Source: http://www.dol.gov/brb/References/reference_works/bla/bldesk/BD07-D1.HTM
Timestamp: 2014-09-20 12:01:01
Document Index: 61114606

Matched Legal Cases: ['§410', 'art 718', '§727', 'art 718', 'art 718', 'art 410', '§727']

BD07-D1
Section 718.204(a) provides that miners are entitled to benefits if they are totally disabled due to pneumoconiosis or were totally disabled due to pneumoconiosis at the time of death. Section 718.204(b) defines total disability in a manner similar to the definition at 20 C.F.R. §410.412. Absent the application of the irrebuttable presumption described in Section 718.304 (which implements Section 411(c)(3)), a miner is considered "totally disabled" if pneumoconiosis prevents or prevented the miner from performing his or her usual coal mine work or comparable and gainful employment as defined at Section 718.204(b)(2). Taylor v. Evans and Gambrel Co., Inc., 12 BLR 1-83 (1988). Accordingly, the Board ruled that once claimant has established the miner's inability to perform usual coal mine work, a prima facie case for total disability exists and the party opposing entitlement bears the burden of going forth with evidence to prove that the miner is able to perform comparable and gainful work as defined in Section 718.204(b)(2). Taylor, supra.
In the absence of contrary, probative evidence, if claimant provides evidence meeting the standards of Section 718.204(c)(1)-(5), the miner's total disability is established. See Shedlock v. Bethlehem Mines Corp., 9 BLR 1-195 (1986); Gee v. W.G. Moore and Sons, 9 BLR 1-4 (1986). Pulmonary function studies may establish total disability under Section 718.203(c)(1). Section 718.204(c)(2) provides for a finding of total disability if arterial blood gas levels satisfy the values listed in Appendix C. These blood gas tables establish different qualifying levels for different altitudes. See 20 C.F.R. Part 718, Appendix C. Note that there is no authority in 20 C.F.R. §727.203(a) to extrapolate any of the values for determining disability that are listed in its subsections so as to make them applicable to cases arising under Part 718. Matteo v. Director, OWCP, 8 BLR 1-200 (1985). Total disability may be established under Section 718.204(c)(3) if a miner has pneumoconiosis and is suffering from cor pulmonale with right sided congestive heart failure. See Newell v. Freeman United Coal Mining Co., 13 BLR 1-37 (1989). Compare 20 C.F.R. Part 718, Appendix C to Subpart D of 20 C.F.R. Part 410.
Where evidence supportive of a finding of total disability is not offered under subsections (c)(1), (c)(2), or (c)(3), Section 718.204(c)(4) provides for a finding of total disability if a physician exercising reasoned medical judgment based on medically acceptable clinical and laboratory diagnostic techniques, concludes that a miner's respiratory or pulmonary condition prevents or prevented the miner from engaging in his usual coal mine work or comparable and gainful work. Compare 20 C.F.R. §727.203(a)(4) and Section 410.414(c). See Part VI.E. and Part IX.A.1.d. of the Desk Book. Finally, Section 718.204(c)(5) provides that lay testimony may establish total disability in a survivor's claim where medical evidence is unavailable. See Pekala v. Director, OWCP, 13 BLR 1-1 (1989); Part X of the Desk Book.
The administrative law judge must discuss all of the evidence of record and determine whether the record contains "contrary probative evidence." "Contrary probative evidence" refer