Strikes the second sentence of 30 U.S.C. 921(c)(2) and replaces the term 'respirable' with 'respiratory' (conforming amendment).

Adds a new paragraph (6) to 30 U.S.C. 921(c) establishing a rebuttable presumption that if a deceased miner was totally disabled due to pneumoconiosis during life and does not meet the irrebuttable presumption under paragraph (3), there is a rebuttable presumption that the miner's death was due to pneumoconiosis; the presumption can be rebutted only by establishing that no part of the death was caused by pneumoconiosis.

Amends 30 U.S.C. 901(a) by striking the phrase 'this disease;' and inserting the phrase 'this disease or who were totally disabled by this disease at the time of their deaths;'.

Strikes specified language in 30 U.S.C. 921(a) (text indicated as 'by striking and all that follows through .' in the amendment text).

Amends Part A of the Black Lung Benefits Act (30 U.S.C. 901 et seq.) by adding a new section '403 Attorneys’ fees and medical expenses payment program' establishing a program to pay attorneys’ fees and reasonable unreimbursed medical expenses for qualifying claims, specifying payment limits, reimbursement by liable operators, and related rules.