Myrtle Clark v. Director, Office of Workers' Compensation Programs, United States Department of Labor

838 F.2d 197, 1988 U.S. App. LEXIS 1453, 1988 WL 6856
CourtCourt of Appeals for the Sixth Circuit
DecidedFebruary 5, 1988
Docket86-3786
StatusPublished
Cited by11 cases

This text of 838 F.2d 197 (Myrtle Clark v. Director, Office of Workers' Compensation Programs, United States Department of Labor) 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
Myrtle Clark v. Director, Office of Workers' Compensation Programs, United States Department of Labor, 838 F.2d 197, 1988 U.S. App. LEXIS 1453, 1988 WL 6856 (6th Cir. 1988).

Opinion

PER CURIAM.

Mrs. Myrtle Clark, the widow of a coal miner, petitions this court for review of a decision in which the Benefits Review Board held (1) that Mrs. Clark had abandoned her initial claim for death benefits, and (2) that the Administrative Law Judge erred in awarding such benefits to Mrs. Clark after considering her second claim therefor. We shall affirm the Board’s decision on the abandonment issue, but reverse it insofar as Mrs. Clark’s second claim for benefits was denied.

I

The decedent, Kenneth Clark, worked in the coal mines for nine and three-quarter years before he died in 1972 at the age of 47. Mrs. Clark filed a claim for black lung benefits on August 23, 1973. The Social Security Administration (SSA) denied the claim, finding no evidence that Mr. Clark had suffered from pneumoconiosis.

After being told that she was entitled to further review under the Black Lung Benefits Reform Act of 1977, Mrs. Clark opted to have her application reviewed by SSA. That agency again denied her claim, and the file was then transferred to the Department of Labor for review. On August 29, 1980, the Department of Labor denied benefits for lack of evidence. Mrs. Clark took no further action on this claim.

On March 22, 1982, Mrs. Clark filed a second application for benefits. Treating the application as a new claim, rather than as an attempt to have the old claim reconsidered, the Department of Labor ruled against Mrs. Clark on September 14, 1982. She requested a hearing before an administrative law judge, and such a hearing was held on January 24, 1985. Because Mr. Clark's medical records had been destroyed in a fire, there had been little evidence for the agencies to work with up until this point. Prior to the hearing, however, Mr. Clark’s body was exhumed and his lungs were removed. The lungs were examined by Dr. William Roberts. From this examination, Dr. Roberts determined that

“[t]he pattern of scarring and pigment deposition within these lungs indicates with reasonable medical certainty that Kenneth Clark suffered from simple coal worker’s pneumoconiosis, commonly referred to as black lung, at the time of his death. The patient’s cause of death as set forth in the death certificate is acute myocardial infarction of seven days duration. The condition of a patient with myocardial infarction would be worsened by pneumoconiosis and I therefore conclude that Mr. Clark’s pneumoconiosis contributed to his death.”

Dr. Roberts was the only doctor to look at the lungs of Mr. Clark in their entirety, but another physician, Dr. Naeye, examined eighteen photographs of the lungs and six glass slides containing specimens of the lung tissue. Although Dr. Naeye observed some “black pigment,” he also found that the pigment was not accompanied by fibrous tissue or small crystals and observed that there was no focal emphysema. Dr. Naeye determined that Mr. Clark did not suffer from pneumoconiosis.

The AU gave greater weight to the report of Dr. Roberts, because Dr. Roberts had examined the lungs themselves in addition to looking at the photographs and glass slides that Dr. Naeye examined. Based on the report of Dr. Roberts, the AU found that Mr. Clark had pneumoconi-osis which contributed to his death.

The Director appealed this decision to the Benefits Review Board, and Mrs. Clark filed a cross-appeal challenging a determination by the AU that she had abandoned her initial claim. The Benefits Review Board affirmed the AU as to the abandonment issue, but reversed the award of benefits on the basis of a regulation (20 C.F.R. § 725.309(c)) not cited by either party.

*199 CLARK v. DIRECTOR, O.W.C.P., U.S. DEPT. OF LABOR Cite as 838 F.2d 197 (6th Clr. 1988)

II

Mrs. Clark grounds her claim of nonabandonment on what she sees as the interplay between two regulations. If these two regulations are read as Mrs. Clark would have us read them, the agency would have been required to send her official notice that her claim was on its way to being considered abandoned before any such abandonment could be deemed to have occurred. More specifically, Mrs. Clark argues that the procedural requirements of 20 C.F.R. § 725.409(b) are incorporated into § 725.410(c)(1) by the parenthetical at the end of the latter provision.

The pertinent regulations read as follows:

“§ 725.410 Initial findings by the deputy commissioner.
* * * # # *
(c) If the evidence submitted does not support an initial finding of eligibility, the deputy commissioner shall so notify the claimant in writing. This notification shall specify the reasons why the claim cannot be approved, the additional evidence necessary to establish entitlement, the right of the claimant to submit additional evidence, and the right to request a hearing. Within 60 days from the mailing of such notice, unless such period is extended by the deputy commissioner for good cause shown, the claimant may submit new evidence or request a hearing. If the claimant:
(1) Takes no action within the specified 60 day period, the claim shall be considered denied by reason of abandonment (see § 725.409).”
“§ 725.409 Denial of a claim by reason of abandonment.
(a) A claim may be denied at any time by the deputy commissioner by reason of abandonment where the claimant fails:
(1) To undergo a required medical examination without good cause; or,
(2) To submit evidence sufficient to make a determination of the claim; or,
(3) To pursue the claim with reasonable diligence.
(b) If the deputy commissioner determines that a denial by reason of abandonment is appropriate, he or she shall notify the claimant of the reasons for such denial and of the action which must be taken to avoid a denial by reason of abandonment. If there is no response to the notice within 30 days after such notice is sent, the claim shall be considered denied by reason of abandonment. If the claimant responds in a timely fashion, indicating a desire to pursue the claim, by requesting a hearing or indicating the intent to submit additional evidence, the deputy commissioner shall, if a hearing is requested, proceed in accordance with § 725.412 or allow a reasonable time of not less than 60 days for the claimant to take the specified remedial action. If the claimant completes the action requested within the time allowed, the claim shall be developed, processed and adjudicated as specified in this part. If the claimant does not fully comply with the action requested by the deputy commissioner, the deputy commissioner shall so notify the claimant. If the claimant does not request a hearing or fully comply with the action requested by the deputy commissioner within 30 days of such notification, the claim shall be considered denied by reason of abandonment, except that a new claim may be filed at any time and new evidence submitted where the requirements of § 725.310 are not met.” (Emphasis supplied.)

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838 F.2d 197, 1988 U.S. App. LEXIS 1453, 1988 WL 6856, Counsel Stack Legal Research, https://law.counselstack.com/opinion/myrtle-clark-v-director-office-of-workers-compensation-programs-united-ca6-1988.