Source: https://openjurist.org/298/f3d/511/wolf-creek-collieries-v-director-office-of-workers-compensation-programs
Timestamp: 2018-12-15 13:33:59
Document Index: 252929729

Matched Legal Cases: ['§ 901', '§ 921', '§ 718', '§ 718', '§ 718', '§ 718', '§ 718', '§ 718', '§ 718', '§ 932', '§ 718', '§ 557', '§ 725']

298 F3d 511 Wolf Creek Collieries v. Director Office of Workers' Compensation Programs | OpenJurist
298 F. 3d 511 - Wolf Creek Collieries v. Director Office of Workers' Compensation Programs
298 F3d 511 Wolf Creek Collieries v. Director Office of Workers' Compensation Programs
298 F.3d 511
WOLF CREEK COLLIERIES, Petitioner,
DIRECTOR, OFFICE OF WORKERS' COMPENSATION PROGRAMS, Department of Labor; Evelyn Stephens, Respondents.
No. 00-3404.
Argued: August 7, 2001.
Laura Metcoff Klaus (briefed), Mark E. Solomons (argued and briefed), Greenberg & Traurig, Washington, DC, for Petitioner.
I have reviewed my prior decision dated January 22, 1996 and the medical evidence considered at that time and find no mistake in determination of any fact. Dr. Hieronymus examined the Miner on numerous occasions between 1981 and December 22, 1989, the date of the Miner's death. The most recent examinations by Drs. Broudy and Wright were in 1981. As the Miner's treating physician, Dr. Hieronymus was best suited to make an assessment of the Miner's condition over a period of time. I find his opinion entitled to more weight than the other doctors of record. See Tussey v. Island Creek Coal Co., 982 F.2d 1036, 1042 (6th Cir.1993) (more weight may be accorded to the conclusions of a treating physician because he is more likely to be familiar with the miner's condition). Dr. Kraman never examined the Miner and his two letters do not explain the bases of his opinions. Due to the lack of support and detail in his letters, his opinions are entitled to little weight. See Risher v. Office of Workers' Compensation Program, 940 F.2d 327, 331 (8th Cir.1991) (stating that an administrative law judge may disregard medical opinion that does not adequately explain the basis for its conclusion). The consultative reports of Drs. Renn and Castle also fail to establish a mistake of fact. Although they correctly point out that Dr. Hieronymus relied on an erroneous smoking history, I considered this fact in my prior decision. The reliance on an erroneous smoking history is troubling but does not overcome the advantage Dr. Hieronymus had in treating the Miner over the period from 1981 to 1989. Drs. Renn and Castle never examined the Miner and their opinions are entitled to less weight than the opinions of Dr. Hieronymus....
This Court has a very narrow scope of review over the decisions of the Benefits Review Board: the decisions of the Board must be affirmed unless the Board has committed legal error or exceeded its scope of review of the ALJ's findings. Peabody Coal Co. v. Groves, 277 F.3d 829, 833 (6th Cir.2002); Tennessee Consol. Coal Co. v. Kirk, 264 F.3d 602, 606 (6th Cir.2001). The ALJ's findings are conclusive if they are supported by substantial evidence and are in accordance with the applicable law. Id.
Substantial evidence is "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Peabody, supra; Cross Mountain Coal, Inc. v. Ward, 93 F.3d 211, 216 (6th Cir.1996) (quoting Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971)). In deciding whether the substantial evidence requirement is satisfied, we consider whether the administrative law judge adequately explained the reasons for crediting certain testimony and evidence over other evidence in the record in deciding either to award or deny benefits. Peabody Coal Co. v. Hill, 123 F.3d 412, 415-6 (6th Cir.1997) (quoting Director, OWCP v. Congleton, 743 F.2d 428, 430 (6th Cir.1984)). "We do not reweigh the evidence or substitute our judgment for that of the ALJ." Peabody, 277 F.3d at 833 (quoting Tennessee Consol., 264 F.3d at 606.) Thus, we will not reverse the conclusions of an ALJ that are supported by substantial evidence, "even if the facts permit an alternative conclusion." Id. (quoting Youghiogheny & Ohio Coal Co. v. Webb, 49 F.3d 244, 246 (6th Cir.1995)). Finally, when dealing with a claim for benefits, "we keep in mind that the Black Lung Benefits Act is remedial in nature and must be liberally construed `to include the largest number of miners as benefit recipients.'" Peabody Coal Co. v. Hill, supra, 123 F.3d at 414 (quoting Tussey v. Island Creek Coal Co., 982 F.2d 1036, 1042 (6th Cir.1993)). See also, 1972 U.S.Code Cong. & Admin.News 2315, Pub.L. No. 92-303 ("In the absence of definitive medical conclusions there is a clear need to resolve doubts in favor of the disabled miner or his survivor.")
As defined in the Black Lung Benefits Act, 30 U.S.C. §§ 901-945, benefits may be awarded to miners who are totally disabled according to Federal statutory standards due to pneumoconiosis or to the survivors of individuals totally disabled at the time of their death or whose death was caused by pneumoconiosis. See 30 U.S.C. § 921. Benefits under the Black Lung Benefits Act are awarded to survivors of a miner where they prove that (1) the miner had pneumoconiosis; (2) the miner's pneumoconiosis arose out of coal mine employment; and (3) the miner's death was due to pneumoconiosis. 20 C.F.R. § 718.205(a). Claimants must prove each element by a preponderance of the evidence. Adams v. Director, OWCP, 886 F.2d 818, 820 (6th Cir.1989). For claims filed after January 1, 1982, § 718.205(c) establishes three criteria by which a miner's death due to pneumoconiosis may be established: (1) where competent medical evidence establishes that pneumoconiosis was the cause of the miner's death, or (2) where pneumoconiosis was a substantially contributing cause or factor leading to the miner's death or where the death was caused by complications of pneumoconiosis, or (3) where the presumption set forth at § 718.304 is applicable. 20 C.F.R. § 718.205(c). Pneumoconiosis is a "substantially contributing cause" of a miner's death if it hastens the miner's death. 20 C.F.R. § 718.205(c)(5). See also, Brown v. Rock Creek Mining, 996 F.2d 812, 815 (6th Cir.1993). The four methods to establish the existence of coal workers' pneumoconiosis listed in the regulations include: (1) by x-ray evidence; (2) by biopsy or autopsy; (3) by application of the regulatory presumption; and (4) by reasoned medical evidence and opinion. See 20 C.F.R. § 718.202.
Wolf Creek argues that the ALJ "found both the existence of pneumoconiosis and death due to it by presuming that the opinion of a doctor who treated the miner was automatically more credible than any other doctor's opinion simply by virtue of that treatment," and that this "treating doctor presumption violates the Administrative Procedure Act." Petitioner's Brief, p. 18. Petitioner is of the belief that our decision in Tussey v. Island Creek Coal Co., supra, requires that ALJs presume that the opinions of treating physicians are correct and controlling. This identical argument was made by the petitioner, and rejected by this Court, in Peabody Coal Co. v. Groves, 277 F.3d 829 (6th Cir.2002). As we stated in Peabody,
In Tussey v. Island Creek Coal Co., 982 F.2d 1036 (6th Cir.1993), we confirmed that the "opinions of treating physicians are entitled to greater weight than those of non-treating physicians." Id. at 1042. However we did not suggest that treating physicians should automatically be presumed to be correct — we indicated that their opinions should be "properly credited and weighed." Id. Indeed, Peabody concedes as much: "In post-1994 unpublished decisions, however, this Court almost uniformly has recognized that notwithstanding Tussey, ALJs are not required to credit treating doctors' opinions either standing alone or where there is conflicting proof in the record." Petitioner's Br. at 29. We therefore conclude that Peabody's "treating physician presumption" argument lacks merit and disagree with its characterization of the Tussey decision as ambiguous or in conflict with established law.
Post-Tussey cases make it clear that there is no requirement that a treating physician's opinion be deemed controlling. For example, in Griffith v. Director, OWCP, 49 F.3d 184 (6th Cir.1995), we found no error in the ALJ's decision to discredit a treating physician's opinion. In that case, the ALJ concluded that the record was devoid of any persuasive evidence to establish that the miner's death was due to pneumoconiosis and, therefore, denied benefits. The ALJ relied on the fact that the death certificate did not mention pneumoconiosis as a cause of death, and that the autopsy report found no evidence of pneumoconiosis. He noted that the medical reports of two doctors, who had only examined Griffith once, diagnosed pneumoconiosis, but felt that they "`add[ed] nothing as to the cause of the miner's death.'" 49 F.3d at 185. Finally, he remarked that Griffith's treating physician's report was equivocal regarding the etiology of the miner's pulmonary disease as well as the cause of the miner's death, and was therefore given less weight. We held that "under these circumstances, the ALJ was not required to give greater weight to the opinion of the treating physician." Id.
As Petitioner acknowledges, we have similarly held in numerous post-Tussey unpublished cases that there is no requirement that ALJs give conclusive weight to treating physicians' opinions. See e.g., Arch of Kentucky, Inc. v. Hickman, 188 F.3d 506, 1999 WL 646283, at *4 (6th Cir.1999) (unpublished decision; text available on WESTLAW) (court recognized that "the diagnoses of treating physicians are not entitled to conclusive weight or even a presumption in favor of the Claimant" but noted that their opinions "deserve `special consideration'"); Kirk v. Elm Coal Corp., 187 F.3d 636, 1999 WL 618030, at *3 (6th Cir.1999) (unpublished decision; text available on WESTLAW) ("Although the opinion of a treating physician may be accorded more weight, ..., a treating physician's report which is neither well-reasoned nor well-documented should not be given greater weight"); Creighton v. Bee Coal Co., 33 Fed.Appx. 774, 2002 WL 535785, at *5 (6th Cir.2002) (ALJ did not err in refusing to give greater weight to treating physicians' opinions where their opinions regarding whether pneumoconiosis contributed to the miner's death were neither well-supported nor adequately reasoned).
We held in Tussey that a treating physician's opinion should be "given [its] proper deference." Tussey, 982 F.2d at 1042. 20 C.F.R. § 718.104(d)(5) delineates the criteria to be evaluated in determining the level of deference that would be proper: In appropriate cases, the relationship between the miner and his treating physician may constitute substantial evidence in support of the adjudication officer's decision to give that physician's opinion controlling weight, provided that the weight given to the opinion of a miner's treating physician shall be on the credibility of the physician's opinion in light of its reasoning and documentation, other relevant evidence and the record as a whole.
In Peabody Coal Co. v. Groves, supra, we held that the ALJ as factfinder should decide whether a physician's report is "sufficiently reasoned," because such a determination is "essentially a credibility matter." 277 F.3d at 836 (quoting Director, OWCP v. Rowe, 710 F.2d 251, 255 (6th Cir.1983)). The ALJ as factfinder found that Dr. Hieronymus's opinion was the most credible evidence in the record regarding the cause of Mr. Stephens' death.
Anticipating retirement, Mr. Stephens had previously applied for black lung benefits in 1981 but later agreed to an order of dismissal when he was awarded Kentucky occupational disease benefits. The state award negated any federal black lung benefits he may have been awarded during his lifetimeSee 30 U.S.C. § 932(g).
"ILO classification" refers to the International Labor Organization's International Classification of Radiographs of the Pneumoconioses, a system for interpreting chest x-rays and classifying them for the degree of pneumoconiosis present. An ILO rating of 1/0, 1/1 or greater is evidence of pneumoconiosisSee 20 C.F.R. § 718.102(b).
See 5 U.S.C. § 557(c)(3)(A) (1977) (The Administrative Procedure Act requires that an administrative law judge's decision be accompanied by "findings and conclusions, and the reasons or basis therefor, on all material issues of fact, law or discretion presented on the record."); see also 20 C.F.R. § 725.477(b) (1992); Director, OWCP v. Congleton, 743 F.2d 428, 429 (6th Cir.1984).