If a beneficiary has a work-related illness or injury, services provided for treatment of that illness or injury should be covered by Workers' Compensation (WC) or Federal Black Lung benefits. It is important that the Medicare claim form note the treatment is related to a work-related illness or injury, even in the injury or illness occurred in the past.

Payment under Medicare may not be made for any claims if payment has been made or can be made under a Workers' Compensation (WC) law or plan of the United States or any state, or under the Federal Black Lung Program.

If a Medicare patient is entitled to Black Lung medical benefits, claims relating to the Black Lung disease should be sent to the Department of Labor at the following address:

U.S. Department of Labor
P.O. Box 8302
London, KY 40742

If Black Lung-related services are denied by the Department of Labor, a claim can be submitted to Medicare for those services with a copy of the denial notice from the Department of Labor.

In addition, if a Medicare patient is entitled to Black Lung medical benefits, any services completely unrelated to the Black Lung condition (e.g., broken leg) may be submitted to Medicare.

CMS Regulation References: Publication 100-05, Chapter 1 (PDF, 191 KB)

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