619 F. App'x 447
6th Cir.2015Background
- Claimant Reddin Byrge, a surface miner, filed BLBA claims in 2007 (denied for lack of pneumoconiosis) and again in 2010; the 2010 claim invoked the revived 15-year statutory presumption (30 U.S.C. § 921(c)(4)).
- The ALJ found Byrge had total respiratory disability, worked 15 years in surface conditions "substantially similar" to underground mines, invoked the 15-year presumption, and awarded benefits; the Benefits Review Board affirmed.
- Premium Coal (employer/insurer) appealed, arguing: (1) 20 C.F.R. § 718.305(b)(2) is invalid; (2) the 2010 subsequent claim under 20 C.F.R. § 725.309(c) was improper because change-in-law is not a "change in condition"; and (3) the employer should be allowed to rebut the 15-year presumption by showing pneumoconiosis did not substantially contribute to disability.
- Employer presented experts attributing claimant’s respiratory impairment to bronchiectasis from rheumatoid arthritis; ALJ accepted diagnosis but rejected experts’ causation opinions as unreasoned and insufficient to rule out coal-dust contribution.
- Sixth Circuit denied Premium Coal’s petition, holding Premium Coal waived its regulatory-validity challenge for failure to raise it before the Board, affirmed that the subsequent claim was properly considered, and upheld the ALJ’s application of the rule-out standard to rebut the 15-year presumption.
Issues
| Issue | Byrge's Argument | Premium Coal's Argument | Held |
|---|---|---|---|
| Validity of 20 C.F.R. § 718.305(b)(2) (definition of "substantially similar") | Regulation is valid and applicable | Regulation invalid: unsupported by science and inconsistent with Congress; challenge may be raised | Waived—Premium Coal failed to raise before Board; court refused to reach validity on appeal |
| Proper vehicle for 2010 claim under 20 C.F.R. § 725.309(c) (change in condition) | Subsequent claim valid; claimant demonstrated change (invocation of 15-year presumption and new medical opinion) | Change in law is not a "change in condition"; res judicata/Pittston issues | Subsequent claim permitted; change in condition shown by new medical evidence; res judicata and Pittston arguments rejected per precedent |
| Standard to rebut 15-year statutory presumption | Presumption invoked; employer must "rule out" any contribution of coal-dust to disability | Employer should be allowed to rebut by proving pneumoconiosis did not "substantially contribute" (a lesser standard) or that pneumoconiosis was too mild | Court affirmed rule-out standard (employer must show coal-dust played no part); contributing-cause standard applies when burden is on miner |
| Sufficiency of employer’s rebuttal evidence (bronchiectasis from RA) | Employer presented expert proof that RA-caused bronchiectasis, not coal dust, caused disability | Expert opinions conclusory and failed to account for 15 years of exposure or explain why coal exposure could not aggravate condition | ALJ reasonably discounted experts; evidence did not rebut presumption; award of benefits affirmed |
Key Cases Cited
- Cent. Ohio Coal Co. v. Dir., Office of Workers' Comp. Programs, 762 F.3d 483 (6th Cir.) (elements of entitlement under BLBA)
- Island Creek Kentucky Mining v. Ramage, 737 F.3d 1050 (6th Cir.) (application of 15-year presumption to surface miners)
- Arch on the Green, Inc. v. Groves, 761 F.3d 594 (6th Cir.) (standard for proving disease causation when burden is on miner)
- Big Branch Resources, Inc. v. Ogle, 737 F.3d 1063 (6th Cir.) (employer must "rule out" coal-dust contribution when rebutting presumption)
- Buck Creek Coal Co. v. Sexton, 706 F.3d 756 (6th Cir.) (subsequent claims under § 725.309 do not violate res judicata)
- Greene v. King James Coal Mining, Inc., 575 F.3d 628 (6th Cir.) (standard of review for Board legal conclusions and ALJ substantial-evidence review)
- Youghiogheny & Ohio Coal Co. v. Webb, 49 F.3d 244 (6th Cir.) (miner’s BLBA claim does not abate on death)
- Pittston Coal Group v. Sebben, 488 U.S. 105 (U.S.) (distinguishing mandamus to reopen from subsequent-claim procedures)
- Draw v. City of Lincoln Park, 491 F.3d 550 (6th Cir.) (panel bound by Circuit precedent)
- Usery v. Turner Elkhorn Mining Co., 428 U.S. 1 (U.S.) (addressed and rejected as limiting § 921(c)(4)'s application)