Cumberland River Coal Company v. Billie Banks
2012 U.S. App. LEXIS 16431
| 6th Cir. | 2012Background
- Banks filed a 2003 claim after new evidence of pneumoconiosis; ALJ Merck awarded benefits; BRB affirmed; Cumberland River Coal appeals.
- Regulation 20 C.F.R. § 725.309(d) was amended to require a change in condition shown by new evidence, altering the prior compare-evidence test.
- ALJ Merck found a change in entitlement due to legal pneumoconiosis, and Banks was disabled due to that condition.
- Cumberland challenged the change-in-condition ruling and the sufficiency of evidence for legal pneumoconiosis and disability causation.
- The Director urged deference to the agency’s interpretation; the court adopted that interpretation and upheld the award of benefits.
- The opinion discusses the latent/progressive nature of pneumoconiosis and the proper weighting of medical opinions from Forehand, Rasmussen, Jarboe, and Dahhan.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Interpretation of § 725.309(d) change in condition | Banks/Director: new regulation requires only a change via new evidence. | Cumberland: old framework requires comparing old and new evidence. | Adopt Director's interpretation; change means disproof of continuing validity, no full evidence comparison required. |
| Sufficiency of evidence that Banks has legal pneumoconiosis and that it contributed to disability | Banks contends new opinions establish legal pneumoconiosis contributing to disability. | Cumberland argues the new medical opinions are insufficient or not well-reasoned. | Substantial evidence supports Banks's legal pneumoconiosis and its substantial contribution to total disability. |
| Weight afforded to medical opinions (Forehand, Rasmussen, Jarboe, Dahhan) and reasoning | ALJ properly weighed the new opinions as reasoned medical judgments. | Weighting of Drs. Jarboe and Dahhan was improper or inconsistent. | ALJ's evaluation was rational; the Dahhan/Jarboe reasoning was properly discounted where impermissible or unsupported. |
Key Cases Cited
- Lisa Lee Mines v. Director, OWCP, 86 F.3d 1358 (4th Cir. 1996) (recognizes the 'one-element' test in change-in-condition analysis)
- Consolidation Coal Co. v. Williams, 453 F.3d 609 (4th Cir. 2006) (limits the one-element test guidance in change in condition cases)
- Sharondale Corp. v. Ross, 42 F.3d 993 (6th Cir. 1994) (adopts a one-element test but requires qualitative difference in later records)
- Tennessee Coal Co. v. Kirk, 264 F.3d 602 (6th Cir. 2001) (requires material change showing newer evidence supports entitlement)
- U.S. Steel Mining Co. v. Director, OWCP, 386 F.3d 977 (11th Cir. 2004) (supports agency interpretation of § 725.309(d))