The Department of Labor’s Office of Workers’ Compensation Programs (OWCP) has issued a final rule regarding the submission of digital radiographs in federal Black Lung claims. The rule updates the existing film-radiograph standards and provides parallel standards for digital radiographs. It also updates outdated terminology and removes certain obsolete provisions.
Last summer, the Department of Labor released a direct final rule to “update the existing quality standards for administering and interpreting film-based chest radiographs and to add parallel standards for digital radiographs.” Despite challenges from three commenters – two of which represented the coal industry – the new rule does not revise last summer’s proposal.
The commenters asked that a provision prohibiting the use of x-rays converted from digital to film – or vice-versa – be removed from the regulation. The DOL declined on the grounds that there is no scientific evidence demonstrating accurate radiograph readings from converted x-rays.
The commenters also expressed concern over the cost impact of the rule. Because the rule does not require medical facilities to update or replace their existing equipment, the DOL reiterated its belief that the rule is cost-neutral for the parties in claim proceedings. As the DOL states, “The final rule continues to allow submission of traditional analog film radiographs. Thus, facilities may proceed as they have in the past with no charge in cost burden.”
There are numerous benefits to standardizing digital radiographs in Black Lung adjudications. From a legal standpoint, it will relieve parties of the evidentiary burden of proving medical acceptability of digital X-rays. From a position of public health, the rule will increase miners’ access to radiographic technology, “which in turn will increase the number of medical providers available to OWCP and reduce delays in processing miners’ benefits claims.” As we wrote in February,
The use of digital radiography is of more than academic interest because using digital radiography would expand the number of radiologists who can participate in the black lung benefits system. Currently many radiologists use digital radiography rather than traditional film-screen x-rays, but the regulations do not treat digital radiography as equal to film-screen radiography. If more radiologists could participate in the black lung benefit system, some delays would be reduced, especially in areas of the country where radiologists do not encounter enough black lung to justify investing in film-screen technology.
The rule is scheduled to take effect May 19, 2014.