Apogee Coal Company v. OWCP

113 F.4th 751
Court of Appeals for the Seventh Circuit·Decided August 19, 2024·No. 23-2521·Published·Cited by 4 cases

Opinion

In the

United States Court of Appeals For the Seventh Circuit

No. 23-2521 APOGEE COAL COMPANY, et al., Petitioners,

v.

OFFICE OF WORKERS’ COMPENSATION PROGRAMS, Respondent.

Petition for Review of an Order of the Benefits Review Board.

No. 22-0262 BLA

ARGUED MAY 13, 2024 — DECIDED AUGUST 19, 2024

Before SCUDDER, ST. EVE, and PRYOR, Circuit Judges. SCUDDER, Circuit Judge. Harold Grimes developed black lung disease after 34 years of working in coal mines. He died of lung cancer in 2018. It is undisputed that Grimes’s spouse, Susan, is eligible for survivor’s benefits under the Black Lung Benefits Act. This appeal requires us to decide who must pay those benefits. A Department of Labor administrative law judge assigned financial responsibility to Apogee Coal Company —Grimes’s last employer—and the Benefits Review 2 No. 23-2521

Board affirmed. Central to both decisions was the conclusion that Arch Resources Inc.—Apogee’s former parent corporation —bore responsibility for paying the benefits on Apogee’s behalf. Arch disagrees and insists that Mrs. Grimes’s benefits must instead come from the Black Lung Disability Trust Fund. On the record before us, we agree with Arch. Neither the ALJ nor the Board has identified any provision (or combination of provisions) in the Act or its implementing regulations that justify holding Arch liable for the benefits obligations of Apogee. So we grant Arch’s petition for review, vacate the Board’s decision, and remand with instructions that Mrs. Grimes’s benefits be assigned to the Trust Fund.

I

A

The Black Lung Benefits Act provides disability benefits to miners “totally disabled” due to black lung disease. See Pittston Coal Grp. v. Sebben, 488 U.S. 105, 108 (1988); see also 30 U.S.C. §§ 901(a), 922(a), 932(c). It does so largely at the expense of the mining industry itself. Whenever possible, the statute assigns financial responsibility for a miner’s benefits to one of the coal mine operators in whose service the miner developed black lung disease. See Old Ben Coal Co. v. Luker, 826 F.2d 688, 693 (7th Cir. 1987); see also 30 U.S.C. § 932(c); 20 C.F.R. § 725.495(a)(1). When no such entity is capable of paying , the cost of benefits falls to the Black Lung Disability Trust Fund, see 26 U.S.C. § 9501(d)(1)(B), which is jointly administered by the Secretary of the Treasury, the Secretary of Labor, and the Secretary of Health and Human Services, see id. § 9501(a)(2), and funded by an excise tax on coal, see id. §§ 9501(b)(1), 4121(a)(1).

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The Department of Labor adjudicates benefits claims under the Act. See 30 U.S.C. § 932a; see also U.S. Dep’t of Labor v. Triplett, 494 U.S. 715, 717 (1990) (describing administrative scheme). The Department’s Division of Coal Mine Workers’ Compensation performs this work in field offices across the nation. 30 U.S.C. § 903(a); see also DCMWC Offices and Leadership , https://www.dol.gov/agencies/owcp/dcmwc/districtoffices , archived at [perma.cc/8EVQ-CETS].

The processing of black lung claims occurs in three stages.

The district director for the field office that received the claim undertakes the initial review, including by examining the applicant ’s employment history, see 20 C.F.R. § 725.404(a), and notifying those coal mine operators, if any, that are potentially responsible for paying benefits under the statute. See id. § 725.407(a)–(b); see also Rockwood Cas. Ins. Co. v. Director, Off. of Workers’ Compensation Programs, 917 F.3d 1198, 1205–06 (10th Cir. 2019) (discussing notification process). Absent the requisite notice, liability for benefits obligations cannot be imposed on a coal mine operator. See 20 C.F.R. § 725.360(a)(3). In addition to fulfilling these threshold functions, district directors have substantial authority to gather evidence, see id. § 725.404, develop the medical record, see id. § 725.414, and hear argument from interested parties, see id. §§ 725.408(a)(2), 725.412(a)(1), 725.416(a).

The work of the district director culminates in the issuance of a decisional document called a preliminary decision and order (or PDO for short) that “resolve[s] [the] claim on the basis of the evidence submitted to or obtained by the district director .” Id. § 725.418(a). In any case in which the district director awards benefits, it must designate the coal mine operator, if any, that the Act and its implementing regulations make 4 No. 23-2521

liable for the miner’s benefits. See id. § 725.418(d). Absent such a designation, the district director must assign the claim and attendant payment obligation to the Trust Fund. See 26 U.S.C. § 9501(d)(1)(B).

The Act and its regulations establish a two-step procedure for determining which employer, if any, is liable for awarded benefits. A district director first identifies each of the miner’s previous employers that qualify as a so-called potentially liable operator under five criteria enumerated in 20 C.F.R. § 725.494(a)–(e). Only the fifth of these criteria is contested in this appeal—that “[t]he operator [be] capable of assuming [] liability for the payment of continuing benefits ….” Id. § 725.494(e). After identifying the pool of potentially liable operators, the district director must then select a single responsible operator according to the formula prescribed by a neighboring regulation, § 725.495. As a general rule, that regulation makes liable “the potentially liable operator … that most recently employed the miner.” Id. § 725.495(a)(1).

Parties dissatisfied with a district director’s PDO may seek referral to an ALJ for a formal hearing to resolve any contested issue. See id. §§ 725.450, 725.451. In most respects, the district director’s findings do not bind the ALJ. The ALJ may not, however, revisit the district director’s decision to designate a particular employer as the financially liable operator under the Act’s liability rules. See Rockwood Cas. Ins. Co., 917 F.3d at 1215. If the ALJ determines that the district director designated the wrong entity, “a new responsible operator may not be named.” Id. The benefits are instead paid out of the Trust Fund. See Regulations Implementing the Federal Coal Mine Health and Safety Act of 1969, as Amended, 65 Fed. Reg. 79990 (Dec. 20, 2000) (“In the event the responsible

No. 23-2521 5

operator designated by the district director is adjudicated not liable for a claim, the Black Lung Disability Trust Fund will pay any benefit award.”).

A party that disagrees with an ALJ’s decision may challenge it before the Benefits Review Board. See 33 U.S.C. § 921(b); 20 C.F.R. § 802.205(a). The Board’s authority is strictly appellate—it may not “engage in a de novo proceeding or unrestricted review of a case brought before it.” 20 C.F.R. § 802.301(a). Board decisions may be appealed to the court of appeals “for the circuit in which the [claimant’s] injury occurred .” 33 U.S.C. § 921(c).

B

To ensure that potentially liable operators have the financial ability to pay benefits, Congress has mandated that all operators either acquire a commercial insurance policy covering their black lung liability or receive the Department of Labor’s approval to self-insure. See 30 U.S.C. § 933(a); 20 C.F.R. § 726.1; see also Lovilia Coal Co. v. Williams, 143 F.3d 317, 319– 20 (7th Cir. 1998) (explaining that operators that fail to do one or the other “may be punished by civil penalty”).

The self-insurance option permits an operator to satisfy its financial obligations under the Act by demonstrating to the Department’s satisfaction that it has sufficient resources to forgo the procurement of commercial insurance coverage.

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Apogee Coal Company v. OWCP, 113 F.4th 751 (7th Cir. 2024).

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