RECENT SIGNIFICANT DECISIONS
Black Lung Benefits Act
Office of Administrative Law Judges
United States Department of Labor
MONTHLY DIGEST # 130
ay and June 1997
James Guill
Associate Chief Judge for Longshore
Thomas M. Burke
Associate Chief Judge for Black Lung
Circuit courts of appeal
In Director, OWCP v. Hamm , ___ F.3d ___, Case No. 96-1380 (4th Cir. May 19, 1997), a copy of which is attached, the court noted that offset provisions under the Act are "designed to supplement, but not duplicate, state benefits for pneumoconiosis." As a result, it concluded that the Board's determination that Claimant's "federal benefits . . . be offset by only 20 percent of his total state benefits because only 20 percent of those benefits could be attributable to pneumoconiosis," was in error. In this vein, the Fourth Circuit stated the following:
- Hamm receives lifetime benefits from West Virginia for total disability. Prior to obtaining his total disability award, Hamm received a number of permanent partial disability (PPD) awards from the state. In 1974, 1977, and 1988, he obtained PPD awards of 15, 15, and 20 percent respectively for pneumoconiosis. His second and third awards were based on increases in his total impairment due to pneumoconiosis to 30 percent and finally 50 percent.
Consequently, the court determined that the aggregate prior awards resulted in a State determination "that Hamm suffers 50 percent permanent disability on account of pneumoconiosis" such that his federal benefits "should be offset by 50 percent of the amount of his second injury award."
[ III(A), offset of federal benefits ]
In Crace v. Kentland-Elkhorn Coal Corp. , ___ F.3d ___, Case No. 96-3538 (6th Cir. Apr. 7, 1997), Claimant filed a Part B claim with the Social Security Administration which subsequently denied it. More than a year later, a second claim was filed with the Department of Labor under Part C. After referral of the claim to the OALJ, but prior to a formal hearing, an administrative law judge dismissed Employer as a party to the claim, transferred liability to the Black Lung Disability Trust Fund (Fund), and awarded benefits. On appeal, the Board determined that Employer should have remained a party and remanded the claim for a new hearing. On remand, a second administrative law judge held a hearing with Employer as a party and issued a decision denying benefits.
Claimant's appeal of the denial eventually reached the Sixth Circuit which concluded that the claim was not suitable for transfer to the Fund because Claimant never elected review of his denied Part B claim:
- The government points to computer data indicating that it sent an election card to Mr. Crace. (citation omitted). Mrs. Crace does not remember receiving such a car, however, and although she would not have seen all the mail sent to her post office box, she notes that Mr. Crace normally took care of his correspondences. Where letters have been properly sent, we presume that they have reached their destination in the usual time and have been received by the person to whom they were addressed. (citation omitted). The government's computer evidence entitles it to this presumption. Mrs. Crace's testimony that her husband normally took care of his correspondence does not adequately rebut it.
As a result, the court held that Employer was a party to the claim and, although, the first administrative law judge awarded benefits, Employer was not a party at that time and is, therefore, not bound by that decision. The court then stated that the denial of benefits by the second administrative law judge, where Employer was a party, was supported by substantial evidence in the by record. In this vein, the court concluded the following:
- Recent evidence is particularly important in black lung cases, where because of the progressive nature of pneumoconiosis, more recent evidence is often accorded more weight. The most recent administrative law judge was presented with a new, more complete picture of Mr. Crace's health. His determination (denying benefits) was supported by substantial evidence.
Consequently, the denial of benefits was affirmed.
[ III(C)2)(d), transfer of liability ; IV(D)(3)(b), "later evidence" rule ]