1010; 64 Stat. 1271) [8 F.R. 6811, May 25, 1943, as amended at 25 F.R. 10795, Nov. 15, 1960]

§ 62.7 Same; approval of claims.

(a) If upon examination and audit of a claim for reimbursement of claims expense the Bureau finds that insufficient or inadequate information or proof has been supplied with the claim, further information or proof shall be submitted as required by the Bureau, and failure to supply available information and proof, upon request, may result in disallowance of items not adequately supported as justly reimbursable.

(b) No item shall be approved for reimbursement with respect to which there has been failure by the claimant to

justify any such item as a reasonable and necessary claims expense, or where the Bureau finds that an item of expense was incurred unnecessarily or without reasonable cause. Claims for such reimbursement shall be approved only to the extent that the Bureau finds the claim to be reasonable, and unreasonable or excessive items shall be reduced accordingly for the purpose of such reimbursement. The claimant shall be advised of the action taken upon the claim filed and the amount approved for reimbursement. Where a 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 60 days and claimants outside the United States 6 months, unless unusual circumstances in either case are found to require a longer time, from the 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. Where objections are timely filed, review of the claim and action thereon by the Bureau will be made upon the basis of such objections.

(c) The provisions of § 62.4 relating to examination of records of a claimant and submission of records and papers shall apply with respect to claims under this section.

§ 62.8

Direct payment of benefits.

(a) The Bureau may pay benefits, as they accrue, directly to any person entitled thereto under any applicable workmen's compensation law or agreement as referred to in § 62.1(a), in lieu of reimbursement of an employer, insurance carrier or compensation fund under the provisions of these regulations, under such indemnity agreement as the Bureau may provide.

(b) The Bureau will not accept a case for direct payment until such time as the right of the person or persons entitled to benefits has been established and it finds the case to be one in which the employer, carrier, or fund would otherwise be entitled to reimbursement for benefits thereafter paid.

(c) The Bureau will not accept such cases for direct payment until such time as the rate of compensation or benefit and the period of payment have become relatively fixed and known, unless under the circumstances in a particular case the Bureau should determine that the case should be accepted prior thereto. The transfer of any case to the Bureau for direct payment may be recommended by an employer, carrier, or fund whenever it believes that such transfer properly may be effected within these regulations. Whenever the Bureau determines that under these regulations the transfer of a case for direct payment should be effected, the employer, insurance carrier or compensation fund shall transfer the case to the Bureau at its principal office for such purpose, together with the particular case file of such employer, carrier or fund, or such other records or papers as may be necessary to enable the Bureau to complete payments in the case; failure to transfer such case when requested may result in denial of further reimbursement. The file in such transferred case shall become part of the official records of the Bureau and shall remain in its custody.

(d) Medical and other treatment and care with respect to any disabled person entitled to such treatment, whose case is transferred to the Bureau as herein provided, when practicable may be furnished in a manner consistent with the regulations in Part 2 of this chapter, governing the furnishing of medical treatment under such Act of September 7, 1916, as amended. In furnishing such treatment or care the Bureau may use any private facilities, or such Government facilities as may be available.

(e) Whenever it shall appear advisable to the Bureau, any such case may be referred to any officer or agent identified in § 61.8 of this subchapter for such purpose as the Bureau may direct.

(f) Where any person entitled to benefits, whose case has been transferred under these regulations, has the right to have his claim for workmen's compensation or other benefits, or continuation of benefits, heard before or considered or reviewed by any deputy commissioner, compensation board or agency, or other tribunal, or where the employer, insurance carrier or compensation fund has similar rights with respect to further hearings or adjudicatory processes with respect to a claim or case, the transfer of such case to the Bureau shall not

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)

SUBCHAPTER G-COMPENSATION FOR INJURY, DISABILITY OR DEATH OF CIVILIAN AMERICAN CITIZENS INCURRED WHILE DETAINED BY OR IN HIDING FROM THE IMPERIAL JAPANESE GOVERNMENT

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 71.7

Notice of injury or death.
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 benefits 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" means 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. § 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.

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the Bureau be paid in whole or in such part as the Bureau may determine, for and on behalf of such minor or incompetent directly to the person or institution caring for, supporting or having custody of such minor or incompetent.

(c) In any case in which benefits are payable under this subchapter to any person who is prevented from accepting such benefits by the rules, regulations or customs of the church or the religious order or organization of which he is a member, such benefits will be paid, upon the request of such person, to such church or to such religious order or organization.

§ 71.6 Notice of injury or death.

Notwithstanding any of the provisions in Part 61 of this chapter, no notice or report of injury or death shall be required for claims filed under this subchapter.

§ 71.7 Claim filing, processing, adjudication and time limits.

(a) Claims for injury, disability or death benefits payable under section 5 (f) of the said War Claims Act of 1948, originating in the United States or in its Territories or possessions, shall be filed by mailing to the Bureau of Employees' Compensation, United States Department of Labor, Washington, D.C. 20211. All claims originating in the Philippine Islands may be filed by mailing to the Bureau of Employees' Compensation, United States Department of Labor, Manila, P.I. All claims will be finally processed and adjudicated by the Bureau at its principal office in Washington, D.C.

(b) The limitation provisions for the filing of claims for disability or death benefits, as prescribed by applicable provisions of statute, shall not begin to run earlier than July 3, 1948.

SUBCHAPTER H-[RESERVED]

THE UNIVERSITY OF MICHIGAN LIBRARIES

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