BLACK LUNG DISABILITY BENEFITS
BLACK LUNG DISEASE
If you have black lung disease or Coal Workers Pneumoconiosis, you may qualify for benefits under the federal Black Lung program. Black lung disease can be seen 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.
Breathing in coal dust results in the scarring of the lung tissue and affects the gas exchange 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 conditions, like asthma, COPD, or hypoxemia, then you could have legal pneumoconiosis. This may make require the SSA to pay you SSD benefits. For example, read here if you need to learn more about asthma benefits. Likewise, more information is available about COPD benefits.
A miner is eligible for benefits if that miner has a total disability due to black lung disease 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 miner 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 that requires 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.”
HOW LONG DOES IT TAKE TO WIN BLACK LUNG BENEFITS?
The time it takes to receive black lung benefits can vary based on several factors. These include how complex your case is and how well you complete your application. It also depends upon the current backlog of claims. Therefore, the processing time for black lung benefits could range from several months to many years. You should plan on it taking a number of years.
Here are some factors that can influence the amount of time it takes to get black lung benefits:
- A COMPLETE APPLICATION: A complete application with all necessary documents can help speed up the review process. Any missing information could lead to delays.
- MEDICAL EVIDENCE: Medical evidence is an important part of the application process. The time it takes to gather medical records, have medical exams, and review the written evaluations from medical professionals can impact the overall wait for benefits.
- COMPLEXITY OF THE CASE: Some cases might involve complex medical histories or legal issues that require more time to review. Therefore, this can lead to longer processing times.
- APPEALS AND REVIEWS: If an initial application is denied or there are questions about benefit amounts, then the appeals process can take longer.
- BACKLOG: The volume of claims being worked on by the Department of Labor’s Office of Workers’ Compensation Programs (OWCP) can affect the processing time of your black lung case. If there is a high number of claims in the system, then it might result in longer wait times.
- LEGISLATION: Changes in laws and rules related to black lung benefits can influence processing times as the agency must adjust to new requirements.
A DOCTOR’S REASONED MEDICAL OPINION
According to the regulations, if a doctor offers a reasoned medical opinion that a miner cannot perform his or her usual coal mine work and doing other comparable gainful employment due to pneumoconiosis, then black lung 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.
QUALIFY 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 to extract or prepare 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.
LEGAL PNEUMOCONIOSIS
If you have legal pneumoconiosis, then 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 often 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 black lung disease and his total disability.
IMPORTANT EVIDENCE IN BLACK LUNG CASES
In black lung cases, many issues come into play. There will be expert opinions on both sides of the case. This will require you to be seen by a doctor. Also, various doctors and lawyers will review your medical records. Below is a list of some of the other important evidence in your black lung case:
- Medical History: Gathering a medical history that includes details about your work history in the coal mine and exposure to coal dust is important. Also, your smoking history will be under review.
- Physical Exam: You will have a physical exam to assess your lung function, breathing patterns, and overall health.
- Imaging Studies: Doctors will perform chest X-rays and other imaging studies to look at your lungs and assess any abnormal signs, such as black lung nodules in your lungs.
- Pulmonary Function Tests: You will need to undergo pulmonary function tests to measure lung capacity and efficiency in order to understand your lung condition.
- Laboratory Tests: You will also need to undergo other medical tests, such as blood tests, to assess your oxygen levels, lung function, and potential exposure to coal dust.
- Comparison with Other Medical Conditions: Doctors and lawyers will compare your medical findings and symptoms with those of other lung diseases to determine if there are other explanations for your lung problems.
- Expert Medical Opinion: Medical experts who treat lung diseases, including coal workers’ pneumoconiosis, will offer their opinions.
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 the rules, then you have proven disability under the Black Lung rules. You may have another breathing condition 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 issues prevent 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 you. Because, it shows you can prove that you have CWP. Therefore, if you have legal pneumoconiosis and a lengthy coal mine employment, you have a higher chance of winning benefits.
If you have black lung disease and you can no longer work, then contact Cannon Disability Law. We will review your case for free. Often, we can tell you over the phone if you should apply for black lung benefits.
Likewise, we can also help you apply for SSD and SSI 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 benefits.
HIRE US TO BE YOUR LEGAL TEAM
If you have black lung disease and need benefits, then a medical expert may testify at your hearing. If you don’t hire an attorney, then there is a good chance you will not be able to question the medical or vocational expert at your hearing.
Don’t take that chance. Hire a lawyer in Las Vegas, Nevada and Salt Lake City, Utah with the experience you need to win your benefits. Learn about Nevada SSI benefits here. Also, learn about Utah SSDI benefits information.
If you need a lawyer in Colorado, then we can help you. Likewise, we help clients for California SSD benefits.
In addition to getting black lung benefits, miners can receive medical benefits that cover the costs of necessary medical treatments. Benefits can also cover medications and therapy related to black lung disease. This can include visits to the doctor, hospital stays, surgery, and other medical services.
WE ARE EXPERTS AT SOCIAL SECURITY CASES
In the last 30 years, we have won over 20,000 hearings for our clients. Additionally, we have won over $100 million in ongoing and past due SSDI and SSI benefits for our clients.
During our time in business, we have seen the Social Security Administration change their rules. Over time, it has become more difficult to win Social Security cases, even if you have black lung disease. The medical evidence to prove you meet the SSA listing is also harder to obtain. Additionally, those who come to the hearing without a lawyer are usually not successful in winning benefits.
If you have a severe medical condition, then you know you are not going to be able to work for more than 12 months. Therefore, you need to apply for SSD benefits. You need to do so right away. Don’t wait. Apply for benefits even if you think you might go back to work. If you do go back to work, then you can always withdraw your application.
Meanwhile, if you don’t go back to work, then your application is in process with the SSA. SSDI benefits and SSI benefits are available to you. But, first you must apply. You can file an application online on the Social Security website.
LEARN ABOUT OUR SOCIAL SECURITY LEGAL TEAM
Cannon Disability brings over 60 years of legal experience to your case. For instance, Dianna Cannon has been helping her clients win SSD benefits since 1992. Ms. Cannon has won black lung cases in both Utah and Pennsylvania. Black lung cases are difficult to win and take many years. Finding an attorney who is on your side is important.
Brett Bunkall and Andria Summers also have many years of legal experience. During our practice, we have won many cases for individuals with lung disease. You can learn more on our About Us page.
When you hire your attorney, choose one who has over 30 years of experience. Choose a law office with a stellar record. You want the best attorney you can find to help you. Find one who understands the system. You need to win benefits. In order to win, you should choose a law firm who practices Social Security disability law. Choose to hire our law firm. Contact us now.
