Joseph P. Connors, Sr. v. Amax Coal Co., Inc.

858 F.2d 1226, 1988 U.S. App. LEXIS 13964, 1988 WL 100823
CourtCourt of Appeals for the Seventh Circuit
DecidedSeptember 21, 1988
Docket88-1120
StatusPublished
Cited by49 cases

This text of 858 F.2d 1226 (Joseph P. Connors, Sr. v. Amax Coal Co., Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Seventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Joseph P. Connors, Sr. v. Amax Coal Co., Inc., 858 F.2d 1226, 1988 U.S. App. LEXIS 13964, 1988 WL 100823 (7th Cir. 1988).

Opinion

CUDAHY, Circuit Judge.

Plaintiffs, trustees of the United Mine Workers of America 1950 Benefit Plan and Trust (the “Plan”), claim to have paid out over $27,000 for black lung related medical expenses of miners who worked for Amax Coal Company, Inc. (“Amax”). The trustees seek reimbursement from Amax alleg *1228 ing that the company is liable for these expenses under the Black Lung Benefits Act (the “BLBA”), 30 U.S.C. §§ 901-945 (1982 & Supp. IV 1986). Amax has refused to pay until the trustees establish that these expenses qualify as black lung related medical services that the company is obligated to reimburse under the applicable regulations. See 20 C.F.R. § 725.701(a)-(c) (1988).

The trustees brought suit in federal district court as subrogees to the miners’ rights against Amax, alleging that the company had been unjustly enriched by the Plan’s payment of the black lung related expenses of the company’s former employees. The district court granted Amax’s motion to dismiss for lack of subject matter jurisdiction, ruling that under the BLBA the trustees could only sue in district court to enforce a final compensation order obtained through prescribed procedures and that the trustees’ attempted invocation of the Employee Retirement and Income Security Act (“ERISA”) and federal common law was insufficient to confer subject matter jurisdiction on the district court. The trustees then brought this appeal. We affirm.

I.

Section 422 of the BLBA, 30 U.S.C. § 932(a) (1982 & Supp. IV 1986), incorporates the claims procedures set forth in the Longshore and Harbor Workers’ Compensation Act (the “LHWCA”), 33 U.S.C. §§ 918-928 (1982 & Supp. IV 1986). The procedures outlined in the LHWCA and in the procedural regulations for the black lung benefits program strictly limit claimants’ access to federal district court. District courts decide disputes over black lung benefits awards only when a claimant sues to enforce “a compensation order making an award, that has become final” — that is, an administrative award that has not been appealed within the required time or with respect to which all appeals have been exhausted. 1 Claims for compensation for black lung related medical expenses are subject to three levels of administrative review: an initial determination by the Deputy Commissioner of the Division of Coal Mine Workers’ Compensation, Office of Workers Compensation Programs, 20 C.F.R. §§ 725.410-.420 (1988); a formal hearing, if requested, before an Administrative Law Judge, id. §§ 725.-421, .456-479; and an appeal, if requested, to the Benefits Review Board, id. § 725.481 & Part 802. Section 21(c) of the LHWCA, 33 U.S.C. § 921(d) (1982), requires exhaustion of this three-step procedure as a prerequisite to judicial review in the courts of appeals. 2

The trustees contend, and Amax does not dispute, that the Deputy Commissioner has found Amax liable for the black lung related medical expenses of the miners named in this action and that these determinations have become final. However, Amax does dispute the trustees’ contention that the company can be sued in federal district court and forced to pay particular medical bills not yet certified under 20 C.F.R. Part 725 as having been incurred in the treatment of black lung disease. Amax points out that section 725.707 of the regulations establishes an administrative process for resolving disputes over whether particular expenses were incurred in the treatment of black lung disease. Section 725.707, like the mechanism for resolving the threshold questions of miner eligibility and company liability, provides for initial action by the Deputy Commissioner to be followed by ALT review, Benefit Review Board review and appeal to the courts of appeals. 20 C.F.R. § 725.481, .707 & Part 802 (1988).

The district court concluded, and we agree, that a claimant, whether a miner or a subrogee to a miner, does not possess a *1229 “compensation order making an award, that has become final” — the ticket to admission to district court under section 921(d) — until that party obtains a final administrative determination resolving any dispute as to whether particular expenses are covered expenses. See Connors v. Amax Coal Co., 674 F.Supp. 22, 23-24 (S.D.Ind.1987); see also Lute v. Split Vein Coal Co., 11 Black Lung Rptr. (MB) 1-82 (Benefit Rev.Bd.1987) (Benefit Review Board holds that due process challenge to liability determination is premature prior to miner’s demand for reimbursement and administrative assessment of particular expenses under section 725.707). The trustees contend that section 725.707 should apply only to individual employers’ claims because disputes arising under this section receive expedited processing by ALJs. Extending this priority treatment to subro-gees, according to the trustees, would delay the processing of more pressing claims by individual miners. The trustees concede that the Department of Labor may “perhaps” possess greater expertise in determining which medical expenses qualify for reimbursement under the regulations, but they suggest that the district courts can reduce their comparative disadvantage by relying on the Department’s published guidelines for classifying medical expenses.

The trustees advocate, in effect, that we construe the jurisdiction of agency adjudicators narrowly to enable district courts to alleviate the agency’s work load, notwithstanding that the determinations at issue involve the application of detailed administrative guidelines in a highly technical area. This approach is unsupported by common sense, the language of section 725.707 or, insofar as we have been able to determine, by any judicial or administrative construction of the black lung benefits regulations. Even the trustees’ professed concern about delaying individual miners’ claims is unpersuasive. 3 We therefore affirm the district court’s conclusion that subrogees to the rights of miners against responsible operators under the BLBA may not sue in district court to resolve disputes over whether particular medical bills were incurred in the treatment of black lung disease.

II.

The trustees also argue that the district court had subject matter jurisdiction because the complaint states claims “arising under” federal law within the meaning of 28 U.S.C. section 1331.

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Bluebook (online)
858 F.2d 1226, 1988 U.S. App. LEXIS 13964, 1988 WL 100823, Counsel Stack Legal Research, https://law.counselstack.com/opinion/joseph-p-connors-sr-v-amax-coal-co-inc-ca7-1988.