Vision Processing, LLC v. Christie Groves

705 F.3d 551, 2013 WL 332082, 2013 U.S. App. LEXIS 2019
Court of Appeals for the Sixth Circuit·Decided January 30, 2013·No. 11-3702·Published·Cited by 7 cases

Opinion

*553 OPINION

SUTTON, Circuit Judge.

Since enacting a program for black-lung benefits in 1969, now known as the Black Lung Benefits Act, Congress has repeatedly tinkered with the claim-filing process, sometimes making it harder for miners and survivors to obtain benefits, sometimes making it easier. The question today is whether Congress’s most recent adjustment, a part of something called the 2010 Patient Protection and Affordable Care Act, permits Christie Groves, the widow of a long-time coal miner, to bring a claim for survivor benefits under the new, more-relaxed method for obtaining benefits. The Benefits Review Board concluded that the new law covered this claim, and so do we.

I.

A.

In 1969, when the federal government began providing benefits to coal miners and their dependents, see Title IV of the Federal Coal Mine Health and Safety Act of 1969, Pub.L. No. 91-173, 83 Stat. 742, it permitted survivors to obtain benefits in one of two ways. They could show (1) that the miner’s death was due to pneumoconio-sis, a chronic lung disease caused by working in coal mines or (2) that the miner was totally disabled by pneumoconiosis at the time of his death, even if the disease played no role in his death. See 30 U.S.C. § 901 (1976).

In 1972, Congress eased the showing required to establish total disability from pneumoconiosis. It created a presumption that deceased workers who had worked for at least fifteen years in underground coal mines and had developed a totally disabling respiratory or pulmonary impairment were rebuttably presumed to be totally disabled by pneumoconiosis and to have died from it. 30 U.S.C. § 921(c)(4) (1976).

In 1977, Congress eased the showing required to obtain survivor benefits. It offered automatic benefits to any survivor of a miner who had been awarded benefits on a claim filed during his lifetime. See Black Lung Benefits Reform Act of 1977, Pub.L. No. 95-239, § 7(h), 92 Stat. 95, 100 (1978).

In 1981, Congress changed course. It eliminated automatic benefits for survivors of miners who had been totally disabled by pneumoconiosis. See Black Lung Benefits Revenue Act of 1981, Pub.L. No. 97-119, §§ 203(a)(1), 203(a)(6), 95 Stat. 1635, 1643-44. Congress did so by adding the following italicized limiting clause to the existing provision:

In no case shall the eligible survivors of a miner who was determined to be eligible to receive benefits under this sub-chapter at the time of his or her death be required to file a new claim for benefits, or refile or otherwise revalidate the claim of such miner, except with respect to a claim filed under this part on or after the effective date of the Black Lung Benefits Amendments of 1981.

30 U.S.C. § 932(l) (1982). After 1981, only survivors who could prove that pneu-moconiosis had caused the miner’s death were eligible; the provision for automatic (or derivative) benefits was eliminated. Id. § 203(a)(4), 95 Stat. at 1644. The same legislation also eliminated the fifteen-year presumption. Id. § 202(b)(1)(2), 95 Stat. at 1643.

In 2010, as part of the Patient Protection and Affordable Care Act, Congress reversed course again. Section 1556 of the Act reinstated the fifteen-year presumption and automatic survivor benefits. Pub.L. No. 111-148, § 1556(a)-(b) (2010). The 2010 amendments “apply with respect to claims filed ... after January 1, 2005, that are pending on or after the date of *554 enactment of this Act.” Id. § 1556(c), 124 Stat. at 260.

B.

Earl Groves worked in the Kentucky coal mines for twenty-nine years. In December 2005, he suffered a work-ending injury: a collapsed lung. Groves filed a claim for black-lung benefits on March 3, 2006, and Vision Processing contested the claim. Four months later, in July 2006, Mr. Groves died of a heart attack and chronic obstructive pulmonary disease. Mr. Groves’ widow, Christie Groves, filed a claim for survivor benefits on August 1, 2006. Vision Processing contested the claim.

An administrative law judge granted Mrs. Groves’ claim for lost living-miner benefits. But the ALJ denied her claim for survivor benefits on the ground that Mrs. Groves had not submitted sufficient proof to support a finding that her husband had died from pneumoconiosis.

Mrs. Groves appealed the survivor-benefits ruling against her, but the company did not appeal the living-benefits ruling against it. While the appeal was pending, Congress enacted the Patient Protection and Affordable Care Act, which included the just-mentioned changes to the black-lung benefits program. The Benefits Review Board allowed supplemental briefing on the amendment’s effect on Mrs. Groves’ claim, after which it reversed the ALJ’s decision and awarded survivor benefits.

II.

The first question presented is easy to describe: Do the 1981 or the 2010 rules for handling survivor-benefit claims apply to Mrs. Groves’ request for survivor benefits? If the 1981 rules apply, Mrs. Groves has not submitted sufficient proof to support a finding that her husband died from pneumoconiosis, as the ALJ concluded and as Mrs. Groves has not disputed on appeal. If the 2010 rules apply, she is spared this burden and qualifies for automatic benefits, as the ALJ determined that her husband was eligible for living-miner benefits at the time of his death and as the company did not appeal that decision. Vision Processing takes the position that the new rules apply only to claims filed by miners; Mrs. Groves takes the position that the new rules apply to claims filed by miners or survivors.

The answer to this question takes a little more effort. Here is what the language of the 2010 amendments says:

SEC. 1556. EQUITY FOR CERTAIN ELIGIBLE SURVIVORS:
(a) REBUTTABLE PRESUMPTION.—Section 411(c)(4) of the Black Lung Benefits Act (30 U.S.C. 921(c)(4)) is amended by striking the last sentence.
(b) CONTINUATION OF BENEFITS.—Section 422(l) of the Black Lung Benefits Act (30 U.S.C. 932(Z)) is amended by striking “, except with respect to a claim filed under this part on or after the effective date of the Black Lung Benefits Amendments of 1981”.
(c) EFFECTIVE DATE.—The amendments made by this section shall apply with respect to claims filed under part B or part C of the Black Lung Benefits Act (30 U.S.C. 921 et seq., 931 et seq.)

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Vision Processing, LLC v. Christie Groves, 705 F.3d 551, 2013 WL 332082, 2013 U.S. App. LEXIS 2019 (6th Cir. 2013).

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