Opinion ID: 3014238
Heading Depth: 2
Heading Rank: 1

Heading: was still being litigated, Cecilia Soubik

Text: filed her claim for survivor benefits under After mining and hauling coal for the BLBA. The OWCP administratively nearly 50 years, Michael Soubik filed a denied her claim on February 2, 1987, and claim under the BLBA in August 1980. Mrs. Soubik requested a hearing before an The claim stated that Soubik could no ALJ three days later. The claim was then longer work because he was short-winded referred to another ALJ, who found that and had difficulty climbing stairs. The the only remaining question was whether Office of W orkers’ Compensation pneumoconiosis substantially contributed Programs (OWCP) denied his claim in to, or hastened, her husband’s death. July 1981. He requested a hearing in 1982 after being notified that the denial of benefits had been reaffirmed, and a “Clinical pneumoconiosis” consists of hearing was held before an ALJ in 1986. those diseases recognized by the medical He died shortly after the hearing. Dr. Jere community as pneumoconioses, i.e., the Wagner, one of his treating physicians, conditions characterized by permanent signed a death certificate that listed acute deposition of substantial amounts of myocardial infarction as the cause of particulate matter in the lungs and the death. In 1987, an ALJ again denied his fibrotic reaction of the lung tissue to that application for benefits. Although the deposition caused by dust exposure in coal OWCP had stipulated that Mr. Soubik mine employment. This definition suffered from coal miners’ includes, but is not limited to, coal pneumoconiosis, 2 the ALJ concluded that workers’ pneumoconiosis, anthra cosilicosis, anthracosis, anthrosilicosis, massive pulmonary 2 Under 20 C.F.R. § 718.201, fibrosis, silicosis or silicotuberculosis, pneumoconiosis is defined as: arising out of coal mine employment. a chronic dust disease of the lung and its ... sequelae, including respiratory and “Legal pneumoconiosis” includes any pulmonary impairments, arising out of coal chronic lung disease or impairment and its mine employment. This definition sequelae arising out of coal mine includes both medical, or “clinical”, employment. This definition includes, but pneumoconiosis and statutory, or “legal”, is not limited to, any chronic restrictive or pneumoconiosis. obstructive pulmonary disease arising out ... of coal mine employment. 2 However, this ALJ concluded that he was BRB remanded the case to an ALJ for bound by the original ALJ’s determination proceedings consistent with Soubik I. That that pneumoconiosis did not hasten M r. ALJ again denied Mrs. Soubik benefits. Soubik’s death. Accordingly, the second The BRB affirmed and this petition for ALJ denied Mrs. Soubik’s claim for review followed. survivor’s benefits.
In December 1989, Mrs. Soubik 1997 appealed to the BRB. It affirmed the The third ALJ had before him the ALJ’s decision denying her benefits in medical opinions of three doctors as well March 1991, and denied her motion to as the lay opinions of Mr. Soubik’s friends reconsider its decision in October 1991.3 and family. This evidence is summarized Mrs. Soubik then submitted a request for below. modification of the BRB’s decision to OWCP,4 which denied it in April 1992. 1. Medical opinions Over five years later in 1997, a. Dr. Karlavage OWCP granted Mrs. Soubik’s request for Dr. Karlavage, who was board- another hearing before an ALJ. That July, certified in family practice and dedicated an ALJ denied M rs. Soubik’s claim. Mrs. about 40 percent of his practice to treating Soubik appealed to the BRB, but it denied coal miners and former coal miners for her appeal on July 28, 1998. She then pulmonary problems, treated Mr. Soubik filed a petition for review in this court. from October 1985 until his death in April We reversed the BRB’s affirmance of the 1986. During that six-month period, ALJ’s decision in Soubik I and remanded Soubik had three office visits. In his 1986 the case back to the BRB. deposition, Dr. Karlavage stated that he Two years later, in June 2001, the was aware of Soubik’s three pulmonary function tests (“PFTs”). He stated that the 1981 PFT was abnormal, the 1985 PFT 3 Mrs. Soubik and her son sent a letter was normal, and the 1986 PFT was to the BRB appealing its affirmation of the “essentially normal” because it had some ALJ’s decision, and the BRB deemed this normal readings although one reading was letter a motion for reconsideration. “consistent with obstructive lung disease at 29 percent.” Dr. Karlavage also stated in 4 Mrs. Soubik wrote to OWCP stating his deposition that an x-ray from 1981 that she understood she needed to go to indicated anthracosilicosis and one from federal court so she could submit 1 9 8 5 i n d i c a t e d “ pn e um o c o n i o s i s additional evidence to continue the claim, uncomplicated.” and OWCP treated her correspondence as Based on his examinations of a request for modification of the BRB’s Soubik, his review of Soubik’s medical decision. 3 and occupational history, and the medical doctor who conducted that test did not tests he ran, Dr. Karlavage concluded that account for the medication Soubik was Soubik “had lung disease best described as taking and the effect it would have had on pneumoconiosis and I think did have the PFT. coronary artery disease.” He concluded In February 1995, Dr. Karlavage that the pneumoconiosis was caused by wrote a letter to Mrs. Soubik’s attorney. It Soubik’s “exposure over a several decade stated in relevant part: period. . . to silica, rock, and coal dusts.” He reconciled the variable results from the During that time [in which I three PFTs with his conclusion that took care of Mr. Soubik], I Soubik’s death was substantially related to had the opportunity to his pneumoconiosis, stating that Soubik: review a positive chest x-ray and an abnormal pulmonary has a chest x-ray that does function test. As you are indicate pneumoconiosis. aware, Mr. Soubik expired His physical examination when he was 74 years old at revealed, in my opinion, the Shamokin Hospital. The some lung disease. There is patient’s death certificate variability among indicates arteriosclerotic pulmonary function tests heart disease but on further that certainly does occur. . . inquiry, the family has . [P]ulmonary function tests discovered directly from the can and do change from attending physician, that month to month and from c o a l w o r k e r ’ s year to year. So, he was p n eu m oc oniosis w as apparently breathing a little involved in his death. (sic) bit better more recently. ... In conclusion, it is my He also noted a contrary negative reading opinion, as it was before, of one of the chest x-rays indicating that that . . . the patient’s death Soubik did not have pneumoconiosis. was substantially incurred However, he explained that result by due to c oa l worker’s noting the “obvious discrepancies” in the pneumoconiosis. Indeed, he doctor’s report who read the chest x-ray as had arteriosclerotic heart normal. That doctor also claimed that the disease and nerve block, but results of a PFT that was taken at the same there is no doubt in my mind time as this x-ray were abnormal. Dr. that coal worker’s Karlavage also discounted the significance pneumoconiosis weakened of the normal PFT in 1985 because the h i m , w or s e n e d h is 4 condition, and Soubik’s history, Dr. Spagnolo concluded speeded his death. tha t pneumoco niosis was no t a substantially contributing factor to Soubik’s death, and that there was no b. Dr. Wagner reasonable evidence that the miner’s death was caused by complications of Dr. Wagner treated Mr. Soubik for pneumoconiosis. his heart condition from May 1984 until Soubik’s death, and signed Soubik’s death Dr. Spagnolo gave no weight to Dr. certificate.5 Soubik’s death certificate Karlavage’s medical opinion to the listed his cause of death as acute contrary because Spagnolo believed that myocardial infarction with complete heart Karlavage had not adequately explained block and included cardiogenic shock the normal results of the pulmonary under “other significant conditions.” Dr. function tests from 1985 and 1986.6 He Wagner was unaware that Soubik had also also gave no weight to Dr. Wagner’s been treated by Dr. Karlavage when he opinion because it was based on Dr. signed the certificate. Nine years after Karlavage’s records and also failed to Soubik died, Dr. Wagner wrote a letter in explain the normal pulmonary function test response to an inquiry from Mrs. Soubik. results. The letter stated that, after reviewing Dr. Dr. Spagnolo concluded that: Karlavage’s medical records including pulmonary function studies and x-ray the medical record in my findings, Dr. Wagner concluded that opinion provides little Soubik’s pulmonary impairment secondary evidence for the presence of to his pneumoconiosis “could have a pneumoconiosis. In fact, contributed” to the miner’s cardiac the only B-reader report7 condition and subsequent death. c. Dr. Spagnolo 6 As noted above, that is simply not The OWCP had Dr. Spagnolo, who true. Dr. Karlavage explained the normal was board-certified in internal medicine results in 1985 by factoring in the effect of and pulmonary diseases, review Mr. Soubik’s medication. Soubik’s medical history. That history 7 included the PFTs from 1981, 1985, and A “B-reader” is a person with a 1986; two blood gas tests; and two chest x- significant level of qualification for ray readings. Based on his review of reading x-rays, and this court has given B- readers’ x-ray readings greater weight than readings by less qualified personnel. See 5 Unlike the other two doctors whose Labelle Processing Co. v. Swarrow, 72 opinions were in the record, Dr. Wagner’s F.3d 308, 310 n.3 (3d Cir. 1995). Only credentials were not specified. one of the people reading one of Mr. 5 indicates no evidence ... of coal workers’ In summary, . . . Mr. pneumoconiosis. Soubik’s death was not N evertheless, c a u s e d b y a assuming that a pneumoconiosis. A pneumoconiosis was pneumoconiosis was not a present in M r. substantially contributing Soubik, his lung factor leading to his death function in 1985 and and there is no reasonable again in March 1986 evidence (including a well shortly before his reasoned medical opinion) death was normal. that his death was caused by The normal arterial complications of blood gas results in pneumoconiosis. 1985 provide further s upport for t h e conclusion that Mr. 2. Lay evidence Soubik had normal lung function. Thus, There were lay opinions in the this medical record record from Mr. Soubik himself as well as does not provide Mrs. Soubik; Walter Koshinskie, their reliable evidence of a neighbor and Mr. Soubik’s co-worker; clinically significant John Soubik, the Soubiks’ son; Frank impairment of lung Alberts, Mr. Soubik’s brother-in-law; and function or evidence Adeline Cecilia Dilliplane, the Soubiks’ of progression of any daughter’s mother-in-law. lung problem at the
time of his death. Therefore, even if Mr. Soubik testified that he had Mr. Soubik had a suffered difficulty breathing and shortness pneumoconiosis, it of breath for “the last 15 years and as the did not result in a years progress, it is getting more and clinically significant more.” He stated that if he walked a city impairment of his block he would have to stop; that if he had heart or lung. to walk up or down steps, he had to stop several times; and that he coughed up black mucus at night. He also testified that he took Brondicon for his breathing and Soubik’s chest x-rays was a B-reader. He nitroglycerin for his heart. He retired concluded that Soubik’s x-ray did not completely in 1983 due to his breathing indicate pneumoconiosis. 6 problems, had a heart attack in 1984, and Koshinskie testified at the 1989 never smoked. hearing that he had known Mr. Soubik for forty years.9 Soubik had hauled coal for
him, and their homes were close to each Mrs. Soubik testified during the other on the same street. He noticed that 1989 hearing on her survivor claim. She Soubik’s health was slipping because also stated that her husband took Soubik could not walk well or walk up Brondicon for his black lung problem. stairs because it would “take his wind.” She stated that it “sort of loosened up his The day that Soubik died, Koshinskie phlegm [so] that he had to spit up.” She noticed that he was winded from walking also testified that he took medication for outside. his heart after having a heart attack in d. John Soubik 1986, shortly before his death. The day he died, he became short of breath and was John Soubik testified at the 1997 taken to the hospital where he was put in hearing that every time he came home to an oxygen tent. He stayed in the tent until visit his parents, he could see his father’s he died. condition had deteriorated. He observed that his father had “considerably slowed She also testified during the 1997 down,” and heard him make “gasps for hearing that she personally observed her air” and have a “trying to catch his breath husband’s breathing difficulty for “a long feeling.” He also saw his father raise his period of time” before his death. Even chest “like he was trying to get air,” and after he retired from work and started “hold[] on to the bannister a lot going receiving Social Security disability down the stairs.” John Soubik also took benefits, he would breathe heavily and spit his father to the hospital where he was up blood and mucus every day. The “hooked. . . up to that breathing problem was particularly pronounced in apparatus.” the evening. She also saw that, just before his death, he could barely walk and was e. Frank Alberts very weak.8 Alberts testified at the 1997 hearing c. Walter Koshinskie that he had known Mr. Soubik, his brotherin-law, for about 50 years at the time of Soubik’s death in 1986. Alberts had 8 Mrs. Soubik also testified that her brother died of pneumoconiosis, i.e. black 9 lung disease, and that she had seen her He also testified at the April 1986 brother daily for about 20 years before his hearing on M r. Soubik’s claim, but that death. But this testimony is never linked testimony focused on establishing that to any observations she made of her Soubik had worked as a coal miner and husband’s illness. hauler. 7 worked with him for about a decade noted that Mrs. Soubik and “the miner’s starting in the mid-1930s. He “could see sons and sister-in-law” had testified that [Soubik] gradually slowing down. . . over Mr. Soubik had become short of breath a period of years” and “could see his over time, but he did not discuss that breathing was getting slower. . . and he’d evidence. have to fight for his breath” starting in C. Soubik I about 1974 or 1975. He saw Soubik have trouble catching his breath “pretty In Soubik I, we reversed the BRB’s regular.” Periodically, he saw him decision affirming the ALJ’s denial of coughing or spitting when they would benefits, and we remanded for “further visit. He noticed that Soubik had trouble consideration of the lay evidence.” We going up the steps in his house as he got agreed with the ALJ that the only dispute older. was causation. Accordingly, Mrs. Soubik had to establish that Mr. Soubik’s death f. Adeline Cecilia Dilliplane was due to pneumoconiosis, i.e., that Ms. Dilliplane had known Mr. pneumoconiosis “was a substantially Soubik since 1969 when her son married contributing cause or factor” leading to her the Soubiks’ daughter. She stated that Mr. husband’s death or that his “death was Soubik had trouble helping her son build a caused by com plications of house. “[H]e would do some things and pneumoconiosis” under 20 C.F.R. § then he would stop because he’d start 718.205(c).10 We also concluded that Mrs. wheezing. He’d start coughing.” She said Soubik could prove her claim using that she thought he had breathing problems “medical evidence alone, non-medical comparable to hers, and she had serious evidence alone, or the combination of problems with asthma. Over time, they medical and non-medical evidence” under saw each other less often but regularly. Hillibush v. Dep’t of Labor, 853 F.2d 197, During visits she would hear him wheeze 205 (3d Cir. 1988). Hillibush explicitly and “knew he was having a bad. . . held that lay testimony must be considered breathing problem.” in a survivor’s case under 20 C.F.R. § 718.204.
In the case at hand, we held in The ALJ’s 1997 decision denying Soubik I that neither the ALJ nor the BRB benefits was based on Dr. Spagnolo’s opinion. The ALJ discounted Dr. Wagner’s opinion as too vague, and he 10 In Lukosevicz v. Director, OWCP, discounted Dr. Karlavage’s opinion 888 F.2d 1001, 1004, 1006 (3d Cir. 1989), because it was based on “the report of the we held that if the pneumoconiosis hastens miner’s relatives that pneumoconiosis was death, even briefly, it can be considered a involved in the miner’s death” as Dr. substantially contributing cause of death Wagner had conveyed to them. The ALJ under 20 C.F.R. § 718.205(c). 8 had given any consideration to the lay Karlavage’s February 22, 1995 letter evidence offered in support of Mrs. established that the doctor “bases his Soubik’s claim, and this evidence “could conclusions regarding the cause of the be enough to satisfy Mrs. Soubik’s burden miner’s death, in part, . . . only on of proof that pneumoconiosis hastened her statements from the miner’s relatives.” husband’s death.” We also noted that the The ALJ concluded that Dr. ALJ and BRB had relied heavily on the Spagnolo’s opinion would outweigh the opinion of Dr. Spagnolo, and that he had other doctors’ opinions even if they could formed his opinion “based on his review of establish that pneumoconiosis hastened Soubik’s medical history” rather than the Soubik’s death because of Dr. Spagnolo’s opinions of Soubik’s treating physicians, superior credentials and because “Dr. Dr. Karlavage and Dr. Wagner. Wagner. . . did not treat the miner for D. The ALJ’s 2001 Decision on respiratory problems and Dr. Karlavage Remand only saw the miner on three office visits over a six month period.” The ALJ Upon remand from Soubik I, the believed that the lay testimony was also ALJ summarized the lay testimony in the outweighed by “the thorough and complete record. He found that the lay opinions did report of Dr. Spagnolo.” The ALJ not clearly establish that Mr. Soubik’s described Dr. Spagnolo as both “[a] highly ongoing deterioration was due to qualified. . . pulmonary specialist” as well pneumoconiosis or a pulmonary condition. as the beneficiary of a complete review of He also discussed each of the three Soubik’s medical records. The ALJ thus doctors’ opinions again, and reached the concluded that Mrs. Soubik did not same conclusion, that Dr. Spagnolo’s establish pne umoc onio si s w a s a opinion was the most persuasive. substantially contributing factor in her The ALJ again found that Dr. husband’s death or that it hastened his Wagner’s opinion was “equivocal and death, and he therefore denied survivor’s vague” because he merely stated that the benefits. pneumoconiosis “could have contributed”