2009 D e c i sion s O p inion s of the U nit e d S t at e s C our t of Appe al s for the Thir d C ir c uit 4-9-2009 

# Hi l l v . D irec t or OWC P P r e c e de nt i al or N on-P r e c e de nt i al : P r e c e de nt i al D ocke t N o . 06-4868

F o l low thi s a nd a dd it ion al work s at : http://d i git alc ommon s .l a w . vi l l a nova . e du/thir dc ir c uit_2009

Thi s de c i sion i s br ou ght t o you for f r e e a nd ope n a c c e s s b y the O p inion s of the U nit e d S t at e s C our t of Appe al s for the Thir d C ir c uit at V i l l a nova U nive r sity S choo l of L a

w Di git al Reposit ory

. It h as be e n a c c ept e d for inclusion in 2009 D e c i sion s b y a n author i z e d a dmini s tr at or of V i l l a nova U nive r sity S choo l of L a

w Di git al Reposit ory

. F or mor e inform at ion, p le as e c ont a ct Be n j amin . C arl s on@l a

w . vi l l a nova . e du . Re c omme nde d C it at ion
" Hi l l v . Dir e ct or O WC P " (2009). 2009 D e cisio n s . P ape r 1446. http://d i git alc ommon s .l a

w . vi l l a nova . e du/thir dc ir c uit_2009/1446Honora ble A. WallaceTashima, Senior Judge of the * United States Court of Appeals for the Ninth Circuit, sitting by designation. P RE CE DE NT I AL

UN I TED STATES CO UR T OF A PP EALS F O R T H E T H IR D C IR C U IT

_____________ N o. 06- 4868

_____________ P E G G Y H IL L , W id o w o f C h a rle s W . H ill ,

P et i t i oner , v. DI RE CT OR , OF F I CE OF WORKE RS ’ CO M P E NS AT I ON P RO GR AM S , UNI T E D S T AT E S DE P AR T M E NT OF

LABOR, R es pondent
. O n Pet i t i on forR evi ew of an O r derof the B en ef

it s R ev iew B o ard U ni t ed St at es D epart m entof Labor ( BR B N o . 0 6
- 0 2 6 6 BL A) A r gued M ar ch 24, 2008 B efor e: M cK E E , R E N D E L L , & T A SH I M A C i r cui tJ udges *2 ( O pi ni on Fi l ed: A pr i l 9, 2009)

____________ G eor ge E. M ehal chi ck ( ARG UED ) L e n a h a n & D e m p s e y , P .C
. T he K ane Bui l di ng 116 N or t h W as hi ngt on A venue, Sui t e 400 Scr ant on, PA 18503 C ouns el f orP et i t i oner Jo n atha n L
. S n are A l l en H
. Fel dm an Pat r i ci a M
. N ece K r i s t en Li ndber g ( ARGUE D) U ni t ed St at es D epart m entof Labor O ffi ce of t he Sol i ci t or Sui t e N
- 2117 2 0 0 Co n s t i tu t i o n Av e n u e NW W as hi ngt on, D
. C
. 20210

C ouns el s f orR es pondent

_____________ OP I NI ON

_____________3 M cK E E , C i r cui tJ udge T he w i dow of a de cea s ed coal m i ner pet i t i ons forr evi ew of a de ci s i on of the B enef i t s R evi ew B oar d aff

ir m ing an A d m i n i s t r a t i v e L a w J u d g e 's d e n i a l o f h e r c l a i m f

o rs u r v i v o r 's benef i t s u n d e rt h e Bl a c k Lu n g Be n e f i t s Act , 3 0 U. S. C. §§ 901- 945. Fort he r eas ons t hat fol l ow , w e w i l l gr antt he pet i t i on f o rr e v i e w, a n d r e ma n d f o rp a yme n to f

h e rc l a i m. I . F ACT S AND P ROCE DURAL BA CKGROUND C h arles H il l w o rke d in co al m ines in N o rth ea stern P e n n sy lv a n ia f

o r m o re th a n tw e n tyy e a rs. D u rin g h is empl oym ent , he w as r es pons i bl e forphy s i cal l ybr eaki ng up coal
w i t h a pi ck and s hovel and l oadi ng i t i nt o m i ne car s and s haker chut es . H i l l w as al s o i nvol ved i n m i ne dr i ll ing , ta m pi ng exp l osi ves and blas t i ng op erat i on s. H i l l fi r s tappl i ed forB l ack Lung b en efi t s on A pr i l 18, 1980. T he D epart m ent of Laboradmi ni s t r at i vel ydeni ed the4 cl ai m and ther eaf

t erdeni ed tw o addi t i onal cl ai m s thatH i l l fi l ed i n J une of 1984 an d S ept emberof 1991. H i l l appl i ed for benef i t s a four t h t i m e on N ovember 3, 1993 and w as deni ed
once a gai n. T hat deni al w as aff i r m ed af t era form al hear i ng, but t he B enef

i t s R evi ew B oar d r ever s ed t he A L J ’ s deci s i on deny i ng b enef i t s . O n r emand, t he A L J fi nal l yaw ar ded bene fi t s dat i ng back t o N ovember1993, and augment ed t he bene fi t s t o i ncl ude H i l l ’ s w i fe a nd s on w ho w er e l i s t ed as depende nt s . I n aw ar di ng b e n e f its th e A L J c o n c lu d e d th a t: (1 ) th e re c o rd su f f icie n tly
es t abl i s hed the exi ste nce of pneumoconi os i s , ( 2) a ca us al relati o n sh ip ex ist ed b etw ee n the p n eu m o co n iosis an d 9 1⁄2 y ea rs of document ed coa l m ine empl oym ent , and ( 3) H i l l s uffe r ed to ta l d is a b ility d u e to p n e u m o c o n io s is
. H ill d ied o n A u g u st 7 , 2 0 0 4 , an d h is w id o w , P e g g yH ill , t i m el yfi l ed fors ur vi vor ’ s benef i t s undert h e B lack L ung B enef i t s A ct . T h at c l ai m w as deni ed byt he D epart m entof5 L aboron February15, 2005, butM r s . H i l l appea l ed and
re c e iv e d a h e a ri n g b e f

o re a n A L J
. A tt he hea r i ng befor e t he A L J , t he par t i es s t i pul at ed that H i l l had cont r act ed pneum oconi os i s fr om w or ki ng i n t he mi nes bas ed on hi s r ece i ptof B l ack L ung benef i t s dur i ng hi s l i fet i m e. A c c o r d i n g l y, t h e o n l y i s s u e f a c i n g t h e A L J w a s w h e t h e rH i l l 's death had bee n caus ed by p n eum oconi os i s as r equi r ed for
s u r vi vo r ' s b e n e f

i t s u n d e r2 0 C. F. R. § 7 1 8
. 2 5 0 ( c )
. Th e ALJ hear d t es t i m onyfr om M r s . H i l l and r ec ei ved the depos i t i on of D r. K evin C arey . D r. C arey had t reat ed C harl es H i l l atW i l kesB arre G en era l H o s p it al an d at L ak esid e N u rsi n g H o m e, w h ere M r. H il l had d ied ju st a fe w d ay s af ter be ing tr an sfe rred there f ro m W ilk e s-B a rre G e n e ra l. T he A L J deni ed H i l l ’ s cl ai m , and thatdeni al w as aff i r m ed byt he B enef

i t s R evi ew B oar d. T he B oar d concl uded t hatD r . C ar eyhad not m ad e a fi ndi ng of cl i ni cal6 p n e u m o c o n io sis a n d “ d id n o t sta te th a t h is f in d in g o f c h ro n ic
o b stru c tiv e p u lm o n a ry d ise a se /ch ro n ic lu n g d ise a se is re late d to coal m i ne empl oym ent( l egal pneumoconi os i s )
. ” B R B D eci s i on at5. T hus , t he B oar d agr eed w i t h t he A L J ’ s concl us i on t hatt he
e v id e n c e w a s in su f

f icie n t to e sta b lish d e a th d u e to p n e u m o c o n io s is
. T h is p e titio n f

o r r e v ie w f

o llo w e d
. I I . T H E E V I D E N C E B E F O R E T H E A L J D u rin g h e r t e stim o n y b e f o re th e A L J, M r s . H ill confi r m ed thatherhus band had been e xper i enci ng s hor t nes s of br eath and coul d notgo up a fl i ghtof stairs w ithoutt aki ng a br eak. She al s o t es t i fi ed t hat M r . H i l l had a s ever e, pr oduct i ve cough and that he had di ffi cul t y s l eepi ng beca us e of hi s l abor ed breat hing. M rs . H i l l con fi rm ed thatM r. H i l l had t hese
s ym pt om s befor e he had been admi t t ed t o W i l kes
- B arr e G ener al H os pi t al
. H r ’ g T r . at9- 10.7 D r . C areyoper at es a fa m i l ycar e pr act i ce i n N oxen, P e n n sy lv a n ia a n d is b o a rd c e rtifie d in f a m ily m e d icin e . H is p ra c tice in c lu d e s p a tien ts w ith p u lm o n a ryd ise a s e d u e to occupa t i onal expos ur es . D r . C ar eybegan tr eat i ng M r . H i l l w hen H i l l w as hos pi t al i zed a tW i l kes
- B arr e G ener al , and cont i nued af ter H il l’ s tr an sfe r t o L ak esi d e . A lth o u g h D r. C are y ’s
co ll ea g u e, D r. G w en G alasso , w as H il l’ s p ri m aryp h y sici an , D r. C a re ya ss u m e d r e sp o n sib ili tyf o r H ill ’s c a re a f

ter H ill w e n t to t h e n u r s i n g h o me . Dr
. Ca r e y ’ s t e s t i mo n y wa s b a s e d o n h i s o wn exami nati o n s of H i l l , as w el l as D r . G al as s o’ s not es and the not es of s ever al ot her s peci al i s t s at t he hos pi t al and the nur s i ng h o m e . D e p . T r. a t 5 -9
. T h e v a st m a

jo rityo f p r o f

e ss io n a l o b se rv a tio n s o f H ill , a n d t h e c o n c l u s i o n s o f

a v a r i e t yo f

p h y s i c i a n s wh o t r e a t e d h i m, i dent i fi ed s ym pt om s of pneumoconi os i s and the ef fec t s of chr oni c obs t ruct i ve pul m onarydi s eas e ( “C O PD ”)
. O n J ul y16,At e le c ta sis is thec oll a ps eof pa rt or a ll o f a lun g . It is 1 c a us e d b y a blo c kag eof

thea ir pa ssag e s (bron c hu s o r b ro nc hio le s) or by pre ssu reon thelun g . U .S. Nat. Library of Me dic ineand

Nat. Inst. of Health at htt p:/ /www .n lm. nih .g ov/me dlineplu s/enc y /artic le/00 00 65 .htm. 8 2004, t he dayH i l l w as admi t t ed t o t he e m erg en cyr oom at W i l kes
- B arre G ener al , D r . G al as s o not ed the pr es ence of decr eas ed br eath s ounds and r efe r ence d a che s tx- r ay t hat
s h o wed b i b a s i l a r a t e l e c t a s i s . Ei g h t o f t h e t e n p h y s i c i a ns w ho 1 exami ned H i l l dur i ng hi s t hr ee- w eek s t ay at t he ho sp it al m ade
s im ilar o b se rv a tio n s. F o r e x a m p le, w h e n H ill w a s a d m itt e d to th e h o sp ital, D r. D a v id D a les sa n d ro n o ted sc a ttere d rh o n c h i in H i l l ’ s l ungs . Fo u r day s l at er , D r . Pat r i ck D egenna r o obs erved

“ p ro m in e n t m a rk in g s” o n th e lu n g s a n d “ a b n o rm a l o p a c iti e s in t he bas es . ” A pp. at100. D r . W enl i n Fan confi r m ed a r educt i on i n l ung capa ci t y on a ches t x- r aycompl et ed on A ugus t2, 2004. T w o day s l at er , D r . St r as s er per for m ed a ches t x- r ayand not ed:Two physicians, Dr. Sanje ev Ga rgand Dr . Martin Fried, 2 indicated that Hill’s lung s wereclea r to auscultation on Jul y

17, 2004 and Jul y

28, 2004 respe ctively . Dr. De cker , another consulting physician, indicate d that one of H ill’s chest x -ra ys was fre e of infiltrate, but he obser ved dec rea sed bre ath sounds in the same e x amination. His notations therefore cor roborate that Hill’s respiratory

sy stem was compromised. Moreover, the notations of these doc tors areconsistent with observations wehave made about pneumoconiosis. We have e xplained that it is a persistent and progressive disea se and although “ sy mptoms m ay , on occa sion, subside, the condition itself does not improve . . . .” Lab e lle Processing Co. v. Swarrow , 72 F.3d 308, 314 ( 3d Cir. 1995). 9 “[h] azydens i t yi s pr es enti n bot h m i d- l ung fi el ds
. ” A pp. at97. Fi nal l y , D r . C ar eyt es t i fi ed t hatupon H i l l ’ s arr i val atL akes i de
o n A u g u s t 5 , H ill h a d d e c re a se d b re a th so u n d s, so m e c h ro n ic
r honchi , and som e coar s e rhonc hi , al l r el at ed t o a chr oni c l ung d is e a s e . D e p . T r. a t 5
.

2 H i l l di ed at4: 15 a. m . on A ugus t 7, 2004, t w o day s aft er b eing tr an sfe rred to the n u rsi n g h o m e f rom W il k es-B arre G ener al
. D r. C are ycompl et ed the dea t h cert i fi cat e and l i s t ed t he pri m ary cause of death as car diopulm on aryarr est . H e al so10 not ed othercontr i but i ng caus es of deat h i ncl udi ng: r enal fai l ur e,
a rte rio sc ler o tic ca rd io v a sc u lar d ise a se a n d a n e m ia. D u rin g h is dep osi t i on , D r. C areyexp l ai ned ho w H i l l ’s l u n g d i sease cont r i b u t e d t o h i s d e a t h
. Dr
. Ca r e y i n d i c a t e d t h a t e a c h of t he sy m p to m s liste d o n H ill ’s d e a th c e rtific a te— re sp ira to rya rre st,
r enal f a i l u r e , a r t e r i o s c l e r o t i c c a r d i o v a s c ul ar di s eas e, anemi a— w oul d al l be w or s e bec aus e of the l ow ervo lum es of
o x y g e n th a t r e s u lte d f

ro m H ill’ s p u lm o n a ry d is e a s e . O n cr os s - exami n ati on, D r . C ar eyfur t herexpl ai ned that hyponatr emi a–a de fi ci ency of sodi um i n t he bl ood–i s oft en s een i n peopl e w i t h chr oni c l ung di s eas e. H e al s o confi r m ed thatno
m e d ica l r e c o rd s w e re a v a ilab le f o r H ill f o r th e tw o d a y s p rio r to hi s death on A ugus t7, 2004, aft erhe w as t r ans ferr ed t o t he
nur s i ng hom e. D r . C ar eyl as ts aw H i l l on A ugus t5, 2004. I n oppos i ng M r s . H i l l ’ s cl ai m , t he D i r ect oro ff er ed a t w o- page r epor t fro m D r . M i chae l Sher m an. H i s r epor tw as11 bas ed s ol el yon hi s r evi ew of r ecor ds he had r ece i ved fr om t he D e p a rtm e n t o f

L a b o r. T h o se re c o rd s in c lu d e d : H ill ' s d e a th
cert i fi cat e, r ecor ds fr om L akes i de N ur s i ng H om e, and r ecor ds pr ovi ded byt he W y om i ng V al l ey H ea lt h C ar e Sy s t em from W i l kes
- B arr e G ener al H os pi t al
. T he l at t er i ncl uded r ecor ds of H il l’ s th re e -w e e k sta ya t W ilk e s-B a rre G e n e ra l. B a se d o n h is exami nat i on of thos e r ecor ds , D r . Sher m an st at ed “[ t ] her e i s no not e i n t he r ecor d of anys hor t nes s of br eath, dy s pnea, or
r es pi r at or ydi s t r es s . ” A pp. at54. H e ther efor e conc l uded: 1. T he ca u se o f dea t h i s notcl earfr om t he r ecor d. C lea rlyM r. H ill w a s in p o o r c o n d iti o n . H e w a s s e v e re ly m al nour i s hed; an al bum i n of less t han 2. 0 i s as s oci at ed w i t h i m m une compromi s e and he w as t hus l i kel yt o have di ffi cul t yw ar di ng off i nfec t i on. H e had ne w ons etof atr i al fi br i l l at i on and thu s m ayhave ha d under l y i ng cor onaryar t erydi seas e; he w as al s o atr i s k for devel opi ng s y s t emi c embol i fr om t he atr i al fi br i l l at i on. T her e ar e no r ecor ds aft er 8/ 5/ 04, s o t he ci r cumst ance s i m m edi at el y s ur r oundi ng M r . H i l l ' s death t w o day s l at er a re n o t k n o w n . 2. H o w ever , I fi nd no evi dence t hatdeath w as12 c a u se d b yp n e u m o c o n io sis o r th a t p n e u m o c o n io sis contr i but ed sig n ifi c a n tly t o M r. H i l l ' s d eat h. T here i s no evi dence i n t he r ecor d t o s ugges tt hatM r . H i l l had dy s pnea, r es pi r at or y di s t r es s , or r es pi r at or yfai l ur e w hen he arr i ved at t he nur s i ng hom e. I ndeed, he w as fel tt o be s t abl e on t h e d ayof admi s s i on. D eath appea r s t o be r el at ed t o a gene r al l evel of s ever e im pai r m entfr om d em en ti a an d m alnu tr it ion , an d p o ssiblyd u e to h is he art d isease
. H o w ev er, I d o n o t fi n d ev iden ce fo r a c o n tr ib u tio n f

ro m C O P D o r f

ro m p n e u m o c o n io s is
. Id
. (em p h asis ad d ed ).

I I I . THE AL J ’ S DE CI S I ON I n d eny i ng M r s . H i l l ’ s cl ai m , the A L J not ed the i m m edi at e ca us es of dea t h l i s t ed on the dea t h cert i fi cat e, w hi ch in c lu d e d C O P D , b u t f

o c u se d o n th e re lativ e w e ig h t h e w o u ld
as s i gn t o D r . Sher m an’ s r epor tas oppos ed t o t he depos i ti on t es t i m ony of D r . C ar ey . T he A L J offe r ed t he fo l l ow i ng
e x p l a n a t i o n f

o rc o m p l e t e l y d i s m i s s i n g D r . C a r e y’ s t e s t i m o n y: [D r . C ar ey ] di d nots t at e tha tp n e u moc o ni os i s contr i but ed to o r h a ste n e d th e m in e r’s d e a th . R a th e r h e sta ted o n ly th a t th e m in e r’s “ c h ro n ic lu n g d ise a s e ” o r “ c h ro n ic obs t ruct i ve pul m onarydi s eas e” c ont r i but ed t o hi s death.13 I ndeed, i n nei t her t he death cert i fi cat e norhi s t es t i m ony d id D r. C are y stat e th at p n eu m o co n iosis o r a p u lm o n ary d ise a se re late d to c o a l m in e e m p lo ym e n t co n trib u ted to orhas t ened the mi ner ’ s death. A L J ’s D e c is io n a t 5 -6
. T h e ALJ a l s o c r i t i c i z e d Dr
. Ca r e y f o r s p e a k i n g o n l y of h o w “‘[ s ] om eone w ith a c h ro n ic lu n g d ise a se o r c h ro n ic obs t ruct i ve pul m onarydi s eas e’ w as aff ect ed bys uch a condi t i on. ” Id
. at 6 (em p h asis in o ri g inal). T h e A L J’s co n ce rn
r egar di ng t he i m pl i cat i on of D r . C ar ey ’ s t es t i m onyi s evi dence d byt he A L J ’ s s t at ementt hatD r . C ar ey ’ s op inion w as “tan tam o u n t t o stat ing that an y o n e a n d ev e ryo n e w h o su ff ers f ro m a c h ro n ic lu n g d ise a se o r C O P D a n d d ies [ c o u ld c laim th a t] t h o s e c o n d i t i o n s a r e a l way s s u b s t a n t i a l c o n t r i b u t o r s t o or has t ener s of dea t h. ” Id
. T h e A L J, there fo re, ga v e D r. C are y ’s
o p in io n n o w e ig h t. R ather , t he A L J r el i ed upon D r . S h erm an’ s concl us i on14 th a t th e re w a s n o e v id e n c e o f p n e u m o c o n io si s c o n trib u tin g to H ill ’s d e a th . T h e A L J f o u n d th e e v id e n c e o f

d e c re a se d b re a th
so u n d s, sca tt ere d rho n ch i, an d b il ateral crac k les, af ter H il l’ s h o sp ita l s ta yan d p ri o r t o h is de ath, i n su ff ici en t t o su p p o rtD r. C are y ’s co n clus ion
. F inally , the A L J ad d ed tha t ev en if D r. Ca r e y ’ s o p i n i o n wer e e n t i t l e d t o s o me c o n s i d e r a t i o n , i tw as
o u tw eigh ed b ythe s u p erior o p inion an d q u ali fica ti o n s o f D r. S h e rm a n . Id
. T h e B o ard af

firm ed the A L J’s d ec isi o n , fin d ing that D r. C ar eydi d not es t abl i s h l egal orcl i ni cal pneumoconi os i s and that hi s m edi cal opi ni on w as pr oper l y di s cr edi t ed. B R B D eci s i on at 5. T he Boa r d al s o emphasi zed D r . Sherm an’ s det erm i nat i on t hat t h e c a u s e o f

d e a t h i s u n c l e a rd u e t o t h e a b s e n c e o f r e c o r d s t wo d a y s p ri o r t o H ill’ s d e a th
. Id . a t 2
. I V. J URI S DI CTI ON AND S TANDA RD O F REVI EW W e have j ur i s di ct i on t o r evi ew t he B oar d' s det erm i nat i on pur s uantt o 33 U
. S. C
. § 9 21( c)
. T he B oar d i s bound byt he ALJ ' s f i n d i n g s o f

f a c ti f t h e ya r e s u p p o r t e d b ys u b s t a n t i al15 evi dence
. O u r r evi ew of the B oar d' s deci s i on i s l i m i t ed t o a “det erm i nat i on of w hether an err or of l aw has been c om m i t t ed
a n d w h e th e r t h e B o a rd h a s a d h e re d to i ts s c o p e o f re v ie w .” Kow al chi ck v
. D i r ector , OWCP , 8 9 3 F
. 2 d 6 1 5 , 6 1 9 (3d C ir
. 1 9 9 0 )(cit ati o n s o m itted). In r eview i ng t he B oard’s decis i on , w e m ust i n d e p e n d e n t l y r e v i e w t h e r e c o r d a n d d e c i d e w h e t h e rt h e A L J 's fi ndi ngs ar e r at i onal , cons i s t entw i t h appl i cabl e l aw and supp ort ed b ysubst anti al evidence o n the record con si dered as a
w h o le
. See Manci a v. D i r ector , OWCP , 130 F. 3d 579, 584 ( 3d C i r . 1997) ( ci t i ng Kow alchick , 893 F. 2d at619)
. Subst ant i al evidence h as been defined as “such rel evan te v id e nce as a
re a so n a b le m in d m ig h t ac c e p t as a d e q u a te to su p p o rt a concl us i on. ” Id
. W e e x e r c i s e p l e n a r y r e v i e w o v e rt h e A L J 's l e g a l c o n c lu s io n s th a t w e re a d o p te d b yth e B o a rd
. See So u b ik
v. D i r ector , OWCP , 366 F. 3d 226, 233 ( 3d C i r . 2004) ( ci t at i ons
o m itte d ). V. DI S CU S S I ON“Pneumoconiosis, also known as blac k lung dise ase or 3 anthra cosis, is a chronicdust disease of thelung a nd its sequelae, including respirator

y and pulmonary

impairments, arisingout of coal mine e mploy

ment. ‘Pneumoconiosis’ includes both clinical and le g a l pn eumo c on ios is, wh ic h in c lud e , b ut a reno t li mit e d to anthrac os ili c os is, anthrac os is, anthro sil ic os is .
.. , [and ] any c hron ic restric tive or obstructive pulmonar y disease a rising out of

coal mine employ

ment.’” Ba lsa vagev . D ire c tor , O W CP , 295 F.3d 390, 393 n.2 (3d Cir. 2002) (c itations omi tted). 16 “The B l ack Lu n g B enef i t s A ct( A ct ) pr ovi des
. . . t hat benef i t s ar e t o be pr ovi ded ‘ t o t he su r vi vi ng depende nt s of
m i ner s w hos e death w as due t o [pneumoconi os i s . ] ’ ” Lukos evi cz
v . Di r e c t o r, OWCP , 88 8 F
. 2d 1001, 1003 ( 3d C i r . 1989) ( br acke t s i n or i gi nal ) ( ci t i ng 30 U
. S. C
. § 901( a) )
. H ow ever , t he 3 A c td o e s n o td e f

i n e whe n a mi n e r ’ s d e a t h wi l l b e c o n s i d er ed “due t o” pneumoconi os i s . R ather , C ongr es s l eft t hatdefi ni t i on t o t he Secr et aryof Labor w ho “r edel egat ed al l hi s pow er s under t he A ct t o t he D i r ect or [of t he O ffi ce of W or ker s ' C om pens at i on Pr ogr ams]
. ” Id
. I n Lu ko s e v i cz , w e uphel d t he D i r ect or ’ s det erm i nat i on t hata mi ner ’ s death w o u ld b e “due t o” pneumoconi os i s i f that d ise a se “ a c tu a llyh a ste n s d e a th [ o r] is a su b sta n tiallyPur su ant t o th ere gulatio n a pp lic a bleto Mrs . H ill ’s c laim, 4 death is considered due to pneumoconiosis if any of the following c ri te ri a is m e t: 17 contr i but i ng caus e of de ath .
. . . ” Id
. a t 1 0 0 6
. Th e r e , t h e ALJ had d e n i e d a c l a i m f o rs u r v i v o r ’ s b e n e f

i t s b e c a u s e t he i mme d i a t e c a u s e o f d e a t h was p a n c r e a t i c c a r c i n o ma . Th e ALJ concl uded thateven though t he d ea t h cert i fi cat e l i s t ed pul m onaryemphy s ema “as an ‘ ot hers i gni fi cantcondi t i on, ’ ” the
su rviv o r ha d n o t sati sfied h er bu rde n o f p rov ing that the m iner’s d e a th w a s “ d u e to ,” p n e u m o c o n io s is
. Id
. at1003. T he s ur vi vi ng
s pous e and the D i r ect or bot h pet i t i oned forr evi ew of the rul i ng arg u ing that su rviv o r be n ef it s w ere ap p rop ri a te if t h e m iner’s pneumoconi os i s has t ened hi s death, even i f i t w as nott he di r ect
c a u s e . Id
. W e agr eed. W e h eld t hatt he fa ctt hatt he i m m edi at e ca us e of the
m i ner ’ s death w as p an cr eat i c ca ncerw as i r r el evantunder20 C
. F. R
. § 718. 20( c) , bec a u s e th e u n c o n tr a d i c t e d e v i dence s how ed th a t p n e u m o c o n io s is c o n tr ib u te d to th e m in e r’ s d e a th , “ a lb e it br i ef l y. ” Id
. at1005 ( i t al i cs i n or i gi nal )
. T he mi ner ’ s t r eat i ng 4(1 ) W h er e c o mp et entm ed i ca lev i d en ce es t ab l i s h edth atth e m i n er 's death wa s due to pneumoconiosis, or (2 ) Whe re pn eumo c on ios is wa s a su bs tanti a lly c ontributin gc a us e or fa ctor leading to the miner' s death or wherethe death was cause d by complications of pneumoc oniosis, or (3) Wherethe pre sumption [ arisingfrom medical evidenceof complicated pneumoconiosis] set forth at § 718.304 is applicable. 4 ) H o we v er , s urv i v o rs ar e n o tel i gib l e f o r b en ef i t s wh er e th e m i n er 's de ath w a s c a

us e d b y a tra umaticinj ur

y or a princ ipal c a

us eof de ath was a medical c ondition not related to pneumoconiosis, unless the e vid e nc ee sta

bli sh e s th at pn eumo c on ios is w a s a su bs tanti a lly contributingcauseof death. 20 C.F.R. § 718.205(c)
. We ac tually

remand e d to theB oa

rd wi th ins tr

uc tio ns to 5 vacate the order deny

ing benefits and instructe d that the B oard further rema nd to the Deputy

Commi ssioner of the Civil Division of Coal MineWor

ker’ s Co mpens atio n, Of

fi c eof Wor kers ’ Compensation Programs for immediatepay ment of bene fits. Lukosevic z , 888 F.2d at 1004. 18 phy s i ci an had t es t i fi ed thatt he mi ner ’ s l ungs “s how [ed] p u lm o n aryan thrac o sis .
. . [a n d in the d o ctor’s o p in io n ] th is condi t i on s hor t ened [the mi ner ’ s ] l i fe. ” Lukos evi cz , 888 F. 2d at 1 0 0 4
. W e h eld th at th at w as en o u g h to es tablish tha t th e m iner’s d e a t h wa s “ d u e t o ” t h e u n d e r l y i n g p n e u mo c o n i o s i s , a n d we t herefore rem and ed for i m m ediat e paym ent of b enef i t s. Id
. at 5 1 0 0 6 . H ill’ s c a s e is v e ry si m ila r. As t h e Di r e c t o r c o r r e c t l y s u mma r i z e s i n i t s b r i e f , t h e ALJ19 re jec ted D r. C a re y ’s c o n c lu sio n th a t M r. H ill ’s d e a th w a s d u e to p n e u m o c o n io sis f

o r tw o re a so n s. “ [ F ]irst, t he A L J bel i eved thatD r . C ar ey“fa i l ed t o di agnos e a c oal
- m i nee m p lo ym e n t-re late d lu n g d ise a se ; an d se c o n d , h e f a iled to
a d e q u a tely e x p lain h o w th e m in e r’s lu n g d ise a se c o n trib u ted to
orhas t ened de ath. ” R es pondent ’ s B r . at10 n. 6.
. A l t hough t he D i r ect or onl y defe nds t he s econd j us t i fi cat i on now , bot h of the A L J’s ju stif

ica tio n s fo r de n y in g th is cla im a re e x tre m e ly tr o u b lin g a n d p e rp le x in g . A . L ega l an d C l i n i cal D efi n i ti on s of Pn eu m oco n i osi s F irst, th e re is a b so lu telyn o iss u e h e re th a t M r. H ill
s uffe r ed fr om pneumoconi os i s , nor i s t her e anydi s put e thatt hat
co n d it ion resu lt ed fro m h is em p loy m en t i n m ines
. T h e A L J’s
o p inion ev en n o tes t h at “[ T ]he p arti es stipu lat ed that the m iner, C har l es W
. H i l l , had a c oal m i ne e m p loym enthi s t or yof 9 1⁄2 y ear s and thatC lai m ant es t abl i s hed thatt he mi nerhad p n e u m o c o n io s is a ri s in g o u t o f h is c o a l m in e e m p lo ym e n t.” A pp. at28. M or eover , M r . H i l l ’ s br eathi ng di ffi cul t i es and the change s i n his resp i r at or ys y s t em w er e document ed byt he t es t i m onyof M r s . H i l l , as w el l as m ed ical recor ds and the depos i t i on t es t i m onyof D r . C ar eyas s um m ar i zed a bove.20 Forr eas ons t hat ar e nei t her appar ent , norexpl ai nabl e, t he A L J s t r es s ed thatD r . C ar eydi d not sp eci fi cal l ys t at e that “pneumoconi os i s ” cont ri b ut ed t o orhas t ened H i l l ’ s death. I ns t ead, D r . C arey us ed the t erm s “chr oni c l ung di s eas e” or “chr oni c obs t ruct i ve pul m onarydi s eas e. ” That i s a di s t i nct i on
w i t hout a d i f

f e r e n c e ; i t i g n o r e s t he def i ni t i on of

“ p n e u m o c o n io s is ,” c o d if ie d in th e a p p lic a b le re g u la tio n s . A s w e n o te d ear l i er , pneumoconi os i s i s defi ned as “a chr oni c dus t di s eas e of t he l ung and i t s s equel ae, inclu d ing
r es pi r at or yand pul m onary i m pai rm ent s , ar i s i ng out of coa l m i ne empl oym ent . ” 20 C
. F. R
. § 718. 201( a)
. “The l egal defi ni t i on of p n e u m o c o n io s is (i .e . any lu n g d ise a se th a t is sig n if ica n tly
r el at ed t o, or s ubs t ant i al l y aggr avat ed by , dus texpos ur e i n coal
m i ne em pl oym ent ) i s m uch broa der t han t he medi cal defi ni t i on,
w h ich o n lye n c o m p a ss e s lu n g d ise a se s c a u se d b yf ib ro tic
r eac t i on of l ung t i s s ue t o i nhal ed dust
. ” L a b e lle , 72 F. 3d at312 ( emphasi s added)
. T he l egal defi ni t i on t her efor e i ncl udes “any chr oni c r estri cti v e o r ob stru cti v e p u lm o n aryd isease, ” ar i s i ng out
o f co al m ine em p loy m en t. 2 0 C
. F
. R
. § 7 1 8
. 2 0 1 (a). D r. C are y ’s d e sc rip tio n o f

th e c o n d itio n th a t ca u se d M r. H ill ’s d e a th f a llsThe leg al def inition of pneumoconiosis is broad and 6 “ inc lud e s b ut i s n ot l imi te d to , c oal w or kers ' pn eumo c on ios is, anthra cosilicosis, anthrac osis, anthrosilicosis, massive pulmonary fibrosis, progressive ma ssive fibrosis, silicosis or silicotuberculosis, arisingout of coal mine employ ment.”Labelle, 72 F.3d at 315 (citing20 C.F.R. § 718.201). In fac t, even “[c]hronic bronchitis, as a pulmonar y disease, f alls within the leg al definition of pneumoconiosis.” Id
.
21 squarel yw i t hin the regu l at orydefin iti on of p neu m oco niosi s. 6 R athe r th an s eizing u p o n a se m an ti c tec h n icali tyto rejec t D r. Ca r e y ’ s e x p l a n a t i o n o f t h e c a u s e s o f

Hi l l ’ s d e a t h , t h e ALJ
s houl d have r ecogni zed thatD r . C ar eyw as stati ng t hat

“ p n e u m o c o n io sis ,” as d e f in e d u n d e r th e B lac k L u n g B e n e f its A ct , w as a ca us e of, and a ha s t eni ng fac t ori n, hi s death. T h e B o a rd ’s o rd e r a f f ir m in g th e A L J’s d e c isio n is equal l yas puzzl i ng w i t h r es pectt o i t s t r eatm entof the l egal and cl i ni cal d ef

i ni t i ons of pneumoconi os i s . T he B oar d s t at ed the f o llo w in g in e x p lain in g w h y D r. C a re y ’s o p in io n w a s p ro p e rly dis m i ssed byt he A L J: D r . C ar eydi d not make a f i ndi ng of cl i ni cal p n e u m o c o n io sis , an d a s h e d id n o t sta te th a t h is fin d ing o f c h ron ic ob stru cti v e p u lm o n ary di s eas e/ chr oni c l ung di s eas e i s r el at ed t o coal m i ne empl oym ent( l egal pneumoconi os i s ) , t he admi ni s t r at i ve l aw j udge pr operl y found the o p ini on i ns uffi ci entt o es t abl i s h t hatt he mi ner ’s death w as due to pn eum oco niosi s.22 B R B D ec isi o n at 5
. H o w ev er, th ere is ab so lutelyn o issue h ere aboutw hetherH i l l ’ s pneumoconi os i s “i s r el at ed t o coal m i ne empl oym ent . ” H i l l had bee n r ece i vi ng benef i t s undert he B l ack L ung B enef

i t s A ctfor near l yt en y ear s befor e he di ed, and eve n if h e h a d n o t re c e iv e d th o se b e n e f its , the c a u sa l re latio n sh ip betw een hi s “coa l m i ne empl oym ent ” and pneumoconi os i s w as
s t i pul at ed t o befor e the A L J
. D r . C ar ey m ay , orm aynot , have b ee n in a p o sit ion to ren d er a n o p inion ab o u t the c au se o f H il l’ s pneumoconi os i s , buti t s houl d have been obvi ous t hathe di d not have t o. T he i s s ue her e i s w hatcaus ed H i l l ’ s death, notw hat caused his pn eum oco niosi s.

B. D r . C ar e y’ s D e pos i t i on Tes t i m ony W e al s o fi nd t he A L J ' s deci sion t o as s i gn no pr obat i ve val ue t o D r . C ar ey ' s opi ni on beca us e of the doct or ' s condi t i onal
r es pons e t o a hypot het i cal ques t i on t o be s ever el yfl aw ed. T he A L J w as par t i cul ar l ydi s m i s s i ve of the fol l ow i ng t es t i m ony d u rin g D r. C a re y ’s d e p o sitio n : Q
. W e ll, h o w a re th e ya f f e c ted , i n w h a t se n se , w ith resp ec t t o co m p aring h im to so m eo n e w h o d idn ’t hav e t he lung d i sease but w ith al l of those p r o b l e ms ? A
. S o m e o n e w ith a c h ro n ic lu n g d ise a se o r c h ro n ic obs t ru c t i v e p u l mon a r yd i s e a s e i s g o i n g t o h a ve23 l ow er vol um es of oxy gen t hat m akes every t hi ng w o rk h ard er. H is h ea rt ’s g o ing to w o rk ha rde r. If th is is o c c u p a tio n a l ex p o su re th a t h a s c a u se d th is chronic obst ruct i ve p ulm on ary d i sease i t ’s al so g o in g to c a u se h is a rte rio sc ler o tic, to a n e x ten t, h is a rte rio sc ler o ti c c a rd io v a sc u lar d ise a se . H is r enal fai l u r e, i f y ourki dney s ar en’ tget t i ng enough oxy gen, t hatt ends t o pus h t o w ar ds r enal fai l ur e.
T h e A L J in d ica ted , as c ited a b o v e , th a t th is “w a s tan tam o u n t to sta tin g th a t w ith a n y o n e a n d e v e ry o n e w h o su f f e rs f ro m a c h o n ic l u n g d i s e a s e o rC O P D a n d d i e s , t h o s e c o n d i t i o n s a r e a l w a ys
s ubs t anti al c o nt r i but or s t o orhas t ener s of dea t h. ” A pp. at32. H ow ever , D r. C ar eyw as as ked bycouns el t o dr aw a br oader
co m p arison b etw ee n H ill an d a p erso n w ith o u t anyp u lm o n ary dis ease. H i s r espon se r el i es upo n the chronic l un g d i sease al r eadys t i pul at ed t o b y b o th pa r t i es and evi dence d i n ches txra y s. D r. C a re yc o n n e c ted th e se f a c ts to th e sy m p to m s th a t H ill
m ani f e s t e d p r i o r t o h i s d e a t h
. Hi s s t a t e me n t i s n o t a gener al char act er i zat i on; i ti s di r ect l yr el at ed t o H i l l ’ s condi t i on, and
re s p o n s iv e to th e q u e s tio n h e w a s a s k e d
. M o r e o v e r , w e h a v e p r e v i o u s l y c a u t i o n e d t h a ta n e x p e r t 's t est i m on yw i t h respect t o the pulm on arydis ease of a m i ner m ust be exa m i n ed in li ghtof the al l of the t es t i m onyoffe r ed, r ather th a n s im p ly b yw a yo f

s e l e c tiv e q u o te s . See Bal s avage , 29524 F. 3d at 3 9 6 ( "[ S] t at ement s m us tbe vi ew ed i n cont ext–bot h as
res po nses on c ross -exam i nati on t o g eneral qu e st i on s and ag ai nst th e b a c k d ro p o f

re p e a ted a ss e rtio n s th a t p n e u m o c o n io sis
c o n trib u ted to th e [ m ]in e r' s d e a th ."); c f. M a n c ia , 130 F. 3d at590 (n o tin g v a lid u se o f

a h yp o th e tica l q u e stio n a n d a n sw e r in
as s es s i ng w hethe ra mi ner ' s death w as caus ed byunder l y i ng l ung di s eas e)
. I n B al s avage , t h e A L J r e

j e c t e d a n e x p e r t 's t es t i m onybeca us e of hi s us e of the w or d "c oul d" w hen di s cus s i ng w hetherpneumoconi os i s w as a fa ct o r in t he devel opm ent o f cor onaryar t erydi s eas e and a t r i al fi br i l l at i on. 2 9 5 F
. 3 d at396. W e r ej ect ed s uch par s i ng, es peci al l yw hen vi ew ed aga i ns tt he ex p er t ' s unequi vocal t es t i m onyaboutt he
c o n tr ib u to ry ro le o f

p u lm o n a ry d is e a s e to h is p a tie n t's d e a th
. D r. C a re yf

irm lya ss e rte d th a t th e o th e r f a c to rs re late d to H i l l ' s death w oul d nothave be en as s ever e, butfort he pr es ence of pulm onarydi s eas e. N ot hi ng on t hi s r ecor d, i ncl udi ng t he
r epor tof D r . Sher m an underm i nes , D r . C ar ey ’ s t es t i m onyabout th e e f f e c t a c o m p ro m ise d re sp ira to ry sy ste m h a s o n o n e ’s h e a lth and r es i l i ence . T o t he ext ent t hat D r . C ar ey ’ s t es t i m onyw as at
a ll c o n d iti o n a l, th e m e a n in g is u n m ista k a b le w h e n v iew e d in
c o n te x t. See Ma n c ia , 130 F. 3d at593 ( “The A L J w as notfr ee25 t o se l ect i velycredi tt est i m on ym erel ybecau se i tsupp ort s a par t i cul a rc o n c l u s i o n w hi l e i gnor i ng al l evi dence contr aryt o t hat
c o n c lu s io n .” ). M o re sig n if

ica n tly , h o w e v e r, w e a re a t a lo s s to
u n d erstan d w h ythe A L J w as so tr o u b led b yD r. C are y ’s t es t i m ony about t he eff

ect of a c om pr om i s ed r es pi r at or ys y s t em
o n th e hu m an b od y . O ne n eed n ot be boa rd cer t i fi ed in p u lm o n o lo g yn o r h a v e a n a d v a n c e d d e g re e in a n a to m yto appr eci at e the impactt hatl ow oxy gen l evel s i n t he bl ood can have o n t h e h u ma n b o d y . Commo n s e n s e s u g g e s t s t h a t i f t he h e a rt a n d lu n g s d o n o t h a v e a su f f icie n t su p p ly o f

o x y g e n to fu n cti o n p ro p erly , the re su ltco u ld su relyinclu d e o rga n fa il u re
a s w e ll a s o th e r c o m p lic a tio n s . H ere , D r. S h erm an ’s t esti m o n y ev en co n firm ed that M r. H il l w as m alno u ri sh ed w h en ad m itted to the n u rsi n g h o m e. It i s di ffi cul tt o concl ude that an i nadequa t e oxy gen s uppl yi n t he bl ood beca us e of a compromi s ed r es pi r at or ys y s t em w oul d not has t en the demi s e of a nypat i enti n t hatcondi t i on. T hati s w hat D r. C a re ysa id , an d th a t is th e n a tu ra l co n se q u e n c e o f th e sim p le b i ol ogi cal fac tt hatourbodi es need a n adequa t e s uppl yof oxy gen foror gans t o funct i on pr oper l y . I f ther e ar e conc ernsStatis tic s sug g e st that su c h a c on c e rn by theALJ is 7 unwar rante d. Miners and the ir widows who attempt to claim B lack Lungbenef

its meet with little succe ss. SeeOf fi c eof Wor kers ’ Compensation Programs, Annual Repor t to Congre ss, Fiscal Year 2003, at 23 (notingthat the approval rate for initial re view of claims for B lack L

ungbenef its is 7.8%). 26 t hat it b ec o m es t oo eas yt o es t abl i s h t hata mi ner ’ s death w as “due t o” pneumoconi osis gi ven thatcaus at i on, t hos e conc erns
m us tbe addr es s ed byamen d i ng t he A ctort he r egul at i ons pr om ul gat ed under i t . T hey can not be addr es s ed byd en y i ng 7 cl ai m ant s l i ke M r s . H il l b en efi t s t heyar e ent i t l ed t o w hen a
s pous e has pneumoconi os i s as a r es ul t of w or ki ng i n m i nes , and t h a tp n e u m o c o n i o s i s h a s t e n s h i s d e a t h i n s o m e w a y.

C . D r. S h er m a n ’s R ep o rt A s w e have n o ted, D r . Sher m an’ s r epor tdoes not contr adi ctD r . C ar ey ’ s t es t i m onyaboutt he i m pactof a compromi s ed r es pi r at or ys y s t em. R ather , t h e A L J i nt erpr et ed D r . Sher m an as concl udi ng t hatt her e w as “i ns uffi ci ent [ e v id e n c e ] . . . to su p p o rt a f in d in g th a t p n e u m o c o n io sis contr i but ed sig n ifi c a n tly t o t he m i ner ’ s death. ” A L J ’ s D eci s i on
a t6
. T h e A L J ’ s u s e o f t h e p h r a s e “ c o n t r i b u t e d s i g n i f i c a n t l y”
c a u se s u s to w o n d e r if h e w a s a w a re o f

o u r d isc u ss io n in Lukos evi cz . U nderourpr ece dent , t he l aw does notcondi t i on27 survi vo r benefit s onlyup on proof t h a t p n eum oco niosi s w as a
s i gni fi cantors ubs t ant i al contr i but i on t o t he m iner ’ s death;
r ather , t he cl ai m ant ’ s bur den i s al s o s at i s fi ed by pr ovi ng t hatt he
u n d e rly in g p n e u m o c o n io sis h a ste n e d th e m in e r’s d e a th , ev e n if onl ys l i g h tl y . T hus , pneumoconi os i s need notbe the s ol e or even pr i m ary cause of a mi ner ' s death; i tneed onl ybe a
c o n tr ib u tin g f

a c to r. T h e A L J cre d it ed D r. S h erm an ’s rep o rto v er D r. C are y ’s t es t i m on y b eca us e of D r . Sher m an’ s purpor t edl ys uper i or
cr edent i al s and qual i fi cat i ons , as w el l as t he A L J ’ s bel i ef that Dr
. Ca r e yd i d n o t q u a l i f

y a s a t r e a t i n g p h y s i c i a n u n d e r2 0 C. F
. R. § 7 1 8
. 1 0 4
. T h o u g h b o th f ind ing s are d u b io u s h ere , D r. S h e rm a n ’ s o p in io n m u st s til l b e su p p o rte d b ya d e q u a te
e v i d e n c e . See e
. g. , L a n g o v . Di r e c t o r, OWCP , 104 F. 3d 573, 5 7 7 ( 3 d C i r . 1 9 9 7 ) ( “ T h e m e r e s t a t e m e n to f a c o n c l u s i o n b y a phy s i ci an, w i t houtanyexpl anat i on of the bas i s fo r that stat em en t, d o es n o t take the plac e o f th e re q u ir ed rea so n ing
. ”); Ker t es z v. C r es cent Hi l l s C oalC o. , 7 8 8 F
. 2 d 1 5 8 , 1 6 3 (3d C ir
. 1986) ( hol di ng t hat an A L J s houl d r ej ect any m edi cal opi ni on that is insu ff

ici en tl y rea so n ed o r reac h es a co n clus ion co n tr ary to o b jecti v e c li n ical e v iden ce ). D r. S h erm an ’s rep o rtfa ll s sh o rtWe note, as cited in the D irec tor’s brief , that Wil kes-B arre 8 General in dic ate d th at H illwa s disc ha rg e d in sta blec on dition

to L ake sid e . App . at 11 4. Ho wever, an in dic atio n th at a patient i s in stable enough condition to be transferre d to another f acility does no t sh owthat hi s me dic a l prob le ms h a d s omeho w re vers e d c ours e o r w e r er e s o l v e d

e nt i r e l y. 28 of thats t andar d, and does notm er itt he det erm i nat i ve w ei ght th a t th e A L J g a v e it. D es pi t e the uncontr adi ct ed evi dence of H i l l ’ s hi s t or yof p n eu m o co n iosis an d the u n co n tr ad ict ed ev iden ce o f re sp ir atory p rob lem s h e w as e x p erien cing just da y s b ef o re h is de ath, D r. S herm an st at ed w i t h cer t ai nty t hat “ th e re i s no evi dence of a contr i but i on by C O PD or pneumoconi os i s . ” A L J ’ s D eci s i on at 5 (e m p h a sis a d d e d ). T h a t sta tem e n t is sim p lyin c o n sis ten t w ith t he m edi cal r ecor ds , H i l l ’ s m edi cal hi s t or y , and x- r ay s s how i ng M r . H i l l’ s compromi s ed pul m onarys y s t em. E veryphy s i ci an
w h o e x a m ined H il l w ith in a m o n th o f h is de ath, an d ev ery
m ed ical ex am ination an d fin d ing , c o n firm ed h is pu lm o n ary dis ease, decreased brea th soun ds, and res pir at orydiffi cult i es. B r eathi ng pr obl ems, decr eas ed l ung s ounds an d ot her compl i cat i ons cons i s t ent w i t h C O PD w er e document ed dur i ng H ill ’ s h o sp italiz a tio n im m e d iate lyp re c e d in g h is tra n sf e r to L akes i de N ur s i ng H om e. It is u ndi s put ed thata medi cal 8“Rhonchi,” a re de fined a s “adde d sound[s ] occurring 9 d uri n g i n s p i rat i o no r e xp i rat i o ncau s ed b y ai r p as s i n g thro u gh bronchi that a

re na rrowe d by

inflammation or the pre senceof mucus in the lumen” a

nd inheredecrease d lung c apac ity
. Stedman' s Medical Dic tionary 1235 (5th L awyer' s ed. 1982). Other c ourts have note d that the pre senceof rhonc hi in the lung fields is consistent with findings documenting pneumoconiosis. See, e .g. , Pee rless Eagle Coal Co. v. Taylor , 107 F.3d 867, 867 (4 th C ir . 1 99 7) ; Freem an United Coal Min. Co. v. Hudson , 105 F .3 d 6 60 , 6 61 (7 th C ir . 1 99 7) ; Thorn v. Itmann Coal Co. , 3 F.3d 713, 715 (4th Cir. 1993). 29 exami nat i on on A ugus t5t h di s cl os ed decr eas ed br eath s ounds
a n d “ c h ro n ic rh o n c h i.” 9 I t i s wor t h r e p e a t i n g t h at i n Lukos evi cz , supra , w e h e ld t hatt he mi ner ’ s death w as “due t o” pneumoconi osis even t hough t he ac tual cause of dea t h w as pancr eat i c ca ncerr ather t han pneumoconi os i s . W e expl ai ned t hatpneumoconi os i s need onl y have s om e i dent i fi abl e eff ect on t he mi ner ’ s abi l i t yt o l i ve. D e sp ite D r. S h e rm a n ’s r e p o rt, an d th e A L J’s re lian c e o n it, th is
r ecor d es t abl i s hes t hat decr eas ed l evel s of oxy gen i n t he bl ood due atl eas ti n par tt o pneumoconi os i s , has t ened H i l l ’ s death. D . A v a il a b il it y o f R ec o rd s N ea r T im e o f D ea th D r . She r ma n , t h e ALJ a n d t h e Boa r d a l l h i g h l i g h tt he ab sen ce o f a n ym ed ical reco rds f o r th e tw o d ay s p ri o r t o H il l’ s d e a th , a n d u s e th a t to su p p o rt th e c o n c lu sio n th a t th e re c o rd is i nco nclusi ve as t o w hetherM r. H i l l died due t o p neu m oco niosi s.30 H ow ever , s uch anal y s i s i s i ncons i s t entw i t h t he par al l el
re g u lat ory sch e m e p ro v id e d b y th e S o c ial S e c u rity A dm i nis t rat i on . 20 C
. F
. R
. § 4 10
. 46 2(b) s t at es: W her e the evi dence es t abl i s hes t hata dec eas ed m iner su ff

ere d fro m p n eu m o co n iosis or a re sp ira b le d ise a se a n d d e a th m a y h a v e b e e n d u e to m u lti p le c a u se s, d e a th w ill b e f o u n d d u e to p n e u m o c o n io sis if

it i s n o t m e d ica llyf

e a sib le to di s t i n g ui s h w hi ch di s eas e ca us ed dea t h or sp e c if ica llyh o w m u c h e a c h d i se a se c o n trib u ted to c a u s in g d e a th
. M o r e o v e r , g i v e n t h e u n c o n t r a d i c t e d e v i d e n c e o n t h i s r e c o r d , we can thi nk o f n ot hi ng t hats ugges t s ei t hert hats om e my s t er i ous for ce i nt ervened ort hatM r . H i l l ’ s p n eu m oconi os i s underw ent
a m ira c u lo u s re v e rsa l an d h is b lo o d o x yg e n lev e ls re tu rn e d to
n o rm al ri g h t b ef

o re h e d ied. H ere , m ed ical reco rds f rom a m ere f iv e d a y s b e f

o re H ill ’s d e a th d o c u m e n t th e c o m p lica tio n s o f h is p n e u m o c o n io sis
. D r. S h e rm a n ’s re p o rt d o e s n o t o f f e r a c re d ib le t heoryt hatw oul d expl ai n how M r . H i l l w oul d have be en
s om ehow abl e t o s hake of f the ef fec tof pneumoconi os i s i n t he t w o day s befor e he di ed s o t hathi s r es pi r at or yarr est, r enal fa il u re, art eriosc leroti c c ard iov asc u lar disea se, an d an em ia w ere
s om ehow notexac erbat ed byt he r es pi r at or ydi s eas e thathe had
su ff ere d fro m f

o r s o m an yy ea rs prior to h is de ath. W e a re31 s i m pl yunabl e t o i m agi ne anyt hi ng t hatc o u l d have be en r evea l ed b ya m ed ical e x am ination d u ri n g the fin al 4 8 h o u rs of M r. H il l’ s li fe that w o u ld h av e u n d e rm in e d the f o rce o f D r. C are y ’s t e s t i mon y , o rt h e v a l i d i t yh i s c o n c l u s i o n s , a n d n ei t he rt h e ALJ
n o r th e B o a rd su g g e sts a n y th in g th a t co u ld h a v e h a d th a t ef f e c t.

“ [ C ]o u rts h a v e lo n g a c k n o w led g e d th a t p n e u m o c o n io sis i s a pr ogr es s i ve i r r ev ersi bl e di s eas e . . . . ” L a b e lle , 72 F. 3d at 3 1 5
. D r . Sher m an’ s r epor ti n no w ayunderm i nes D r . C ar ey ’s
o p in io n th a t lo w o x yg e n lev e ls in th e b lo o d a ss o c iate d w ith pneumoconi os i s or C O PD can c om pr om i s e eve r ys y s t em i n t he b o d y . Y e t, bo th th e A L J a n d D r. S h e r m a n w e re re lu c tan t to
con cl ud e t hat H i l l ’s death w as due to pn eum oco niosi s becau se
n o o n e s a w h i m o n Au g u s t 7 , t h e d a yh e d i e d , o rwi t h i n t h e t wo day s befor e he pas s ed aw ay . T he i m pl i cat i on t hats uch r ecor ds
ar e m andat or y for t he r ece i pt of benef i t s pl ace s an unfa irand in a p p ro p ria te b u rd e n o n a n yp e tit io n e r o r c laim a n t. R egr et t abl y , t he r es u lt h ere i s m or e cons i s t entw i t h an att em p t t o justi fyd en y ing b en ef it s tha n w ith a n e u tr al i n q u iry i nt o w hethert he r ecor d es t abl i s hes el i gi bi l i t yforbenef i t s . T he A L J ’s f o c u s o n th e tim e im m e d iate lyp re c e d in g d e a th w o u ld
ra ise insu rm o u n table o b stacles to a n eli g ible su rviv o r,Our c oncer n over thedenial of benefits here is not 10 mitigated by

Dr. Sherma

n’s purporte dly

“superior cre dentials.” As we note d above, D r. Sherman doe s not contest Dr. Carey ’s assessment of H ill’s respiratory problems, only

whether Hill’s death wa s due to his pneumoconiosis, and the re cord raises concerns about whe ther heunderstood what is meant by that phrase
. See Balsavage , 295 F.3d at 397. 32 condi t i oni ng det erm i nat i on of benef i t s noton a mi ner ’ s m edi cal h isto ry , b u t o n th e tim in g o f d o c to rs’ v isits. T h e law sim p ly does not r equi r e a m i ner w i t h a r es pi r at or ys y s t em t hathas been
ra v a g e d b y m in e - r e late d p n e u m o c o n io sis to h a n g o n u n til a phy s i ci an ca n documenthi s l as tm om entof l i fe s o t hatt he
su rviv o r w il l be a b le to d o cu m en t th at his im p aired resp ir atory
s y s t em hast ened hi s death. 10

VI . CO NC L US I ON F o r all the re aso n s set fo rth ab o v e, w e ho ld th at th e A L J’s deni al of M r s . H i l l ’ s r eques tfors ur vi vor ’ s benef i t s undert he B l ack Lung B enef

i t s A ctand the Boa r d’ s s ubs equentaff i r m ance of thatdeci s i on ar e not s uppor t ed by s ubs t ant i al evi dence i n t he
r ecor d. I n herbr i ef, M r s . H i l l “ur ges t hi s C our tnott o r emand t he mat t erforfur t hercons i der at i on. G iven t he for egone concl us i on, bas ed on the pr operanal y s i s of the evi dence of
r ecor d,
. . . t hi s C our t s houl d i s s ue an O r dervaca t i ng t he deni al
o f b en ef it s an d su b sti tuti n g an aw ard o f b en ef it s. ” (P eti ti o n er’s33 B r. a t 1 3 .) I n lig h t o f

th e f a c ts p re s e n te d , w e a g re e . T her e i s no i s s ue of c r edi bi l i tyher e, nori s t her e any di s put e t hat H i l l s uffe r ed fr om w or k r el at ed pneumoconi os i s or t he s y s t emi c effec t of t hatpr ogr es s i ve di s eas e. T he conf l i ct i ng i nfer ence s i nt r oduced byt he A L J ar e conc l us i vel yr es ol ved by
corr ectappl i cat i on of the r egul at or ys cheme, as w el l as our pr ece dent , l eavi ng on lyone conc l us i on pos s i bl e— t hat p n e u m o c o n io s is h a s te n e d H ill’ s d e a th
. S e e M a n c ia , 130 F. 3d at 579 ( ci t i ng K o w al chi ck , 893 F. 2d at624)
. G i ven the medi cal evi dence on this r ecor d, w e bel i eve thatM r s . H i l l has
es t abl i s hed herent i t l ement t o s ur vi vor ’ s benef i t s as a mat t erof law , a n d th e re is no th in g lef t to d o b u t a w a rd th e b e n e f its sh e is
c le a rl ye n title d to . Ac c o r d i n g l y , we wi l l “ g r a n t t h e p e t i t i o n f o rr e v i e w,
r ever s e t he deci s i on of t he B oar d and r emand f orthe li m i t ed purpos e of aw ar di ng s ur vi vor ’ s benef i t s i n acc or dance w i t h 20 C
. F
. R
. § 7 2 5
. 5 0 3 (c). W e u rge the B o ard to ex p ed it e this aw ard
s o th a t s u rv iv o r’ s b e n e f its w ill b e g i n a s s o o n a s p o s s ib le .” Ma n c ia , 1 3 0 F .3 d a t 5 9 4 . “[ F ]u rth e r a d m in istra tiv e re v iew is
u nw arr ant ed. ” S u l

y ma v . Di r e c t o r, OWCP , 827 F. 2d 922, 924 (3 d C ir . 1 9 8 7 ).