PUBLISH UNITED STATES COURT OF APPEALS
TENTH CIRCUIT

ANTELOPE COAL COMPANY/RIO TINTO ENERGY AMERICA, Petitioner,

v. ROLLAND E. GOODIN; DIRECTOR, OFFICE OF WORKERS’ COMPENSATION PROGRAMS, UNITED STATES DEPARTMENT OF LABOR, Respondents. No. 12-9590

ON PETITION FOR REVIEW OF A DECISION AND ORDER OF THE BENEFITS REVIEW BOARD, UNITED STATES DEPA RTMENT OF LABOR (No. 11-0843 BLA)
William S. Mattingly, Jackson Kelly PLLC, Morgan town, West Virginia, appearing for Petitioner. Jared L. Bramwell, Kelly & Bramwell, Drap er, Utah, appearing fo r Respondent Rolland E. Goodin. Sean Bajkowsky, Counsel for Appellate Litig ation (M. Patricia Smith, Solicitor of Labor, Rae Ellen Frank James, Associ ate Solicitor, and Rita A. Rop polo, Attorney, with him on the briefs), United States Depa rtment of Labor, Office of the Solicitor, Washington, DC, appearing for Respondent United States Department of Labor.

Before KELLY, McKAY, and MATHESON, Circuit Judges. FILED United States Court of Appeals Tenth Circuit 

### March 3, 2014
Elisabeth A. Shumaker Clerk of Court-2- MATHESON , Circuit Judge.

Rolland E. Goodin worked at surface coal mines for 25 years and smoked cigarettes for more than 40 years. He de veloped a respiratory condition and filed for benefits under the Black Lung Benef its Act (“BLBA”). 30 U.S.C. §§ 901, et seq

. An Administrative Law Judge (“ALJ”) awarde d Mr. Goodin benefits. His employer, Antelope Coal Company/Rio Tinto Energy America (“Antelope”), appealed, and the Department of Labor Benefits Review Boar d (“Review Board”) affirmed the grant of benefits. Antelope filed this petition fo r review of the Review Board’s order. Antelope’s primary argument is that the ALJ wrongly limited its options to rebut a regulatory presumption that Mr. Goodin’s work as a coal miner caused his respiratory condition. Specifically, it ar gues 20 C.F.R. § 718.305(d), 1 a rule limiting the type of evidence that may be used for rebuttal, s hould not apply to coal mine operators like Antelope. Alternatively, Antelope argues even if the rule applies, the ALJ’s findings and explanation concerning the cause of Mr. Goodi n’s disability were incomplete. Exercising jurisdiction under 33 U.S.C. § 921 (a), we deny Antelope’s petition.
I. BACKGROUND We begin with the relevant statutes and re gulations and then turn to the facts and

1 A revision of this regulation beca me effective October 25, 2013. See infra Part I.A.5. We apply the revised version for reasons noted later in this opinion. See infra Part II.B. Unless otherwise indicated, all citations to the C.F.R. are to the 2013 regulations.-3- procedural history of Mr. Goodin’s case.
A. Legal Background Congress enacted the BLBA in 1969 to compensate miners who develop pneumoconiosis—black lung disease. The BLBA provides benefits to coal miners who become totally disabled from pneumoconiosis. Five parts of the BLBA and regulations are particularly relevant here.
1. Elements of a Claim To obtain benefits under the BLBA, a claima nt must prove: (1) he or she suffers from pneumoconiosis; (2) the pneumoconiosis ar ose out of coal mining employment; (3) he or she is totally disabl ed due to a respiratory or pulmonary impairment; and (4) pneumoconiosis is a s ubstantially contributing cause of his or her total disability. See 20 C.F.R. §§ 725.202(d)(2), 718.204( c)(1); 30 U.S.C. §§ 902, 921; Energy West Mining Co. v. Oliver , 555 F.3d 1211, 1 214 (10th Cir. 2009).
2. Pneumoconiosis Defined The BLBA recognizes two types of pneumoconi osis: clinical and legal. Clinical pneumoconiosis refers to dis eases the medical community r ecognizes as pneumoconiosis, which includes “conditions characterized by . . . the fibrotic reaction of the lung tissue to . . . deposition [of particulate matter] caused by dust exposu re in coal mine employment.” 20 C.F.R. § 718.201(a)(1). Legal pneumoconiosis, added in 1978, 30 U.S.C. § 902(b), is “any chronic lung-4- disease or impairment and its sequelae 2 arising out of coal mine employment. This definition includes, but is not limited to, a ny chronic restrictive or obstructive pulmonary disease arising out of coal mine employment.” 20 C.F.R. § 718.201(a)(2). This encompasses “a broader class of lung diseases that are not pn eumoconiosis as the term is used by the medical community.” Andersen v. Dir., OWCP , 455 F.3d 1102, 1104 (10th Cir. 2006). “Arising out of coal mine employm ent” means the disease or impairment is “significantly related to, or substantially a ggravated by, dust expo sure in coal mine employment.” 20 C.F.R. § 718.201(b).
3. The 15-year Presumption The BLBA created a presumption that a mi ner is disabled due to pneumoconiosis when he or she has worked for 15 years in un derground coal mines or substantially similar conditions and is totally disabled fro m a respiratory or pulmonary condition (the “15-year presumption”). In other words, a mi ner who proves 15 years of coal mine work and total disability is entitled to a presumptio n that the remaining elements of his claim are established. This presumption expired in 1982. 30 U.S.C. § 921(c)(4) (2006). In 2010, Congress adopted the Byrd Amen dments to the BLBA as part of the Affordable Care Act (“ACA”), Pub. L. No. 111–148, § 1556, 124 St at. 119, 260 (2010). The amendments reinstated th e 15-year presumption for clai ms filed after January 1,

2 Sequelae is the “aftereffect of disease, condition, or injury ” or its “secondary result.” Merriam-Webster.com, http://www. merriam-webster.com/dictionary/sequela (last accessed Dec. 9, 2013).-5- 2005. See 30 U.S.C. § 921(c)(4) (2012). 3 Section 921 provides that the Secret ary of Labor can rebut the 15-year presumption only by proving (1) the claimant does not have pneumoconiosis, or (2) the claimant’s impairment “did not arise out of, or in connection with, employment in a coal mine.” Id. § 921(c)(4). In 1976, the Supreme Cour t ruled the rebuttal limitations apply only to the Secretary and do not apply to coal mine operators. Usery v. Turner Elkhorn Mining Co. , 428 U.S. 1, 34-37 (1976). 4

3 The statute reads in relevant part: [I]f a miner was employed for fifteen years or more in one or more underground coal mines, and if . . . a chest roentg enogram [(x-ray)] submitted in connection with such miner’s . . . claim . . . is interpreted as negative . . . and if other evidence de monstrates the existence of a totally disabling respiratory or pulmonary impairment, then there shall be a rebuttable presumption that such mi ner is totally disabled due to pneumoconiosis. . . . The Secretary [of Labor] shall not apply . . . the requirement . . . that the miner work in an underground mine where he determines that conditions of a miner’s employment in a coal mine other than an underground mine were substantially sim ilar to conditions in an underground mine. The Secretary ma y rebut such presumption only by establishing that (A) such miner does not, or did not, have pneumoconiosis, or that (B) his respiratory or pulmonary impairment did not arise out of, or in connection with, empl oyment in a coal mine. 30 U.S.C. § 921(c)(4). We note that a claimant with a positive x-ray is eligible for a different presumption. Id. at § 921(c)(3).

4 The parties disagree whether Usery is still valid law in light of subsequent amendments to the BLBA. We do not resolv e this question because we conclude that Mr. Goodin would have prevailed even without the rebuttal limitations.-6- 4. Rule-out Standard The U.S. Department of Labor (the “D epartment”) maintain s that a rule-out standard applies to the second method of rebuttal, requiring proof that rules out any connection between the claimant’s disa bility and coal mine employment. See Regulations Implementing the Byrd Amendm ents to the Black Lung Benefits Act: Determining Coal Miners’ and Survivors’ En titlement to Benefits, 78 Fed. Reg. 59,101, 59,107 (Sept. 25, 2013). Some courts have agreed. See, e.g. , Peabody Coal Co. v. Hill , 123 F.3d 412, 417-18 & n.9 (6th Cir. 1997); Rose v. Clinchfield Coal Co. , 614 F.2d 936, 939 (4th Cir. 1980). This standard derive s from 20 C.F.R. § 718. 305(d) (2010), which, before its revision in 2013, stated, “Where the cause of death or total disability did not arise in whole or in part out of dust exposure in the miner's coal mine employment . . . the presumption will be considered rebutted.” Id. (emphasis added). 5 Although we have not addressed whether th e rule-out standard applies to rebuttal of the 15-year presumption, we have held th at a rule-out standard applied to a similar presumption of pneumocon iosis arising from proof of total disability and 10 years of coal mine employment. See Rosebud Coal Sales Co. v. Wiegand , 831 F.2d 926, 928-29 (10th Cir. 1987). That presumption was based on a now-defunct interim regulation that contained identical language to § 718.305(d) (2010). See id. To rebut that presumption,

5 As discussed below, a final rule e ffective October 25, 2013, changed the language of this provision. But the revi sed language has the same effect—requiring the rebutting party to establish th at “no part of the miner’s . . . disability was caused by pneumoconiosis . . . .” 20 C. F.R. § 718.305(d)(1)(ii).-7- we said employers must show that “t otal disability or death of the miner did not arise in whole or in part out of coal mine employment.” Id. at 928 (emphasis added) (quoting interim regulation 20 C.F.R. § 727.203(b )(3) (1987)). The employer must “rule out any relationship between the disability and the coal mine employment.” Mangus v. Dir.,
OWCP , 882 F.2d 1527, 1529 (10th Cir. 1989) (citing Rosebud Coal Sales , 831 F.2d at 928)). We see no reason to interpret § 718.305(d) (2010) or the revised § 718.305(d)(1)(ii) (2013) any di fferently and hold the rule-o ut standard applies here. See Big Branch Res., Inc. v. Ogle , 737 F.3d 1063, 1071 n.5 (6th Cir. 2013) (noting the rule-out standard is consistent with the revised regulation).
5. The October 25, 2013 Final Rule After Congress enacted the ACA, the De partment issued a Notice of Proposed Rulemaking to implement the Byrd Amendments. See Regulations Implementing the Byrd Amendments to the Black Lung Bene fits Act: Determining Coal Miners’ and Survivors’ Entitlement to Benefits, 77 Fed. Reg. 19,455 (proposed Mar. 30, 2012). The comment period closed May 29, 2012. Id. at 19,456. The Department issued its Final Rule on September 25, 2013, with an effective date of October 25, 2013. See Regulations Implementing the Byrd Amendm ents to the Black Lung Benefits Act: Determining Coal Miners’ and Survivors’ En titlement to Benefits, 78 Fed. Re g. 59,101-8- (Sept. 25, 2013). 6 The Final Rule revised two sections of the regulations that are relevant to this case: 20 C. F.R. § 718.305(b)(2), 7 which defines when working conditions are substantially similar to underg round mining; and § 718.305(d)(1), 8 which governs the permissible methods of rebuttal.
B. Factual and Procedural History Mr. Goodin worked at surface coal mines, including the Antelope Coal Mine in Wyoming, from 1981 to 2006, when he retired because of respiratory health issues. On May 14, 2007, Mr. Goodin applied for BLBA benefits. As Mr. Goodin’s last employer,

6 Mr. Goodin filed his claim in 2007, after the January 1, 2005 filing date required by the Byrd Amendments. The relevant proc edural history in this case—the ALJ’s August 2011 decision, the Review Board’s September 20 12 ruling, and Antelope’s November 2012 notice of appeal to this c ourt—took place after the Byrd Amendments were enacted, but before the Depart ment issued its Final Rule.

7 This provision states, “The conditions in a mine other than an underground mine will be considered ‘substantially similar’ to t hose in an underground mine if the claimant demonstrates that the miner was regularly exposed to coal-mine dust while working there.” 20 C.F.R. § 718.305(b)(2).

8 This provision states, In a claim filed by a miner, the part y opposing entitlement may rebut the presumption by-- (i) Establishing both that the miner does not, or did not, have: (A) Legal pneumoconiosis as de fined in § 718.201(a)(2); and (B) Clinical pneumoconiosis as defined in § 7 18.201(a)(1), arising out of coal mine employment (see § 718.203); or (ii) Establishing that no part of the miner's respiratory or pulmonary total disability was caused by pn eumoconiosis as defined in § 718.201. 20 C.F.R. § 718.305(d)(1).-9- Antelope is the named operator for his clai m. A Department ALJ heard his case in Casper, Wyoming on October 20, 2010.
1. Evidence Presented to the ALJ At the hearing, Mr. Goodin testified in person about his working conditions at surface coal mines in the various positions he held, which included warehouse worker for four to five years, equipment operator for 11-12 years, and equipment oiler in the mine pit for nine years. We will discuss Mr. Go odin’s working conditions in more detail later in the opinion. He also testified about hi s forty-year smoking history, stating that he started smoking in his 20s, tried to quit multip le times, and successfu lly quit in 2004 or 2005. He smoked, on average, a p ack of cigarettes each day. The parties introduced conflicting medica l evidence regarding (1) readings of chest x-rays and CT scans; (2) results from pulmonary func tion tests and arterial blood gas studies; (3) interpretations of patient history; (4) statistical reasoning; and (5) diagnoses.

a. Mr. Goodin’s Medical Evidence Mr. Goodin submitted Dr. Andras Bodoni’s and Dr. Cecile Rose’s medical reports and deposition testimony, Dr. Donald Smith’s treatment re cords, and additional x-ray and CT scan interpretations. Dr. Bodoni, board-certified in internal me dicine, examined Mr. Goodin to satisfy the Department’s obligation under 30 U.S.C. § 923(b) to provide each claimant-miner with “an opportunity to substantiate his or her claim by means of a complete pulmonary-10- evaluation.” See 30 U.S.C. § 923(b). Dr. Bodo ni diagnosed Mr. Goodin with pneumoconiosis from exposure to coal dust and with total disability from a combination of pneumoconiosis and another respiratory disease. Appx., Vo l. I at 17. He based this diagnosis on a physical exam ination, patient history, a nd his positive x-ray reading. Id. at 41. Dr. Bodoni opined that although Mr. Goodin had other respiratory conditions, none of them constituted the entire disa bility without pneumoconiosis. Id . Dr. Bodoni testified it was impossible to tell the differe nce in impact between coal mine exposure and smoking. Id. at 32-33. Dr. Rose—board-certified in pulmonary medicine, general preventive/occupational medicine, and inte rnal medicine, as well as a B-reader 9

— examined Mr. Goodin at his request. She base d her opinion on a physical examination, patient history, and a positive x-ray and CT scan. Appx., Vol. I at 78-79. She also reviewed the medical records and opinions from Dr. Bodoni and Antelope’s primary medical experts. She concluded Mr. Goodin was totally disabled from his respiratory condition, which resulted, at least in part, from his previous exposure to coal mine dust. Id. at 84. Dr. Rose recognized that mu ltiple factors, including smoking, caused Mr. Goodin’s respiratory condition, but still conc luded that coal mini ng was a substantially contributing factor. Id. at 83-84. Dr. Rose disagreed w ith Antelope’s experts and filed a supplemental report after their depositions to rebut their testimony.

9 A B-reader is a doctor who is certifie d to read x-rays for pneumoconiosis. Appx., Vol. II at 276 n.8.-11- Dr. Smith was Mr. Goodin’s treating physician. Mr. Goodin submitted Dr. Smith’s treatment notes, which said, “The patient has had abnormal lung function for years and probably his recent ex posures caused a mild exac erbation. The radiographic picture is certainly not typical for Coal Worker’s pneumoconiosis but the patient may have a slowly active fibrosis in addition to the emphysema.” Appx., Vol. II at 267. Mr. Goodin submitted additional interpretati ons of his tests. Dr. Afzal Ahmed examined three admissible x-rays 10 and found opacities in all zones indicating pneumoconiosis. Id. at 277. Dr. David Lynch reviewed a 2010 CT scan that Dr. Rose ordered. Id. at 279. Dr. Lynch determined that although the CT scan did “not show typical features of coal workers [sic] pneumoc oniosis, it could certainl y be related to coal dust exposure. Alternatively, this could be secondary to cigarette smoking. Moderate emphysema may be related to coal dust exposure and/or smoking.” Appx., Vol. I at 93. b. Antelope’s Medical Evidence Antelope submitted Drs. Lawrence Repshe r’s and Robert Farney’s reports and deposition testimony as well as additional inte rpretations of Mr. Goodin’s x-rays and CT

scans. Dr. Repsher, board-certified in internal medicine and pulmona ry disease and a Breader, examined Mr. Goodin at Antelope’s request. He concluded that Mr. Goodin’s respiratory disease was chronic obstructive pulmonary disease (“COPD”) due to heavy

10 Dr. Ahmed reviewed a fourth x-ray, but it exceeded the number of x-rays Mr. Goodin could submit and the ALJ did not consider it.-12- smoking, noting that Mr. Goodin’s chest x-ray showed no evidence of pneumoconiosis. Appx., Vol. II at 262. He based his opinion on Mr. Goodi n’s chest x-ray and a CT scan showing opacities consistent with smoking but not typical of pneumoconiosis. Id. He also explained that although a few coal mine rs will develop COPD from coal mine dust, statistically “in this individual coal miner, to an overwhelming proba bility, any detectable COPD would be the result of cigarette smoki ng and/or asthma, but not the result of the inhalation of coal mine dust.” Appx., Vol. I at 48. He thought Dr. Rose’s pulmonary function tests were not reliable and probably invalid because the resu lts were unlikely. Dr. Repsher also concluded Mr. Goodin’s pulmonary capacity is likely sufficient to perform his last coal mining job, and theref ore Mr. Goodin is not totally disabled. Appx., Vol. II at 275. Dr. Farney, board-certified in internal medicine, pulmonary medicine, and sleep medicine, examined Mr. Goodin at Antelope ’s request. Unlike D r. Repsher, he agreed with Dr. Rose that Mr. Goodin is totally a nd permanently disabled, but stated that Mr. Goodin does not have pneumoconiosis. Appx., Vo l. II at 264. Instead, he diagnosed Mr. Goodin with COPD from smoking. Id. He stated that coal dust exposure can cause COPD, but the degree of COPD from coal dust is usually mild unless the dust exposure was high, in which case a chest x-ray would be abnormal. Id. at 264-65. Dr. Farney ruled out pneumoconiosis from coal dust expos ure because “the risk of developing coal worker’s [pneumoconiosis] is less in surface mining,” Appx., Vol. I at 64, smoking has a higher risk of respiratory conditions than coal dust exposure, and Mr. Goodin’s chest-13- x-ray was negative for pneumoconiosis. Antelope also submitted the following inte rpretations of Mr. Goodin’s tests. Dr. Cristopher Meyer interpreted one x-ray (which Dr. Ahmed also reviewed) as negative for pneumoconiosis. Appx., Vol. II at 277. D r. Jerome Wiot interpreted another x-ray as also negative for pneumoconiosis. Id. Dr. Wiot analyzed a 2008 CT scan, concluding, “There is no evidence of coal worker’s pne umoconiosis. There is mild emphysema. There is mild . . . fibrosis . . . [that] is not a manifestation of coal dust exposure.” Id. at 279. Finally, Dr. Meyer reviewed Mr. Goodin’s 2010 CT scan, concluding that although “there are many causes of pulmonary fibrosis, th [e] pattern is not typical of coal worker’s pneumoconiosis . . . .” Appx., Vol. I at 90-91. 11
* * * * In summary, three of the four doctors, Dr s. Bodoni, Rose, and Repsher, agreed Mr. Goodin was totally disabled. Th ey disagreed as to the cause. Mr. Goodin’s experts, Drs. Bodoni and Rose, concluded his disability resulted, at least in part, from pneumoconiosis due to coal mining. Antelope’s experts, Drs. Repsher and Farney, concluded Mr. Goodin’s disability may have resulted fro m COPD caused by heavy smoking. They based this conclusion on test results not typical for pneumoconiosis and Mr. Goodin’s health history. They also opined that Mr. Goodin’s wo rk at a surface mine made

11 Antelope argues the ALJ improperly failed to consider Dr. Meyer’s interpretation of this CT s can because the ALJ did not sp ecifically mention it in his analysis. This issue is addressed below.-14- pneumoconiosis statistically improbable be cause (1) most miners will not develop chronic COPD from coal dust exposure, an d (2) because the risk of developing pneumoconiosis from surface mining is less th an from underground mining due to lower coal dust exposure.
2. The ALJ’s Decision The ALJ found Mr. Goodin (1) had worked for more than 15 years in surface mining conditions substantially similar to underground mining and (2) was totally disabled from his respiratory impairment. Appx., Vol. II at 271, 275. These findings established the 15-year presumption. The ALJ stated Antelope had the burden under § 921 to rebut this presumption by a pre ponderance of the evid ence showing (1) Mr. Goodin did not have pneumoconi osis or (2) his disability did not arise out of coal mine employment. Id. at 276. The ALJ held that Antelope had failed to rebut the pr esumption and awarded Mr. Goodin BLBA benefits. Id. at 283. He found the x-ray evidence to be in equipoise and Dr. Rose’s report and conclu sions to be persuasive. 12 Id. at 278, 281, 283. He found Drs. Repsher’s and Farney’s statis tical reasoning unpersuasive because they failed to show why Mr. Goodin was not w ithin the subgroup of individuals who suffer from pneumoconiosis caused by surfa ce mining conditions or why co al dust could not have aggravated the COPD the doctors attributed to smoking. Id. at 282-83. Accordingly, the

12 The ALJ did not place much weight on Dr. Bodoni’s conclusions due to his relative lack of credentials.-15- ALJ concluded, Antelope “has not rebu tted the presumption . . . by showing a preponderance of the evidence that [Mr. Goodin] does not have pneumoconiosis” or that the “pneumoconiosis did not arise out of his coal mine employment . . . .” Id. at 283.
3. Subsequent Proceedings The Benefits Review Board affirmed the ALJ’s decision on September 27, 2012. It determined the ALJ had applied the pr oper legal standard, substantial evidence supported his factual findings, and the de cision contained no reversible error. Antelope petitioned this court, challenging the legal standard applied to its rebuttal evidence, the test for determining substan tial similarity to underground coal mining conditions, the completeness of Mr. Goodin’s Department-provided pulmonary exam, the ALJ’s consideration of medical evidence, a nd the completeness of the ALJ’s analysis. On the day of oral argument, September 25, 2013, the Department issued its Final Rule implementing and interpreting statutor y changes made by the ACA, which became effective on October 25, 2013. The par ties submitted supplemen tal briefing on the applicability and impact of th e Final Rule on this case.
II. DISCUSSION
A. Standard of Review For questions of fact, we determine whether the Review Board “properly concluded that the ALJ’s decision was supported by substantial evidence.” Hansen v.-16- Dir., OWCP , 984 F.2d 364, 368 (10th Cir. 1993). 13 “Substantial evidence is ‘such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.’” Id. (quoting Consolidated Edison Co. v. NLRB , 305 U.S. 197, 229 (1938)). We do not reweigh the evid ence, but instead ask if, ba sed on the record as a whole, substantial evidence is presen t to support the ALJ’s decision. See Energy West Min. Co. v. Oliver , 555 F.3d 1211, 1217 (10th Cir. 2009). “[T]he task of weighing conflicting medical evidence is within the sole province of the ALJ.” Hansen , 984 F.2d at 368. “[W]here medical professionals . . . disagree[], the trier of fact is in a unique position to determine credibility and weigh the evidence.” Id. at 370. For questions of law, we review th e Review Board’s decision de novo. See Mangus v. Dir., OWCP , 882 F.2d 1527, 1530 (10th Cir. 1 989). We give no deference to the Review Board’s interpretation, see Lukman v. Dir., OWCP , 896 F.2d 1248, 1251 (10th Cir. 1990), “however, we give ‘considerable weight’ to the Department[’s] . . . construction of the statute it is entrusted to administer and ‘substantial deference’ to the agency’s reasonable interpreta tion of its own regulations,” Andersen , 455 F.3d at 1103 (citations omitted), unless such interpretation is “plainly erroneous or inconsistent with the regulation,” Mullins Coal Co. v. Dir., OWCP , 484 U.S. 135, 159 (1987); see also Auer v. Robbins , 519 U.S. 452, 461 (1997).

13 Although we are formally reviewing th e Review Board’s decision, because the standard of review for questions of fact requires us to determine whether the ALJ’s decision is supported by substantial evid ence, we focus on the ALJ’s decision and analysis.-17- B. Final Rule Applicability Before we discuss the ALJ’s and Review Board’s determinations, we first address whether relevant provisions of the Final Ru le, which became effective October 25, 2013, apply to this case. They do. The relevant provisions concern (1) how to establish the 15-year presumption by showing above-ground mining conditions are s ubstantially similar to underground mine conditions, 20 C.F.R. § 718.305(b )(2), and (2) how to rebut th e presumption, 20 C.F.R. § 718.305(d)(1). 14 These provisions apply because th ey do not change existing law and are substantially consistent with prio r regulations and agency practices. See Nat’l Mining Ass’n v. Dep’t of Labor , 292 F.3d 849, 859 (D.C. Cir. 2002); Farmers Tel. Co., Inc. v.
FCC , 184 F.3d 1241, 1250 (10t h Cir. 1999) (stating an inte rpretive rule may operate retrospectively when it “merely clarifies or explains existing la w or regulations”). “If a new regulation is substantively cons istent with prior regulations or prior agency practices, and has been accepted by all Courts of Appeals to consider the issue, then its application to pe nding cases” is proper. Nat’l Mining , 292 F.3d 860. Here, neither provision changes th e substantive law because e ach merely clarifies the Department’s position and conforms to circuit court cases. Section 718.305(b)(2) addre sses when a surface miner’s working conditions are substantially similar to unde rground mining working conditio ns. The only circuit to

14 The rules are quoted in full in footnotes 7 and 8, supra .-18- address this issue has long he ld that surface miners do not need to provide evidence of underground mining conditions to compar e with their own wo rking conditions. See, e.g. , Freeman United Coal Mining Co. v. Summers , 272 F.3d 473, 479 (7th Cir. 2001); Blakley v. Amax Coal Co. , 54 F.3d 1313, 1319 (7th Cir. 1995); Dir., OWCP v. Midland Coal Co. , 855 F.2d 509, 512 (7th Cir. 1988). Th ese decisions validate the Department’s longstanding position that c onsistently dusty working cond itions are sufficiently similar to underground mining conditions. See, e.g. , Midland Coal , 855 F.2d at 511-12. The revised regulation codifies that interpreta tion by making regular exposure to coal mine dust the standard to determine substantial similarity of surface working conditions to those in underground mines. See 20 C.F.R. § 718.305(b)(2). Similar reasoning applies to revised § 718.305(d)(1), which outlines the permissible methods of rebutting the 15 -year presumption. The changes to § 718.305(d)(1) also comport with the Depa rtment’s ongoing interpretation and do not substantively change the law. The original regulation required, for rebuttal, proof the disability did not arise fro m coal mine employment. 15 See, e.g. , Blakley , 54 F.3d 1313 at

15 The original language states, “The presumption may be rebutted only by establishing that the miner does not, or did not have pneumoco niosis, or that his or her respiratory or pulmonary impairment did not arise out of, or in connection with, employment in a coal mine.” 20 C.F.R. § 718.305(a) (2010). The new regulation states, “In a clai m filed by a miner, the party opposing entitlement may rebut the presumption by . . . (i) [e]stablishing both that the miner does not, or did not, have . . . [l ]egal pneumoconiosis . . . [and c]linical pneumoconiosis . . . arising out of coal mine employment . . . or (ii) [e]stablishing that no part of the miner’s Continued . . .-19- 1319. The revised regulation requires proo f that pneumoconiosis, as defined in the statute, did not cause any part of the disability. See 20 C.F.R. § 718.305(d)(1). Because the statute defines pneumoconiosis as “a rising out of coal mine employment,” see 20 C.F.R. § 718.201(a), the practical effect of th e revised rule is the same, and it therefore applies to this case.
C. Did the ALJ Err in Finding that Mr. Goodin Is Entitled to the 15-Ye ar Presumption? The ALJ determined and th e Review Board affirmed th at Mr. Goodin is entitled to the 15-year presumpti on because he (1) worked for at least 15 years in conditions substantially similar to underground mi ning and (2) was totally disabled from a respiratory or pulmonary impairment. See 30 U.S.C. § 924(c)(4). Substantial evidence supported this determination.
1. 15 Years Working in Conditions Substa ntially Similar to Underground Coal Mining The ALJ found that Mr. Goodin worked as a coal miner for at least 25 years in surface mining. The question in this petition is whether the ALJ proper ly determined that Mr. Goodin’s surface mining working conditions were substantially similar to those in underground mining.

______________________________________ Cont. respiratory or pulmonary total disability was cau sed by pneumoconiosis . . . .” 20 C.F.R. § 718.305(d)(1) (2013).-20- Mr. Goodin testified he held three diffe rent jobs while working in the mines— warehouse worker, equipment operator, and equi pment oiler. Appx., Vol. I at 122-23. He started as a warehouse worker for four to five years and then worked as an equipment operator for three years. Id. As an equipment operator, he drove a truck with an attached shovel, drove a water truck, and op erated a machine called a scraper. Id. at 123. Although he was located in the cabs of the vehicles, and some trucks had air filtration, “there was no way [to keep the dust out], even when you clos ed the doors, it was just like a cloud of dust inside the cabs.” Id. at 148. He also described that the truck was “always kicking up a puff of dust ,” and the dust would just hang in the air. Id . at 127, 148. When the wind blew, it was “like a sand blaster sometimes.” Id . at 132. His duties frequently required him to get in and out of the equipment and work outside for a period of time. Id. at 125. Mr. Goodin next worked as an equipm ent oiler for nine years. During this time, he serviced the equipment exclusively in the mine pit while the other equipment was running, “so it would get pretty dusty out there . . . .” Id . at 130. Finally, he returned to working as an equipment operator for eight to nine years. The ALJ said Mr. Goodin had the burden of showing substantial similarity between his surface and undergr ound mining conditions, but “m ust only establish that he was exposed to sufficient coal dust in his surface mine employment.” Appx., Vol. II at 270 (quoting Blakley , 54 F.3d at 1319); see also Summers , 272 F.3d at 480. The ALJ found Mr. Goodin to be a cred ible witness and said, “Based on my experience with the testimony of undergroun d miners, I find [Mr. Goodin’s] description-21- of the conditions in the strip mines where he worked to be substant ially similar.” Appx., Vol. II at 271. 16 Because Mr. Goodin worked as an equipment operator and oiler for more than fifteen years, the ALJ did not consider th e working conditions in the warehouse. The ALJ’s decision and most of Antelope’s arguments were based on the previous version of § 718.305(b)(2). Antelope argues that the “substantial similarity” standard under that regulation, without additional gui dance, is arbitrary and gives the Review Board and this court no meaningful basis to evaluate the ALJ’s decision. Although we find some merit in this argument, we conc lude the revised regulation provides such guidance. The revised regulation states, “The conditions in a mine other than an underground mine will be considered ‘substantially similar’ to those in an unde rground mine if the claimant demonstrates that the miner was regularly exposed to coal-mine dust while working there.” 20 C.F.R. § 718.305(b)(2). It instruct s ALJs to find substantial similarity if the miner was regularly exposed to coal du st. The clarified standard— regular dust exposure—provides suffici ent guidance to measure similarity. Under this standard, Antelope argues the evidence fails to sh ow that Mr. Goodin’s surface mine working conditions were substan tially similar to thos e in an underground

16 The ALJ erred in basing his opinion on his personal experience with the testimony of underground miners . This error is harmless, however, because the evidence the ALJ properly accepted was sufficient to meet the “regular exposure” standard under the revised regulation. See 20 C.F.R. § 718.305(b)(2).-22- mine. We do not reweigh the evidence, but mere ly ask if there is s ubstantial evidence to support the ALJ’s determination. See Energy West , 555 F.3d at 1217. Mr. Goodin testified at length about th e working conditions in his various positions. 17 His testimony provided substantial eviden ce of regular exposure to coal dust. We agree with the Review Boar d that there was substantial evidence to supp ort the ALJ’s finding that Mr. Goodin worked for at le ast 15 years in surface mining conditions substantially similar to underground mining.
2. Total Disability From a Respir atory or Pulmon ary Condition The ALJ determined that M r. Goodin is totally disabled from a respiratory condition. Appx., Vol. II at 275. Although An telope presented the AL J with evidence to rebut Mr. Goodin’s disability , it does not, as the Review Board noted, challenge the ALJ’s determination of total disability. See id. at 287 n.3.
* * * * For the foregoing reasons, we conclude the ALJ did not err in finding that Mr. Goodin is entitled to the 15-year presumptio n. The Review Boar d properly concluded

17 Antelope does not dispute Mr. Goodin’s recounting of his working conditions. It contends the air filter in the trucks prot ected Mr. Goodin from expo sure to enough dust to meet the standard. The evid ence showed the dust was only kept out in one truck, which Mr. Goodin only operated about ten percent of his time as an equipment operator. Even in that truck, Mr. Goodin testified there wa s still dust in the cab because he was required to get in and out of the truck frequently throughout th e day. Appx., Vol. I at 147-48. The ALJ, in weighing this evidence, concluded Mr. Goodin was regularly exposed to coal dust even inside the trucks. Appx., Vol. II at 271. We find substantial evidence to support this conclusion.-23- there was sufficient evidence to su pport the ALJ’s determination.
D. Did the ALJ Err in Finding that Ante lope Did Not Rebut the Presumption? The ALJ correctly stated that Mr. Goodin had the burden to establish by a preponderance of the evidence that “(1) he suffers from pneumoconio sis; (2) arising out of coal mine employment; (3) he is totally di sabled; and (4) his total disability is caused by pneumoconiosis.” Appx., Vol. II at 256; see 20 C.F.R. §§ 725.202(d)(2), 718.204(c)(1). The ALJ determ ined Mr. Goodin was totally disabled (element (3)) and the 15-year presumption satisfied the rema ining three elements ((1), (2), and (4)). Section 921(c)(4) states the Secretary ma y rebut the 15-year presumption only two ways: by proving (1) the claimant does not ha ve pneumoconiosis (legal and clinical), or (2) the claimant’s impairment “did not arise out of, or in connectio n with, employment in a coal mine.” 30 U.S.C. § 921(c)(4). The Depa rtment has applied this limitation to both the Secretary and mine operators like Antelo pe, and it has enacted regulations reflecting this interpretation. See 20 C.F.R. 718.305(d)(1). We first review (1) whether there is s ubstantial evidence to support the ALJ’s conclusion that Antelope faile d to rebut the 15-presumption under these two methods. We conclude there was. We then address (2 ) whether Mr. Goodin ca n prevail even if the ALJ erred in determining that an operator such as Antelope is limited to the two rebuttal methods. We conclude Antelope failed to rebut Mr. Goodin’s cl aim even without the rebuttal limitations and therefore any error in applying the rebuttal limitations was harmless.-24- 1. Did Antelope Rebut the Presumptio n under the Rebutta l Limitations? We review the ALJ’s determination that Antelope failed to rebut the presumption under the substantial evidence standard. See Hansen , 984 F.2d at 368. This analysis is divided between the two rebu ttal limitations—the presence of pneumoconiosis and whether pneumoconiosis cau sed the total disability.

a. Did Antelope rebut that Mr. Goodin has pneumoconiosis? The ALJ concluded Antelope failed to rebut the presumption that Mr. Goodin suffered from legal pneumoconiosis because th e medical tests were inconclusive and Antelope’s experts were unpersuasive. 18 First, as to the medical te sts, the ALJ found the x-ray evidence “in equipoise for the existence of pneumoconiosis” and “not su fficient for [Antelope] to show that [Mr. Goodin] does not have pneumoconiosis.” Ap px., Vol. II at 278. Although Mr. Goodin’s “CT scan[s were] not typical of pneumoconios is,” they did show that Mr. Goodin “does have some lung disease” and Antelope faile d to show why this lung disease was not pneumoconiosis because Antelope’s experts were not persuasive. Id. at 283.

18 As stated above, legal pneumoconio sis is “any chronic lung disease or impairment and its sequelae arising out of coal mine employment .” 20 C.F.R. § 718.201(a)(2) (emphasis added). “[A] dise ase ‘arising out of coal mine employment’ includes any chronic pulmonary disease or respiratory or pulmonary impairment significantly related to, or substantially aggr avated by, dust expo sure in coal mine employment.” Id. § 718.201(b). Clinical pneumoconiosis includes “thos e diseases recognized by the medical community as pneumoconiosis” characterized by the “deposition [of particulate matter] caused by dust exposure in coal mine employment .” Id. § 718.201(a)(1) (emphasis added).-25- Second, as to Antelope’s experts, Dr. Repsher stated that “to an overwhelming probability, any detectable CO PD would be the result of cigarette smoking and/or asthma, but not the result of the inhalation of coal mine dust.” Id. at 263. Dr. Farney’s main reason that smoking and not coal dust caused Mr. Goodin’s lung disease “is the absence of a significant risk f actor for coal dust. He wo rked on a surface mine, which statistically has less risk.” Id. at 266. The ALJ found the An telope’s experts’ reliance on statistical probabilities undermined their u ltimate conclusion that Mr. Goodin did not have pneumoconiosis becaus e they did not show why Mr. Goodin is not among the cohort of those who suffer COPD from surface coal mining. Id. at 282-83. Antelope did not show that Mr. Goodin did not have legal pneumoconiosis. It therefore did not rebut the presumption. We do not reweigh the evid ence on appellate review, see Energy West , 555 F.3d at 1217, and conclude the record adequate ly supports the ALJ’s determination. b. Did Antelope rebut that pneumoc oniosis caused any part of Mr. Goodin’s disability? The ALJ, applying the rule-out standard , concluded Antelope did not show that “no part” of Mr. Goodin’s respiratory disab ility “was caused by pneumoconiosis.” 20 C.F.R. § 718.305(d)(1)(ii); see Appx., Vol. II at 282-83. To rebut the presumption using this method, Antelope needed to rule out any connection between M r. Goodin’s disability and his pneumoconiosis. The relevant medical evidence is the sa me evidence the ALJ considered in determining wh ether Antelope rebutted the presumption that Mr. Goodin-26- has pneumoconiosis. Although the ALJ did not sp ecifically analyze disability causation, he made findings showing that Antelope did not rebut the presumption. 19 The ALJ found that Mr. Goodin suffered from a totally disabling respiratory conditi on. Appx., Vol. II at 276. He found persuasive Dr. Rose’s conclusion that Mr. Goodin was totally disabled from his respiratory condition, which, she said, resulted, at least in pa rt from his previous exposure to coal mine dust. Id. at 283. Dr. Rose recognized that multiple fact ors, including smoking, caused Mr. Goodin’s lung condition, but she still concluded that coal mining was a substantially contributing factor. Id. at 260-61. Conversely, the ALJ found unp ersuasive Antelope’s evid ence that smoking alone caused Mr. Goodin’s condition. Id. at 282-83. The ALJ furt her said that even if Antelope’s evidence had pers uaded him that smoking caused Mr. Goodin’s condition, Antelope still had failed to show that coal dust had not aggravated or materially worsened Mr. Goodin’s condition. Id. at 283 (“Both doctors simply eliminate coat dust exposure as a cause, but do not adequately explain why it could not have contributed to [Mr. Goodin’s] lung diseas e in addition to his history of smoking.”); see 20 C.F.R. § 718.201(b). Finally, the ALJ found that Antelope had “not rebutted the presumption by showing [Mr. Goodin’s] pneumoconiosis did no t arise out of his coal mine employment

19 See Island Creek Ky. Mining v. Ramage , 737 F.3d 1050, 1 061-62 (6th Cir. 2013) (holding ALJ’s “brief” reasoning on disability causation was sufficient).-27- as the definition of legal pneumoconiosis subsum es that finding.” Appx., Vol. II at 283. Because (1) the ALJ found th at Mr. Goodin has legal pneum oconiosis, which Antelope failed to rebut; (2) legal pneum oconiosis by definitio n arises from exposure to dust in coal mining employment; and (3) Dr. Rose c oncluded that Mr. Goodin’s total disability resulted in part from coal dust exposure, An telope failed to rule out any connection between Mr. Goodin’s pneumocon iosis and his total disability. 20 We conclude the record supports the ALJ’s decision and the Review Board’s affirmance.
2. Was the ALJ’s Application of the Re buttal Limitations Harmless Error? Antelope argues the rebuttal limitations (1 ) may not be applied to operators, and (2) impermissibly restricted its ability to prove and argue that coal mining did not substantially contribute to Mr. Goodin’s disability. We do not decide whether the rebuttal limitations apply to Antelope 21 because any error in the ALJ’s invocation of the rebuttal limitations was harmless. See 5 U.S.C. § 706(2)(F) (“[D]ue account shall be

20 Antelope argues the ALJ did not make a finding and explanation as to whether it successfully rebutted the presumption that the disability arose from coal mining employment. As explained above, although the ALJ did not provide a separate analysis for this particular element, the reasoning a nd evidentiary analysis throughout the ALJ’s opinion supports the ALJ’s holding that the presumption was not rebutted. This fulfills the ALJ’s duty of explanati on under the Administrative Pr ocedure Act (“APA”) because we can “discern what the AL J did and why he did it.” Gunderson v. U.S. Dep’t of Labor , 601 F.3d 1013, 1022 (10th Cir. 2010) (quotations omitted).

21 The Sixth Circuit has addressed this issue. See Big Branch Res., Inc. v. Ogle , 737 F.3d 1063, 1069-70 (6th Cir. 2013) (citing Morrison v. Tenn. Consol. Coal Co. , 644 F.3d 473, 479 (6th Cir. 2011) (holding the rebuttal limita tions applied to the employer)).-28- taken of the rule of prejudicial error.”); Hillsdale Envtl. Loss Prevention, Inc. v. U.S. Army Corps of Eng’rs , 702 F.3d 1156, 1165 (10th Cir. 20 12) (“[E]ven if an agency violates the APA, its error does not require reversal unless a plaintiff demonstrates prejudice resulting from the error.”); Gunderson v. U.S. Dep’t of Labor , 601 F.3d 1013, 1022 (10th Cir. 2010) (“[W]e may overturn th e ALJ’s decision only if the error . . . prejudicially affected a substantial ri ght of a party.” (quotations omitted)). The ALJ did not limit Antelope ’s presentation of rebuttal evidence, and the record contains substantial evidence that Antelope did not rebut the four elements of Mr. Goodin’s prima facie case. See Island Creek Ky. Mining v. Ramage , 737 F.3d 1050, 1061 n.4 (6th Cir. 2013) (stating the ALJ did not restrict the employer’s rebuttal methods and the employer could not othe rwise rebut the presumption); Mingo Logan Coal Co. v.
Owens , 724 F.3d 550, 555-56 (4th Cir. 2013) (same). 22 Despite the ALJ’s finding that Mr. Goodi n was entitled to the 15-year presumption and that the rebuttal limitations applied, the ALJ still allowed Antelope to present rebuttal evidence without rest riction, and Antelope does not co ntest otherwise. The ALJ did not even decide that the 15-year presumption applied until a ll evidence from both parties had been submitted. Antelope’s evidence was in sufficient to rebut any of the presumptively established elements of Mr. Goodin’s claim.

22 As stated above, the four elements of M r. Goodin’s prima facie case are, “(1) he suffers from pneumoconiosis; (2) arising out of coal mine employment; (3) he is totally disabled; and (4) his total disability is caus ed by pneumoconiosis.” Appx., Vol. II at 256; see 20 C.F.R. §§ 725.202( d)(2), 718.204(c)(1).-29- First, as to Mr. Goodin suffering from pne umoconiosis, we have already upheld the ALJ’s finding that Antelope did not rebut this element. Second, as to Mr. Goodin’s pneumoconiosis arising out of coal mine employment, the ALJ noted that legal pneumoc oniosis by statutory definiti on arises from coal mining. Appx., Vol. II at 283; 20 C.F.R. § 718.201(a )(2). Because Antelope failed to rebut the first element—the presence of legal pneumoconiosis—Antelope also failed to rebut the presumption that the pneumoconiosis arose out of Mr. Goodin’s coal mine employment. Appx., Vol. II at 283. Third, as to Mr. Goodin bein g totally disabled, Drs. Bodoni, Rose, and Farney all agreed Mr. Goodin wa s totally disabled. Id. at 275. The ALJ discounted Dr. Repsher’s opinion to the contrary because Dr. Repshe r appeared to misunderstand Mr. Goodin’s job duties and because he did not consider M r. Goodin’s more recent test results. Id. Fourth, as to pneumoconiosis havi ng caused Mr. Goodin’s total disability, Antelope needed to show that coal mining was not a “substantially contributing cause” to rebut this fourth element. 23 It did not do so. The ALJ quoted the correct standard: A miner shall be considered totally disabled due to pneumoconiosis if [it] . . . is a substantially contributi ng cause of the miner’s totally disabling respiratory or pulmonary impairment. Pneumoconiosis is a “substantially contributing cause” of the minder’s disability if it:

23 The rule-out standard does not factor into this analysis because it is tied to the rebuttal limitations.-30- (i) Has a material adverse effect on the miner’s respiratory or pulmonary condition; or (ii) Materially worsen s a totally disabling respiratory or pulmonary impairment which is caused by a disease or exposure unrelated to coal mine employment. Id . at 274; see 20 C.F.R. § 718.204(c)(1). 24 As stated above, the ALJ found that Mr. Goodin suffered from a totally disabling respiratory cond ition and that Antelope had not shown that coal dust had not aggravated or materially worsened Mr. Goodin’s condition. The record contains substantial ev idence to support these findings. The ALJ ultimately concluded that Ante lope had failed to rebut any of the presumptively established elements of Mr. Goodin’s claim and that Mr. Goodin “has established that he suffers from pneumoconiosi s which is totally disabling and is caused by his coal mine employment.” Appx., Vol. II at 283. After careful review of the record a nd the ALJ’s opinion and reasoning, we conclude the rebuttal limitations did not affect the outcome. The ALJ did not limit Antelope’s evidence, and any alleged erro r was harmless because Mr. Goodin would have prevailed even withou t the rebuttal limitations.
E. Antelope’s Remaining Arguments Antelope contends the Department’s O ffice of Workers’ Compensation Programs

24 This regulation provides instruction when , as here, the claimant’s respiratory condition is the product of both smoking and co al mine dust. The coal mine dust is a substantial cause if it had a material adverse effect on the condition. See 20 C.F.R. § 718.204(c)(1)(i).-31- (“OWCP”) did not perform a complete pul monary exam on Mr. Goodin because the x-ray from the exam was unread able. Antelope also main tains the ALJ erred in not considering all of the medical evidence it presented.
1. Incomplete Pulmonary Exam 30 U.S.C. § 923(b) states, “Each miner w ho files a claim for benefits under this subchapter shall upon request be provided an opportunity to substantiate his or her claim by means of a complete pulmonary evaluation.” “ A complete pulmonary evaluation includes a report of physical examinati on, a pulmonary function study, a chest roentgenogram [(x-ray)] and, unless medi cally contraindicated, a blood gas study. ” 20 C.F.R. § 725.406. A report from a physical examination submitted with a claim must include results from a chest x-ray that is conducted and interpre ted pursuant to the regulations in § 718.102. Id . § 718.104(a)(5). Section 718. 102 provides that an x-ray must be of suitable quality for proper cla ssification of pneumoconiosis and cannot be used as evidence of pneumoconi osis unless it abides by the provisions in the section. Id

. § 718.102. Antelope argues that the OWCP faile d to perform a complete pulmonary examination on Mr. Goodin due to the poor quality of th e chest x-ray from the OWCP exam. Although the Departme nt and Mr. Goodin agree that Mr. Goodin was entitled to a complete pulmonary exam, they argue that Antelope cannot challenge the completeness of the exam because the exam was for Mr. Go odin’s benefit in establ ishing his claim, not for the operator’s benefit in defending the claim.-32- Dr. Bodoni conducted the OWCP exam, incl uding the chest x-ray interpretation. He thought the x-ray showed complicated pneumoconiosis. 25 Appx., Vol. II at 258-59. The ALJ discounted Dr. Bodoni’s findings beca use of his lack of expertise in reading x-rays, his failure to rate the x-ray’s quality , and Antelope’s rebu ttal evidence that the x-ray was unreadable. Id. at 277-78, 281. The ALJ stated that the x-ray, while arguably readable, was not of good quality. Id. The ALJ therefore put little weight on Dr. Bodoni’s reading and found the x-ra y was neither positive nor negative for pneumoconiosis. Id. Even so, the ALJ he ld the quality of the x -ray did not render the entire examination deficient. Id. Antelope’s argument to the contrary fails . Mr. Goodin underwent five additional chest x-rays, including one just five months after the challenged OWCP examination, which Antelope’s expert, Dr. Repsher, reviewed. Id. at 277. In fact, Mr. Goodin had so many chest x-rays interpretations that the ALJ was not able to consider them all because of evidentiary limitations. Moreover, the chest x-ray concerns c linical pneumoconiosis, and the ALJ determined that Mr. Goodin suffers from legal pneumoconiosis. Even if the x-ray had been more readable and had shown no clinic al pneumoconiosis, the ALJ’s determination of legal pneumoconiosis would stand because legal pneumoconiosis ca n be found without evidence of clinical pneumoconiosis.

25 Per Antelope’s request, Drs. Wiot and Meyer, both B-readers, also reviewed the x-ray and found it unreadable.-33- 2. Failure to Consider Medical Evidence The BLBA states that “all re levant evidence shall be cons idered . . . .” 30 U.S.C. § 923(b). Antelope argues that the ALJ’s failur e to consider some of its medical evidence calls for a remand for full cons ideration of the evidence. Antelope contends the ALJ failed to consid er three parts of the medical evidence. First, it argues that because the ALJ di d not discuss Dr. Meyer’s late-submitted interpretation of a CT scan in the analysis section of his decision, he must not have considered it. Second, Antelope complains the ALJ did not state what role Dr. Smith’s treatment notes played in the outcome. Fi nally, Antelope argues the ALJ failed to credit Drs. Farney’s and Repsher’s explanations th at Mr. Goodin’s smoking, not his exposure to coal dust, produced his respiratory condition. These arguments lack merit. The AL J mentioned all of this evidence—Dr. Meyer’s interpretation of the CT scan, Dr. Sm ith’s treatment records, and the reports and depositions of Drs. Farney and Repsher. Appx ., Vol. II at 255, 262-67. That the ALJ did not discuss every aspect of the evidence in his analysis does not mean he did not consider the evidence. See Clifton v. Chater , 79 F.3d 1007, 1009-10 (10th Cir. 1996) (“The record must demonstrate that the ALJ considered all of the evidence, but an ALJ is not required to discuss every piece of evidence.”). Moreover, Antelope does not persuasively argue that this evidence would have affected the outcome. As w ith the challenged x-ray disc ussed above, the CT scan interpretation could only rebut evidence of clinical pneumoconiosis, and the ALJ found-34- Antelope had failed to meet its burden of rebutting legal pne umoconiosis. The treatment notes also only go to clinical pneumoconios is: Dr. Smith wrote, “The radiographic picture is certainly not typical for Coal Worker’s pneumoconiosis but the patient may have a slowly active fibrosis in addition to the emphysema.” Appx., Vol. II at 267. Antelope’s arguments are more a matte r of disagreement with the ALJ’s assessment of the evidence as opposed to whether he considered the evidence at all. We may not reweigh the evidence but can only determine whether substantial evidence supported the decision. Energy West , 555 F.3d at 1217. “[T]he task of weighing conflicting medical evidence is within the sole province of the ALJ.” Hansen , 984 F.2d
at 368.
III. CONCLUSION Based on the foregoing, we deny Antelope’s petition for review.