Collins v. Old Ben Coal Co.

• Decision Date: 26 October 1988
• Docket Number: No. 85-2893,85-2893
• Citation: 861 F.2d 481
• Parties: Dorothy V. COLLINS, Petitioner, v. OLD BEN COAL COMPANY and Director, Office of Workers' Compensation Programs, United States Department of Labor, Respondents.
• Court: U.S. Court of Appeals — Seventh Circuit

Page 481

861 F.2d 481

Dorothy V. COLLINS, Petitioner, v. OLD BEN COAL COMPANY and Director, Office of Workers' Compensation Programs, United States Department of Labor, Respondents.

No. 85-2893.

United States Court of Appeals Seventh Circuit.

Argued Dec. 11, 1987.

Decided Oct. 26, 1988.

Joe D. Black, Ramsey & Black, Vincennes, Ind., for petitioner.

Jeffrey J. Bernstein, U.S. Dept. of Labor, Washington, D.C., Bronius K. Taoras, Old Ben Coal Co., Lexington, Ky., for respondents.

Before FLAUM and EASTERBROOK, Circuit Judges, and GRANT, Senior District Judge. ^*

GRANT, Senior District Judge.

Petitioner Dorothy V. Collins, widow of coal miner William L. Collins, seeks review of the final order of the Department of Labor's Benefits Review Board (Board) affirming the denial of survivor benefits by an Administrative Law Judge (ALJ) under the Black Lung Benefits Reform Act, 30 U.S.C. Secs. 901 et seq. We have jurisdiction under the Longshore and Harbor Workers' Compensation Act, 33 U.S.C. Sec. 921(c), and the Black Lung Benefits Act, 30 U.S.C. Sec. 932(a). Petitioner raises only one issue: whether there was substantial evidence to support the ALJ's finding that the deceased miner had not died or become totally disabled as a result of a chronic respiratory condition or pneumoconiosis. We affirm.

On April 14, 1978, William L. Collins filed a claim for benefits under the Black Lung Benefits Reform Act, which was enacted by Congress "to provide benefits ... to coal miners who are totally disabled due to pneumoconiosis ¹ and to the surviving dependents of miners whose death was due to such disease." 30 U.S.C. Sec. 901(a). While his claim was pending, the miner suffered a heart attack and died. His widow, Dorothy V. Collins, petitioner herein, filed for survivor's benefits on March 5, 1979.

The Department of Labor denied petitioner's claim on August 1, 1979 and again, after reviewing additional information, on May 2, 1980. The agency reasoned that the evidence did not show that Collins had died of pneumoconiosis or was suffering from the disease when he died.

A formal hearing on Collins' claim was held before Administrative Law Judge Robert L. Hillyard on June 15, 1982. Concluding that the claimant could not establish entitlement to benefits under the pertinent black lung benefits provisions, 20 C.F.R. Secs. 727.203(a) and 410.454, he denied the claim on October 8, 1982. The Benefits Review Board affirmed ALJ Hillyard's decision on August 27, 1985, finding that it was supported by substantial evidence. Mrs. Collins has appealed that determination to this court.

I

The Black Lung Benefits Act (and its amendments), found at Title IV, 30 U.S.C. Secs. 901-960, is the black lung compensation program enacted by Congress in 1972. ² To become eligible for benefits under the Act, a miner must satisfy four basic requirements: (1) that he is a coal miner as defined by the Act; (2) that he is afflicted with pneumoconiosis; (3) that he is totally disabled; and (4) that the cause of his disability is pneumoconiosis. See The "Black Lung" Act: An Analysis of Legal Issues Raised Under the Benefit Program (1981) (Federal Judicial Center) at 9. A claimant satisfies these elements by presenting records of his work history, specific evidence of his medical illness, and in some circumstances by personal or third-party affidavits describing the claimant's inability to engage in heavy work and his breathing difficulties. Id. Although the burden of proving eligibility and entitlement to benefits is on the claimant, the statute eases this burden by creating a rebuttable presumption of total disability or death due to pneumoconiosis. 30 U.S.C. Sec. 921. The criteria for entitlement to the presumption have been promulgated as regulations by the Secretaries of Labor and Health and Human Services. ³

The Labor Department's regulations implementing the Act create a rebuttable presumption of total disability under section 727.203(a). After ten years of coal mine employment, a miner is presumed to be totally disabled by, or to have died from, pneumoconiosis if one of the five requirements of 20 C.F.R. Sec. 727.203(a)(1)-(5) is satisfied. The first four are based upon objective medical evidence: (1) a chest X-ray, biopsy, or autopsy that establishes the existence of pneumoconiosis; (2) ventilatory studies that establish the presence of a chronic respiratory or pulmonary disease; (3) blood gas studies that demonstrate the presence of an impairment in the transfer of oxygen from the lung alveoli to the blood; and (4) other medical evidence, including the documented opinion of a physician exercising reasoned medical judgment, that establishes the presence of a totally disabling respiratory or pulmonary impairment. The fifth basis was established specifically to allow a surviving spouse or relative of a deceased miner a means of proving total disability when there is no medical proof:

(5) In the case of a deceased miner where no medical evidence is available, the affidavit of the survivor of such miner or other persons with knowledge of the miner's physical condition, demonstrates the presence of a totally disabling respiratory or pulmonary impairment.

20 C.F.R. Sec. 727.203(a)(5).

Within the Department of Health and Human Services, the Social Security Administration (SSA) is responsible for implementing another set of regulations concerning black lung benefits. The provision allowing a presumption of disability or death due to pneumoconiosis is found in Part 410, Subpart D of its regulations. The SSA requirements for determining the existence of the disease are quite similar to those criteria found in the Labor regulations. A survivor may establish a claim for benefits under section 410.454 if she can prove the existence of pneumoconiosis by X-ray, biopsy or autopsy; by evidence of fifteen years in "underground coal mine" conditions and of a totally disabling chronic respiratory or pulmonary impairment; or by the same totally disabling impairment but arising out of coal mine employment. 20 C.F.R. Sec. 410.454(a)-(c). Under section 410.454(c) "other relevant evidence" may be used to establish the existence of the totally disabling condition, including a spouse's affidavits:

(c) Other relevant evidence. Even though the existence of pneumoconiosis is not established as provided in paragraph (a) or (b) of this section, a finding of death due to pneumoconiosis may be made if other relevant evidence establishes the existence of a totally disabling chronic respiratory or pulmonary impairment, and that such impairment arose out of employment in a coal mine. As used in this paragraph, the term "other relevant evidence" includes medical tests such as blood gas studies, electrocardiogram, pulmonary function studies, or physical performance tests, and any medical history, evidence submitted by the miner's physician, his spouse's affidavits, and in the case of a deceased miner, other appropriate affidavits of persons with knowledge of the individual's physical condition, and other supportive materials. In any event, no claim for benefits under Part B of title IV of the Act shall be denied solely on the basis of a negative chest roentgenogram (X-ray).

20 C.F.R. Sec. 410.454(c).

Mrs. Collins' claim was properly evaluated by the administrative law judge first under the Labor regulations, section 727.203(a), ⁴ and then under the SSA criteria for entitlement to the presumption, section 410.454. ⁵ The ALJ found that the widow was not entitled to benefits under either provision. However, Mrs. Collins asserts that the ALJ did not adequately consider the non-medical, or lay, testimony presented at the hearing in his evaluation of her claim. Had he properly credited that evidence, contends the claimant, he would have found it sufficient to establish the presumption.

II

The facts found in this record, as presented at the hearing before the ALJ, are not in dispute.

Born in 1912, William L. Collins began working in a coal mine in 1932. He was employed by the respondent Old Ben Coal Company from 1938 until his death, performing several different jobs at a strip mine. After suffering a heart attack in 1977 or 1978, the miner spent six months recuperating, but returned to work intending to continue until his retirement in September of 1979. However, he re-entered the hospital in February of 1979 with cardiac arrhythmia and died on February 25, 1979 of an acute myocardial infarction.

The only testimony given at the hearing was that of the claimant Mrs. Collins. She stated that she had been married to Mr. Collins since 1936, and described her husband's various jobs at the mine, all of which had been dusty and dirty. Concerning his health, she testified that his respiratory condition was very noticeable for at least ten years: He had horrible coughing spells with choking and spitting, shortness of breath, and exhaustion. Nevertheless, she commented, he insisted upon working despite his condition until his retirement in September of 1979. Mrs. Collins also testified that her husband, prior to his death, had been unable to perform his jobs adequately, and had to be helped by the other miners.

The medical records submitted as exhibits included the results of the clinical tests administered to Mr. Collins on August 24, 1978: two X-rays, a pulmonary function study, and an arterial blood gas study. None of the tests revealed abnormal lung impairment. The miner's death record listed the primary cause of death as myocardial infarction. Also admitted into evidence were the reports of physicians who had examined and treated the miner. Two doctors filed letters documenting treatment of Mr. Collins for upper respiratory infections. There were four reports sent by Dr. Howard, medical director of the respiratory therapy department of the hospital that treated Mr. Collins. The physician described the miner's complaints and stated that, in his opinion, Mr. Collins did have a...