Third Circuit Holds that State Workers’ Comp. Denial Resets Statute of Limitations for Federal Black Lung Benefits Claim (Eighty Four Mining Co. v. Director, OWCP [Morris])

Map of 3rd Circuit Jurisdiction

Yesterday the U.S. Court of Appeals for the Third Circuit issued a precedential decision holding that a denial of a Pennsylvania workers’ compensation claim for black lung resets the federal Black Lung Benefits Act’s statute of limitations.  While courts agree that a denial in a prior federal claim resets the statute of limitations,  yesterday’s decision expands this doctrine to cover denials in previous state claims.  As a result, Eighty Four Mining Co. v. Director, OWCP [Morris], 812 F.3d 308 (3d Cir. 2016) (slip opinion available here), expands slightly the number of miners who can seek federal black lung benefits.  As explained at the bottom of this post, the Third Circuit’s decision is a sound and sensible approach that extends the respect that federal ALJs provide to their federal colleagues to their state counterparts and ensures that coal miners will not be unfairly penalized for accepting the decisions of state adjudicators.

Facts

Morris considered a federal black lung benefits claim by Charles E. Morris, who worked as a coal miner for almost 35 years.  In 2006, Mr. Morris was examined by Dr. Robert Cohen who diagnosed him with black lung disease.  Based on this diagnosis, Mr. Morris filed a Pennsylvania workers’ compensation claim for occupational disease benefits.  Contesting this claim, Eighty Four Mining hired Dr. Gregory Fino who provided his opinion that Mr. Morris did not have black lung, but rather had emphysema due to smoking.  Eighty Four Mining argued that Dr. Fino’s opinion should be credited over Dr. Cohen’s and that Mr. Morris did not have black lung.  On March 31, 2008, the state workers’ compensation judge decided to credit Dr. Fino and denied Mr. Morris’s workers’ compensation claim.

In January 2011, Mr. Morris filed for federal black lung benefits after his breathing problems worsened.

In response, Eighty Four Mining argued that Mr. Morris’s federal black lung benefits claim was too late because Dr. Cohen’s 2006 opinion of disability due to black lung triggered the statute of limitations for federal black lung benefits.  (The federal Black Lung Benefits Act requires that a claim by a miner “be filed within three years after . . . a medical determination of total disability due to pneumoconiosis.” 30 U.S.C. § 932(f).  This provision has been interpreted to contain important exceptions, such as the “misdiagnosis” exception that provides that a medical determination that is later deemed a misdiagnosis does not trigger the limitations period.)

The Department of Labor’s ALJ rejected Eighty Four Mining’s argument, holding that the Pennsylvania workers’ compensation decision rendered Dr. Cohen’s opinion a “misdiagnosis” as a matter of law. (ALJ decision here.)  The ALJ then considered the merits of Mr. Morris’s claim and found that he proved he was disabled due to pneumoconiosis using evidence after 2010.

A divided Benefits Review Board (BRB decision here) affirmed the ALJ’s award on alternative grounds.  The Board held that judicial estoppel prevented Eighty Four Mining from arguing that Dr. Cohen’s diagnosis should be credited because it had earlier argued that this opinion was incorrect.  The Board also affirmed Mr. Morris’s award on the merits.

In response, Eighty Four Mining petitioned the U.S. Court of Appeals to review just the timeliness issue.

Third Circuit Opinion

In a divided opinion authored by Circuit Judge Vanaskie and joined by Senior Circuit Judge Rendell, the Third Circuit affirmed Mr. Morris’s award of benefits.  The Third Circuit reasoned that because its previous decision in Helen Mining Co. v. Director, OWCP [Obush], 650 F.3d 248 (3d Cir. 2011), held that a previous denial in a federal claim renders any previous medical determination of disability due to pneumoconiosis a “misdiagnosis,” the same principle must apply when the denial comes from a state judge rather than a federal judge.

The court explained:

The core concept behind the holding that a misdiagnosis resets the statute of limitations is that a miner presumably cannot self-diagnose black lung disease—he must instead rely upon the expertise of those “presumably far more skilled and educated than the miner.” See [Arch of Ky., Inc. v. Director, OWCP [Hatfield], 556 F.3d 472, 481 (6th Cir. 2009)] (quoting Peabody Coal Co. v. Dir., Office of Workers’ Comp. Programs, 48 F. App’x 140, 146 (6th Cir. 2002)). When a state adjudicator repudiates a diagnosis of black lung disease, a miner cannot himself determine the correctness of that conclusion. To hold that the state adjudicator’s determination does not reset the statute of limitations would be to hold the miner responsible for determining not just whether his doctor made a correct diagnosis, but for determining whether the state adjudicator correctly determined that that diagnosis was incorrect. This “trap for the unwary or unsophisticated miner” is precisely the reason why a diagnosis repudiated in a contested adjudication does not trigger the statute of limitations. See id.

. . .

To hold otherwise in this case would mean that Morris’s second claim would be timely if he had initially unsuccessfully sought BLBA benefits but is untimely because he first elected to pursue state workers’ compensation benefits.  Such a difference in result is untenable.

(slip op. at 11–12).

The court’s analysis turned on an interpretation of the phrase “medical determination” in the Black Lung Benefits Act, 30 U.S.C. § 932(f).  The court gave the phrase a broad interpretation to give effect to the statute’s remedial purpose.  The court did not depend on a theory of res judicata (see note 3 of the opinion) and rejected the Board’s theory of judicial estoppel (see note 4 of the opinion).

Dissenting from the majority opinion, Senior Circuit Judge Nygaard provided his view that there is no law providing that a Pennsylvania Workers’ Compensation Administrative Law Judge is competent to rule that a diagnosis of disabling black lung is a misdiagnosis under the Black Lung Benefits Act.  Judge Nygaard reasoned that because the state and federal laws use different standards, a denial in a state claim cannot be conclusive in a federal claim.  (Judge Nygaard agreed with the majority’s use of the canon of statutory interpretation that provides liberal interpretations to remedial statutes and agreed with the majority that the Board’s judicial estoppel reasoning was problematic.)

Analysis

The Third Circuit in Morris reached an eminently sensible approach to an understandably confusing issue affecting coal miners and their families.  To my knowledge, this was an issue of first impression; I am not aware of another case that confronts precisely the issue of whether a state judge’s determination that a miner does not have pneumoconiosis resets the federal statute of limitations.

The court was wise to focus just on the Black Lung Benefits Act’s statute of limitations provision and avoid a res judicata analysis.  By doing so, it simplified the analysis and made sure that the separate legal standards under state and federal laws are respected while also taking into account the reality that most coal miners respect the decisions of both state and federal judges and after being denied black lung benefits by either, will accept that at that time, they are not entitled to federal black lung benefits.

A decision otherwise would have been against equity, comity, and federalism.  It would have not only implied that state judges are often wrong about the facts related to black lung, but also created needless inefficiencies by forcing cautious claimants to file weak federal claims after their state denials just to ensure that they get a federal denial to reset their statute of limitations.

The Third Circuit’s decision in Morris does not apply nationwide, but its sound reasoning should carry considerable weight in cases that present this issue in other circuits.

Mr. Morris was represented by Heath M. Long, Esq. of Pawlowski, Bilonick & Long of Edensburg, PA.

Eighty Four Mining was represented by Norman A. Coliane, Esq. and Paul E. Sutter, Esq. of Thompson, Calkins & Sutter of Pittsburgh, PA.

The Director, OWCP was represented by Helen H. Cox, Esq. and Gary K. Stearman, Esq. of the U.S. Department of Labor’s Solicitor’s Office.

4 Responses to “Third Circuit Holds that State Workers’ Comp. Denial Resets Statute of Limitations for Federal Black Lung Benefits Claim (Eighty Four Mining Co. v. Director, OWCP [Morris])”

  1. Doc Holliday

    Great post Evan. I have a case I think this will help me with.

    Doug Holliday

    Reply
  2. Ryan Leonard

    Evan,

    I have been subscribing to your blog for about a year, and appreciate your analysis tremendously.

    Let me preface this scenario with the fact that I am not a lawyer.

    Based on my, albeit limited, understanding of state black lung benefits, state benefits are typically more lucrative than federal black lung benefits; thus, state claims are usually filed before federal. Also, since Mr. Morris’ state claim was denied in prior to the revival of the “15-year presumption”, I agree with your analysis that Mr. Morris most likely felt, if he filed a claim for federal black lung benefits, it too would be denied.

    Now, given the current legal federal black lung environment, have you seen, or do you anticipate seeing, a change to the mentality that “coal miners respect the decisions of both state and federal judges” and that more claimants are filing federal claims despite a state denial?

    Thanks,
    Ryan Leonard

    Reply
    • Evan B. Smith

      Thanks for the kind words! I don’t think that the amount of respect that coal miners have for judicial decisions has changed. Like everybody, coal miners understand that both the law and a person’s health change over time so a denial is not necessarily the end of the road. I think that most miners who were previously denied in a state claim who are now filing a federal claim are doing so because they believe their breathing has gotten worse, not because they just think that the state judge was wrong and that they would do better in the federal system. What I experience the most are miners who received some Kentucky workers’ compensation benefits based on a diagnosis of pneumoconiosis who get frustrated when they are denied for federal black lung benefits later because they don’t meet the federal disability criteria.

      Reply

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