Fourth Circuit Reverses Benefits Review Board Yet Again in Long-Pending Black Lung Case
In a case highlighting the often-criticized administrative delays within the U.S. Department of Labor’s adjudication process, the Fourth Circuit reversed a decision by the Benefits Review Board affirming an ALJ’s denial of survivor’s benefits under the Black Lung Benefits Act (“the Act”) and awarded benefits to a surviving miner’s spouse.
The procedural delays in the resolution of the spouse’s claim, however, are striking. The miner, who worked for 36 years in the industry, filed a claim for lifetime benefits under the Act when he stopped working in 1983. In 1988, an ALJ awarded him benefits after determining he had legal pneumoconiosis based on a chronic respiratory condition and that even though he was a regular smoker, the best evidence was that his work in the mines contributed to this condition. The mining company did not appeal and he received benefits until his death in 1997. His surviving spouse then filed for survivor’s benefits pursuant to 30 U.S.C. § 922(a)(2). Four years later, an ALJ heard her case and concluded that the 1988 ALJ decision was not entitled to collateral estoppel on the issue of whether the miner suffered from pneumoconiosis and denied the claim based on an independent review of the record. In 2006, however, the Fourth Circuit concluded that collateral estoppel did indeed apply to the holding of the 1988 ALJ decision that the miner suffered from pneumoconiosis due to coal dust exposure and remanded the case for an ALJ to determine if pneumoconiosis contributed to the miner’s death, which is also required for survivor’s benefits. Since the Fourth Circuit’s 2006 decision, three different decisions have been issued by two different ALJs and three decisions have been issued by the Benefits Review Board. Finally, the case returned to the Fourth Circuit last week after an ALJ again concluded that the surviving spouse was not entitled to benefits because the relied-upon physician opinions did not support a finding that pneumoconiosis hastened the miner’s death and the Benefits Review Board affirmed the ALJ’s order.
Making a point to note that the widow was 62 years old when filing her original claim for survivor’s benefits but now was 78, the Fourth Circuit announced, “We hold, better late than never,” that the Benefits Review Board decision is reversed and that the widow be awarded benefits. The court explained that the ALJ failed to give appropriate weight to the miner’s treating physician’s opinion, which was required based on prior case law. In this case, the treating physician who helped the miner for the last three years of his life had documented in detail his opinion that pneumoconiosis caused the miner’s condition and hastened his death. The ALJ also failed to give appropriate weight to a U.S. Department of Labor-hired physician, who had documented the same opinion, and cautioned that prior case law requires that even poorly documented causation opinions properly diagnosing pneumoconiosis carry more weight than those opinions that have denied the presence of the disease.
