872 F.3d 754
6th Cir.2017Background
- Jimmy Bowling, a Kentucky coal miner with ~29 years underground work, is eligible for Black Lung Benefits under the Act and invoked the 15-year rebuttable presumption reinstated by the ACA.
- Bowling filed a claim; the District Director designated Island Fork Construction as the responsible operator and issued a Proposed Decision awarding benefits; Island Fork requested de novo ALJ review.
- After the Proposed Decision but before the ALJ hearing, Island Fork’s insurer (Frontier) became insolvent and KIGA (Kentucky Insurance Guaranty Association) assumed responsibility for Frontier’s claims.
- Department of Labor regulations allow an operator to be treated as financially capable if it obtained an insurance policy that covers the claim, unless the insurer is insolvent and obligations are not otherwise guaranteed; at the ALJ stage there is no procedure to re-designate a different responsible operator.
- The core dispute: whether KIGA (as the state guaranty association) must pay benefits as successor guarantor of Frontier’s policy, or whether the federal Black Lung Trust Fund must pay because the policy is excluded under KIGA’s enabling statute (exceptions for "ocean marine insurance" and insurance "guaranteed by governmental agencies").
- The ALJ and Benefits Review Board held KIGA liable; Island Fork appealed. The Sixth Circuit affirmed, holding KIGA is liable for Frontier’s coverage because neither statutory exception applies.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Personal jurisdiction / party status of KIGA | Bowling: KIGA participated and forfeited challenge; jurisdiction exists | KIGA: not properly named as party by District Director; lacked opportunity to develop record | Court: KIGA participated before ALJ/Board and did not preserve a party-status objection; jurisdiction not forfeited |
| Forfeiture based on Ratliff precedent | Bowling: Ratliff requires forfeiture when guarantor delays challenge to liability | KIGA: timing differs here; Frontier became insolvent after Director named Island Fork, so KIGA lacked opportunity earlier | Court: Ratliff forfeiture not controlling due to timing; Court reaches merits of KIGA's statutory defenses |
| Whether Black Lung coverage is "ocean marine insurance" excluded from KIGA | Bowling: Black Lung Act is not maritime; not within "ocean marine" definition | KIGA: statute covers Longshore Act and similar federal statutes; Black Lung is similar and thus excluded | Court: Black Lung coverage is not "ocean marine insurance" under Kentucky law; exception does not apply |
| Whether Black Lung coverage is "guaranteed by governmental agencies" (exclusion) | Bowling: Trust Fund is not a written guaranty under Kentucky law; it does not meet statutory guaranty requirements | KIGA: Trust Fund functions as government guarantor/backstop so exclusion applies | Court: Trust Fund is not a statutory guarantor (no written guaranty contracts); exclusion does not apply; KIGA liable for Frontier's policy |
Key Cases Cited
- Big Branch Res., Inc. v. Ogle, 737 F.3d 1063 (6th Cir. 2013) (standard of review for Board and ALJ decisions)
- Appleton & Ratliff Coal Corp. v. Ratliff, [citation="664 F. App'x 470"] (6th Cir.) (forfeiture precedent when guarantor delays liability challenge)
- Boyd & Stevenson Coal Co. v. Director, Office of Workers' Comp. Programs, 407 F.3d 663 (4th Cir. 2005) (state guaranty association assumption of black lung benefits discussed)
- Ark. Coals, Inc. v. Lawson, 739 F.3d 309 (6th Cir. 2014) (Black Lung Act requires operators to pay benefits to the maximum extent feasible)
- Gibson v. American Bankers Insurance Co., 289 F.3d 943 (6th Cir. 2002) (discussing federal flood insurance arrangements and government-backed programs)