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
Symbol |
Definition |
LM |
Miner |
LS |
Wife |
LS 5 |
Second Wife |
LT |
Divorced wife |
L1-L9 |
Child |
BLACK LUNG PAYMENT (DEATH) CLAIMS SYMBOLS
Symbol |
Definition |
LW |
Widow |
LX |
Divorced widow |
L1-L9 |
Surviving Child |
P1 |
Natural father |
P3 |
Adopting father |
P5 |
Stepfather |
P2 |
Natural mother |
P4 |
Adopting mother |
P6 |
Stepmother |
S1, S3 S5, S7
|
Brother |
S2, S4 S6, S8
|
Sister |