GAO reviewed the procedures used by the Social Security Administration to approve black lung benefits claims. Approval of these claims was not contrary to law; it was based on provisions of law which GAO believes do not adequately assure that benefits are provided only to those disabled from black lung or to the survivors of those who died of black lung. The agency approved claims on the basis of affidavits from spouses or other dependent persons, inconclusive medical evidence, and prseumptions based on years of coal mine employment. A random sample of claims indicated that, in 88.5 percent of the cases, medical evidence was not adequate to establish disability or death from black lung. GAO believes that medical evidence should be used as the basis for determining eligibility for black lung benefits, but awarding benefits based on years of employment seems more appropriate for pension programs than disability programs. GAO is currently reviewing the Department of Labor's administration of the program.