Opinion ID: 2975340
Heading Depth: 3
Heading Rank: 1

Heading: Dr. Zaldivar’s Opinion

Text: Claimant challenges the ALJ’s reasoning for the crediting of Dr. Zaldivar’s opinion of no disability causation, because Dr. Zaldivar “listed the etiology [of Claimant’s disability] as pulmonary -5- fibrosis[,] but did not make any finding as to the cause [of the pulmonary fibrosis].”1 The issue for our purposes is whether the ALJ adequately explained the reasons for crediting Dr. Zaldivar’s opinion. In his decision following remand by the BRB, the ALJ noted that Dr. Zaldivar, a Boardcertified Internist, Pulmonologist, and B reader,2 opined that Claimant’s disability was due to pulmonary fibrosis unrelated to coal mine employment rather than a manifestation of pneumoconiosis. The ALJ quoted relevant portions of Dr. Zaldivar’s deposition testimony in which Dr. Zaldivar explained the basis for his diagnosis that Claimant’s disability was not due to pneumoconiosis. First, Dr. Zaldivar explained that coal workers’ pneumoconiosis does not cause the particular pattern of scarring seen on the x-ray–a diffuse rather than focal pattern of scarring–but instead the pattern indicates Claimant has pulmonary fibrosis not caused by coal dust inhalation. Second, the ALJ noted that Dr. Zaldivar used the specific results of the pulmonary function and arterial blood gas tests to exclude coal miner’s pneumoconiosis as a cause for the disability. According to Dr. Zaldivar, coal miners’ pneumoconiosis causes airway obstruction, which Claimant did not manifest. Claimant did however have a restriction of lung capacity. Dr. Zaldivar testified that a restriction can be a symptom of pneumoconiosis, but only when there is progressive massive fibrosis with densities that are B or higher, also not evidenced by Claimant. 1 Without citation to specific pages in the joint appendix, Claimant also argues that Dr. Zaldivar’s opinion vacillated, in that Dr. Zaldivar “originally diagnosed category 3/2 coal workers’ pneumoconiosis and now changed his opinion to find no coal workers’ pneumoconiosis.” We are unable to substantiate claimant’s assertion, and deem this argument as waived. 2 A “B-reader” has demonstrated proficiency in assessing and classifying x-rays for pneumoconiosis by successfully completing an examination conducted by or on behalf of the Department of Health and Human Services. 20 C.F.R. § 718.202(a)(1)(ii)(E). -6- The ALJ afforded substantial weight to Dr. Zaldivar’s opinion, finding it supported and based on objective evidence, and noted Dr. Zaldivar’s superior credentials. Contrary to Claimant’s argument on appeal, it is of no event that Dr. Zaldivar failed to trace his diagnosis of pulmonary fibrosis to a particular cause. Rather, it was decisive that Dr. Zaldivar had medically supported reasons for excluding coal dust exposure as a cause of the pulmonary fibrosis, which in turn caused his disability. We thus find that the ALJ adequately explained his reasons for crediting Dr. Zaldivar’s opinion.