WEICK, Circuit Judge.
Plaintiff Gastineau has appealed from an order of the District Court affirming the denial by the Secretary of Health, Education and Welfare of his claim for black lung benefits. For the reasons stated below, we affirm the judgment of the District Court.
Plaintiff was born on May 13, 1910, and has a sixth grade education. He worked in the nation’s underground coal mines for forty-two years. The cause of his retirement from mining in 1970 was a severe back injury which he received in an accident on the job. On account of this back injury, he and his wife had been receiving Social Security total disability benefits since 1970, under the Social Security Act, 42 U.S.C. §§ 423, 402(b), and Gastineau individually has also been receiving Workmen’s Compensation benefits since 1971.
In 1970 plaintiff also filed applications for black lung benefits pursuant to the Federal Coal Mine Health and Safety Act of 1969, 30 U.S.C. § 901 et seq. His claim was denied initially and was again denied after the review required by the 1972 amendments to the Act, 30 U.S.C. § 941. He requested a hearing, which was granted, and an Administrative Law Judge determined, apparently on the basis of positive X-rays, that Gastineau was entitled to black lung benefits. On its own motion, the Appeals Council submitted Gastineau’s X-rays to Dr. W. P. Montgomery, a Diplómate in Internal Medicine and a consulting certified reader, who reread the X-rays as negative for pneumoconiosis. On this basis, the Appeals Council reversed the decision of the ALJ.
In seeking review in the District Court, 30 U.S.C. § 923(b), incorporating 42 U.S.C. § 405(g), Gastineau claimed, first, that he was entitled to an irrebuttable presumption of disability under 30 U.S.C. § 921(c)(3),1 and second, that he was entitled to a rebut-table presumption of disability under 30 U.S.C. § 921(c)(4).2 The District Court [358]*358granted the Secretary’s motion for summary judgment from which judgment Gasti-neau now appeals to this Court.
Plaintiff Gastineau’s primary argument on appeal is that he was entitled to the rebuttable presumption of 30 U.S.C. § 921(c)(4), which provides that (1) if a miner has been employed for fifteen years or more in the nation’s underground coal mines, and (2) if the X-rays submitted in connection with his claim have been read as negative, but (3) “if other evidence demonstrates the existence of a totally disabling respiratory or pulmonary impairment,” then there is a rebuttable presumption that the miner is totally disabled by pneumoconiosis.3
It is undisputed that plaintiff satisfies the first two elements of the presumption.
First, he was employed underground for forty-two years. Second, all of the X-rays submitted by Gastineau were reread as negative by Dr. W. P. Montgomery, a certified reader and consultant to the Bureau of Hearings and Appeals. On the basis of this negative X-ray evidence, Gasti-neau’s application under 30 U.S.C. § 921(c)(3) was properly denied. It is not the function of this Court to resolve conflicts in the medical evidence, but rather it is the function of the Secretary, whose expertise is given great deference. E. g., Seacrist v. Weinberger, 538 F.2d 1054, 1056-57 (4th Cir. 1976).
A substantial questipn exists however, whether “other evidence demonstrates the existence of a totally disabling respiratory or pulmonary impairment,” the third criterion of § 921(c)(4). The regulation implementing this section, 20 C.F.R. § 410.-414(b)(1), incorporates by reference § 410.-422(b) and § 410.426(a), which require that in order to be within the scope of the Act, a chronic respiratory or pulmonary impairment must be shown by the claimant to be the primary cause of the claimant’s total disability.4 See Ansel v. Weinberger, 529 [359]*359F.2d 304, 308-09 (6th Cir. 1976); Cope v. Mathews, 415 F.Supp. 467, 469 (E.D.Tenn. 1976); Arbonaise v. Weinberger, 401 F.Supp. 983, 990 (N.D.W.Va.1975); Baker v. Secretary of HEW, 383 F.Supp. 1095, 1100-01 (W.D.Va.1974). Cf. Koski v. Weinber-ger, 401 F.Supp. 990, 994 (N.D.W.Va.1975).
This burden has not been carried by plaintiff in the present case. Plaintiff has not shown the existence of a totally disabling chronic respiratory or pulmonary impairment, lacking both (A) medical evidence of the existence of such impairment, § 410.-424, and (B) medical evidence with respect to the requirement that the impairment be the primary cause of the disability, § 410.-426.
A
First, the physical examinations performed on August 3, 1973 by Dr. Allen and on January 13, 1974 by Dr. Odom, both found plaintiff’s lungs “clear to ascultation and percussion.” Neither found cyanosis or clubbing or any other significant impairment. Dr. Odom’s pulmonary function study showed only a “mild” impairment, and the result of the study by Dr. Van Lith on July 30, 1972, was “normal.”
We note that Dr. Odom did state that plaintiff was “totally and permanently disabled for coal mining and work in a dusty environment.” This statement however, was based at least in part on X-rays that were later reread as negative. Dr. Clarke on December 10, 1973, and Dr. Martin on November 7, 1973, also found total disability on the basis of X-rays later reread as negative; and Dr. Clarke’s pulmonary function studies were rejected as not meeting the standards of 20 C.F.R. § 410.430. Furthermore, such statements by physicians are not determinative of the ultimate question whether plaintiff is disabled, the decision of which is the function and responsibility of the Secretary. 20 C.F.R. § 410.471.
We also note the lay testimony of plaintiff and his wife that Gastineau has a serious breathing problem which interferes with his sleep and has curtailed his physical activities. Further, we note Gastineau’s testimony that his breathing problems had begun to interfere with his mining work as early as a year before his back injury forced him to leave the mines.
This lay evidence, coupled with the “mild” impairment found by Dr. Odom, and the diagnosis by Dr.
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WEICK, Circuit Judge.
Plaintiff Gastineau has appealed from an order of the District Court affirming the denial by the Secretary of Health, Education and Welfare of his claim for black lung benefits. For the reasons stated below, we affirm the judgment of the District Court.
Plaintiff was born on May 13, 1910, and has a sixth grade education. He worked in the nation’s underground coal mines for forty-two years. The cause of his retirement from mining in 1970 was a severe back injury which he received in an accident on the job. On account of this back injury, he and his wife had been receiving Social Security total disability benefits since 1970, under the Social Security Act, 42 U.S.C. §§ 423, 402(b), and Gastineau individually has also been receiving Workmen’s Compensation benefits since 1971.
In 1970 plaintiff also filed applications for black lung benefits pursuant to the Federal Coal Mine Health and Safety Act of 1969, 30 U.S.C. § 901 et seq. His claim was denied initially and was again denied after the review required by the 1972 amendments to the Act, 30 U.S.C. § 941. He requested a hearing, which was granted, and an Administrative Law Judge determined, apparently on the basis of positive X-rays, that Gastineau was entitled to black lung benefits. On its own motion, the Appeals Council submitted Gastineau’s X-rays to Dr. W. P. Montgomery, a Diplómate in Internal Medicine and a consulting certified reader, who reread the X-rays as negative for pneumoconiosis. On this basis, the Appeals Council reversed the decision of the ALJ.
In seeking review in the District Court, 30 U.S.C. § 923(b), incorporating 42 U.S.C. § 405(g), Gastineau claimed, first, that he was entitled to an irrebuttable presumption of disability under 30 U.S.C. § 921(c)(3),1 and second, that he was entitled to a rebut-table presumption of disability under 30 U.S.C. § 921(c)(4).2 The District Court [358]*358granted the Secretary’s motion for summary judgment from which judgment Gasti-neau now appeals to this Court.
Plaintiff Gastineau’s primary argument on appeal is that he was entitled to the rebuttable presumption of 30 U.S.C. § 921(c)(4), which provides that (1) if a miner has been employed for fifteen years or more in the nation’s underground coal mines, and (2) if the X-rays submitted in connection with his claim have been read as negative, but (3) “if other evidence demonstrates the existence of a totally disabling respiratory or pulmonary impairment,” then there is a rebuttable presumption that the miner is totally disabled by pneumoconiosis.3
It is undisputed that plaintiff satisfies the first two elements of the presumption.
First, he was employed underground for forty-two years. Second, all of the X-rays submitted by Gastineau were reread as negative by Dr. W. P. Montgomery, a certified reader and consultant to the Bureau of Hearings and Appeals. On the basis of this negative X-ray evidence, Gasti-neau’s application under 30 U.S.C. § 921(c)(3) was properly denied. It is not the function of this Court to resolve conflicts in the medical evidence, but rather it is the function of the Secretary, whose expertise is given great deference. E. g., Seacrist v. Weinberger, 538 F.2d 1054, 1056-57 (4th Cir. 1976).
A substantial questipn exists however, whether “other evidence demonstrates the existence of a totally disabling respiratory or pulmonary impairment,” the third criterion of § 921(c)(4). The regulation implementing this section, 20 C.F.R. § 410.-414(b)(1), incorporates by reference § 410.-422(b) and § 410.426(a), which require that in order to be within the scope of the Act, a chronic respiratory or pulmonary impairment must be shown by the claimant to be the primary cause of the claimant’s total disability.4 See Ansel v. Weinberger, 529 [359]*359F.2d 304, 308-09 (6th Cir. 1976); Cope v. Mathews, 415 F.Supp. 467, 469 (E.D.Tenn. 1976); Arbonaise v. Weinberger, 401 F.Supp. 983, 990 (N.D.W.Va.1975); Baker v. Secretary of HEW, 383 F.Supp. 1095, 1100-01 (W.D.Va.1974). Cf. Koski v. Weinber-ger, 401 F.Supp. 990, 994 (N.D.W.Va.1975).
This burden has not been carried by plaintiff in the present case. Plaintiff has not shown the existence of a totally disabling chronic respiratory or pulmonary impairment, lacking both (A) medical evidence of the existence of such impairment, § 410.-424, and (B) medical evidence with respect to the requirement that the impairment be the primary cause of the disability, § 410.-426.
A
First, the physical examinations performed on August 3, 1973 by Dr. Allen and on January 13, 1974 by Dr. Odom, both found plaintiff’s lungs “clear to ascultation and percussion.” Neither found cyanosis or clubbing or any other significant impairment. Dr. Odom’s pulmonary function study showed only a “mild” impairment, and the result of the study by Dr. Van Lith on July 30, 1972, was “normal.”
We note that Dr. Odom did state that plaintiff was “totally and permanently disabled for coal mining and work in a dusty environment.” This statement however, was based at least in part on X-rays that were later reread as negative. Dr. Clarke on December 10, 1973, and Dr. Martin on November 7, 1973, also found total disability on the basis of X-rays later reread as negative; and Dr. Clarke’s pulmonary function studies were rejected as not meeting the standards of 20 C.F.R. § 410.430. Furthermore, such statements by physicians are not determinative of the ultimate question whether plaintiff is disabled, the decision of which is the function and responsibility of the Secretary. 20 C.F.R. § 410.471.
We also note the lay testimony of plaintiff and his wife that Gastineau has a serious breathing problem which interferes with his sleep and has curtailed his physical activities. Further, we note Gastineau’s testimony that his breathing problems had begun to interfere with his mining work as early as a year before his back injury forced him to leave the mines.
This lay evidence, coupled with the “mild” impairment found by Dr. Odom, and the diagnosis by Dr. Snyder dated January 24, 1973, of “chronic bronchitis,” might together establish a compensable impairment were it not for the substantial contrary medical evidence credited by the Secretary. The Appeals Council found:
The credible evidence, including X-ray interpretations, pulmonary function study results and other relevant evidence of record, does not demonstrate significantly impaired lung function as a result of chronic respiratory or pulmonary condition.
We hold that this finding was supported by substantial evidence on the record.
B
Second, plaintiff has not carried his burden under §§ 410.414(b)(1) and 410.426(a) of proving that his respiratory impairment was “totally disabling” in the sense that it was the primary cause of his total disability. Gastineau’s departure from the mines was the result of an injury to his back incurred in a mining accident, causing a herniated lumbar disc which required surgery. He did not leave the mines because of any black lung ailment. At the time of the hearing of this case, plaintiff and his wife were receiving a total of $505.30 per month in Social Security and Workmen’s Compensation disability benefits for this injury. In his Application for Benefits Under The Federal Coal Mine Health and Safety [360]*360Act of 1969, Gastineau described his disability as “back injury — disc problems” and indicated that he was at that time receiving Social Security Disability benefits. Since that time he has also been receiving Workmen’s Compensation benefits. The record is not clear whether those benefits of $505.30 monthly have been increased.
Although a finding of a disability by another agency is not determinative, 20 C.F.R. § 410.470, it can nevertheless lend some support to the Secretary’s determination. Cope v. Mathews, supra at 470 n. 2.5
A determination of whether a miner is totally disabled should be made from all of the facts of the case. 20 C.F.R. § 410.-422(c). Considering the fact that the evidence was in conflict with respect to whether the plaintiff was totally disabled within the meaning of the Act, from any black lung ailment, and considering the strong evidence that plaintiff was totally disabled by his back injuries, we affirm the finding of the District Court that the evidence “adequately supports the Appeals Council’s implicit conclusion that the primary reason for plaintiff’s [disability] is not his lung condition,” and its conclusion that therefore, plaintiff Gastineau has not demonstrated the existence of a totally disabling condition within the scope of 30 U.S.C. § 921(c)(4) and 20 C.F.R. § 410.426(a). We do not know how a claimant can be totally and permanently disabled more than once.
For these reasons, the judgment of the District Court is affirmed.