Today in Lemarco, Inc. v. Helton, 559 F. App’x 465 (6th Cir. 2014) (slip op. here), the U.S. Court of Appeals for the Sixth Circuit affirmed an award of black lung benefits in a widow’s case and rejected the company’s arguments that its physicians’ opinions should have been given more weight.
In an unpublished decision by Judge Cook (joined by Judges Keith and Kethledge), the court applied the deferential substantial evidence standard and concluded that the ALJ’s weighing of the medical evidence was reasonable. The decision has limited precedential value, but the Sixth Circuit did not apply the “estimable time” portion of the test for whether black lung hastened a miner’s death, suggesting that physicians may no longer need to estimate the extra time that a miner would have lived were in not for black lung.
Wayne Helton worked as a coal miner for thirteen years and died of congestive heart failure. His widow filed a claim for black lung benefits and submitted opinions from Dr. William Clarke and the treating physician Dr. Rachel Eubank, which both supported Mrs. Helton’s claim. Importantly, Dr. Eubank explained that Mr. Helton’s COPD caused cor pulmonale which ultimately caused his heart failure. The company submitted opinions from Dr. David Rosenberg and Dr. Matthew Vuskovich, which both opined that Mr. Helton’s COPD was not related to coal mine dust exposure and did not cause his death.
The ALJ credited the opinions of Drs. Clarke & Eubank as well-reasoned and discounted the opinions of Drs. Rosenberg and Vuskovich because their opinions clashed with the preamble to the Department of Labor’s regulations. For example, even though the regulations say a claimant does not need to prove fibrosis, Dr. Rosenberg said the lack of fibrosis meant Mr. Helton’s COPD was not due to coal mine dust (implying that Mr. Helton would need to prove fibrosis to win, a view in tension with the regulations). Similarly, although the regulations recognize that coal mine dust and smoking may combine to cause pneumoconiosis, Dr. Vuskovich did not offer any explanation for excluding coal mine dust and attributing all of Mr. Helton’s COPD to smoking.
The Sixth Circuit reaffirmed that an ALJ can consult the preamble and afford less weight to opinions that conflict with the medical principles adopted by the Department of Labor. Because the company doctors used flawed theories to deny that Mr. Helton had pneumoconiosis, their conclusions about the cause of Mr. Helton’s death were undermined.
Further undermining the company’s position, although a cardiovascular specialist determined that Mr. Helton had signs of cor pulmonale, Dr. Vuskovich said “there was no evidence of chronic cor pulmonale.” For some reason, rather than confront this conflict, the attorneys for the company maintained that Dr. Vuskovich did not make such a determination. The Sixth Circuit found this discrepancy as a convincing reason to discount the credibility of Dr. Vuskovich—and in turn, the company’s argument.
An interesting aspect of the decision concerned the “estimable time” portion of the Sixth Circuit’s test to determine whether pneumoconiosis hastened the miner’s death. In Eastover Mining Co. v. Williams, 338 F.3d 501, 508 (6th Cir. 2003), the court stated that a survivor must provide medical evidence describing “a specifically defined process” by which pneumoconiosis “reduce[d] the miner’s life by an estimable time.” The “estimable time” portion of the test is problematic because physicians have difficulty estimating with any precision how much longer a miner would have lived if it weren’t for black lung. However, in Lemarco, Inc. v. Helton, the court did not apply the “estimable time” portion of the test. This is the same approach that the court used in a similar case from 2012, Sandy Fork Mining Co. v. Beverly, 491 F. App’x 662, 663 (6th Cir. 2012). The court now has two holdings—albeit via unpublished decisions—which suggest that the court has abrogated the “estimable time” portion of the test. This is good news for survivors and the credibility of the black lung system because it removes an unnecessary requirement which physicians often see as unanswerable.
Congratulations to John C. Carter for the win on behalf of Mrs. Helton.