Jesse Adams v. Director, OwcpJesse Adams v. Director, Owcp
Claimant Jesse Adams petitions this court to review a final order of the Benefits Review Board (BRB or Board) denying his claim for benefits under the Black Lung Benefits Act (Act),
Adams filed the instant claim for benefits on July 9, 1982. 2 A hearing was held before an Administrative Law Judge (ALJ) on March 7, 1985. The record discloses that Adams was a miner in underground coal mines for twelve years and two and one-half months between 1943 and 1961. From 1962 until 1969, Adams was employed as a mechanic and a welder in a stone quarry, and between 1969 and 1979, he was self-employed as a mechanic and welder. In both of these non-mining occupations, Adams was exposed to noxious arc-welding fumes. In addition, Adams had a long-standing habit of cigarette smoking.
Mr. Adams' respiratory problems first surfaced in 1972. The evidence heard by the AU indicated that Adams’ respiratory disease had worsened since its onset. Adams would become short of breath upon exertion, and he suffered from morning cough. Adams was also afflicted with heart problems and an ulcerated stomach, both of which had resulted in hospital stays and surgery.
Although the medical evidence presented to the AU was to a certain extent conflicting, Adams clearly established by x-ray that pneumoconiosis had invaded his lungs,
see
Despite the confluence of these facts establishing a totally disabling lung disease
Since Adams’ claim was filed after March 31, 1980, it was properly evaluated by the ALJ and the BRB under the Secretary of Labor’s permanent regulations found at 20 C.F.R. Part 718.
See Tennessee Consolidated Coal Co. v. Crisp,
In the instant claim, it is undisputed that Adams has pneumoconiosis,
This inquiry is mandated by the statutory requirement that the miner is entitled to benefits only if he is “totally disabled due to pneumoconiosis.” 30 U.S.C. 901(a). This requirement is reiterated in the specific regulatory language under review:
Except as provided in § 718.305, proof that the miner suffers or suffered from a totally disabling respiratory impairment as defined in paragraphs (c)(1), (2), (4) and (5) of this section shall not, by itself, be sufficient to establish that the miner’s impairment is or was due to pneumoconi-osis.
The Director argues that, as a general matter, two avenues are open for a claimant to establish total disability “due to” pneumoconiosis when the statutory presumptions are not available. First, in the absence of x-ray evidence (or other qualifying evidence under
The Director also recognizes a second method for a claimant to prove causation, which is at issue here: a miner who is totally disabled by respiratory disease, and who has established the existence of “clinical” pneumoconiosis by x-ray, may prove the requisite causal nexus between the two by competent medical evidence. The Department of Labor regulations, however, nowhere define the circumstances under which such a living miner’s totally disabling lung disease will be considered “due to” pneumoconiosis under the Act and
The causation standard embodied in the term “due to”, however, is not susceptible to such easy interpretation. As the Department of Labor stated in promulgating regulations explaining the requirement of “death due to pneumoconiosis” for survivors’ claims cited above:
The words do not speak clearly and unambiguously for themselves. The causal nexus of “due to” has been given a broad variety of meanings in the law ranging from sole and proximate cause at one end of the spectrum to contributing cause at the other.
48 Fed.Reg. 24,276 (May 31, 1983). Given this obvious ambiguity in the “due to” language, it is somewhat surprising for the Director now to argue that its meaning is unequivocal. Since the Director cites us to little regulatory or statutory support for his restrictive interpretation of “due to”, however, his reliance on this rhetorical flourish is perhaps understandable.
In defense of the Board’s holding that Adams must show that his pneumoconiosis is “in and of itself” totally disabling, the Director principally relies on the provision in
For purposes of the Act, “pneumoconio-sis” means any chronic dust disease of the lung and its sequelae, including respiratory and pulmonary impairments, arising out of coal mine employment. This definition includes, but is not limited to, coal workers’ pneumoconiosis, anthroco-silicosis, anthrocosis, anthrosilicosis, massive pulmonary fibrosis, progressive massive fibrosis, silicosis or silicotuber-culosis, arising out of coal mine employment. For purposes of this definition, a disease “arising out of coal mine employment” includes any chronic pulmonary disease resulting in respiratory or pulmonary impairment significantly related to, or substantially aggravated by, dust exposure in coal mine employment.
20 C.F.R. 718.201. The Director argues that when
In our view, however, these regulations will not support the construction that the Director thrusts upon them. Neither sec
The Director asserts that his proposed enhanced causation standard follows from the requirement in the third sentence of
Moreover, we are not persuaded by the Director’s contention that the third sentence of
Since we find that Adams has established the existence of pneumoconiosis as defined in
The original regulations promulgated by the Secretary of Health, Education and Welfare (now Health and Human Services), for example, required the claimant to prove only that “his pneumoconiosis is ... the
•primary
reason for his inability to engage in ... comparable and gainful work.”
A similar lesson can be drawn from the treatment given to the Department of Labor’s interim regulations found at 20 C.F.R. Part 727. Under section 727.203, a claimant with ten years of coal mine employment may be presumed totally disabled due to pneumoconiosis upon satisfying one of several medical criteria,
id.
§ 727.203(a), and the responsible operator is then afforded the opportunity to rebut the presumption,
id.
§ 727.203(b). One of the rebuttal provisions states that the miner will not be entitled to benefits if his “total disability or death ... did not arise in whole or in part out of coal mine employment.”
Id.
§ 727.203(b)(3). Following the BRB’s lead, and at the behest of the Director, we have repeatedly interpreted this provision (contrary to its express terms) as allowing rebuttal if the employer established that the miner’s disability was not caused, in whole or
in part,
by pneumoconiosis. Thus, in
Gibas v. Saginaw Mining Co.,
If an employer is able to prove that pneu-moconiosis played no part in causing the miner’s disability, then the employer has satisfied the requirement of section 727.-203(b)(3). Where, however, pneumoco-niosis is a contributing cause to a miner’s total disability, he is conclusively entitled to benefits.
Id.
at 1120 (emphasis added).
See also Crisp,
Given these prior regulatory and judicial treatments of the requirement that a miner’s total disability be “due to” pneumoco-niosis before he is entitled to benefits under the Act, we cannot accept the Board’s and the Director’s current assertion that the Act and the regulations require total disability by pneumoconiosis “in and of itself” or “standing alone”.
7
We note, moreover, that the lesser standard imposed by
Instead, we believe that the causation inquiry mandated by Part 718 should be guided by our aforementioned experience in interpreting the provisions of Part 727. Just as the Director and the BRB successfully argued that section 727.203(b)(3) should be construed to impose parallel causation requirements on the relationship between pneumoconiosis and coal mine employment and the relationship between total disability and pneumoconiosis, we believe that those two inquiries should also receive parallel treatment under the regulations in Part 718. We therefore hold, consistent with our prior decision in
Southard,
that in order to qualify for benefits under Part 718, a miner, who is found to suffer from pneumoconiosis under section 718.-202, must affirmatively establish only that his totally disabling respiratory impairment (as found under
Accordingly, the Board’s order finding Adams ineligible for benefits is REVERSED, and his claim is remanded to the Board for an award of benefits under the Act.
Notes
.This appeal was originally brought by Adams in the United States Court of Appeals for the Seventh Circuit. Since Adams’ coal mine employment occurred solely within the Sixth Circuit in the Commonwealth of Kentucky, however, the Seventh Circuit transferred the case to this court pursuant to
. A prior claim for benefits that was administratively denied and became final in May of 1981 is not at issue on this petition for review.
. Actually, the ALJ held that the presumption had been rebutted on the strength of Adams' smoking history and exposure to welding fumes. The BRB’s decision, however, specifically avoided this ground for affirmance. Before this court, the Director now concedes that the ALJ’s holding on the rebuttal issue was erroneous, and that the record will not support a finding that Adams' pneumoconiosis did not arise “at least in part" out of his coal mine employment.
. We note that this analysis does not read the third sentence of
In addition, we believe that this remaining application of the third sentence of section 718.-201 is not precluded by our prior decision in
Southard.
Although some of the language in
Southard
could be read to suggest that a miner should never have to make a causation showing greater than that required by
. The view we take of the definition of pneumo-coniosis in
. The
Peabody Coal
court stated that the ALJ’s formulation indicated that pneumoconiosis "was, at the very least, the
major cause
of the claimant’s impairment.”
. Additionally, we observe that the Department of Labor's regulations interpreting the requirement of "death due to pneumoconiosis” in the context of survivors’ claims similarly permit a claimant to recover without showing that the deceased miner died from pneumoconiosis "in and of itself”. See 20 C.F.R. 718.205.
. We also note at this juncture that we find no evidence in the Act that might justify the application of a more severe causation requirement under the Part 718 regulations than under the regulations in Parts 727 or 410. As we pointed out in
Tennessee Consolidated Coal Co. v. Crisp,
. In rejecting the Director’s proposed causation standard in favor of a more lenient requirement, we take an action that is not only consistent with congressional intent, but is also in accord with the regulatory framework. In particular, we note that our decision in no way infringes on, or "obviates the advantage conferred on miners” by, the presumption contained in section 718.305.
Cf. Tucker v. Director, OWCP,
10 Black Lung Rep. 1-35, 1-41 (B.R.B.1987). That section provides a presumption of total disability due to pneumoconiosis to miners with at least fifteen years of coal mine employment upon a showing that they suffer from a totally disabling respiratory disease under section 718.104(c).
See
. Dr. Lehman also noted that Adams suffers from severe arteriosclerosis, which contributes to his overall disability. The record does not disclose, however, that Adams' heart condition is a contributing cause to his totally disabling impairment (as found under
. Nothing in this record suggests that Adams’ pneumoconiosis has played only an infinitesimal or de minimus part in his totally disabling respiratory impairment, so we need not consider here whether such a finding, if supported by substantial evidence, would support a denial of benefits under the Act.