Milburn Colliery Co. v. Hicks
| Decision Date | 06 March 1998 |
| Docket Number | No. 96-2438,96-2438 |
| Citation | 138 F.3d 524 |
| Parties | MILBURN COLLIERY COMPANY, Petitioner, v. Guy HICKS; Director, Office of Workers' Compensation Programs, United States Department of Labor, Respondents. |
| Court | U.S. Court of Appeals — Fourth Circuit |
ARGUED: William Steele Mattingly, Jackson & Kelly, Morgantown, WV, for Petitioner. Jeremy Young Taylor, National Legal Research Group, Inc., Charlottesville, VA, for Respondents. ON BRIEF: Ann B. Rembrandt, Jackson & Kelly, Charleston, WV, for Petitioner. Don M. Stacy, Beckley, WV, for Respondent Hicks.
Before LUTTIG and WILLIAMS, Circuit Judges, and MERHIGE, Senior United States District Judge for the Eastern District of Virginia, sitting by designation.
Reversed and remanded by published opinion. Judge WILLIAMS wrote the opinion, in which Judge LUTTIG and Senior Judge MERHIGE joined.
Guy Hicks applied for benefits under the Black Lung Benefits Act (the Act), see 30 U.S.C.A. §§ 901-945 (West 1986 & Supp.1997), on May 28, 1981. An Administrative Law Judge (ALJ) reviewed Hicks' claim on three separate occasions. The Benefits Review Board (Board) remanded the claim twice for reconsideration. The ALJ's third order awarding benefits was finally affirmed by the Board, fifteen years after Hicks applied for benefits. Milburn Colliery Company (Milburn) now petitions for review of the Board's order. Because the ALJ failed to consider all of the relevant evidence and made several other errors of law, we vacate and remand to the Board with instructions to assign the claim to a new ALJ for a prompt review of Hicks' application for benefits.
Hicks labored underground as a coal miner for approximately forty years. His last employment in the coal mines was with Milburn from 1974 to 1982. Hicks applied for benefits under the Black Lung Benefits Act after suffering a heart attack in 1981. After Hicks underwent coronary artery bypass surgery in 1982, he never returned to work in the coal mines.
The record contains reports from six physicians dating from 1979 to 1988 that conflict as to whether Hicks has a totally disabling respiratory condition or is disabled solely by another ailment such as his heart disease or obesity. Additionally, the reports conflict as to whether, if disabled, his disability was attributable to coal workers' pneumoconiosis or another factor such as his smoking history. The same ALJ has evaluated the evidence three times. The ALJ's 1989 denial of benefits (First Order) was reversed and remanded by the Board in 1993. The ALJ's award of benefits in 1993 (Second Order) was reversed and remanded by the Board in 1995. His 1995 award (Third Order), which was affirmed by the Board in 1996, incorporated all non-inconsistent rulings from his 1989 and 1993 decisions; thus, in essence, we review all three decisions.
Milburn now appeals, arguing that the arterial blood-gas study evidence does not support a finding of total disability and that the reliance upon medical opinion was neither supported by the evidence nor consistent with applicable law.
We review claims for benefits under the Act to determine whether substantial evidence supports the ALJ's findings of fact. See Dehue Coal Co. v. Ballard, 65 F.3d 1189, 1193 (4th Cir.1995). Substantial evidence is "more than a mere scintilla." Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229, 59 S.Ct. 206, 217, 83 L.Ed. 126 (1938). It is "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Id. In determining whether substantial evidence supports the ALJ's factual determinations, we must first address whether all of the relevant evidence has been analyzed and whether the ALJ has sufficiently explained his rationale in crediting certain evidence. See Sterling Smokeless Coal Co. v. Akers, 131 F.3d 438, 439 (4th Cir.1997). We review the ALJ's and the Board's conclusions of law de novo to determine whether they are rational and consistent with applicable law. See Dehue, 65 F.3d at 1193. Because the ALJ failed to analyze all of the relevant evidence, failed to adequately explain his reasons for crediting certain evidence and discrediting other evidence, and made several errors of law, Hicks' claim must be remanded for further consideration.
Hicks filed his claim for benefits after March 31, 1980. Thus, the standards for determining whether he is disabled due to pneumoconiosis are found in 20 C.F.R. Part 718. See 20 C.F.R. § 718.2 (1997). To establish eligibility for benefits under 20 C.F.R. Part 718, a claimant must prove that (1) he has pneumoconiosis; (2) the pneumoconiosis arose out of his coal mine employment; (3) he has a totally disabling respiratory or pulmonary condition; and (4) pneumoconiosis is a contributing cause to his total respiratory disability. See Robinson v. Pickands Mather & Co., 914 F.2d 35, 36, 38 (4th Cir.1990); 20 C.F.R. §§ 718.201-.204 (1997). Milburn does not dispute that Hicks has pneumoconiosis or that his pneumoconiosis arose out of his coal mine employment. The dispute centers around whether Hicks is totally disabled from a respiratory or pulmonary condition and whether pneumoconiosis contributed to his total disability.
The Act requires a miner to establish that he has a totally disabling respiratory condition. 1 See Jewell Smokeless Coal Corp. v. Street, 42 F.3d 241, 243 (4th Cir.1994). In the absence of contrary probative evidence, a miner will establish total respiratory or pulmonary disability pursuant to the criteria set forth in 20 C.F.R. § 718.204(c) by submitting either (1) qualifying pulmonary function tests; (2) qualifying arterial blood-gas tests; (3) evidence that the miner suffers from cor pulmonale with right-sided congestive heart failure; or (4) a reasoned physician's report which concludes that the miner's respiratory or pulmonary condition prevents the miner from engaging in his usual coal mine work or comparable gainful employment. 2 See 20 C.F.R. § 718.204(c) (1997). If contrary probative evidence exists, "the ALJ must assign the contrary evidence appropriate weight and determine whether it outweighs the evidence that supports a finding of total disability." Lane v. Union Carbide Corp., 105 F.3d 166, 171 (4th Cir.1997).
Hicks does not dispute that the three pulmonary function tests in the record all produced non-qualifying values, and he produced no evidence establishing cor pulmonale with right-sided congestive heart failure. We must therefore determine whether Hicks established total disability under § 718.204(c)(2) on the basis of unchallenged arterial blood-gas studies, or under § 718.204(c)(4) by uncontradicted reasoned medical opinion evidence. If the evidence is contradicted, we must determine whether the ALJ conducted an appropriate analysis of the evidence to support his conclusion.
In his First Order, the ALJ concluded that Hicks had presented valid arterial blood-gas studies showing that Hicks was totally disabled. 3 See 20 C.F.R. § 718.204(c)(2) (1997). The record, however, contained reports of four blood-gas studies performed on Hicks, the results of which were in conflict. 4 Although the ALJ noted that the blood-gas test results were contradictory, he found the studies to be, at the least, equally probative, and thus sufficient to provide Hicks with the benefit of the "true doubt" rule. 5 He also decided to accord the greatest weight to the October 8, 1979, study performed by Dr. Rasmussen because it was the only study validated by an independent physician, Dr. Gaziano. Milburn challenged the ALJ's reliance upon blood-gas study evidence in finding Hicks totally disabled. The Board upheld the ALJ's decision, reasoning that the ALJ was not required to accord greater weight to the most recent blood-gas study evidence and that the ALJ acted within his discretion in applying the "true doubt" rule and in according greater weight to the October 8, 1979, study because it was the only independently validated study. For other reasons the Board remanded the case for further evaluation.
It is undisputed that the blood-gas study evidence was contradictory. Out of a total of nine tests, the five initial tests produced qualifying results, and the four later tests did not. Although we have explicitly rejected a "later is better" approach to contradictory x-ray evidence in cases arising under the Act, see Adkins v. Director, OWCP, 958 F.2d 49, 51 (4th Cir.1992), the parties conceded at oral argument that because pneumoconiosis is a progressive disease, later nonqualifying arterial blood-gas studies are inconsistent with coal workers' pneumoconiosis, see Gray v. Director, OWCP, 943 F.2d 513, 520-21 (4th Cir.1991) ().
Even if we look to factors other than the chronological relationship of the tests, we question whether the ALJ's conclusions with respect to the blood-gas studies were reasonable. The ALJ and the Board credited Dr. Rasmussen's 1979 blood-gas study solely because it was validated by Dr. Gaziano for the United States Department of Labor. Dr. Gaziano, however, merely checked a box verifying that the test was technically acceptable. He provided no reasons for his opinion. Therefore, his validation lent little additional persuasive authority to Dr. Rasmussen's 1979 study. Cf. Lane v. Union Carbide Corp., 105 F.3d 166, 172 (4th Cir.1997) ().
The ALJ did not discuss the reports submitted by three qualified physicians that criticized Dr. Rasmussen's interpretation of the blood-gas studies. Dr. Fino, who is board-certified in both Internal Medicine and Pulmonary Disease,...
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