Freda M. Grant v. Director, Office of Workers' Compensation Programs, United States Dept. Of Labor

Citations: 857 F.2d 1102; 1988 U.S. App. LEXIS 13078; 1988 WL 98974Docket: 87-3674

Court: Court of Appeals for the Sixth Circuit; September 28, 1988; Federal Appellate Court

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Freda M. Grant appeals the Benefits Review Board's affirmation of an administrative law judge's (ALJ) denial of her application for black lung survivor's benefits. The appeal raises issues regarding the sufficiency of evidence supporting the ALJ's decision and the application of relevant regulations. Freda's husband, William H. Grant, worked in coal mines for nine years, but his black lung benefits application was filed in March 1979, shortly before his death in June 1979. Freda submitted her survivor's benefits claim on June 27, 1979, which was denied at both initial and reconsideration stages.

The ALJ found that William Grant had insufficient coal mine employment to qualify for benefits under the interim presumption outlined in 20 C.F.R. Sec. 727.203. Consequently, the ALJ assessed the application under Part 410, Subpart D, referencing the precedent set in Muncy v. Wolf Creek Collieries Coal Co. The ALJ acknowledged evidence of pneumoconiosis from x-rays and autopsy findings but determined that Freda failed to prove her husband's total disability due to pneumoconiosis or that his death was causally linked to the condition stemming from his coal mining work. Even under the presumption in 20 C.F.R. Sec. 410.490, Freda could not establish a connection between her husband's pneumoconiosis and his coal mine employment.

The Benefits Review Board upheld the ALJ's findings, concluding that substantial evidence indicated Freda did not demonstrate the existence of a totally disabling pulmonary impairment. The court now reviews this decision based on the limited medical evidence available, which includes x-ray assessments, blood gas studies, pulmonary function tests, and various physician and autopsy reports.

The document details various X-ray studies conducted on Mr. Grant, highlighting the qualifications of the interpreting physicians, their findings, and relevant pulmonary function tests. Notably, Dr. Straughan and Dr. Cole provided interpretations of X-rays from 1967 and 1976, with both acknowledging technical quality and slight under-penetration. Dr. Gordonson and Dr. Green reported unreadable results in 1979. 

Dr. Schuster, in a 1979 evaluation, found Grant's pulmonary function tests normal and concluded no significant pulmonary complaints despite a long history of smoking. Conversely, Dr. Kosater, Grant's treating physician, indicated total and permanent disability due to respiratory issues, noting changes consistent with emphysema and chronic bronchitis in X-rays, and reported Grant's autopsy revealed significant pneumoconiosis.

The Coroner's report identified the cause of death as cerebral anoxia from an aortic aneurysm rupture, despite noting marked emphysema. The review focused on whether the prior ruling was supported by substantial evidence, ultimately affirming that Mrs. Grant did not meet the burden of proof for survivor's benefits under specified regulations, which required demonstrating pneumoconiosis related to coal mine employment.

The ALJ found insufficient evidence to establish total disability due to pneumoconiosis under Part 410 standards, primarily relying on Dr. Kosater's letters from 1977, 1981, and 1983. The 1977 letter does not attribute a cause to Grant's disability, while the 1981 letter indicates treatment for breathing issues began in 1979. Although the 1983 letter mentions autopsy evidence of pneumoconiosis, it also states that Grant sought Social Security disability for "multiple other problems" prior to his death, failing to demonstrate total disability due to pneumoconiosis at that time. Additionally, Dr. Schuster's report noted "no significant pulmonary complaint," supporting the conclusion that Grant was not disabled by lung disease. 

The appeal raises the question of whether the ALJ should have applied the new Part 718 regulations rather than the old Part 410 regulations after determining that Mrs. Grant did not meet the interim presumption under 20 C.F.R. Sec. 727.203. The Director argues for the application of Part 718, citing Sec. 727.203(d), which allows for eligibility to be established under Part 718 if not established under Part 727. However, previous cases cited by the Director are not compelling due to the precedent set in Kyle v. Director, OWCP, which mandates that if the interim presumption is unavailable due to a miner's insufficient work history in coal mining, the ALJ must apply the Sec. 410.490 presumption. This aligns with the requirement that the criteria applied must not be more restrictive than those applicable to claims filed on June 30, 1973. The Sec. 410.490 presumption can be applied to miners with less than ten years of coal mine employment, contrasting with the ten-year requirement for Sec. 727.203.

Kyle's ruling is applicable to this case, clarifying that the old Part 410 regulations or the new Part 718 regulations do not present a conflict for claims filed before March 31, 1980, but adjudicated afterward. It mandates that if the ten-year coal mine employment requirement makes the presumption in Sec. 727.203 unavailable, the less restrictive presumption in Sec. 410.490 should be applied. In Mrs. Grant's case, the ALJ primarily assessed her claim under Part 410 but also briefly considered Sec. 410.490's presumption, which allows for a presumption of totally disabling pneumoconiosis for miners with less than ten years of employment if there is a positive x-ray for pneumoconiosis linked to coal mine work. 

However, Mrs. Grant failed to demonstrate that her husband's pneumoconiosis was caused by his coal mine employment. The ALJ noted a lack of evidence connecting Mr. Grant's pneumoconiosis to his coal mine work, despite the petitioner suggesting that his later employment in electrical repairs indicated a link. This argument was weakened by Mr. Grant's extensive history of smoking and the delayed onset of his treatment for respiratory issues, which began 37 years after he stopped working in coal mines. 

Consequently, the ALJ rationally concluded that the petitioner did not provide sufficient evidence to establish a causal relationship between Mr. Grant's coal mine employment and his pneumoconiosis, leading to the affirmation of the Secretary's denial of survivor's black lung benefits. The petitioner did not dispute that Mr. Grant's death was not due to pneumoconiosis. The text also notes that the Part 727 regulations are temporary and that claims filed prior to the effective date of the new regulations must adhere to less restrictive criteria.

Petitioner failed to provide evidence of causation under Sec. 410.490(b)(2), resulting in the interim presumption not being invoked. Consequently, the Director's rebuttal methods for Sec. 410.490’s presumption are not relevant. The Secretary's denial of survivor's black lung benefits is affirmed, as Petitioner does not dispute the ALJ's finding that her husband's death was not caused by pneumoconiosis. The temporary regulations under Part 727, established by the Black Lung Benefits Reform Act of 1977, apply to claims filed before March 31, 1980, and must be no more restrictive than those for claims filed before June 30, 1973. Part 727 also references Part 718, which includes the Part 410 regulations.