The proposed amendments to the regulations implementing the Federal Coal Mine Health and Safety Act of 1969, as amended, (hereinafter, the Act), as published in the Federal Register, Vol. 62 at pp. 3338-3435 (January 22, 1997), if adopted as final regulations, would reflect the most sweeping changes to the federal black lung program since the enactment of the 1981 Amendments to the Act. The comment period ended on August 21, 1997, and the Department of Labor presumably has been reviewing the extensive record developed in hearings and obtained through comments.
The Department has estimated that “final action” will be taken on the regulations during June 1998. 62 Fed. Reg. at 57726 (Oct. 29, 1997). However, there is no deadline for adopting final rules. It is possible that the Department will abandon the proposed amendments, but some form of final regulation seems more likely.
There is good reason to hope for abandonment of, or major alternations in, the proposed regulations. As currently drafted, the proposed amendments present major problems.
The Department believes that the regulatory changes “will not have a significant economic impact upon the coal industry or significantly affect the approval rate for black lung claims.” 62 Fed. Reg. at 3371. The Department incorrectly minimizes the adverse “economic impact” of these significant changes.
To the extent that the proposed changes “are intended to encourage faster, fairer and cheaper benefit determinations” (62 Fed. Reg. at 3371) as part of a “streamlining” effort, they almost certainly will have the opposite effect. The proposed changes will, in all likelihood, result in protracted litigation, resulting in costlier benefit determinations. Several of the proposed regulatory provisions are novel and will require interpretation by the U.S. Courts of Appeals, or possibly by the Supreme Court. Some of the proposed changes arguably violate the intent of the Act, the Due Process Clause of the United States Constitution, as well as the requirements of the Administrative Procedure Act (APA), 5 U.S.C. § 551, et seq., again encouraging litigation to resolve these issues.
The proposed regulations, among other things, broaden the “legal” definition of pneumoconiosis in the proposed amendment to Section 718.201, and ease the burden of proof for causation under proposed Section 718.204(c)(1). These proposals, if adopted in the final regulations, are likely to result in compensation not only for respiratory conditions unrelated to coal mining employment, but also could result in compensation for non-respiratory diseases. Due to the critical nature of the Department's expanded definition of pneumoconiosis in proposed Section 718.201 and the expanded definition of total disability due to pneumoconiosis in proposed Section 718.204, these two provisions are discussed in some detail below.
Following the discussion of Section 718.201 and Section 718.204, a few selected provisions of the proposed Part 725 regulations are addressed. We have not attempted to address each and every revision within the proposed amendments.
The statutory definition of the term “pneumoconiosis” is “a chronic dust disease of the lung and its sequelae, including respiratory and pulmonary impairments, arising out of coal mine employment.” 30 U.S.C. § 902(b). The proposed Section 718.201(a) correctly acknowledges this statutory definition, but then divides the statutory definition into two different types of pneumoconiosis, defined as “clinical” pneumoconiosis and “legal” pneumoconiosis.
1. “Clinical” Pneumoconiosis
The creation of two separate types of pneumoconiosis causes confusion. Contrary to the implication of the proposed regulation, “clinical” pneumoconiosis is not an entirely separate condition apart from “legal” pneumoconiosis. If a claimant has “clinical” pneumoconiosis, then he has “legal” pneumoconiosis and further inquiry is not necessary. See Ansel v. Weinberger, 529 F.2d 304, 310 (6th Cir. 1976) (if the claimant is able to produce a positive x-ray, there is no need to consider other evidence to establish pneumoconiosis, since the existence of a negative x-ray is a prerequisite to the reliance upon establishment of pneumoconiosis by other evidence).
Since “clinical” pneumoconiosis necessarily constitutes “legal” pneumoconiosis, it is unnecessary for the regulation to define the two terms separately. We have suggested that the Department abandon the effort to define pneumoconiosis as two separate types of conditions and to provide one definition of pneumoconiosis, which includes clinical pneumoconiosis within the broader definition of the term provided by the Act.
2. “Legal” Pneumoconiosis
More importantly, the Department's proposed definition of “legal” pneumoconiosis is far too broad. The Department's proposed “legal” definition of pneumoconiosis in Section 718.201(a)(2) includes “any chronic restrictive or obstructive pulmonary disease arising out of coal mine employment.” Section 718.201(b) defines “arising out of coal mine employment” to include a lung disease “substantially aggravated by” dust exposure.
The proposed “legal” definition makes no reference to the statutory requirement that “pneumoconiosis” means a “chronic dust disease.” 30 U.S.C. § 902(b) (emphasis supplied). By eliminating the requirement that “pneumoconiosis” must be a “dust” disease of the lung, the Department expands the potential diseases which might be considered to constitute this newly defined “pneumoconiosis.” By excluding the requirement of a “dust” disease, and by including any “obstructive” pulmonary disease, the proposed regulation potentially includes within the definition of pneumoconiosis conditions which are actually caused by other factors, such as cigarette smoking and/or heredity, but which might be considered to be “aggravated by” dust exposure.
We have urged the Department to consult with health authorities and pulmonary experts, including consultation with the Surgeon General of the United States, the National Institute for Occupational Safety & Health (NIOSH) and the Food and Drug Administration (FDA), to obtain a consensus from the scientific and medical communities regarding a proper definition of pneumoconiosis, including whether it is an “obstructive” disease and a “progressive” disease.
The Department must ensure that the Black Lung Benefits Act is not providing a mechanism for compensating the adverse health effects of tobacco products or other conditions unrelated to coal mining. This issue should be subjected to complete and unbiased scientific investigation, based upon a study of a relevant group of miners.
The Department's proposed Section 718.204 maintains the current two-part standard, requiring the claimant, first, to establish that he suffers from a totally disabling respiratory or pulmonary impairment and, secondly, to establish causation of his disability. See Jewell Smokeless Coal Co. v. Street, 42 F.3d 241 (4th Cir. 1994). The Department, however, proposes to liberalize the standards for establishing both facts.
1. Disability
Although the proposed regulations in defining “pneumoconiosis” acknowledge that pneumoconiosis is a pulmonary disease, in defining total disability in proposed Section 718.204(a) the Department proposes to require consideration of “a nonpulmonary or nonrespiratory condition or disease” (emphasis supplied). Thus, in determining whether the miner is or was totally disabled due to pneumoconiosis, a condition unrelated to the miner's lungs can be relied upon under the proposed regulation, if such condition causes a respiratory or pulmonary impairment. The preliminary comments by the Department reflect the Department's belief that this can include neurological diseases, cardiac diseases, spinal cord injury and other trauma. 62 Fed. Reg. at 3345.
Non-respiratory diseases should not provide a basis for an award of benefits under the Black Lung Benefits Act, contrary to the language of the proposed regulation. We have suggested that the Department exclude loss of lung function caused by non-respiratory and non-pulmonary conditions from qualifying to establish respiratory or pulmonary disability for the purposes of the Act, consistent with prior case law. See e.g., Twin Pines Coal Co. v. U.S. Dept. of Labor, 854 F.2d 1212 (10th Cir. 1988) (pulmonary function study abnormalities caused by non-respiratory disease cannot support entitlement); Street, supra.
2. Causation
Under the Department's causation standard, as proposed in Section 718.204(c)(1), claimant's causation burden is satisfied if he demonstrates that pneumoconiosis is a “substantially contributing cause” of disability, i.e. that it has “an adverse effect on the miner's respiratory or pulmonary condition”, or “worsens a totally disabling respiratory or pulmonary impairment.”
The Department's comments indicate its belief that the proposed “substantially contributing cause” standard under Section 718.204(c)(1) “mirrors the criteria for proving that pneumoconiosis contributed to the miner's death” as provided by Section 718.205(c). 62 Fed. Reg. at 3345. For death claims, the “substantially contributing cause” language has been liberally construed as being satisfied if pneumoconiosis “hastens the miner's death” in any way. E.g. Mancia v. Director, OWCP, 130 F.3d 579 (3d Cir. 1997). Thus, the Department implies that it intends something equivalent to a “hastening” of disability standard to be applied to causation under Section 718.204(c)(1).
We feel that the provisions of proposed Section 718.204(c)(1), referencing an “adverse effect” or a “worsening effect” as satisfying claimant's causation burden, are too vague. We have suggested that the Department develop a more specific and meaningful definition of causation, which imposes the burden of proof upon the claimant to prove by a preponderance of the evidence that pneumoconiosis is an actual contributing cause to his total disability. In so doing, the Department should impose the burden on the claimant to establish that pneumoconiosis is more than a de minimis factor in causing disability. This would be consistent with current case law. See Black Diamond Coal Mining Co. v. Director, OWCP, 95 F.3d 1079 (11th Cir. 1996); Peabody Coal Co. v. Smith, 127 F.3d 504 (6th Cir. 1997). It would also be faithful to the purpose of the Act to provide benefits only to miners who are totally disabled due to pneumoconiosis, 30 U.S.C. § 901.
As recognized in the Department's preliminary comments regarding the proposed Section 725.309 provisions, the current “duplicate” claims regulation at 20 C.F.R. § 725.309 has been the subject of decisions by the various circuits. 62 Fed. Reg. at 3351. The circuits have developed slightly differing standards to apply to “duplicate” claims. For a discussion of the differing standards, see Wyoming Fuel Co. v. Director, OWCP, 90 F.3d 1502 (10th Cir. 1996). Despite this conflict in the circuits, the Supreme Court declined to grant a petition for writ of certiorari in Lisa Lee Mines. v. Director, OWCP, 86 F.3d 1358 (4th Cir. 1996) (en banc), cert. denied, 136 L.Ed.2d 711 (1997).
We agree that a single standard should be adopted by the Department in order to eliminate the potential for inconsistent handling of “duplicate” claims. We believe, however, that the proposed regulation is objectionable and should be redrafted before being issued in final form.
The proposed regulation renames these claims as “additional” claims, rather than “duplicate” claims. Under Section 725.309(d) of the proposed regulations, an “additional” claim is allowed after a prior “final” denial, if “the claimant demonstrates that one of the applicable conditions of entitlement ... has changed since the date upon which the order denying the prior claim became final.” 62 Fed. Reg. at 3396. Section 725.309(d)(3) creates a rebuttable presumption that the miner's physical condition has changed, once one condition of entitlement is established; a presumption which is rebutted only if the employer demonstrates that the original order denying the claim was “clearly erroneous” and that the claim should have been approved as a matter of law. Even if the presumption is rebutted, the proposed regulation allows the claimant to obtain an award, if there has been a significant deterioration in the miner's condition. Any facts which were previously stipulated, or were uncontested during the proceedings on the originally denied claims cannot be reopened under proposed Section 725.309(d)(4).
There is no statutory basis for the Department of Labor to create a rebuttable presumption to shift the burden of proof from the claimant to the employer. Indeed, there is no statutory basis for Section 725.309, at all. The presumption created by the Department's proposed amendment to Section 725.309(d)(3) arguably violates the Administrative Procedure Act (APA), 5 U.S.C. § 551 et seq., which has been incorporated into the Black Lung Benefits Act. As established by the Supreme Court in Director, OWCP v. Greenwich Collieries, 512 U.S. 267 (1994), the provisions of the APA govern claimant's burden of proof under the Black Lung Benefits Act. This requires the claimant to establish all elements of entitlement by a “preponderance of the evidence.” Greenwich Collieries, supra. We have urged the Department to eliminate the creation of any presumption in Section 725.309.
We have also encouraged the Department to reconsider the provision in Section 725.309(d)(4), which precludes new findings of fact in a refiled claim based upon a party's failure to contest an issue, or based on a stipulation regarding an issue, during the course of the original proceedings. If a claimant is going to be given the right to refile a new claim more than one year after a prior final denial, then it would seem that all issues should be open for litigation, and all defenses should be available, once the claimant demonstrates a change in his or her physical condition. We can see no rational basis for allowing relitigation of certain issues, but applying strenuous concepts of issue preclusion to others.
Proposed Section 725.414 restricts the development of evidence by both claimant and operators. The proposed regulation allows no more than two pulmonary evaluations or consultative medical reports. If multiple operators are named as parties, this limit applies to all operators collectively. The proposed regulation would seem to be contrary to the statutory mandate that “all relevant evidence shall be considered.” 30 U.S.C. § 923(b). It also would appear to violate the APA and would appear to violate the Due Process Clause of the United States Constitution.
The Department appears to admit that its proposed regulation would violate 5 U.S.C. § 556(d), which ensures that a party under the APA “is entitled to present his case or defense by oral or documentary evidence, to submit rebuttal evidence, and to conduct such cross-examination as may be required for a full and true disclosure of the facts.” The Department attempts to justify the violation of the APA by stating that “the Department believes that the Secretary has the authority to promulgate regulations which vary the APA's hearing requirements.” 62 Fed. Reg. at 3359. This argument has been rejected by the Supreme Court in Greenwich Collieries. The APA has been incorporated into the Act by Congress and the Department of Labor cannot usurp that congressional determination.
Proposed Section 725.414(a)(3)(i), which would limit the potentially liable operators “collectively” to obtaining the results of no more than two pulmonary evaluations or consultative reports, presents special problems. The Department's policy of identifying multiple potentially liable operators, as reflected in proposed Section 725.407, leads the Department to propose this restriction on each potentially liable operator's ability to defend itself as a means to protect claimants from multiple exams. In so doing, the Department proposes to violate the right of each operator to obtain its own legal representation and to defend itself against the taking of its property. This would seem to be a clear violation of the Due Process Clause of the United States Constitution.
If the Department wishes to “ensure that the claimant is not overwhelmed by operator-developed medical evidence”, it can avoid that possibility by making a proper determination on the responsible operator issue at the initial stages of the case, rather than identifying unnecessary multiple “potentially” liable operators. The determination of how many “potentially” liable operators it wishes to name is totally within the control of the Department. If the Department insists on naming multiple operators, then each operator must be entitled to its own defense and to its own examination and the final regulation must recognize that right.
The restrictions reflected in proposed Section 725.414 are carried over to the provisions of proposed regulation Section 725.456, governing the introduction of evidence before the administrative law judge. The Department proposes to limit the evidence which the administrative law judge may consider and directs that evidence “in excess of the limitations contained in § 725.414 shall not be admitted into the hearing record in the absence of extraordinary circumstances (see § 725.414(d)).”
Proposed regulation Section 725.457(c), governing testimony allowed at the hearing, perpetuates the problems caused by the limitation of evidence contained in Section 725.414 by limiting who may testify.
We believe proposed Section 725.414 improperly restricts the parties' rights to present their case. We have encouraged the Department to abandon these restrictions in order to comply with the requirements of the APA, the Act, and the Constitution.
While the proposed regulations threaten to throw the Black Lung Program into turmoil and would open up a whole new set of legal issues to be litigated before the administrative law judges, the Benefits Review Board and the United States Courts of Appeals, the recent case law reflects that the issues under the current set of regulations are becoming settled. There have been no major breakthroughs or changes in the recent case law. The recent decisions have been more evolutionary than revolutionary.
A discussion of some of the more interesting decisions arising under specific provisions of the regulations is provided below.
The courts of appeals continue to recognize the rights of claimants to file and pursue “duplicate” claims under 20 C.F.R. § 725.309. Section 725.309 allows miners to file a new claim at any time after one year from a prior denial of benefits and to obtain a new hearing on the claim. The only restriction is that the claimant must demonstrate a “material change in conditions” in order to reopen the previously denied claim.
As noted in the discussion of the proposed amendments to Section 725.309, infra, the courts have not been entirely consistent in interpreting the meaning of “material change in conditions.” However, it appears that the prevailing standard is the so-called “one-element” standard set forth by the Fourth Circuit in Lisa Lee Mines v. Director, OWCP, 86 F.3d 1358 (4th Cir. 1996) (en banc), cert. denied, 136 L.Ed.2d 711 (1997). This standard has been adopted by the Eighth Circuit in Lovila Coal Co. v. Harvey, 109 F.3d 445 (8th Cir. 1997). It is also the standard that has been adopted in the Third and Sixth Circuits. Under the “one-element” standard, the claimant must demonstrate by new evidence at least one of the elements of entitlement previously adjudicated against him.
The Benefits Review Board, in Flynn v. Grundy Mining, 21 BLR 1-40 (1997) (on reconsideration), acknowledged that the “one-element” standard as adopted in the Sixth Circuit requires a deterioration in the miner's condition. In Flynn, the Board remanded the claim to the administrative law judge to address whether the judge simply disagreed with the prior denial of benefits or whether a material change in condition actually had occurred.
The Seventh Circuit in Peabody Coal Co. v. Spese, 117 F.3d 1001 (7th Cir. 1997) (en banc), tried to bring the standard it adopted in Sahara Coal Co. v. OWCP, 946 F.2d 544 (7th Cir. 1991), more in line with the “one-element” standard. In Sahara Coal, the court defined a “material change in conditions” as meaning either that the miner did not have black lung disease at the time of the first application, but developed it subsequently and became disabled by it, or that the pneumoconiosis had progressed to the point of disability, where it was not disabling at the time of the first application. The Seventh Circuit, in Spese, 117 F.3d at 1008-09, discussed the “one-element” standard and indicated that the test “is the correct one,” if properly applied. Thus, it appears that the Seventh Circuit, in Spese, has taken a step backward from its more favorable Sahara Coal standard.
The Tenth Circuit, in Wyoming Fuel Co. v. Director, OWCP, 90 F.3d 1502 (10th Cir. 1996), rejected the “one-element” standard. Instead, the court, in Wyoming Fuel, applied a standard requiring a “material worsening” of each element previously decided against the claimant.
It is uncertain at this time as to whether further attempts to bring this issue before the United States Supreme Court will bear fruit. The Supreme Court, of course, denied the opportunity to review this issue in the Lisa Lee Mines case. Since most of the circuits seem to be trying to bring their case law in line with one another, and, since the Department of Labor is proposing to rewrite the regulation, the Supreme Court may not wish to intervene.
Modification requests by claimants under 20 C.F.R. § 725.310 are more common than the filing of duplicate claims under Section 725.309. Modification requests, in fact, have become prevalent. The case law liberally construing the modification provisions as allowing the reopening of a case on the basis of either an alleged mistake of fact, or a change in conditions, is now well entrenched. Under this case law, modification is available in “almost limitless terms.” Jessee v. Director, OWCP, 5 F.3d 723, 724 (4th Cir. 1993). The Director has gone so far as to argue in favor of allowing claimants to pursue multiple modifications after a denied duplicate claim, on the basis that “successive modification requests [are] entirely permissible” under the regulations. (Dir's. Resp. Br. in Baker v. Whitaker Coal Corp., BRB No. 97-0757 BLA.)
Recent examples of the liberal application of the modification regulation can be found in Midland Coal Co. v. Director, OWCP, 120 F.3d 64 (7th Cir. 1997), and Jonida Trucking, Inc. v. Hunt, 124 F.3d 739 (6th Cir. 1997).
In Midland, the miner filed his original claim in July 1976. The claim was denied in October 1980 and modification was requested in June 1981. The miner died in January 1982, before an examination could be conducted on behalf of the operator. The widow received benefits based on the miner's modification petition. The court suggested, without addressing in detail, that the correct onset date for benefits payments reverted back to the date of the filing of the original claim, rather than the date of the modification request. (It does not appear that the onset date issue was raised on appeal).
In Jonida, the court utilized the modification regulation to forgive a claimant's untimely request for a hearing, treating the untimeliness as irrelevant. The claimant was denied benefits in January 1988 and failed to request a hearing within 30 days. Instead, he submitted new evidence in July 1988, apparently without requesting modification. Reasoning that under the court's application of the modification provisions, the administrative law judge was under a duty to rethink all of the evidence under a modification request, just as he would if claimant had made a timely appeal, the Sixth Circuit ruled that the judge's treatment of claimant's untimely action as being timely constituted “harmless” error. (In contrast to this liberal attitude toward the time limits contained in the regulations, compare Peabody Coal Co. v. Abner, 118 F.3d 1106 (6th Cir. 1997), where the court dismissed an appeal as being untimely, where an employer filed an appeal following a second motion for reconsideration to the Board, reasoning that allowing such action would render time limits under the Act a “joke.”)
Not surprisingly, with the liberal attitude that has been adopted toward modification, operators are utilizing the procedure with greater frequency. Section 725.310 of the regulations clearly applies by its terms to “any party.” Therefore, it is appropriate that employers, along with claimants and the Director, have the same rights to modification proceedings. If modification is to be liberally allowed, it must be allowed evenhandedly. As noted above, under the Director's interpretation, this includes the right to make “successive modification requests.”
The Office of Administrative Law Judges has acknowledged the right of an employer to develop new medical evidence during modification proceedings instituted by the employer and has ordered the claimant to participate in a new physical examination and to answer discovery requests. E.g. Hatfield v. Arch of Kentucky, Case No. 94-BLA-1364 (Oct. 3, 1997); Witten v. Triple W Fuels, Inc., Case No. 98-BLA-0194 (Feb. 19, 1998). Employers are also finding it possible to obtain a denial of benefits by utilizing Section 725.310 to overcome an original award of benefits. The administrative law judge will grant the employer's modification request following an original award and will deny benefits based on new medical evidence which demonstrates that the prior award was mistaken. E.g. Morgan v. Whitaker Coal Corp., Case No. 96-BLA-1842 (Dec. 30, 1997).
20 C.F.R. § 718.202 provides the regulatory provision for establishing pneumoconiosis. The regulation provides that pneumoconiosis may be established by x-ray evidence (Section 718.202(a)(1)), biopsy or autopsy (Section 718.202(a)(2)), the application of certain presumptions (Section 718.202(a)(3)) and on the basis of a medical opinion “notwithstanding a negative x-ray” (Section 718.202(a)(4)).
In Penn Allegheny Coal Co. v. Williams, 114 F.3d 22 (3d Cir. 1997), the court interpreted Section 718.202 as requiring that evidence presented under the different methods of proof enumerated in the regulation must be weighed together to determine if claimant established the presence of pneumoconiosis. The Third Circuit reasoned that this outcome was required in order to comply with the statutory mandate that “all relevant evidence” be considered. The court, in Penn Allegheny, rejected the Board's interpretation that the regulation provides disjunctive methods. (For a discussion of the Board's interpretation of Section 718.202(a), see Church v. Eastern Associated Coal Co., __ BLR __, BRB No. 95-0516 BLA, (Sept. 30, 1997) modifying on recon., 20 BLR 1-8 (1996).) The court ruled that the Board erred in finding pneumoconiosis based on x-ray evidence alone, without evaluating the other evidence. The error in this case, however, was found to be “harmless” since the court determined that “substantial evidence” supported the administrative law judge's pneumoconiosis finding based upon medical reports and biopsy evidence.
In Peabody Coal Co. v. Hill, 123 F.3d 412 (6th Cir. 1997), the court affirmed the administrative law judge's finding of pneumoconiosis based upon medical opinion evidence under Section 718.202(a)(4), despite x-ray evidence which did not establish the presence of pneumoconiosis under Section 718.202(a)(1). The court allowed the administrative law judge to fault the employer's physicians for failing to rule out pneumoconiosis as a cause of the claimant's respiratory condition. The court, further, found that the judge could credit the claimant's doctors as having based their diagnoses of pneumoconiosis upon factors other than positive x-ray reports alone.
20 C.F.R. § 718.204 provides the provisions for claimants to establish the presence of a totally disabling respiratory or pulmonary impairment and to establish that such disability was caused in part by pneumoconiosis.
The causation requirement of the regulation has been the subject of three recent decisions from the United States Court of Appeals for the Sixth Circuit. In Hill, supra, the court affirmed an award of benefits, ruling that causation is demonstrated if pneumoconiosis contributes only “partially” to disability. In Jonida, supra, the court affirmed the award of benefits notwithstanding the presence of a disabling heart condition, ruling that claimants can receive benefits if pneumoconiosis contributes “in part” to total disability. In Smith, supra, the court clarified that the “in part” standard for causation requires the claimant to prove that pneumoconiosis was more than a de minimis part of disability and the court rejected the administrative law judge's finding that causation was established if pneumoconiosis played “any role.”
Liberal causation standards have also been applied to widows' claims. A widow may establish that the miner's death was due to pneumoconiosis under the provisions of 20 C.F.R. § 718.205.
The United States Courts of Appeals have uniformly adopted the “hastening of death” standard, which allows a widow to carry her burden of proof by demonstrating that pneumoconiosis was a “hastening” factor in the miner's demise. This standard can lead to apparently anomalous results. Miners who have died from strokes and heart disease have been deemed to have died “due to” pneumoconiosis under the liberal application of a “hastening of death” standard. E.g. Northern Coal Co. v. Director, OWCP, 100 F.3d 871 (10th Cir. 1996) (strokes and heart disease); Bradberry v. Director, OWCP, 117 F.3d 1361 (11th Cir. 1997) (myocardial infarction); Mancia, supra (heart disease). It is interesting to note, however, that in Lango v. Director, OWCP, 104 F.3d 573 (3d Cir. 1997), the court affirmed a denial of a widow's claim, where the miner's death was due to lung cancer. The court, in Lango, affirmed the administrative law judge's finding that the doctor who concluded that pneumoconiosis hastened the miner's death from lung cancer did not provide a reasoned medical judgment.
— Ronald E. Gilbertson
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