Jesse Adams v. Director, Owcp

886 F.2d 818, 1989 U.S. App. LEXIS 15163, 1989 WL 111548
CourtCourt of Appeals for the Sixth Circuit
DecidedSeptember 29, 1989
Docket88-3946
StatusPublished
Cited by140 cases

This text of 886 F.2d 818 (Jesse Adams v. Director, Owcp) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Jesse Adams v. Director, Owcp, 886 F.2d 818, 1989 U.S. App. LEXIS 15163, 1989 WL 111548 (6th Cir. 1989).

Opinion

CELEBREZZE, Senior Circuit Judge.

Claimant Jesse Adams petitions this court to review a final order of the Benefits Review Board (BRB or Board) denying his claim for benefits under the Black Lung Benefits Act (Act), 30 U.S.C. §§ 901-945 (1982). 1 Claimant Adams argues that the BRB erred in requiring him to prove that his pneumoconiosis “in and of itself” or “standing alone” caused his totally disabling respiratory or pulmonary impairment. We agree with Adams that application of the Board’s standard to a claim such as his, in which the miner has established the existence of employment-related pneumoconiosis and a totally disabling respiratory impairment, is an unduly restrictive reading of the statutory and regulatory language “total disability due to pneumoconiosis” and is thus inconsistent with the beneficial purposes of the Act. Accordingly, we grant the petition for review and reverse the BRB’s order.

Adams filed the instant claim for benefits on July 9, 1982. 2 A hearing was held before an Administrative Law Judge (ALJ) on March 7, 1985. The record discloses that Adams was a miner in underground coal mines for twelve years and two and one-half months between 1943 and 1961. From 1962 until 1969, Adams was employed as a mechanic and a welder in a stone quarry, and between 1969 and 1979, he was self-employed as a mechanic and welder. In both of these non-mining occupations, Adams was exposed to noxious arc-welding fumes. In addition, Adams had a long-standing habit of cigarette smoking.

Mr. Adams' respiratory problems first surfaced in 1972. The evidence heard by the AU indicated that Adams’ respiratory disease had worsened since its onset. Adams would become short of breath upon exertion, and he suffered from morning cough. Adams was also afflicted with heart problems and an ulcerated stomach, both of which had resulted in hospital stays and surgery.

Although the medical evidence presented to the AU was to a certain extent conflicting, Adams clearly established by x-ray that pneumoconiosis had invaded his lungs, see 20 C.F.R. § 718.202(a)(1), and the Director has accordingly conceded the existence of the disease. Because Adams suffered from pneumoconiosis and had more than ten years of coal mine employment, he was also entitled to the presumption that his pneumoconiosis arose out of his coal mine employment. See id. § 718.203(b). This presumption went unrebutted. 3 In addition, the AU found that the qualifying results of a pulmonary function test established that Adams suffered from a totally disabling respiratory or pulmonary impairment. See id. § 718.204(c)(1).

Despite the confluence of these facts establishing a totally disabling lung disease *820 and pneumoconiosis arising from coal mine employment, the ALJ denied benefits under the Act. Assessing the medical opinions of record, the AU concluded that Adams had failed to establish the requisite causal link between his pneumoconiosis and his total disability: “The record contains no medical evidence that affirmatively establishes that Claimant’s total disability was due to pneu-moconiosis standing alone ” (emphasis added). On appeal, the BRB held that its prior decision in Wilburn v. Director, OWCP, 11 Black Lung Rep. 1-135 (B.R.B. 1988), dictated that the claimant must prove his pneumoconiosis was “in and of itself” totally disabling. The Board concluded that the ALJ’s “standing alone” formulation was equivalent to the “in and of itself” standard, and upon finding the ALJ’s conclusion supported by substantial evidence, the BRB affirmed. This timely petition for review ensued.

Since Adams’ claim was filed after March 31, 1980, it was properly evaluated by the ALJ and the BRB under the Secretary of Labor’s permanent regulations found at 20 C.F.R. Part 718. See Tennessee Consolidated Coal Co. v. Crisp, 866 F.2d 179 (6th Cir.1989); 20 C.F.R. § 718.2. Under Part 718, the miner must prove three facts in order to receive Black Lung Benefits: (1) that he suffers from pneumoconiosis; (2) that his pneumoconiosis arose at least in part out of his coal mine employment; and (3) that he is totally disabled by pneumoconiosis. See Director, OWCP v. Mangifest, 826 F.2d 1318, 1320 (3d Cir.1987); 20 C.F.R. §§ 718.2, 718.202, 718.203, 718.204; see also Strike v. Director, OWCP, 817 F.2d 395, 399 (7th Cir.1987). The claimant bears the burden of proving each of these elements of his claim by a preponderance of the evidence, except insofar as he is aided by a presumption. See 20 C.F.R. § 718.403; Mangifest, 826 F.2d at 1320; see also 20 C.F.R. §§ 718.203(b), 718.302-.306 (presumptions).

In the instant claim, it is undisputed that Adams has pneumoconiosis, id. § 718.202(a)(1), that his pneumoconiosis arose from his twelve years of coal mine employment, id. § 718.203, and that he suffers from a totally disabling respiratory impairment, id. § 718.204(c). The only issue in dispute on this petition to review, therefore, is whether Adams is totally disabled “due to” pneumoconiosis. More specifically, the narrow question presented concerns the degree of causation necessary when the claimant has established his pneumoconiosis by x-ray (but has been unable to invoke the irrebuttable presumption of section 718.304) and has also shown the existence of a totally disabling respiratory disease by medical evidence under section 718.204(c) (but has not qualified for the rebuttable presumption in section 718.305 because of less than fifteen years coal mine employment).

This inquiry is mandated by the statutory requirement that the miner is entitled to benefits only if he is “totally disabled due to pneumoconiosis.” 30 U.S.C. 901(a). This requirement is reiterated in the specific regulatory language under review:

Except as provided in § 718.305, proof that the miner suffers or suffered from a totally disabling respiratory impairment as defined in paragraphs (c)(1), (2), (4) and (5) of this section shall not, by itself, be sufficient to establish that the miner’s impairment is or was

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Bluebook (online)
886 F.2d 818, 1989 U.S. App. LEXIS 15163, 1989 WL 111548, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jesse-adams-v-director-owcp-ca6-1989.