RECENT SIGNIFICANT DECISIONS

Black Lung Benefits Act

Office of Administrative Law Judges
United States Department of Labor

MONTHLY DIGEST # 126
September - October 1996


    Circuit Courts of Appeal

   In Peabody Coal Co. v. Spese , 94 F.3d 369 (7th Cir. 1996), the court held that a subsequent claim filed under § 725.309 merges with an earlier claim where a claimant demonstrates that a "material change in conditions" has occurred. oreover, "benefits should begin as soon after the filing date of (the first claim) as possible . . .." Thus, the court found that, because the first claim was denied for failure to demonstrate the existence of pneumoconiosis, benefits are payable on the second claim, wherein the miner established the presence of the disease, as of the month in which the first claim was "formally denied."

   In addition, the court concluded that the regulatory standards which govern the "merged" claims are those applicable to the first claim which, in Spese , were the Part 727 regulations. Finally, the court upheld an administrative law judge's use of the "later evidence" rule in weighing x-ray evidence where the last study was positive for existence of pneumoconiosis and the negative studies were dated at least three years earlier.

[ subsequent claim under § 725.309 -- merger with earlier claim; application of "later evidence" rule in weighing x-ray interpretations upheld ]

   In Richardson v. Director, OWCP , , 94 F.3d 164 (4th Cir. 1996), the court reiterated that "[c]linical pneumoconiosis is only a small subset of the compensable afflictions that fall within the definition of legal pneumoconiosis under the Act" and that "COPD, if it arises out of coal mine employment, clearly is encompassed within the legal definition of pneumoconiosis, even though it is a disease apart from clinical pneumoconiosis." It further noted that, in a survivor's claim under Part 718, Claimant must demonstrate that pneumoconiosis "hastened" the miner's death "in any way." The court also held that the Director's "stipulation," that the miner suffered from legal pneumoconiosis arising from coal dust exposure at the time of death, was binding notwithstanding a lack of medical evidence in the record to support the stipulation.

[ § 718.201 "pneumoconiosis" defined; "hastening death" standard under § 718.205; stipulation of party is binding ]


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