[Code of Federal Regulations]
[Title 20, Volume 1]
[Revised as of April 1, 2005]
From the U.S. Government Printing Office via GPO Access
[CITE: 20CFR61.102]

[Page 122-123]
 
                      TITLE 20--EMPLOYEES' BENEFITS
 
CHAPTER I--OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR
 
PART 61_CLAIMS FOR COMPENSATION UNDER THE WAR HAZARDS COMPENSATION ACT, 
AS AMENDED--Table of Contents
 
                   Subpart B_Reimbursement of Carriers
 
Sec. 61.102  Disposition of reimbursement requests.

    (a) If the Office finds that insufficient or inadequate information 
has been submitted with the claim, the carrier shall be asked to submit 
further information. Failure to supply the requested information may 
result in disallowance of items not adequately supported as properly 
reimbursable.
    (b) The Office shall not withhold payment of an approved part of a 
reimbursement request because of denial of another part of the 
reimbursement request.
    (c) The Office shall regard awards, decisions and approved 
settlement agreements under the Defense Base Act or other applicable 
workers' compensation law, that have become final, as establishing prima 
facie, the right of the beneficiary to the payment awarded or provided 
for.
    (d) The Office shall advise the carrier of the amount approved for 
reimbursement. If the reimbursement request has been denied in whole or 
in part, the Office shall provide the carrier an explanation of the 
action taken and the reasons for the action. A carrier within the United 
States may file objections with the Associate Director for Federal 
Employees' Compensation to the disallowance or reduction of a claim 
within 60 days of the Office's decision. A carrier outside the United 
States has six months within which to file objections with the Associate 
Director. The Office may consider objections filed beyond the time 
limits under unusual circumstances or when reasonable cause has been 
shown for the delay. A determination by the Office is final.
    (e) In determining whether a claim is reimbursable, the Office shall 
hold the carrier to the same degree of care and prudence as any 
individual or corporation in the protection of its interests or the 
handling of its affairs would be expected to exercise under similar 
circumstances. A part or an item of a claim may be disapproved if the 
Office finds that the carrier--
    (1) Failed to take advantage of any right accruing by assignment or 
subrogation (except against the United States, directly or indirectly, 
its employees, or members of its armed forces) due to the liability of a 
third party, unless the financial condition of the third party or the 
facts and circumstances surrounding the liability justify the failure;
    (2) Failed to take reasonable measures to contest, reduce, or 
terminate its liability by appropriate available

[[Page 123]]

procedure under workers' compensation law or otherwise; or
    (3) Failed to make reasonable and adequate investigation or injury 
as to the right of any person to any benefit or payment; or
    (4) Failed to avoid augmentation of liability by reason of delay in 
recognizing or discharging a compensation claimant's right to benefits.