Source: https://www.ssa.gov/OP_Home/rulings/di/09/SSR76-06-di-09.html
Timestamp: 2017-03-30 00:37:54
Document Index: 740887498

Matched Legal Cases: ['§ 901', '§ 413', '§ 923', '§ 205', '§ 405', '§ 410', '§ 410', '§ 410', '§ 410', '§ 410', '§ 410', '§ 410', '§ 410', '§ 410', '§ 410', '§ 410', '§ 410']

Disability Insurance SSR 76-6c: SECTIONS 402(f) and 411(b) (30 U.S.C. 902(b) and 921(b)) -- FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969 AS AMENDED -- TOTAL DISABILITY DUE TO PNEUMOCONIOSIS -- APPLICABILITY OF INTERIM PRESUMPTION OF TOTAL DISABILITY
Plaintiff has filed this action challenging the final decision of the Secretary of Health, Education and Welfare denying his claim for "black lung" benefits under the Federal Coal Mine Health and Safety Act of 1969, as amended, 30 U.S.C. § 901 et seq. Jurisdiction is pursuant to § 413(b) of the Act, 30 U.S.C. § 923(b), which incorporates § 205(g) of the Social Security Act, 42 U.S.C. § 405(g). The sole issue to be decided by this court is whether the Secretary's decision is supported by "substantial evidence," and if it its, this court must affirm.
Based on the results of the pulmonary function study, the Administrative Law Judge concluded that plaintiff's pulmonary disorder had progressed to such a level of severity that he was totally disabled as defined in the Act and Regulations. Specifically, he relied on 20 C.F.R. § 410.490. Under § 410.490 there is a rebuttable presumption of total disability where the ventilatory tests show a level of lung function equivalent to or less than the applicable values specified in the table in this section. For a man of plaintiff's height (67 ins) the values must be equal to or less than 2.3 and 92 liters FEV1 and MVV respectively. (Plaintiff's studies showed 2.25 and 75.87 liters).
While the interim rules of § 410.490 were designed to be more liberal than the permanent criteria set forth in §§ 410.412-410.462, the do, however, make this presumption of disability applicable only to miners with at least 10 years of coal-mining employment. In the present case, the evidence establishes that plaintiff worked only 5 years in the nation's coal mines, and therefore, he is not entitled to rely on the presumption in § 410.490.[1]
Instead, he must establish totally disabling pneumoconiosis under the permanent criteria set out in §§ 410.412-410.462. If ventilatory studies show a breathing impairment of the level of severity specified in the table provided in § 410.426(b), pneumoconiosis will be found to be disabling.[2] In this case, plaintiff's maximum voluntary ventilation (75.87 liters) and 1 second forced expiratory volume (2.25 liters) exceed those values specified in the aforementioned table (62 liters and 1.7 liters, respectively); accordingly, plaintiff has not established pneumoconiosis under this section. Likewise, plaintiff has failed to establish pneumoconiosis under any of the other permanent criteria, §§ 410.412-410.462.
[1] The presumption referred to is that found in § 410.490(b)(1)(ii) based on ventilatory study results. There is a presumption of total disability based on X-ray, biopsy or autopsy evidence of pneumoconiosis in § 410.490(b)(1)(i). While in either subsection the impairment must be found causally related to coal miner employment (see § 410.490(b)(2)), the presumption requiring at least 10 years of coal mine employment in § 410.490(b)(3) refers only to ventilatory study results. [ED.]