RECENT SIGNIFICANT DECISIONS

Black Lung Benefits Act

Office of Administrative Law Judges
United States Department of Labor

MONTHLY DIGEST # 134
December 1997 - February 1998

James Guill
Associate Chief Judge for Longshore

Thomas M. Burke
Associate Chief Judge for Black Lung

   A. Circuit Courts of Appeal

   In Jonida Trucking, Inc. v. Hunt , ___ F.3d ___, Case No. 96-3472 (6th Cir. June 26, 1997), Claimant was found entitled to benefits but refused payments from Employer, who was Claimant's long-time friend. Instead, Claimant sought payments from the Trust Fund. Employer stated that it failed to contest the claim "because it had relied on information from (Claimant) that any award would run against the Trust Fund and not against (Employer)." When Claimant was informed that he could not receive benefits from the Trust Fund, he requested a withdrawal of his claim which was denied by the Board. Because Claimant did not join Employer in its appeal of the Board's denial of withdrawal of the claim, the court held that Employer did not have "standing to appeal the withdrawal issue." The court stated that "it is clear that an employer is not the proper party to argue that its employee's best interests are served by allowing him to forfeit payments from the employer."

   Upon review of the merits of the claim, which involved a petition for modification, the court reiterated that "the fact-finder has the authority, if not the duty, to rethink prior findings of fact and to reconsider all evidence for any mistake in fact or change in conditions." The Sixth Circuit further stated that, under 20 C.F.R. Part 718, Claimant must demonstrate that his pneumoconiosis contributes, at least in part, to his total disability to be entitled to benefits. It concluded that the administrative law judge properly weighed the medical evidence in finding that the miner was totally disabled and noted the following:

Although DelVecchio and Garson relied on pulmonary tests exhibiting levels of impairment below that required to establish total disability under section 718.204(c)(1), these tests did demonstrate some impairment and can form a basis, along with other evidence, for a reasoned medical decision establishing total disability under Section 718.204(c)(1)."
   Finally, the court held that Employer could not be relieved of its liability for failure to timely controvert on grounds that it relied on Claimant's mistaken representation that the Trust Fund would be held liable for benefits. As a result, the court concluded that Employer failed to demonstrate "good cause" for its failure to timely controvert both the claim and its designation as the responsible operator. The court then upheld an order directing that Employer, a trucking company, secure the payment of $150,000 in benefits pursuant to 20 C.F.R. § 725.606.
[ withdrawal of claim ; modification ; failure to timely controvert/good cause ]

   In United States v. Insurance Co. of North America , ___ F.3d ___, Case No. 97-5075 (D.C. Cir. Dec. 23, 1997), Employer qualified as a self-insurer and obtained 1973 and 1982 indemnity bonds from Insurance Company of North America (INA). INA argued that it was liable for only those claims which arose during the 1982 bond period and not for all claims outstanding during the bond period. The court held that "[b]ecause liability under the Act is assigned only to the operator with which a miner was most recently employed for at least one year, . . . INA was liable under the 1982 bond only for claims in which the miner had completed at least one year's employment with Kaiser during the bond period . . .." The court then remanded the case for a determination "with the admission of extrinsic evidence, if necessary, whether the parties to the bond intended that the first year of employment or the last year of employment be the trigger of liability (for INA) and to reassess damages in accordance with that determination."

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