Congressional Democrats have introduced a measure designed to streamline the process for miners filing benefits claims under the Black Lung Benefits Act – and to help miners overcome the “resource disparities” between themselves and the coal companies who use legal maneuvering to block the miners’ claims.
Introduced by Rep. Matt Cartwright (D-PA), the ‘‘Black Lung Benefits Improvement Act of 2014’’ (H.R. 5751) would make substantial changes to the way claims are filed and adjudicated and would include the establishment of a National Institute for Occupational Safety and Health (NIOSH) program that would provide unbiased evidence for particularly severe cases of pneumoconiosis – the group of mining-related pulmonary diseases commonly known as ‘‘black lung disease.’
H.R. 5751 notes that the determination of a claimant’s eligibility for these benefits often requires complex, adversarial litigation. “Resource disparities between coal companies and such claimants are widespread within the statutory and regulatory framework of such Act. Comprehensive reforms are necessary to ensure that coal miners are not at a disadvantage when filing claims for benefits.”
Evidence key to claims process
The Government Accountability Office (GAO) has found that many claimants are not equipped with the medical and legal resources necessary to develop evidence to meet the requirements for benefits. Miners often lack complete and reliable medical evidence, consequently increasing the risk that the individuals who review claims for benefits will be presented with insufficient medical evidence.
“Similarly, without better options for legal representation, significant numbers of such claimants proceed with their claims through a complex and potentially long administrative process without resources that Department of Labor officials and black lung disease experts note are important for developing evidence and supporting their claims.”
Fewer than 25% of claimants are represented by an attorney when filing a claim.
“Absent efforts to remedy administrative problems and address structural weaknesses in the process for obtaining benefits, claimants with meritorious claims will not receive benefits.”
Mine operators withheld medical evidence
The measure would require the full disclosure of medical information related to a claim – relevant evidence that has, in some cases, been withheld by mine operators’ legal representatives, according to records of adjudications. In at least some of the cases examined, the disclosure of such evidence would have substantiated a miner’s claim for bene fits. Additionally, withholding medical information “can endanger miners by depriving them of important information about their own health and the potential need to seek medical treatment.”
At Johns Hopkins: Misread x-rays, high fees
The bill alludes to a scandal involving Johns Hopkins Medicine, in which a physician who was paid by coal companies to interpret chest x-rays for black lung incidence was found to be wrong in at least 100 cases. Despite the fact that the rate of black lung disease among miners is on the rise, Dr. Paul Wheeler, head of the Hopkins unit that reads x-rays in black lung cases, testified in court that the last time he found a case of severe black lung was in the 1970's or early 80's. Wheeler was paid approximately ten times the usual amount to interpret x-rays. (Johns Hopkins Medicine suspended its black lung program after the discrepancies came to light.)
“Investigations have uncovered that there are NIOSH-certified B Readers who have systematically misclassified chest radiographs while employed by coal operators or their law firms for the purpose of opposing claims under such Act. In response, the Department of Labor has directed claims examiners ‘not to credit negative chest x-ray readings for pneumoconiosis’ by one widely used physician employed at a prominent medical center unless the conclusions of such physician ‘have been rehabilitated.’ Where chest radiographs are needed to establish entitlement to benefits, claimants should have access to accurate interpretations so as to ensure the fair adjudication of such claims.”
Although miners are barred from filing a new claim one year after a decision, H.R. 5751 would allow those whose claims were rejected due to “a certain physician whose interpretations have since been determined by the Department of Labor to be generally not worthy of credit” to do just that.