This bill aims to streamline the benefits process for survivors of miners whose deaths were caused by pneumoconiosis by amending the Black Lung Benefits Act. It strengthens existing rebuttable presumptions and introduces new ones, making it easier for survivors to establish eligibility. For miners employed for at least 10 years in a coal mine, the presumption that their death was due to pneumoconiosis can now only be rebutted by proving no part of the death was caused by the disease. A new rebuttable presumption is also created for miners who were totally disabled by pneumoconiosis during their lifetime, subject to the same strict rebuttal standard. The legislation also restores certain pre-1981 provisions, ensuring that miners who were totally disabled by pneumoconiosis at the time of their deaths are covered under the Act. These amendments, including the strengthened presumptions, apply retroactively to claims filed up to five years before the enactment date and still pending. Furthermore, the bill establishes an Attorneys' Fees and Medical Expenses Payment Program to assist claimants in contested cases. Under this new program, the Secretary of Labor will pay attorneys' fees and reasonable, unreimbursed medical expenses for claimants in "qualifying claims," defined as contested claims without a final order within one year. The program sets maximum payments of $4,500 for attorneys' fees and $3,000 for medical expenses per claim, with liable operators required to reimburse the fund. Finally, the bill mandates the Government Accountability Office to conduct reviews on interim benefit payments, the sufficiency of current benefit payments, and the impact of allowing survivors to file subsequent claims.