employees, which had the effect of eliminating cost-of-living adjustments for miners, surviving spouses, and dependents under the Black Lung Benefits Act during such years. Reforms are needed to ensure that benefits are not eroded due to inflation and are brought up to date to keep up with the cost of living. (4) Congress intended for coal companies to have primary responsibility for benefits due to black lung disease acquired by their workers. However, because many companies have self-insured their obligations without proper collateral available and subsequently defaulted on those obligations, too many former workers have had to rely on the public Black Lung Disability Trust Fund as a backstop. Reforms are needed to ensure that companies are prepared to meet their primary responsibilities and that their plans for self-insurance are fiscally sound. (5) Black lung disease has been the underlying or contributing cause of death of more than 78,000 miners since 1968. After decades of decline, the incidence of coal miners with black lung disease is on the rise, recently reaching levels not seen in 25 years. According to the National Institute for Occupational Safety and Health, miners are developing advanced cases of the disease at younger ages. In response, the Department of Labor took important steps to combat the disease, including promulgating a rule in 2014 that reduced the allowed concentration of coal dust and addressed weaknesses in the dust sampling system. Retrospective studies should be continued to determine whether revisions to the standards are necessary to eliminate the disease. The Mine Safety and Health Administration of the Department of Labor has made clear its intent to issue rules around respirable crystalline silica. In the interim, the Mine Safety and Health Administration launched an enforcement initiative to protect miners from the health hazards of respirable crystalline silica. Under this initiative, the Mine Safety and Health Administration will conduct inspections on silica hazards and