Opinion ID: 3014238
Heading Depth: 2
Heading Rank: 2

Heading: standard of review

Text: to the miner’s death, as he had in 1997. He also found that Dr. Karlavage’s opinion Because the BRB adopted the was “not well documented nor well ALJ’s factual findings, we independently reasoned” because “he did not discuss the review the entire record to determine if the basis for [his] conclusion [that the miner ALJ’s factual findings are rational, was totally disabled from coal mine consistent with applicable law, and employment due to his lung disease] given supported by substantial evidence on the his own deposition testimony that the record considered as a whole. See Mancia miner’s pulmonary function study results v. Director, OWCP, 130 F.3d 579, 584 (3d from studies taken in 1985 and 1986 were Cir. 1997) (citing Kowalchick v. Director, normal.” He also stated that Dr. 9 OWCP, 893 F.2d 615, 619 (3d Cir. 1990)). contributing factor to, Soubik’s breathing Substantial evidence has been defined as impairment. The ALJ concluded that Dr. such relevant evidence as a reasonable Spagnolo’s opinion regarding the cause of mind might accept as adequate to support Mr. Soubik’s breathing problems was a conclusion. Id. We exercise plenary more persuasive than these lay opinions. review over the ALJ’s legal conclusions B. Weighing the medical evidence adopted by the BRB. Id.; see also Carozza v. U.S. Steel Corp., 727 F.2d 74, 77 (3d Although the lay evidence alone did Cir. 1984). not offer an etiology of Mr. Soubik’s breathing troubles,11 the ALJ improperly III. Discussion minimized its significance in weighing Dr. Spagnolo’s opinion and Dr. Karlavage’s Mrs. Soubik argues that the ALJ did contrary opinion. Mrs. Soubik argues that not follow Soubik I on remand because he this was error because Dr. Spagnolo’s failed to properly weigh the lay evidence conclusion that no pneumoconiosis was in the context of the evidence as a whole. present contradicted the parties’ stipulation She also argues that the ALJ did not to the contrary. She also argues that the properly consider the opinions of Dr. ALJ erred in discounting Dr. Karlavage’s Karlavage and Dr. Wagner. Finally, opinion and that he misunderstood the assuming we find these arguments basis of that opinion.12 meritorious, she requests that we grant her BLBA benefits rather than remanding and reversing. 11 The ALJ could hardly expect lay A. Weighing the lay evidence testimony to establish causation or etiology. That is beyond the purview or The ALJ did consider the lay the competence of lay witnesses. Such evidence on remand per our instructions in testimony can only be expected to Soubik I. His opinion summarized what corroborate certain symptoms and each layperson said and analyzed its establish pertinent behavior or quality of probative value. The ALJ noted that each life issues. Expert testimony will usually of the lay witnesses established that Mr. be required to establish the necessary Soubik was having trouble breathing, relationship between such observed indicia noticed that Mr. Soubik had increased of pneumoconiosis and any underlying trouble with his breathing over time, and pathology. observed his frequent coughing and 12 spitting up mucus and/or blood. He then Mrs. Soubik also argues that the ALJ explained his rationale for rejecting the lay improperly disregarded Dr. Wagner’s evidence. According to the ALJ, the lay opinion because it was conditional. As evidence that Mr. Soubik had breathing noted above, his opinion stated that t r o u b l e d i d n o t e st a b l i sh t h at pneumoconiosis “could” have contributed pneumoconiosis was responsible for, or a to Mr. Soubik’s death. She cites to Piney 10 In Soubik I we noted that the ALJ or she relied upon such an opinion. Scott v. “relied heavily” on Dr. Spagnolo’s Mason Coal Co., 289 F.3d 263, 269 (4th opinion, and that opinion was based solely Cir. 2002) (internal citation omitted). Like on a review of Soubik’s medical history. the medical opinion in Scott, Dr. Dr. Spagnolo never saw M r. Soubik. We Spagnolo’s expert opinion states that thus raised the ALJ’s reliance on Dr. Soubik did not have pneumoconiosis Spagnolo’s opinion as an issue, but did not despite the parties’ agreement that he did. definitively state that the ALJ had Dr. Spa gnolo’ s opinion c an be incorrectly relied on it. Accordingly, there distinguished from the opinion in Scott is no law of the case regarding the doctors’ because he stated that even if Soubik had opinions. pneumoconiosis, there is still no evidence that it contributed to his death. However, The Court of Appeals for the Fourth that superficial “hypothetical” does not Circuit has held that an ALJ may not credit reconcile his opinion with the stipulation a medical opinion stating that a claimant that pneumoconiosis was present. did not suffer from pneumoconiosis Common sense suggests that it is usually causing respiratory disability after the ALJ exceedingly difficult for a doctor to had already accepted the presence of properly assess the contribution, if any, of pneumoconiosis unless the ALJ stated pneumoconiosis to a miner’s death if “specific and persuasive reasons” why he he/she does not believe it was present. The ALJ did not explain why Dr. Spagnolo’s opinion was entitled to such Mountain Coal Co. v. Mays, 176 F.3d 753, controlling weight despite Dr. Spagnolo’s 763 (4th Cir. 1999). In Piney M ountain, conclusion that Soubik did not have the the court evaluated a medical opinion that disease that both parties agreed was stated that “pneumoconiosis could be present. considered a complicating factor” in the miner’s death. The court held only that Moreover, on remand, the ALJ such an opinion need not be rejected, as obviously misunderstood how Dr. the petitioner argued, stating that “a Karlavage arrived at his opinion and this reasoned medical opinion is not rendered contributed to his improper discounting of a nullity because it acknowledges the Dr. Karlavage’s conclusion. The ALJ limits of reasoned medical opinions.” Id. cited part of Dr. Karlavage’s letter to Mrs. However, the court also recognized that Soubik’s counsel, which stated: “The “uncertainty is not proof, and claimants patient’s death certificate indicates must prove entitlement.” Id. Accordingly, arteriosclerotic heart disease but on further under Piney Mountain, the ALJ was free to inquiry, the family has discovered directly minimize the probative value of Dr. from the attending physician, that coal Wagner’s conditional opinion but he did worker’s pneumoconiosis was involved in not have to reject it solely because it his death.” The ALJ then concludes that, appeared to be equivocal. 11 since Dr. Karlavage based his opinion that lay evidence standing alone does not pneumoconiosis contributed to Soubik’s provide support for the theory that death on information from Soubik’s pneumoconiosis hastened or caused Mr. family, Dr. Karlavage’s opinion was not Soubik’s death. He does not explain why well-reasoned nor well-documented. he assumed that Dr. Karlavage’s opinion would be worth less than Dr. Spagnolo’s That conclusion is not supported by because Dr. Karlavage took such substantial evidence. In fact, it is flatly information into account when forming his contradicted by Dr. Karlavage’s 1986 opinion. Indeed, it seems that Dr. deposition, which was part of the record Karlavage’s opinion would be stronger from Mrs. Soubik’s earlier hearings before because it factored in the lay observations other ALJs. The deposition details Dr. of those who knew Mr. Soubik.13 Karlavage’s examination and analysis of three PFTs, the same two chest x-rays that Dr. Spagnolo relied on, and his own 13 personal observations of the patient. Moreover, at oral argument the Based on this information, Dr. Karlavage government conceded that Dr. Spagnolo opined in 1986 that So ubik ’s might have come to a different result if he pneumoconiosis advanced his death. The had the benefit of the lay evidence. As language in Dr. Wagner’s 1995 letter, noted above, Dr. Spagnolo concluded that written nine years after he issued his initial there was no “reliable evidence of a opinion regarding the factors contributing clinically significant impairment of lung to Soubik’s death, indicates only that Dr. function or evidence of progression of any Wagner later amended his opinion to say lung problem at the time of his death.” t h a t p n eumoconiosis could ha ve Yet it is clear from the testimony of those contributed to Soubik’s death after he who knew Soubik that he was having an reviewed Dr. Karlavage’s records and increasingly difficult time breathing and opinion. Dr. Karlavage’s opinion was regularly coughed up mucus. Moreover, based on much more than just the family’s the testimony of those who knew Soubik opinion that pneumoconiosis hastened also established that he was placed in an Soubik’s death. It was therefore irrational oxygen tent when last admitted to the for the ALJ to discount Dr. Karlavage’s hospital and that he never recovered. The opinion merely because it refers to Dr. ALJ never explained why testimony as Wagner’s 1995 letter. compelling as this can be ignored in favor of a doctor who opined that Soubik had no It was also improper for the ALJ to “clinically significant” lung problems. assume that Dr. Karlavage’s consideration This is especially true when that doctor of information from Mr. Soubik’s family never saw the patient, and all but ignored and others who had observed him regularly the fact that parties are assuming that was a failing. The ALJ did not explain pneumoconiosis was present given their that assumption. He stated only that the stipulation on this point. 12 The ALJ also failed to give Dr. be granted compensation upon remand.14 Karlavage’s opinion the additional We agree that this litigation has deference it was due as the opinion of a been unnecessarily protracted. We have treating physician. The ALJ stated that he previously expressed our frustration over did not credit Dr. Karlavage’s opinion as the inefficiency and delay that is all too that of a treating physician because Dr. often part of the black lung administrative Karlavage had only seen Soubik three process. We have done so in a case where times over six months. That was, of a claimant had been litigating her claim for course, three more times and six months benefits for seven years, ten fewer years more than Dr. Spagnolo saw him. So than Mrs. Soubik. Mancia, 130 F.3d at 593 easily minimizing a treating physician’s (internal citation omitted). In Mancia, we opinion in favor of a physician who has quoted our decision in Lango v. Director, never laid eyes on the patient is not only OWCP, 104 F.3d 573 (3d Cir. 1997) in indefensible on this record, it suggests an noting that we had “previously expressed inappropriate predisposition to deny our concern over the ‘dism aying benefits. It is well-established in this ine f f ic ie ncy’ of the bla c k lu ng circuit that treating physicians’ opinions administrative process.” 130 F.3d at 593 are assumed to be more valuable than (quoting Lango, 104 F.3d at 575-76). The those of non-treating physicians. Mancia v. delay in Lango was 14 years, again Director, OWCP, 130 F.3d 579, 590-91 substantially shorter than the delay that (3d Cir. 1997). The ALJ nevertheless Mrs. Soubik was made to endure. We ignored Dr. Karlavage’s clinical expertise; there gave several examples of inordinate an expertise derived from many years of diagnosing and treating coal miners’ pulmonary problems. The ALJ did so without making any effort to explain why Dr. Spagnolo’s board certification in pulmonary medicine was a more 14 Mrs. Soubik also argued that the compelling credential than Dr. Karlavage’s delay was particularly unfair to her many years of “hands on” clinical training. because she was 85 years old, implying C. Directing BLBA benefits that she might not live long enough to receive the benefits she was due if we did We turn to the final issue that Mrs. not direct the BRB to grant them. As Soubik raises. She asks us to remand this noted above, Mrs. Soubik died before oral case to the BRB solely to direct entry of an argument in this case. In light of her award of benefits based on the inordinate death, we need not now consider this delay in properly adjudicating her claim. argument. It is, however, an all too tragic She argues that allowing her claim to drag example of the kind of hardship that can on any longer would be unfair and result from the all too frequent delay in inappropriate because she would certainly these cases. 13 delay ranging from ten years 15 to as many many cases languish while as seventeen,16 and even nineteen years.17 waiting for an ALJ or the We then stated, “[h]opefully, the BRB to hear them. publication of our concern will come to the Although there may have attention of authorities who can do been special circumstances something about it.” Lango, 104 F.3d at in some of these cases that 576. We made that statement in 1997. explain the delay, and we Yet, even after that admonition, it took the have not ex haus tively BRB two years to remand this matter to examined the records, there the ALJ following our remand to the BRB. is enough basis in the mere We therefore have little reason to think recitation of the facts to that the delays that attend black lung prompt consideration by the litigation have been mitigated or even relevant administrators . . . . addressed by the administrative agencies Dela ys are esp ecially involved. Given our continuing concern, significant for recipients of we take the liberty of reiterating at length black lung benefits since the concerns we expressed in Lango: most are nearing the end of Were this the only case to their lives. Claimants have come to our attention with less time to use the benefits, such delay, we would be and they often must wait inclined to attribute it to a when illness is increasing rare bureaucratic snag. their expenses but while However, we note that some retirement has reduced their recent black lung cases in income. Worse, some may this circuit suggest that this die before litigation resolves dismaying inefficiency is their claims. not unusual . . . . As far as