Source: https://law.justia.com/cases/federal/appellate-courts/F2/884/726/464398/
Timestamp: 2019-10-17 23:21:28
Document Index: 403764247

Matched Legal Cases: ['§ 901', '§ 902', 'art 727', '§ 4121', '§ 922', 'art 727', 'art 718', '§ 902', '§ 901', 'art 727', '§ 932']

Arthur Bonessa, Petitioner, v. United States Steel Corp., Respondent,anddirector, Office of Workers' Compensation Programs, U.s.department of Labor, Party in Interest, 884 F.2d 726 (3d Cir. 1989) :: Justia
Justia › US Law › Case Law › Federal Courts › Courts of Appeals › Third Circuit › 1989 › Arthur Bonessa, Petitioner, v. United States Steel Corp., Respondent,anddirector, Office of Workers'...
Arthur Bonessa, Petitioner, v. United States Steel Corp., Respondent,anddirector, Office of Workers' Compensation Programs, U.s.department of Labor, Party in Interest, 884 F.2d 726 (3d Cir. 1989)
US Court of Appeals for the Third Circuit - 884 F.2d 726 (3d Cir. 1989) Submitted Under Third Circuit Rule 12(6)June 26, 1989. Decided Sept. 5, 1989. Rehearing Denied Nov. 29, 1989
Paul A. Tershel, Melenyzer & Tershel, Washington, Pa., for petitioner.
Robert C. Jones, USX Corp., Pittsburgh, Pa., for respondent USX Corp.
Elizabeth Hopkins, Office of the Sol., U.S. Dept. of Labor, Washington, D.C., for party in interest Director, OWCP, etc.
We are asked to determine the meaning of "total disability due to pneumoconiosis" as that phrase is understood in the context of the 1981 amendments to the Federal Coal Mine Health and Safety Act of 1969, 30 U.S.C. § 901 et seq. (amended 1982), and the regulations promulgated pursuant thereto.
The federal black lung program, a comprehensive attempt to manage occupational disease compensation, has been a continuing source of controversy. First enacted in 1969, the Federal Coal Mine Health and Safety Act has undergone alternatively liberalizing and restricting amendments. Congress enacted the first set of amendments in 1972 to counteract the constrictive interpretation given to the Act by the Social Security Administration, charged with responsibility for a portion of the program, which denied approximately 50% of the claims filed. In response, Social Security adopted the so-called "interim presumptions" which set forth certain criteria for eligibility for benefits based upon medical evidence and years of coal mine employment. 20 C.F.R. Secs. 410, 490 (1980). Post-adoption, the Social Security's approval rate rose, but a low percentage of benefits awarded to claims filed still existed for the portion of the program administered by the Department of Labor. Because of this, Congress, in 1977, once again amended the statute to require the Department of Labor to adopt criteria "no more restrictive" than the interim presumptions of the Social Security Administration. 30 U.S.C. § 902(f) (2). With the incorporation of these presumptions into its regulations, found at 20 C.F.R. Part 727, the Department of Labor approval rate increased. So, however, did the deficit in the 1978-established Black Lung Trust Fund, to approximately $1.2 billion. Schroeder, Legislative and Judicial Responses to the Inadequacies of Compensation for Occupational Disease, 49 Law and Contemporary Problems 151, 168-69 (Autumn 1986).
In response to the swelling deficit of the fund, on January 1, 1982, the Black Lung Revenue Benefits Act of 1981, 26 U.S.C. § 4121 (1981), and the Black Lung Benefits Amendments of 1981, 30 U.S.C. §§ 922, 923 (1982), became effective. These amendments tightened the formulation for determining entitlement to benefits and altered the procedures applicable to the payment of such benefits. See generally Lopatto, The Federal Black Lung Program: A 1983 Primer, 85 W.Va. L. Rev. 677 (1983), for an overview of the 1981 legislation.
As mentioned above, the Department of Labor eliminated the presumption, significant to Bonessa's claim, that was previously found at 20 C.F.R. Sec. 727.203(b) (3). This section provided that proof of certain years of working as a miner gave rise to a presumption that a claimant's pneumoconiosis was due to his coal mine employment. The presumption was rebutted by evidence that the miner's total disability "did not arise in whole or in part out of coal mine employment." 20 C.F.R. Sec. 727.203(b) (3).
Bonessa acknowledges that his claim is not governed by the Part 727 regulations, nevertheless, he asserts that our interpretation of Sec. 727.203(b) (2), as announced in Carozza v. United States Steel Corporation, 727 F.2d 74 (3d Cir. 1984), is still applicable in determining the issue of whether his disability must be shown to be the exclusive result of his pneumoconiosis. In Carozza, we held that, properly read, 20 C.F.R. Sec. 727.203(b) (3) does not permit the award of benefits for partial disability, but only for total disability of which pneumoconiosis is a contributing cause. Id. at 78. The holding of Carozza was reaffirmed in Bernardo v. Director, Office of Workmen's Compensation Programs, 790 F.2d 351 (3d Cir. 1986), and embraced by the Court of Appeals for the Eleventh Circuit in Alabama By-Products Corporation v. Killingsworth, 733 F.2d 1511, 1516 n. 10 (11th Cir. 1984), (agreeing with Carozza that Sec. 727.203(b) (3) permits award of benefits for disability when pneumoconiosis is a contributing cause). Bonessa urges us to apply this conclusion that pneumoconiosis need only be a contributing, and not a sole, cause of the disability to recognize his eligibility for benefits.
48 Fed.Reg. 24,276 (1983). The resulting regulation, 20 C.F.R. Sec. 718.205(c), reads in relevant part:
Without a doubt, a miner seeking benefits must show that he is totally disabled not merely by a respiratory or pulmonary condition but by pneumoconiosis. Generally, under the applicable Part 718 regulations, the miner must prove that he has pneumoconiosis, that he contracted it through his coal mine employment, and that he is totally disabled due to the disease. See 20 C.F.R. Secs. 718.201-204.
20 C.F.R. Sec. 718.204(c) (4), applicable here, explains that total disability can be found:
If a physician exercising reasonable medical judgment, based on medically acceptable clinical and laboratory and diagnostic techniques, concludes that a miner's respiratory or pulmonary condition prevents or prevented the miner from engaging in employment as described in p b of this section.
20 C.F.R. Sec. 718.204(c) (4).
Despite the language of Sec. 718.204(c) (4), subsection (b) of Sec. 718.204 which defines total disability requires a showing of disability resulting specifically from pneumoconiosis, not merely by some other respiratory or pulmonary condition. This limitation, as it applies to a living miner's claim, is inexplicably found in 20 C.F.R. Sec. 718.204(c) (5), which reads in relevant part:
(Emphasis added.)1 Our task, then is to analyze this language of Sec. 718.204(c) (5) as it gels with an attempt to prove total disability under Sec. 718.204(c) (4).
Bonessa contends that there is no support in the language of Sec. 718.204(c) (5) that pneumoconiosis must be in and of itself totally disabling. He then argues that the medical evidence presented under Sec. 718.204(c) (4) clearly demonstrated that he was totally disabled due to pneumoconiosis. Bonessa thus urges that the ALJ committed a critical error, subsequently compounded by the Board, by failing to credit a physician's, Dr. Silverman's, assessment of total disability " [b]ecause Dr. Silverman did not specifically find that claimant's respiratory or pulmonary impairment alone was totally disabling, his report cannot support a finding of total disability under this subsection." ALJ Decision and Order at 7.2
" ' [W]e review the decisions of [the Board] for error of law and to assure ourselves that it has adhered to the statutory scope of review.' " Hillibush v. U.S. Department of Labor, Benefits Review Board, 853 F.2d 197, 202 (3d Cir. 1988), quoting, Kertesz v. Crescent Hills Coal Company, 788 F.2d 158, 162 (3d Cir. 1986).3 Accordingly, our discussion necessitates an examination of the administrative proceedings.
The ALJ first determined that although Bonessa could not demonstrate the presence of pneumoconiosis under the presumptions of either 20 C.F.R. Sec. 718.304, dealing with x-ray diagnosis, radiograph, biopsy or autopsy, or Sec. 718.306, applicable to death claims, he did find that the existence of pneumoconiosis could be established on the basis of x-ray evidence pursuant to Sec. 718.202(a) (1). The ALJ noted that the contradictory nature of the x-ray evidence established "true doubt" as to the existence of pneumoconiosis and resolved that doubt, as is proper, in favor of Bonessa.
Next, the ALJ applied Sec. 718.203(b) which affords to miners who worked ten or more years in the mines a rebuttable presumption that the pneumoconiosis arose out of coal mine employment. The ALJ found the presumption to be unrebutted.
The ALJ then reviewed the medical evidence in order to determine whether Bonessa was totally disabled due to pneumoconiosis. Under the Act, Bonessa would be totally disabled if pneumoconiosis prevented him from engaging in gainful employment requiring the skills and abilities comparable to those of any employment in a mine in which he was previously engaged with some regularity and over a substantial period of time. 30 U.S.C. § 902(f) (1) (A); 20 C.F.R. Sec. 718.204(b). The ALJ examined the several criteria for establishing total disability as set forth at Sec. 718.204(c) (1) through (c) (5) and discarded each section as inapplicable with the exception of Sec. 718.204(c) (4). This provision, as previously discussed, outlines that a miner may establish total disability if a physician concludes that a respiratory or pulmonary condition prevented him from engaging in his usual coal mine work or comparable and gainful work.
Doctor Silverman: diagnosis of hypertension, anthracosilicosis, (a condition included in the 20 C.F.R. Sec. 718.201 definition of pneumoconiosis) and possible coronary disease; a combination of all Bonessa's problems prevented him from returning to work; and, anthracosilicosis made 'substantial contribution' to his disability.
On appeal to the Board, Bonessa specifically challenged the ALJ's evaluation of Dr. Silverman's report. Bonessa argued that under Sec. 718.204(c) (4), once a claimant establishes total disability, a presumption is created that total disability is due to pneumoconiosis and the burden shifts to the party opposing entitlement to show that pneumoconiosis is not the cause of total disability. The Board, citing Wilburn v. Director, OWCP, 11 BLR 1-135 (1988), found instead that the ALJ properly found Dr. Silverman's opinion insufficient to meet Bonessa's burden under Sec. 718.204(c) (5) to establish that pneumoconiosis is in and of itself, totally disabling. The Board also rejected Bonessa's contention that it was irrational for the ALJ to credit Dr. Abrons' opinion on disability.
A review of the deference owed to an agency's interpretation of its regulations was outlined in Director, Office of Workers Compensation Programs v. Mangifest, 826 F.2d 1318 (3d Cir. 1987). There we acknowledged the Supreme Court's mandate that courts must defer to an agency's consistent interpretation of its own regulations unless it is plainly erroneous or inconsistent with the regulation. Bowles v. Seminole Rock & Sand Company, 325 U.S. 410, 65 S. Ct. 1215, 89 L. Ed. 1700 (1945); see also Revak v. National Mines Corporation, 808 F.2d 996 (3d Cir. 1986). Mangifest nonetheless held that such deference does not afford the Director the opportunity to rewrite the regulations through interpretation. 826 F.2d at 1324. Also, the degree of deference is measured by the extent that the Director's interpretation does not strain the plain meaning of the words, or imply language that does not exist. Bethlehem Steel Corporation v. Occupational Safety and Health Review Committee, 573 F.2d 157, 161 (3d Cir. 1978).
In this vein, we examine the Board's reliance on the case of Wilburn v. Director, OWCP, 11 BLR 1-135 (1988), as the basis of the Director's interpretation of "total disability due to pneumoconiosis." In Wilburn, the Board agreed with the Director's position that to establish total disability pursuant to Sec. 718.204(c) (4), under Sec. 718.204(c) (5) it is not sufficient to establish that claimant's total disability is due to pneumoconiosis. To meet a claimant's burden, according to the Director in Wilburn, total disability due to pneumoconiosis must be established by presenting competent evidence demonstrating that his pneumoconiosis is, in and of itself, totally disabling.
(c) One comment received suggested that paragraph (c) should be further revised or a new subsection be promulgated to make clear that the miner's total disability must be due to pneumoconiosis. Paragraphs (a) and (b) of this section already state that pneumoconiosis "as defined in Sec. 718.201" must be the cause of the miner's total disability. No useful purpose would be served by reiterating the requirement again in paragraph (c) of this section. The same comment also suggests that paragraph (c) should further state that the pneumoconiosis must have arisen from employment in the nation's coal mines. That requirement is made express in Sec. 718.203 and no useful purpose would be served in repeating it in other sections of the regulations which discuss other criteria for establishing eligibility for benefits. Finally, the same comment also suggests that language should be added to make clear that, except as provided in Sec. 718.305 proof of a totally disabling respiratory or pulmonary impairment shall not by itself be sufficient to establish that the miner's impairment is due to pneumoconiosis. The Department agrees that such an addition would be helpful and paragraph (c) has been revised to incorporate that suggestion.
The last sentence in this quote is a reference to 20 C.F.R. Sec. 718.204(c) (5) which indeed states that proof that a miner suffers from respiratory or pulmonary impairment does not establish that the miner's impairment is due to pneumoconiosis. This provision, however, does not state, directly or inferentially, that the miner's impairment must be due solely to pneumoconiosis and, therefore, is not supportive of the Director's position assumed in Wilburn.
We find that the more telling comment was elicited from the Director in its discussion construing the words "due to" in the context of "death due to pneumoconiosis." 48 Fed.Reg. 24,276 (1983). Already possessing a regulatory definition for "total disability," 20 C.F.R. Sec. 718.204(b), and for pneumoconiosis, 20 C.F.R. Sec. 718.201, the words "due to" present the only opportunity for judicial interpretation.
The Director has conceded that the words "due to," as they are understood to demonstrate a causal nexus, invoke a broad range of meaning. To counteract this ambiguity in the context of survivors' claims, the Director promulgated Sec. 718.205(c) providing that death will be considered due to pneumoconiosis if it was a "substantially contributing cause or factor leading to the miner's death."
The language of Sec. 718.204(c) (5), construed as preclusive by the Director in Wilburn, is rather a common sense statement that the disability must be due to pneumoconiosis and not solely to some other respiratory impairment. This is a necessary corollary to the statute's purpose to assist those claimants who became disabled from coal mine employment. 30 U.S.C. § 901(a).
For example, in Gessner v. Director, OWCP, 11 BLR 1-1 (1987), survivor benefits were sought claiming that a miner was totally disabled by pneumoconiosis at the time of his death. The bulk of the Board's decision was related to the particular evidence proffered by the claimant, not relevant either to Wilburn or the present matter. In a footnote, however, the Board did comment that, under Sec. 718.204(c) (5), a claimant must prove, either via direct proof or by presumption, that a deceased miner's respiratory disease was due to pneumoconiosis, Gessner, 11 BLR at 1-3 n. 4, however, did not use any modifying language indicating that a miner's disability must be due exclusively to pneumoconiosis.
Clearly distinguishable from Bonessa's claim is Baumgartner v. Director, OWCP, 9 BLR 1-65 (1986), where the Board found that the claimant failed to carry his burden that his disability was due to pneumoconiosis since the only medical report in the record attributed his disability to heart disease. Likewise, in Gee v. W.G. Moore and Sons, 9 BLR 1-4 (1986), a claim of total disability due to pneumoconiosis was rejected since one medical report made no finding as to disability and the other found disability due to cigarette smoking. We emphasize that none of these cases held, nor even intimated, as did Wilburn, that pneumoconiosis must be the only cause of a miner's disability.
We conclude that the language of Sec. 718.204(c) (5) serves as an admonition that one may not prove total disability due to pneumoconiosis simply by demonstrating the presence of any respiratory or pulmonary ailment. Rather a miner must show that pneumoconiosis is a substantial contributor to the disability. If the permanent regulations intended to extinguish living miners' entitlement to benefits when pneumoconiosis is a significant contributor to the disability, which, as Carozza demonstrates, was a proper reading of the former Part 727 regulations, then the Department would have promulgated this intention specifically, as it did to eliminate survivors' claims for deaths unrelated to pneumoconiosis.
We recall that pneumoconiosis was diagnosed by three of the physicians who examined Bonessa. Since the basis upon which the Board affirmed the ALJ's order was the Board's erroneous acceptance of the ALJ's rejection of Dr. Silverman's report because it did not establish that pneumoconiosis was the sole factor in Bonessa's disability, and since this is an improper interpretation of the statute and regulations, we will remand this matter for further consideration in light of the correct legal standards. Hillibush v. U.S. Dept. of Labor, 853 F.2d at 207. We will therefore vacate the Board's judgment and remand this case for further proceedings in light of this opinion.
With the exception of the highlighted phrase, Sec. 718.204(c) (5) concerns claims of miners deceased prior to January 1, 1982, and does not otherwise address claims of living miners alleging total disability
To avoid confusion, we note that anthracosilicosis (which falls within the statutory definition of pneumoconiosis, 20 C.F.R. Sec. 718.201), was the only respiratory disease diagnosis made by Dr. Silverman, although his report did consider that Bonessa had a history of smoking. Therefore Bonessa's respiratory impairment, according to Dr. Silverman, could only have been caused by pneumoconiosis
The scope of review of the Board is dictated by statute and instructs that the ALJ's decision and order must be affirmed if it is supported by substantial evidence, is rational, and is in accordance with the law. 30 U.S.C. § 932(a)