Opinion ID: 623780
Heading Depth: 2
Heading Rank: 2

Heading: Lambright’s Claim

Text: Lambright filed a claim for black lung benefits on March 19, 1998, while he was still employed as a coal mine welder by Bridger. His last day of work was -6- June 26, 1998, and he died on January 31, 2002. Upon Lambright’s death, Dr. Michael J. Dobersen, the medical examiner for Arapahoe County, Colorado, conducted an autopsy. Dr. Dobersen is board certified in anatomic, clinical, and forensic pathology. His macroscopic examination of Lambright’s lungs revealed “extensive anthracosis with focal irregular areas of anthracotic scarring, some of which measure up to 2½ inches in greatest dimension.” He attributed Lambright’s death “to complications of complicated coal workers’ pneumoconiosis (progressive massive fibrosis) also known as black lung disease. A component of silicosis was also apparent. Evidence of severe cor pulmonale was also apparent.” Bridger retained two pathologists to review Dr. Dobersen’s findings, Drs. Erika Crouch and Joseph Tomashefski. Dr. Crouch is board certified in anatomic pathology. She reviewed Dr. Dobersen’s report, autopsy slides, and other of Lambright’s medical records before issuing an opinion on December 3, 2002. Dr. Crouch concluded Lambright suffered from “simple coal workers’ pneumoconiosis and simple siderosis arising from welding as well as centriacinar emphysema, acute bronchopneumonia, and changes consistent with severe pulmonary hypertension.” Reviewing the autopsy slides, she observed “no areas of ‘massive fibrosis or complicated silicosis’” and described the lesions she did observe as “relatively small in size and number.” Dr. Crouch ruled out Lambright’s pneumoconiosis as a significant contributing factor to his death. Dr. -7- Tomashefski is board certified in clinical and anatomical pathology. He concluded Lambright suffered from mild simple coal workers’ pneumoconiosis and mild centracinar emphysema, and that the simple pneumoconiosis did not cause or contribute to Lambright’s death. Dr. Tomashefski ruled out complicated pneumoconiosis because the largest coalescent, pneumoconiotic lesion he observed from the autopsy slides measured less than two centimeters in diameter, which was below the minimum size required for a diagnosis of complicated pneumoconiosis. See 20 C.F.R. § 718.304. The 2005 ALJ decision credited the opinion of Dr. Dobersen over the contrary opinions of Drs. Crouch and Tomashefski for four reasons. First, Dr. Dobersen was the prosector, and therefore the only reviewing pathologist who made first-hand observations of Lambright’s lungs. 3 Second, Dr. Dobersen’s report provided very specific measurements and detailed findings, including the 2.5 inch (6.35 cm) lesion. Third, the ALJ concluded Dr. Dobersen demonstrated understanding of the concepts of simple and complicated pneumoconiosis. Finally, the ALJ concluded Dr. Dobersen had superior qualifications because he was board certified in more sub-disciplines of pathology than Drs. Crouch or Tomashefski. The ALJ also reviewed the medical evidence, including chest x- rays, CT-scans, hospitalization and treatment records, and medical opinion 3 The ALJ made clear Dr. Dobersen’s opinion was not accorded greater weight for this reason alone. -8- evidence. The ALJ nonetheless concluded the autopsy evidence was the most compelling and accorded the most weight to Dr. Dobersen’s opinion. Applying the irrebutable presumption of 20 C.F.R. § 718.304, the ALJ awarded benefits on both the lifetime and survivor claims. The ALJ concluded the lifetime benefit onset date was March, 1998, the month in which Lambright filed his claim. The survivor benefit onset date began January, 2002, the month of Lambright’s death.