Today the U.S. Court of Appeals for the Sixth Circuit affirmed a Kentucky coal miner’s award of federal black lung benefits via an unpublished decision.
Lance Coal Corp./Golden Oak Mining Co. v. Caudill (slip op. here) held that the ALJ provided rational reasons for (1) crediting the opinions of two doctors who considered Phillip Caudill to be disabled over two doctors hired by Lance Coal who disagreed, and (2) finding that Lance Coal failed to meet its burden to rebut the presumption that Mr. Caudill’s disability was caused by coal-mine employment.
Caudill stands out for clarifying that an ALJ may credit a physician’s opinion on disability even if the opinion does not take into account later-developed evidence.
As an unpublished decision that focused on the ALJ’s weighing of the specific facts in Mr. Caudill’s case, today’s decision has limited precedential weight, but the decision is helpful for black lung practitioners. Caudill not only clarifies that an ALJ can still credit a well-reasoned physician’s opinion even if subsequent evidence calls the opinion into question, but also provides helpful definitions of medical jargon related to black lung and serves as a further example of the difficulty that coal companies currently have in overturning awards of federal black lung benefits before the U.S. Courts of Appeals.
Phillip W. Caudill is a Kentucky coal miner who was given credit for 17.75 years of coal-mine employment, of which approximately 3 years was underground and the rest was on surface mines. As the court explained, the ALJ found that while working on the surface mines, Mr. Caudill was exposed to dust conditions that were substantially similar to underground conditions “due to the (1) proximity of the surface operations to the underground mines, (2) lack of breathing protection, including respirators, (3) lack of dust control, including water to spray down dust on the roads, and (4) use of vehicles with open rather than closed cabs.” (slip op. at 9)
Although Mr. Caudill’s pulmonary function tests, arterial blood gas tests, and EKG did not qualify him as disabled from a respiratory perspective, two physicians—Dr. Katie DeFore and Dr. Ronald Klayton—considered him disabled while two other physicians—Dr. Gregory Fino and James Castle (who were both hired by Lance Coal)—did not consider Mr. Caudill disabled. Similarly, although Drs. Fino and Castle did not consider Mr. Caudill’s respiratory impairment to be related to his coal-mine employment, Drs. DeFore and Klayton did (i.e., they diagnosed him with “legal pneumoconiosis” even though is x-rays were generally negative).
The sequence that the physicians evaluated Mr. Caudill and provided opinions was important:
- March 2010 Dr. DeFore performed the Department of Labor’s evaluation
- August 2010, Dr. Fino performed his evaluation for Lance Coal
- September 2011, Dr. Klayton perfomed his evaluation for Mr. Caudill
- November 2011, Dr. Castle performed his evaluation and record review for Lance Coal
- January 2012, Dr. Castle’s deposition by Lance Coal
- January 2012, Dr. Fino’s deposition by Lance Coal
On August 29, 2013, the ALJ (Judge Silvain) awarded benefits to Mr. Caudill. (ALJ decision here).
On August 27, 2014, the Benefits Review Board affirmed the ALJ’s award. (BRB decision here)
Sixth Circuit Opinion
Before the Sixth Circuit, Lance Coal argued that the ALJ’s decision was improper because the ALJ violated the Administrative Procedure Act in failing to address the fact that Dr. DeFore’s and Dr. Klayton’s opinions did not address the subsequent evidence generated by Drs. Fino and Castle.
The Sixth Circuit’s opinion (written by Judge Clay and joined by Judges Norris and Cook) rejected this argument for 3 reasons:
- Requiring an ALJ to give less weight to medical opinions that do not account for later-developed evidence fails to account for the Black Lung Benefits Act’s requirement that “all relevant evidence” be considered. 30 U.S.C. § 923(b) (emphasis in court’s opinion).
- A legal rule imposed by an appellate court requiring ALJs to give more weight to medical opinions that contain later evidence would improperly intrude on the ALJ’s role to determine the credibility of the witnesses in an individual case.
- Further, such a rule would be unworkable and unfair against a miner because coal companies tend to develop evidence later due to the process through which evidence is developed (e.g., the Department of Labor’s exam is almost always first) as well as coal companies’ financial ability to go back to doctors and seek supplemental opinions.
The court expanded on the third, policy-based reason, stating that a rule that preferred later evidence
would significantly weaken a miner’s ability to rely on a DOL-sponsored examination to support his claim for benefits and thereby increase the likelihood that he would have to rely on later examinations paid for out-of-pocket in order to assure that his physician’s examination accounted for the evidence produced by any subsequent employer-sponsored examinations.
In the same vein, such a scheme would likely tip the scales in black lung benefits cases in favor of employers because of their greater financial ability to engage in a medical opinions arm’s race, trumping each medical opinion procured by the miner with a later, more comprehensive opinion by a physician of the employer’s choosing.
(slip op. at 19–20).
The Sixth Circuit also rejected Lance Coal’s argument that the ALJ’s opinion was not supported by substantial evidence.
The Sixth Circuit held that the ALJ provided rational reasons for crediting the opinions for Drs. DeFore and Klayton. (In specific, even though Mr. Caudill’s testing did not meet the DOL disability criteria, their opinions “noted that Caudill had hypoxemia, a low FEV1 value, an abnormal physiological response to exercise, mild restrictive lung disease, and a diminished ability to lift heavy objects, clearly explained why Caudill’s legal pneumoconiosis prevented him from returning to his former, heavy exertion coal mine employment.” (slip op. at 23))
The court also held that the ALJ provided rational reasons for concluding that Lance Coal did not rule out any connection between Mr. Caudill’s 17.75 years of coal-mine employment and his respiratory disability. In specific, the fact that Mr. Caudill’s PFT values improved somewhat over time did not account for the permanent respiratory problems Mr. Caudill faced. In addition, the court reiterated that Dr. Fino’s emphasis on the 17-year gap between the end of Mr. Caudill’s coal-mine employment and the onset of his shortness of breath “directly conflicts with the regulations’ recognition of pneumoconiosis as a ‘latent and progressive disease which may first become detectable only after the cessation of coal mine dust exposure.‘” (slip op. at 25 (quoting 20 C.F.R. § 718.201(c))).
Accordingly, the court affirmed Mr. Caudill’s award of benefits.
The Sixth Circuit’s decision in Caudill is mostly notable for its analysis of the issues related to the chronology of medical evidence in black lung claims. The court held that chronology alone is not a per se reason to prefer a later medical opinion and also recognized that realistic reasons that coal miners may rely on older evidence than coal companies in black lung claims.
The opinion also clearly and thoroughly explained the “light-touch” approach that the court takes in reviewing the ALJ’s credibility determinations.
And although not a part of the court’s explicit analysis, the court’s opinion incorporated about ten definitions of medical terms such as “dyspnea” and “hypercarbia” from Dorland’s Illustrated Medical Dictionary. Although one should be cautious when relying on judicial opinions for medical facts, attorneys often like to define words by referring to court opinions that incorporate definitions of the words as a way to show that a given definition has been relied on by previous judges.
On a further factual level, the case could also be worth citing for aspects of its fact pattern. The case stands as a clear example of a surface miner with borderline medical testing regarding disability and negative x-rays who was able to receive an award that is supported by law. A case like Mr. Caudill’s can be difficult to win before an ALJ and people representing miners like Mr. Caudill may benefit from comparing their facts to Mr. Caudill’s.
Caudill should be a useful opinion to cite even though it does not change the state of black lung law.
Phillip W. Caudill was represented by Joseph E. Wolfe, Mary Rachel Barnhill, and Andrew Delph of Wolfe, Williams & Reynolds
Lance Coal Corp./Golden Oak Mining Co. was represented by Jeffrey Robert Soukup, Kathy Lynn Snyder, Kevin Thomas Gillen, and Waseem Karim of Jackson Kelly, PLLC.
The Director, OWCP was represented by MacKenzie Fillow, Gary K. Stearman, and Willow Fort of the Department of Labor’s Solicitor’s Office.