Peabody Coal Co. v. Director, Office of Workers' Compensation Programs

48 F. App'x 140
CourtCourt of Appeals for the Sixth Circuit
DecidedOctober 2, 2002
DocketNo. 01-3043
StatusPublished
Cited by12 cases

This text of 48 F. App'x 140 (Peabody Coal Co. v. Director, Office of Workers' Compensation Programs) 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
Peabody Coal Co. v. Director, Office of Workers' Compensation Programs, 48 F. App'x 140 (6th Cir. 2002).

Opinion

PER CURIAM.

Petitioners Peabody Coal Company and Old Republic Insurance Company (collectively “Peabody”) appeal from the decision of the Benefits Review Board (“the Board”) affirming the Administrative Law Judge’s (“ALJ”) award of benefits under the Black Lung Benefits Act, 30 U.S.C. §§ 901-945 (“the Act”), to Respondent Carol W. Dukes.

I. Introduction

Peabody raises two issues on appeal. First, it claims Dukes should be denied black lung benefits because his claim, as a subsequent claim, was not timely filed pursuant to the three-year statute of limitations in 30 U.S.C. § 932(f). Second, it asserts that, even if Dukes’s claim was timely, no benefits should be awarded because Dukes did not present evidence of a material change in his condition since the dismissal of his earlier claim, as required by Sharondale v. Ross, 42 F.3d 993 (6th Cir.1994), and his subsequent claim is therefore barred by res judicata.

Dukes and the Director of the Office of Worker’s Compensation Programs (the “Director”) respond1 and Dukes asserts his second claim was timely2 because, although the subsequent claim was filed outside the statute of limitations, he had filed an initial claim for benefits with the Department of Labor within the statute of limitations period, and that is all § 932(f) requires. Moreover, both Dukes and the Director argue that Dukes has necessarily exhibited a material change in his condition because the ALJ found Dukes now has pneumoconiosis, whereas an Examiner denied his initial claim, finding he did not.

Relying on the plain language of the statute and our previous decision of Tennessee Consolidated Coal Co. v. Kirk, 264 F.3d 602 (6th Cir.2001), we find the statute of limitations applies to all Part C claims for black lung benefits filed by a miner,3 not just the initial one, and begins to run upon the communication to the miner of a medical determination of total disability due to pneumoconiosis. However, we find that Dukes’s claim is nonetheless timely because he had not received a “medical determination” under the statute until 1995.

Furthermore, we find the ALJ did not provide sufficient analysis to support the finding that Dukes has manifested a change in condition since his prior denial. We hereby affirm the decision of the Board that Dukes’s second claim was timely filed, but vacate the award and remand this cause to the ALJ for a determination of whether Dukes had exhibited a material [142]*142change in his condition between the denial of his first claim and the filing of his second.

II. Background

Respondent Mr. Carol William Dukes was born in 1928. He worked in the coal mines of Kentucky for nineteen years. Dukes’s employment with Peabody terminated on December 31, 1985, when the mine he had worked in for the previous seventeen years closed. Dukes never returned to mine work.

Between 1987 and 1988, Dukes received opinions from several doctors indicating he was suffering from pneumoconiosis, more commonly known as “black lung disease.” On February 17, 1988, Dukes filed a claim with the Department of Labor under the Act. The Department of Labor identified Peabody Coal Company as the responsible coal mine operator4 liable for the claim under 20 C.F.R. §§ 725.490-725.493, and notified them of the pending litigation.

In order to qualify for benefits under the Act, Dukes had to show (1) he was totally disabled (2) due to pneumoconiosis (3) arising at least in part out of coal mine employment. See Tussey v. Island Creek Coal Co., 982 F.2d 1036, 1038 (6th Cir. 1993). The Department of Labor Examiner denied the claim on July 25, 1988, finding, in spite of doctors’ opinions to the contrary, Dukes did not meet any of the three criteria required for an award of benefits. Pursuant to Department of Labor procedures, Dukes submitted additional medical evidence, but his claim was again denied on August 29, 1989. Dukes failed to file a timely appeal to the ALJ’s office and otherwise declined to pursue his administrative remedies.

Dukes never returned to work, but filed a second application for benefits with the Department of Labor on August 7, 1995. The Department denied this second claim on January 23, 1996, again finding Dukes did not have pneumoconiosis. This time, however, Dukes chose to pursue his administrative options and filed a timely appeal with the ALJ, and the matter was transferred to that office.

A hearing was held, and the ALJ found (1) Dukes’s second claim had been timely filed, (2) Dukes had nineteen years of coal mine employment, (3) Dukes had established a material change in condition since the prior denial, (4) Dukes had pneumoconiosis arising out of his coal mine employment, and (5) the pneumoconiosis rendered him totally disabled. Benefits were awarded beginning August 1, 1995.

Peabody filed a timely notice of appeal with the Benefits Review Board, claiming Dukes’s 1995 claim should have been time barred based on the three-year statute of limitations that should have commenced whenever Dukes first received a medical determination of his disease, sometime between 1987 and 1988. On September 9, 1999, the Board affirmed the ALJ’s findings, stating Dukes’s claim was timely because the statute of limitations only applies to a miner’s very first claim for benefits. Since Dukes’s 1988 claim was timely, all subsequent claims would be as well. Peabody timely filed a motion for reconsideration that the Board denied in November 2000. Peabody then filed a timely petition for review with this Court.

III. The Statute of Limitations

Peabody claims Dukes’s August 7, 1995 claim was outside the three-year statute of [143]*143limitations provided in 30 U.S.C. § 932(f), and should be denied as untimely.

A. Application of the Statute of Limitations to Subsequent Claims

Section 932(f) states “[a]ny claim for benefits by a miner under this section shall be filed within three years after whichever of the following occurs later: (1) a medical determination of total disability due to pneumoconiosis; or (2) March 1, 1978.” The provision’s implementing regulation, 20 C.F.R. § 725.308(a), further provides:

A claim for benefits filed under this part by, or on behalf of, a miner shall be filed within three years after a medical determination of total disability due to pneumoconiosis which has been communicated to the miner or a person responsible for the care of the miner, or within three years after the date of enactment of the Black Lung Benefits Reform Act of 1977, whichever is later ...

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Bluebook (online)
48 F. App'x 140, Counsel Stack Legal Research, https://law.counselstack.com/opinion/peabody-coal-co-v-director-office-of-workers-compensation-programs-ca6-2002.