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Circuit Court Outline





A.  Miner

      1.  Coal Mine; Coal Mine Dust

      2.  Status/Function/Situs & Situs/Function Tests

      3.  Construction/Transportation Workers

      4.  General Case Listings For Covered and Not Covered Coal Mine Employment [listed in Circuit order]

     a.  Cases: Covered Coal Mine Employment

     b.  Cases: Not Covered Coal Mine Employment

B.  Survivors/Dependents

[Digest Headings: Widow-Subsequent Remarriage; SSA Benefits As Miner's Property; Impact of State Law; Disabled Child; Conveyance of a Home; Eligible Survivors at Section 725.545(c)(4-7); Under the 2000 Amendments to the Regulations]

C.  Pneumoconiosis

[Digest Headings: Anthracosis in Lymph Nodes; Progressive Nature of Pn; Applicability of Revised Regulation 20 C.F.R. §718.210(a)]

D.  Total Disability

[Digest Headings: Establishing Total Disability Under the Act; Age As a Cause of Disability]

E.  Length of Coal Mine Employment

F.  Usual Coal Mine Employment

[Digest Headings: Voluntary Overtime]

G.  Comparable and Gainful Work

H.  Responsible Operator

[Digest Headings: Changing Form of Business Entity; Withdrawal of Controversion; Federal Government as Operator; Notice to Carrier; Identifying the Responsible Operator; Transfer of Liability]

I.  Benefits

J.  Workers’ Compensation Law


A.  Requirement to File State Workers' Compensation Claim; Offset

[Digest Headings: Section 725.535(b) Validity; Offset]

B.  Consequences of Filing a Part B Claim

[Digest Headings: Converting Part B Claims to Part C; Prior Findings of Entitlement; Medical Benefits Only]

C.  Payment of Benefits

    1.  Generally; Assessment of Interest

    2.  Under the 1981 Amendments to the Act: Transfer Cases

[Digest Headings: Trust Fund Liability]

    3.  Overpayments

a.  Erroneous Information

b.  Income and Expenses

c.  Defeat the Purposes of the Act

d.  Changed One’s Position for the Worse

e.  Miscellaneous

D.  Applicable Law

[Digest Headings: Application of Current Law By Appellate Tribunal]

E.  Viability of Claims

    1.  Abandonment

[Digest Headings: Distinguishing Sections 725.409 and 725.410]

    2.  Merger of Claims/Duplicate Claims

a.  Tenth Circuit's Duplicate Claim Approach

b.  Material Change of Conditions

1).  Subsequent Claims

c.  Merging Duplicate Claims

d.  Duplicate Survivors’ Claims

e.  Under the 2000 Amendments to the Regulations

    3.  Subsequent Claims/Revised Version of 20 C.F.R. §725.309

    4.  Statute of Limitations

F.  Modifications

    1.  Generally

    2.  Procedural Issues

    3.  Mistake of Fact/Change in Conditions

G.  Commencement of Benefits

    1.  Onset of Total Disability Due to Pneumoconiosis

a.  Section 727.302 Validity

b.  Generally

    2.  The Effect of Continued Employment

H.  Scope of Review

    1.  Generally; Timeliness

a.  Thirty Day Notice; Section 725.458

    2.  Administrative Procedure Act

    3.  Law of the Case

    4.  Issues on Appeal

a.  Board's Authority

b.  Jurisdiction

[Digest Headings: Jurisdiction on Interest Cases]

c.  Secretary’s Authority

I.  Policies in General

1.  Settlements and Releases

J.  Timeliness of Claim Filing


A.     The Claims Process

1. Filing of Claims/Appeals, Service, Sufficiency of Pleadings

[Digest Headings: Actual Knowledge of Service; Sufficiency of Pleadings (Cross-appeals); Timely Filing of Appeals; Interlocutory Appeals; Validity of Section 802.206(e)]

2. The District Director's Role and Representative

[Digest Headings: Deference to the Director in Interpreting Regulations; Relationship Between District Director and the Director; Validity of DOL Denial Letter; Pre-Hearing Conferences; Reply Briefs; Notification of Claim/Initial Finding; Maintenance of the Record]

    3. Claimants' Right to Complete Pulmonary Evaluation

B.  Full and Fair Hearing

    1.  Right to a Hearing; Waiver

            [Digest Headings: Right to a Hearing; Waiver]

    2.  Due Process

    3.  Right to Counsel

    a.  Role of Government Attorney

[Digest Headings: Absence of Counsel; Acts of Counsel Binding on Party]

    4.  Admission of Evidence

    5.  Costs

C.  Evaluation and Weighing of Evidence

    1.  Elements of Entitlement

    a.  Generally; Interpretation of Medical Data

    b.  Disability

[Digest Headings: Date at Which Disability is Judged; Inferring Total Disability]

    c.  Existence of Pneumoconiosis

    d.  Cause of Disability and Pneumoconiosis

[Digest Headings: Concurrent Causes of Disability; Silent Evidence; Erroneous Premise; Proof of Coal Dust Exposure]

    2.  Specific Evidentiary Principles

    a.  Blevins Test for Admissibility

    b.  Later Evidence

    c.  True Doubt

    d.  Adverse and Negative Inferences

            [Digests Headings: Use of Negative Inferences]

    3.  Medical Reports

    a.  Physicians: Qualifications/Treating/Non-Examining

    b.  Hostility: Opinions in Conflict with the Act

c.  Opinions Contrary to the Revised Regulations

    4.  Miscellaneous

    a.  Lay Testimony/Evidence

    b.  X-Rays, Readers and Quality Standards

[Digest Headings: Distinguishing “B” Readers; Section 413(b) Prohibition; Substantial Evidence]

    c.  Autopsy and Biopsy Evidence, Quality Standards

    d.  Ventilatory and Blood Gas Studies, Quality Standards

    e.  Vocational Experts and Evidence

    f.  Contraindication of Continued Employment


A.  In General

    1.  Applicability

    2.  Validity

    3.  Quality Standards

            a.  Applicability

            b.  In General

B.  Existence of Pneumoconiosis

1.      Section 718.202(a)(1):  X-ray Evidence

2.      Section 718.202(a)(2):  Biopsy or Autopsy

3.      Section 718.202(a)(3):  Presumptions

a.       Section 718.304: Complicated Pneumoconiosis

[NOTE: for digests and discussion of Sections 718.304, 718.305 and 718.306 please refer to Parts V and VII of this outline]

    4.  Section 718.202(a)(4):  Medical Reports

    5.  Under the 2000 Revisions to the Regulations

C.  Pneumoconiosis Arising Out of Coal Mine Employment

D.  Total Disability:  Section 718.204

    1.  Generally

    2.  Section 718.204(c)(1)

    3.  Section 718.204(c)(2)

    4.  Section 718.204(c)(3)

    5.  Section 718.204(c)(4)

    6.  Section 718.204(c)(5)

E.  Cause of Disability

        1.  Section 718.204(b)

        2.  Section 718.204(c)(1)

F.  Survivors' Claims Without Benefit of a Presumption: Section 718.205

[NOTE: for digests and discussion of Section 718.303, please refer to Part VII of this outline]


A.  Section 411(c)(1)

B.  Section 411(c)(3)

C.  Section 411(c)(4)


A.  20 C.F.R. §727.203 Interim Presumption in General

    1.  Section 727.203(a)(1)

    2.  Section 727.203(a)(2)

    3.  Section 727.203(a)(3)

    4.  Section 727.203(a)(4)

    5.  Section 727.203(a)(5)

B.  Rebuttal of the Interim Presumption

    1.  Section 727.203(b)(1), (b)(2) Rebuttal

a.  Total disability is without regard to cause

b.  Rebuttal can not be established on the basis of no impairment

c.  Total disability from a respiratory standpoint

d.  Comparable and Gainful Work

    2.  Section 727.203(b)(3) Rebuttal

a.  Third Circuit

b.  Fourth Circuit

c.  Sixth Circuit

d.  Seventh Circuit

e.  Eighth Circuit

f.   Ninth Circuit

g.  Tenth Circuit

h.  Eleventh Circuit

    3.  Section 727.203(b)(4) Rebuttal

C.  20 C.F.R. §410.490 Interim Presumption

[Claims Filed Prior to March 31, 1980]

    1.  Miners with Ten or More Years of Coal Mine Employment

    2.  Miners with Less than Ten Years of Coal Mine Employment


A.  Derivative Entitlement

B.  Section 411(c)(1)

C.  Section 411(c)(2)

D.  Section 411(c)(3)

E.  Section 411(c)(4)

F.  Section 411(c)(5)


A.  Review of Attorney Fee Awards Made Below

    1.  General Overview

    2.  Successful Prosecution of the Claim

    3.  Jurisdiction

    4.  Issues on Appeal of Attorney Fee Awards

    a.  Opposition to Attorney Fees

b.  Counsel's Appeal of Substantial Reductions in the Requested Fee

    1).  The Hourly Rate

2).  The Number of Hours

    5.  Liability for Attorney Fees

    6.  Miscellaneous Issues

B.     Attorney Fees For Services Performed Before the Board

1.    Hourly Rate

2.  Successful Prosecution of Claim Before the Board