Consol of Ky., Inc. v. Allen Madden

Court of Appeals for the Sixth Circuit·Decided October 5, 2020·No. 19-4089·Unpublished

Opinion

NOT RECOMMENDED FOR PUBLICATION File Name: 20a0565n.06

No. 19-4089

UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT

CONSOL OF KENTUCKY, INC., ) FILED ) Oct 05, 2020 Petitioner, ) DEBORAH S. HUNT, Clerk )

v. )

) ON PETITION FOR REVIEW ALLEN R. MADDEN; and DIRECTOR, OFFICE ) FROM THE BENEFITS OF WORKERS’ COMPENSATION PROGRAMS, ) REVIEW BOARD UNITED STATES DEPARTMENT OF LABOR, )

)

Respondents. )

BEFORE: SUHRHEINRICH, LARSEN, and READLER, Circuit Judges.

SUHRHEINRICH, Circuit Judge. Allen R. Madden was awarded black lung benefits under the Black Lung Benefits Act, 30 U.S.C. §§ 901–944 (“Act”) upon his third try.1 His employer, Consol of Kentucky (Consol), petitions this court for review, claiming that liability should be transferred to the Director, Office of Workers’ Compensation Programs (“Director” and “OWCP”) because the Director’s procedural failings deprived Consol of its due process rights. Alternatively, Consol urges that we deem Madden’s third claim untimely. Lastly, Consol asserts that the administrative law judge’s finding that it failed to rebut the presumption of clinical pneumoconiosis is not supported by substantial evidence. For the following reasons we deny the petition for review.

1 Because pneumoconiosis is a “latent and progressive disease,” Cumberland River Coal Co. v. Banks, 690 F.3d 477, 482 (6th Cir. 2012), the Act allows a claimant to file a “subsequent claim” more than one year after a prior denial if he “demonstrates that one of the applicable conditions of entitlement . . . has changed.” 20 C.F.R. § 725.309(c).

I. Background

This appeal involves a long and winding road to black lung benefits for Madden. Because the parties are undoubtedly well aware of the facts, procedural history, and pertinent rules and regulations that line the path to resolution in this matter, we have endeavored to streamline our discussion with that in mind and provide only those details necessary to resolve the issues properly before us.

A. Facts

Madden worked as a miner for twenty–two years, mostly underground. He quit working in 1999 after injuring his back. He was employed by Consol at the time. Madden has also been a very heavy smoker for most of his life. It is undisputed at this juncture that Madden has a totally disabling respiratory impairment.

B. Procedural History

The 2002 Claim. Madden filed his first claim for black lung benefits on December 9, 2002.

On November 24, 2003, the Director denied it. This claim was deemed abandoned on February 3, 2004.

The 2005 Claim. Madden filed a second claim for benefits on February 5, 2005. After a hearing, ALJ Bergstrom issued an order denying benefits on September 27, 2007. ALJ Bergstrom concluded that Madden failed to establish the existence of pneumoconiosis or a totally disabling pulmonary disability. In so doing, ALJ Bergstrom considered and rejected the medical opinion of the Director’s physician, Dr. Rasmussen, who diagnosed Madden with total disability based on both clinical and legal pneumoconiosis due to cigarette smoking and coal mine dust exposure 2 in favor of Consol’s experts, Drs. Jarboe and Repsher, who found no evidence of clinical or legal

2 ALJ Bergstrom’s decision stated that Dr. Rasmussen examined Madden on April 27, 2005, January 19, 2006, and September 21, 2006.

pneumoconiosis or any other pulmonary disease aggravated by exposure to coal mine dust. Both felt that Madden’s breathing problems were due to cigarette smoking. Madden did not appeal this decision and it became final thirty days after it was filed. See 20 C.F.R. §§ 725.478; 725.479.

Modification Request. On April 3, 2008, Madden filed a request for modification of the denial of benefits. See 33 U.S.C. § 725.310. In conjunction with his modification request, Madden was seen a fourth time by Dr. Rasmussen, and also by a Dr. Baker, who diagnosed Madden as having both clinical and legal pneumoconiosis caused by his employment that was not yet totally disabling. Despite this evidence (or perhaps because of it), Madden failed to provide any evidence to process the claim and on September 12, 2008, the Director proposed denying the modification request “by reason of abandonment.” Madden moved for a formal hearing on the Director’s denial of that request, but on November 4, 2009, changed course and filed a “Motion for Withdrawal of Request For Hearing and Claim” “because the Claimant does not currently meet the disability standards as promulgated under the Act.” On November 5, 2008, ALJ Timlin granted Madden’s motion to withdraw his request for a hearing and administratively closed the claim.

The 2012 Claim. Madden filed his third, and present, claim for benefits on May 21, 2012.

On January 25, 2013, the Director issued a proposed decision and order awarding benefits. Consol requested a hearing before the Department of Labor’s Office of Administrative Law Judges, which was conducted by ALJ Clark on August 26, 2015.

Significantly, the Director failed in its duty to provide the 2005 claim file and the accompanying medical records to the ALJ. See 20 C.F.R. § 725.309(c)(2); Id. § 725.421(b)(4). Prior claim files are required because a subsequent claim “must be denied unless the claimant demonstrates that one of the applicable conditions of entitlement . . . has changed,” 20 C.F.R. § 725.309(c), which is done by assessing “both new and old” evidence, Arkansas Coals, Inc. v.

Lawson, 739 F.3d 309, 314 (6th Cir. 2014). According to Consol, it is this “failure to timely supply all relevant materials [that] has caused the controversy presented on appeal.” None of the records or evidence associated with the 2008 claim were included either.

At the hearing Madden testified that he had been examined by Dr. Rasmussen four times and told each time that he was disabled by black lung disease. Madden initially stated that the evaluations occurred in 2001 or 2002, but on redirect examination said that he could not remember the dates. Mrs. Madden confirmed Madden’s account. She thought that Dr. Rasmussen first examined Madden in 2004, and then in 2006 and 2007. Mrs. Madden also stated that when Madden filed for modification in 2008, his attorney sent him back to Dr. Rasmussen and also to Dr. Baker for examination.

The Maddens’ testimony prompted Consol to move for summary decision. Consol contended that Madden’s 2012 application was untimely because (1) Dr. Rasmussen3 had assessed and informed Madden that he was totally disabled due to pneumoconiosis more than three years before he filed his 2012 claim, see 30 U.S.C. § 932(f); 20 C.F.R. § 725.308(a) (requiring a miner to file his application “within three years” of receiving “a medical determination of total disability due to pneumoconiosis”); and (2) Madden’s withdrawal of his request for modification of ALJ Bergstrom’s decision meant that the underlying claim was also withdrawn and therefore treated as if never filed. See 20 C.F.R. § 725.306(b) (stating that a previously filed claim that has been withdrawn “will be considered not to have been filed”).

ALJ Clark denied Consol’s request on December 22, 2015. He reasoned that Madden’s fully adjudicated 2005 claim could not have been withdrawn because it was subject to the final

3 Consol did not rely on Dr. Baker’s diagnosis, presumably because “Dr. Baker did not tell Mr. and Mrs. Madden anything about the results.” Thus, Dr. Baker’s diagnosis could not trigger the running of the statute of limitations clock. See 20 C.F.R. § 725.308(a).

decision of ALJ Bergstrom issued on September 27, 2007. Next, because ALJ Bergstrom considered and rejected Dr. Rasmussen’s opinions, they were deemed misdiagnoses or nondiagnoses with no legal effect (i.e., they did not trigger the statute of limitations). Furthermore, ALJ Timlin’s order granting Madden’s voluntary withdrawal request could only extend to Madden’s request for a modification hearing, and not the fully adjudicated 2005 claim, because ALJs do not have authority to grant withdrawal of a claim after a decision on the merits.

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