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

662 F. App'x 213
CourtCourt of Appeals for the Fourth Circuit
DecidedOctober 17, 2016
Docket16-1210
StatusUnpublished

This text of 662 F. App'x 213 (Westmoreland Coal Co. v. Director, Office of Workers' Compensation Programs) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fourth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Westmoreland Coal Co. v. Director, Office of Workers' Compensation Programs, 662 F. App'x 213 (4th Cir. 2016).

Opinion

Petition for review granted; affirmed in part, vacated in part, and remanded by unpublished per curiam opinion.

Unpublished opinions are not binding precedent in this circuit,

PER CURIAM:

Gerald W. Mabe filed a claim for benefits under the Black Lung Benefits Act (“BLBA”), 30 U.S.C. §§ 901-944 (2012), Following a hearing, the Administrative Law Judge (“ALJ”) found Mabe’s claim timely and awarded benefits after concluding that the responsible operator, West-moreland Coal Company (“Employer”), failed to rebut the presumption of total disability due to pneumoconiosis applied to Mabe’s claim pursuant to 30 U.S.C. § 921(c)(4) (the “15-year presumption”). The Benefits Review Board (“Board”) affirmed the ALJ’s determination as to the merits of Mabe’s claim but vacated the ALJ’s timeliness determination and remanded for further proceedings. Although the ALJ found the claim untimely on remand, the Board later vacated this determination, concluding that Employer failed, as a matter of law, to rebut the presumption of timeliness accorded Mabe’s claim. The Board therefore remanded for entry of an award, of benefits. Employer now petitions for review of the Board’s decision awarding benefits.

At the outset, we note that the scope of our review of an agency decision involving the BLBA is strictly circumscribed. We review a decision awarding black lung benefits to determine “whether substantial evidence supports the factual findings of the ALJ and whether the legal conclusions of the [Board] and ALJ are rational and consistent with applicable law.” Hobet Mining, LLC v. Epling, 783 F.3d 498, 504 (4th Cir. 2015) (alteration in original omitted). In so doing, we review legal conclusions of the Board and ALJ de novo but must defer to the ALJ’s factual findings if they are supported by substantial evidence. Harman Mining Co. v. Dir., Office of Workers’ Comp. Programs, 678 F.3d 305, 310 (4th Cir. 2012). “Substantial evidence” is defined as “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Island Creek Coal Co. v. Compton, 211 F.3d 203, 207-08 (4th Cir. 2000).

Employer first challenges the Board’s determination that, as a matter of law, it failed to meet its burden to rebut the presumption of timeliness accorded Mabe’s claim under 20 C.F.R. § 725.308(c) (2016). Our review of the record leads us to conclude that the Board’s decision as to the timeliness of Mabe’s claim is based upon substantial evidence and is without reversible error. Westmoreland Coal Co. v. Mabe. No. 15-0028 BLA (B.R.B. Dec. 29, 2015).

Turning to the merits of Mabe’s claim, the ALJ determined, and the Board ultimately affirmed, that Mabe was entitled to the benefit of the 15-year presumption, which Employer failed to rebut. If a miner was-employed in underground coal mines for 16 years or more, has had a chest x-ray interpreted as negative for complicated pneumoconiosis, and demonstrates that he has a totally disabling respiratory or pulmonary impairment, he is entitled to a rebuttable presumption that he is totally disabled due to pneumoconiosis. 30 U.S.C. § 921(c)(4); 20 C.F.R. § 718.305(b)(1) (2016). When the presumption applies, the ALJ must “presume both prongs of the showing required for benefits eligibility: that the claimant has pneumoconiosis arising from coal mine employment, and that this disease is a substantially contributing cause of his disability.” Epling, 783 F.3d at *215 502. To rebut the presumption, the employer either must demonstrate that the miner does not have legal pneumoconiosis or clinical pneumoconiosis “arising from coal mine employment” (the “pneumoconi-osis prong”), 20 C.F.R. § 718.305(d)(l)(i) (2016), or must affirmatively “rule out” the mining-related disease as a cause of disability by demonstrating that “no part of the miner’s respiratory or pulmonary total disability was caused by pneumoconiosis” (the “disability causation prong”), 20 C.F.R. § 718,305(d)(l)(ii) (2016).

A claimant may establish the existence of pneumoconiosis, among other methods, through chest x-rays or medical opinions. 20 C.F.R. § 718.202(a)(1), (4) (2016). Additionally, “[t]he results of any medically acceptable test or procedure,” such as a CT scan, “which tends to demonstrate the presence or absence of pneumoconiosis ... may be submitted in connection with a claim and shall be given appropriate consideration.” See 20 C.F.R. § 718.107(a) (2016); Sea “B” Mining Co. v. Addison, 831 F.3d 244, 249 (4th Cir. 2016). “Although the regulations group the forms of permissible evidence into discrete categories, an ALJ must weigh all of the evidence together when determining whether the miner has established the presence of pneumoco-niosis.” Addison, 831 F.3d at 249. By implication, such evidence also is relevant in considering whether an employer has met its burden to disprove pneumoconiosis on rebuttal.

Employer posits various errors committed in concluding that it failed to rebut both prongs of the 15-year presumption. As to the pneumoconiosis prong, our review of the record leads us to reject Employer’s arguments that the ALJ improperly weighed or failed to consider the x-ray and CT scan evidence in determining that the radiographic evidence of clinical pneu-moconiosis was in equipoise. However, we conclude that the ALJ’s stated reasons for weighing the medical opinions of Drs. Basheda and Hippensteel as to the existence of clinical pneumoconiosis are not in accordance with law or supported by substantial evidence.

First, the ALJ’s opinion appears to be based on a fundamental mischaracterization of Dr. Basheda’s and Dr. Hippen-steel’s opinions. Contrary to the ALJ’s opinion, neither Dr. Hippensteel nor Dr. Basheda assumed that the x-ray evidence was negative for the presence of pneumo-coniosis. Rather, each reviewed both positive and negative x-ray interpretations and reached an independent conclusion regarding this imaging. Dr. Basheda’s opinion, in particular, provided- detailed reasoning for his determination that the x-rays and CT scan evidence did not support a finding of pneumoconiosis. While the ALJ was not required to adopt this reasoning, he was required to consider it and to provide a valid basis for discrediting it. See Mingo Logan Coal Co. v.

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662 F. App'x 213, Counsel Stack Legal Research, https://law.counselstack.com/opinion/westmoreland-coal-co-v-director-office-of-workers-compensation-programs-ca4-2016.