BLACK LUNG DISABILITY BENEFITS
BLACK LUNG DISEASE
If you have black lung disease or Coal Workers Pneumoconiosis, you may be eligible for disability benefits under the federal Black Lung program. Black lung disease is observable on chest x-ray and CT scans. If you have black lung disease, then your chest x-ray or CT scan will show pulmonary nodules in your lungs.
The inhalation of coal dust results in the scarring of the lung tissue and affects the gas-exchanging ability of the lungs to remove carbon dioxide and take oxygen into the bloodstream. Exposure to coal dust over an extended period of time can lead to Coal Workers Pneumoconiosis (CWP). Continued exposure can lead to from the early stages of CWP, known as “simple CWP,” to more advanced stages of scarring known as “complicated CWP” or progressive massive fibrosis (PMF). There is no cure for CWP or for PMF.
If you have other breathing impairments, like asthma, COPD, or hypoxemia, you could have legal pneumoconiosis. This may make you eligible to receive disability benefits. For example, if you need to learn more about asthma disability benefits, then read here. Likewise, additional information is available about COPD disability benefits on our website.
A miner is eligible for benefits if that miner has a totally disability due to pneumoconiosis arising out of coal mine employment. The survivors of a miner are eligible for benefits if the miner’s death was due to pneumoconiosis arising out of coal mine employment. Benefits are only available to miners and their survivors.
PNEUMOCONIOSIS OR BLACK LUNG DISEASE
Under 20 CFR 718.204 (2), total disability due to pneumoconiosis or black lung disease can be established by medical criteria. The medical criteria includes the results of a valid pulmonary function test, a valid arterial blood gas-test, or by evidence that the miner suffers from cor pulmonale with right-side congestive heart failure. See 20 CFR 718.204(2)(i)(A)(B)(C); (2)(ii); (2)(iii). But this is only one way to obtain disability benefits. The regulations state, where total disability cannot be established under these medical criteria, total disability may nevertheless be found if:
- “a physician exercising reasoned medical judgment, based on medically acceptable clinical and laboratory diagnostic techniques, concludes that a miner’s respiratory or pulmonary condition prevents or prevented the miner from engaging in employment as described in paragraph (b)(1)…”. 20 CFR 718.204(2)(iv).
A minor shall be considered totally disabled, as it states in 20 CFR 718.204(b)(1), if:
- “the miner has a pulmonary or respiratory impairment, which standing alone, prevents the miner (1) From performing his or her usual coal mine work; and (ii) From engaging in gainful employment in the immediate area of his or her residence requiring the skills or abilities comparable to those of any employment in a mine or mines in which he or she previously engaged with some regularity over a substantial period of time.”
PHYSICIAN’S REASONED MEDICAL OPINION REGARDING DISABILITY
According to the regulations, if a physician offers a reasoned medical opinion that a miner is prevented from performing his or her usual coal mine work and doing other comparable gainful employment due to pneumoconiosis, disability benefits should be granted. The point of the regulation is to allow miners who suffer from black lung disease to be found disabled because returning to a coal dust environment, like the mine, will make their condition worse and shorten their life span.
ELIGIBILITY FOR BLACK LUNG BENEFITS
The Black Lung Benefits Act defines a miner as any individual who works or has worked in or around a coal mine or coal preparation facility in the extraction or preparation of coal. This also includes an individual who works in coal mine construction or transportation in or around a coal mine.
Therefore, workers exposed to coal dust, such as railroad workers or workers at coal-fired power plants, are not eligible for benefits. People who live near coal mines or power plants are also not eligible for benefits. Even if they have exposure to coal dust.
Additionally, while a miner’s family members may receive benefits as survivors, they may not claim benefits on their own due to exposure to coal dust in the home. For example, family members cannot claim coal dust exposure from cleaning the miner’s soiled clothing.
If you have legal pneumoconiosis, the defendant (usually the insurance company for the coal mine) must rebut the presumption that you are not disabled. This is difficult to do.
It is difficult because legal pneumoconiosis by definition arises from exposure to dust in coal mining employment. However, rebuttal may be shown in two ways. The first way requires the liable party to establish that the miner has neither clinical pneumoconiosis arising out of coal mine employment nor legal pneumoconiosis. 20 C.F.R. § 718.305(d)(1)(i).
THE RULE OUT STANDARD FOR BLACK LUNG CASES
The second method requires the liable party to prove that “no part of the miner’s respiratory or pulmonary total disability” stems from pneumoconiosis. 20 C.F.R. § 718.305(d)(2)(ii). This is frequently called the “rule-out standard.” See Antelope Coal Co./Rio Tinto Energy Am. v. Goodin, 743 F.3d 1331, 1336 (10th Cir. 2014).
In Antelope Coal Co. v. Goodin, 743 F.3d 1331, 1336 (10th Cir. 2014), the 10th Circuit found that Antelope had “not rebutted the presumption by showing [Mr. Goodin’s] pneumoconiosis did not arise out of his coal mine employment as the definition of legal pneumoconiosis subsumes that finding.” Appx., Vol. II at 283.
Because, (1) the ALJ found that the claimant has legal pneumoconiosis, which Antelope failed to rebut; (2) legal pneumoconiosis by definition arises from exposure to dust in coal mining employment; and (3) the doctor concluded that the claimant’s total disability resulted in part from coal dust exposure, Antelope failed to rule out any connection between Mr. Goodin’s pneumoconiosis and his total disability.20
BLACK LUNG DISEASE IS DISABLING
What does this mean for a coal miner with black lung disease? If you prove you have CWP that meets disabling criteria you have proven disability under the Black Lung regulations. You may have another breathing impairment that is also worse due to coal dust.
If so, you are on your way to proving you cannot work in the coal mine. You must show that your breathing impairment prevents you from returning to the coal mine. Then, after that showing, the burden of proof shifts to the insurance company. The insurance company has a high burden of proof. They must rule out any connection between your black lung disease and your total disability.
The fact that the burden of proof is on the insurance company is good news for the claimant. Because, it shows you can demonstrate that you have CWP. Therefore, if you have legal pneumoconiosis and a lengthy coal mine employment, you have a higher chance of winning disability benefits.
If you have black lung disease and you can no longer work, contact Cannon Disability Law. We will review your case for free. Often, we can tell you over the phone if you are eligible to apply for black lung benefits. Likewise, we can also help you apply for Social Security Disability benefits. Call us and we will answer your questions for free. Or, you can contact us on this website. We will see if we can help you with your claim for black lung disability benefits.