Opinion ID: 3152012
Heading Depth: 2
Heading Rank: 1

Heading: Claimant’s Employment History

Text: John Ruby, born in May 1955, was employed as a miner by the Peabody Coal Company for two different stints. According to Ruby, he first began working at Peabody’s Coshocton, Ohio, mine in the fall of 1974. As he explained: It was an underground mine with three sections. 12 men worked each section. I worked at the face of the mine, shooting and loading coal. I was responsible for drilling into the coal, loading the shot, firing it and then loading the coal into buggies which took the coal to the beltline. At various times, I had to also shovel coal back onto the belt when it spilled and sometimes I was required to rockdust by hand. I worked six days a week, and sometimes on Sunday. About onequarter of the time I was at the mine during this period, I worked a double shift. I ate a lot of coal dust on this job. We shot and loaded 500 tons of coal per day and therefore had to work fast. We were issued masks, which I wore, but they quickly plugged up with coal mine dust, which made them ineffective. The mine shut down on October 28, 1978. Following the closing of the Coshocton mine, Ruby obtained other employment outside the mining industry. In the spring of 1980, however, the mining company called Ruby back to work, this time at its Sunnyhill mine in New Lexington, Ohio, where the claimant worked until that mining operation shut down in early 1982. Under penalty of perjury, Ruby described his work at the Sunnyhill mine as follows: This also was an underground mine, where the coal was 38-40 inches high. I worked at the face of the mine, drilling into the coal, operating the cutting machine and sometimes running the buggy loaded with coal. I also did some maintenance work here. When I drilled coal, I used a machine called a coal drill, which included a ten-foot long auger. After I drilled holes in the coal, I loaded the holes with dynamite. As part of my job, I had to haul explosives into the site where we were drilling. The explosives came in fifty pound boxes. Because the coal was low, I had to haul these boxes of explosives in while on my knees or by duckwalking. I hauled other equipment as well. When I operated the cutting machine, it was very dusty. My face was about four feet from where the dust was -2- No. 14-4263 Simco Peabody Coal Co. v. Dir. OWCP, et al. being generated by the cutting machine. When I ran the cutting machine, I had to personally lift and maneuver the electrical cables that supplied power to the machine. These had to be lifted and pushed out of the way as the cutting machine operated. The cables were in mud and water and they were very heavy. It took all the strength I could muster in order to move these cables. When I drove the buggies, it was also dusty as the coal from the buggies would fly into your face as you drove the coal to the beltline. I also had to shovel spillage from the buggies. I worked one shift, usually six days a week at the mine. I was regularly required to lift and carry fifty pounds in these jobs and do a lot of shoveling at a fast pace. B. Medical Evidence Presented to the Administrative Law Judge Although Ruby did not engage in further mining activities after 1982, and although he never smoked cigarettes, cigars, or pipes, he developed severe respiratory problems, such that he has been unable to work since 2009. Thus, in September 2009, he filed a claim for black lung benefits with the Department of Labor’s Office of Workers’ Compensation Programs, alleging that he suffered from shortness of breath, wheezing, and chest pains. As part of the claims procedure, Ruby submitted to a battery of tests over the years. In November 2009, Ruby was seen by Dr. Paul Knight, who is board-certified in internal medicine. During that visit, Ruby underwent a chest x-ray, a pulmonary function test, an arterial blood-gas test, an electrocardiogram, and a physical examination. Knight noted that Ruby claimed he became short of breath after walking only one block, after climbing just five or six stairs, and after moderate exertion, and that, although Ruby was able to lift and carry his groceries, he “couldn’t do that repetitively.” Ruby also reported that he suffered from diabetes, occasional wheezing, coughing, chest pain, and sensitivity to smoke and perfumes. Although the results of Ruby’s chest x-ray, blood-gas test, and electrocardiogram all were within normal limits, Knight documented “[m]oderate obstruction and mild to moderate restriction” in the pulmonary function test. -3- No. 14-4263 Simco Peabody Coal Co. v. Dir. OWCP, et al. Almost three years later, Dr. William Clapp, the medical director of the pulmonary physiology laboratory at a Chicago hospital, reviewed the results of that 2009 pulmonary function test and noted that Knight had overseen five spirometric1 trials on Ruby prior to treating him with bronchodilators and three additional post-bronchodilator trials. According to Clapp’s analysis of the results of the five pre-bronchodilator trials, although there was no evidence that Ruby hesitated during his breathing, three of the results were not acceptable under Department of Labor standards—one because Ruby coughed during the trial, one due to “glottis closure,” and one because of the “poor effort” made by the claimant. Clapp also found that one of the three post-bronchodilator trials was unacceptable, both because of some hesitation in Ruby’s breathing and because Ruby’s effort during the test was “variable.” Nevertheless, Clapp offered his opinion that the studies were valid under Department of Labor criteria because of the minimal variability in the FEV12 values in three of the four acceptable trials.3 Based upon his physical examination of Ruby and upon the results of the valid pulmonary function test, Knight concluded that Ruby suffered from chronic obstructive pulmonary disease (COPD) of moderate severity. Furthermore, noting that Ruby is a nonsmoker, Knight noted that “[t]he only apparent etiology for [Ruby’s] lung disease is dust exposure in the course of work over several years,” and that the “impairment is quite significant and would be considered totally disabling for his last significant job in the coal mines, both from an exertion standpoint and from the ability to tolerate more atmospheric exposure.” 1 “Spirometry” is defined as the “[m]easurement of breathing-power or lung-capacity.” Oxford English Dictionary (2015), www.oed.com. 2 FEV1 values denote the “forced expiratory volume in one second” exhaled by the patient. See 20 C.F.R. § 718.103(a). In the four “acceptable” 2009 trials, Knight documented FEV1 values for Ruby of 1.46 liters, 1.54 liters, 1.56 liters, and 1.57 liters. 3 In March 2010, in order to ensure the validity of the earlier pulmonary testing, the Department of Labor had Dr. Adi Gerblich, a physician with board certification in internal medicine, pulmonary medicine, and critical care, examine the results of Knight’s 2009 pulmonary function studies. After Gerblich reviewed the documentary evidence supplied to him, he also concluded that the “[v]ents are acceptable.” -4- No. 14-4263 Simco Peabody Coal Co. v. Dir. OWCP, et al. Rather than concur in the medical opinion offered by Knight, Simco Peabody hired two medical experts of its own in an effort to defeat Ruby’s claim for benefits. Dr. David Rosenberg undertook his own evaluation of John Ruby in March 2011 to determine whether Ruby had coal workers’ pneumoconiosis caused by past exposure to coal mine dust. Rosenberg concurred in large part with the medical and occupational background that Knight reported for the miner. However, Rosenberg challenged the validity of the pulmonary function tests conducted in 2009, suggesting that the results of those tests “revealed incomplete efforts” on Ruby’s part. Rosenberg also administered his own pulmonary function test, noting that Ruby’s “efforts were incomplete and quite variable” on that test as well, and that Ruby “had a fair amount of coughing during the evaluation.” Nevertheless, prior to the administration of any bronchodilators, Ruby’s FEV1 value on Rosenberg’s test was 2.27 liters, a value significantly greater than the highest (1.57-liter) result recorded by Knight in 2009. When, after the administration of bronchodilators, which should have increased Ruby’s exhalation abilities, Ruby recorded an FEV1 value of only 1.55 liters, Rosenberg aborted the study. Rosenberg concluded that Ruby “possibly has a degree of airflow obstruction,” but that, in any event, “Ruby does not have clinical or legal” pneumoconiosis, and “he is not disabled from performing his previous coal mine job or other similarly arduous types of labor.” Rosenberg did concede that Ruby potentially suffered from asthma, which “would explain the improvement in his spirometric values from several years ago to the present time.” Rosenberg also offered deposition testimony that was considered by the administrative law judge in this matter. In that testimony, he reiterated his opinion that Ruby does not suffer from a totally disabling pulmonary impairment, that Knight’s 2009 pulmonary function tests must be deemed invalid due to incomplete effort on Ruby’s part, and that a diagnosis of legal -5- No. 14-4263 Simco Peabody Coal Co. v. Dir. OWCP, et al. pneumoconiosis cannot be substantiated given the fact that Ruby’s pulmonary-function-test values improved dramatically between 2009 and 2011. He did admit, however, that “virtually all of [his] consulting expert work in the black lung area is done on behalf of coal operators or their insurers,” and that if Knight’s 2009 tests were considered valid, the FEV1 values obtained in those tests would indicate severe airway obstruction. Simco Peabody’s second expert, Dr. George Zaldivar, concurred with Rosenberg that if the 2009 pulmonary function tests were considered valid, the results obtained would indicate a significant, even disabling, pulmonary obstruction. Zaldivar claimed, however, that Knight’s pulmonary function tests on Ruby were “absolutely invalid” because Ruby’s effort on exhalation was “dismal,” inconsistent, and not performed with maximum effort. He also believed that Rosenberg’s pulmonary function test must be considered invalid, especially because it was unlikely that Ruby’s post-bronchodilator test values could be lower than the values obtained during testing before administration of the medication. Ignoring the results of the 2009 and 2011 pulmonary function tests, Zaldivar still concluded that Ruby did not suffer from pneumoconiosis, but rather from mild asthma that would not prevent him from performing his past coal-mine work. Zaldivar based that opinion on the fact that Ruby had been taking asthma medications that are used to treat inflammatory diseases between the time of the 2009 and 2011 pulmonary function tests, and that his 2011 test results were “practically normal.” Following the submission of reports by both Rosenberg and Zaldivar, Dr. Knight responded by letter to the criticisms raised by the other two physicians. He first countered Zaldivar’s claim that Ruby’s effort on the 2009 pulmonary function tests was “dismal” by indicating that he (Knight) had contacted the technician who performed the 2009 tests and that -6- No. 14-4263 Simco Peabody Coal Co. v. Dir. OWCP, et al. the technician “found Mr. Ruby’s effort to be full, meaning acceptable.” Knight also disputed the claims made by the coal company doctors that the results of the 2009 testing showed that Ruby hesitated during expiration. Knight’s review of the test results confirmed his belief that any hesitation shown was “very minor” and did not affect the validity of the results. Additionally, Knight disputed the validity of Rosenberg’s 2011 tests for the same reason expressed by Zaldivar, namely that the test must be called into question because Ruby’s expiration results were significantly worse after administering bronchodilators. Knight further explained that Ruby’s improved performance on part of the 2011 pulmonary function test did not necessarily mean that Ruby’s condition had not deteriorated, but only that Ruby had been taking medicine that “opens the lungs and permits better lung function” immediately prior to submitting to the testing. Finally, Knight expressed disagreement with Rosenberg’s conclusion that Ruby must be considered an asthmatic simply because he had been prescribed certain medications that Rosenberg believed were used only to treat asthma. Knight reaffirmed that neither he nor any other doctor has treated Ruby for asthma and that the medications used by Ruby have been prescribed “for many patients with obstructive lung disease, like Mr. Ruby, who are not asthmatics. The effect of these medicines is to open the airways and this has proved valuable for patients who have coal-dust induced obstruction, cigarette smoke induced obstruction, as well as other forms of obstruction, including asthma.” The parties also placed before the administrative law judge a report prepared in May 2012 by Dr. Shirley Conibear, a medical review officer who is board-certified in occupational medicine. Of relevance to the disputes at issue before this court, Conibear stated that she had reviewed the letters and data provided by both Knight and Rosenberg before noting that the -7- No. 14-4263 Simco Peabody Coal Co. v. Dir. OWCP, et al. supposed improvement in Ruby’s pulmonary-function-test values in 2011 can be explained by the fact that the claimant “was being treated with bronchodilators and inhaled steroids at the time Dr. Rosenberg saw him in March[ ] 2011.” Conibear then concluded that her review of the records indicated that Ruby was then “totally disabled from his last job in the coal mine” “due to COPD/emphysema which is a direct result of his work in the coal mines.” C. Administrative Law Judge’s Decision Presented with this information, the administrative law judge issued lengthy and thorough findings of fact and conclusions of law. Despite the fact that Ruby claimed to have worked in the coal mines for eight years, the administrative law judge used Social Security records to calculate percentages of years actually worked by dividing Ruby’s total earnings for particular years by his base annual wage. Doing so, the administrative law judge credited Ruby with 5.44 years of underground coal mine employment, rather than the eight years that all parties accepted as an appropriate calculation.4 After detailing the evidence before him and the framework for deciding black-lungbenefits cases, the administrative law judge concluded that Ruby could not establish that he suffered from “clinical pneumoconiosis” as that condition is defined by the relevant regulations. Turning to an examination of whether Ruby nevertheless could support a showing of “legal pneumoconiosis,” the administrative law judge accorded full probative weight to the opinions of Drs. Knight and Conibear that Ruby suffered from the legal, nonclinical form of the debilitating pulmonary condition. In addition, he gave no probative weight to the determinations of Drs. Rosenberg and Zaldivar that Ruby did not suffer from legal pneumoconiosis. He discounted 4 Ruby asserts that the administrative law judge inappropriately failed to consider his coal mine employment during the years 1974-1977 in arriving at the figure of 5.44 years. However, the administrative law judge stated clearly in his decision that he credited “Claimant with three years and three months of coal mine employment from 1974 through 1977.” In any event, Ruby recognizes that whether his creditable service is 5.44 years or eight years is irrelevant, “given the result reached” by the administrative law judge. -8- No. 14-4263 Simco Peabody Coal Co. v. Dir. OWCP, et al. Rosenberg’s opinion because the doctor based it in large part on the improved pulmonaryfunction-test scores in the 2011 testing, even though Rosenberg himself admitted in his deposition that Ruby’s use of bronchodilators prior to the administration of the test could account for the change in FEV1 values. He refused to give any probative weight to Zaldivar’s opinion because Zaldivar had concluded, contrary to the administrative law judge’s own determination, that the 2009 pulmonary function test was invalid. Furthermore, the administrative law judge concluded that Ruby’s legal pneumoconiosis arose out of coal mine employment. In doing so, the administrative law judge relied upon the fact that a finding of “legal pneumoconiosis,” as defined in 20 C.F.R. § 718.201(a)(2), inherently presumes that medical evidence and reasoned medical opinion establish that the disease arose at least in part out of coal mine employment. Finally, giving more weight to the opinions of Knight and Conibear, the administrative law judge determined that Ruby had established by a preponderance of the evidence that he was totally disabled from pneumoconiosis, and thus granted Ruby black lung benefits forward from September 2009, “the month and year in which Claimant filed this claim for benefits.” Simco Peabody appealed the administrative law judge’s decision to the Benefits Review Board, contending that the administrative law judge erred in his evaluation of the pulmonary function tests, in his evaluation of the medical-opinion evidence, in his determination of total disability, and in his conclusion that Ruby’s disability was due to pneumoconiosis. The Board, however, unanimously affirmed the administrative law judge’s decision in all respects, leading Simco Peabody to file a petition for review with this court. -9- No. 14-4263 Simco Peabody Coal Co. v. Dir. OWCP, et al.