TN 1 (06-86)

GN 01050.021 Black lung beneficiary identification codes

Form SSA-101-U3 (Determination of Award) will be used to authorize payment of all black lung allowances and will be prepared manually in the Office of Disability Operations. The chief differences between the SSA-101-U3 when used to authorize black lung benefit payments and the SSA-101-U3 when used to authorize disability benefit payments are: (1) the benefit computation data in item 4 of the form will be omitted; (2) the benefit symbol(s) shown in items 6 and 12 will be “LM” for miner, “LW” for widow, etc. and (3) the annotation “BLACK LUNG CASE” will appear in item 11 (Remarks). The following BIC chart reflects the benefit symbols for black lung claimants and auxiliaries.

BLACK LUNG PAYMENT (LIFE) CLAIMS SYMBOLS
SymbolDefinition
LMMiner
LSWife
LS 5Second Wife
LTDivorced wife
L1-L9Child
BLACK LUNG PAYMENT (DEATH) CLAIMS SYMBOLS
SymbolDefinition
LWWidow
LXDivorced widow
L1-L9Surviving Child
P1Natural father
P3Adopting father
P5Stepfather
P2Natural mother
P4Adopting mother
P6Stepmother
S1, S3
S5, S7
Brother
S2, S4
S6, S8
Sister

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0201050021
GN 01050.021 - Black lung beneficiary identification codes - 02/11/2014
Batch run: 02/11/2014
Rev:02/11/2014