Opinion ID: 576917
Heading Depth: 3
Heading Rank: 1

Heading: Presumption of total disability.

Text: 10 An interim rebuttable presumption of total disability due to pneumoconiosis arising out of employment may be available to a coal miner employed in that capacity for ten or more years. 20 C.F.R. § 727.203(a) (1991). Boyles' length of mine employment fulfilled the first requirement to invoke the presumption. One other requirement must be fulfilled before the presumption may be applied. Id. That is, a living claimant will be found totally disabled due to pneumoconiosis if he shows one of four specific medical findings indicating pneumoconiosis, pulmonary or respiratory disease, or total pulmonary or respiratory impairment. Zeigler Coal Co. v. Sieberg, 839 F.2d 1280, 1282 (7th Cir.1988). These four findings may be based on either: chest x-rays or biopsies, § 727.203(a)(1); ventilatory studies, § 727.203(a)(2); blood gas studies, § 727.203(a)(3); or other medical evidence, § 727.203(a)(4). 1 The ALJ found that Boyle fulfilled the second requirement because the ventilatory studies indicated respiratory and pulmonary disease. 11 Peabody argues that the ventilatory study which registered qualifying ratios triggering the presumption was inaccurate because Boyles was taking Visken, a blood pressure medication which may depress respiratory performance. Two doctors, Dr. Ali and Dr. Miller, theorized about the effects Visken may have on ventilatory studies. The ALJ's initial failure to discuss these effects resulted in error and remand for a decision on this issue. On remand, the ALJ examined Dr. Ali's deposition testimony. Dr. Ali was asked if beta-blocker medication, such as Visken, hurt breathing. He responded Depends how the patient reacts to it. Before they affect the pulmonary function you probably would know from the patients how they react to it, but they can. From these statements, the ALJ concluded that Dr. Ali was perfectly aware of Boyles' reaction--if any--to Visken, and that Dr. Ali made his diagnosis in this light. 12 Peabody challenges the second ALJ decision on two grounds. First, Peabody argues that because Dr. Miller discussed the possible effects of Visken, but the ALJ did not readdress Dr. Miller's testimony, the ALJ has again erred. We find this argument unavailing. Dr. Miller's viewpoint was not overlooked on remand because the ALJ quoted from his first opinion which referred to Dr. Miller's Visken concerns. Next, Peabody cites error because the Visken's effects were discussed generally in terms of pulmonary and respiratory function--but not addressed specifically to Boyles and the 1984 ventilatory study that gave rise to the presumption. This argument is stronger. 13 Although Dr. Ali was deposed, neither party pressed him for an explanation of his vague statement that some patients may have a depressed respiratory reaction while taking Visken. Nor did the ALJ fully inquire into all matters at issue. 20 C.F.R. § 725.455(b) (1991); see Freeman United Coal Mining Co. v. Benefits Review Bd., 912 F.2d 164, 169 (7th Cir.1990). Dr. Ali was never asked to be more specific and state whether Boyles suffered adverse reactions to Visken at the time of the respiratory study. This question remains open and we are therefore unable to determine if the presumption was properly invoked based on the ventilatory studies. In Poole v. Freeman United Coal Mining Co., 897 F.2d 888 (7th Cir.1990), we faced a similar open question. There, the ALJ rejected an argument that a pulmonary function test was affected by a respiratory infection suffered by the claimant. We determined that because no affirmative evidence supported the proposition that the test was affected, the ALJ's decision was supported by substantial evidence. Id. at 895. In the present case, we have testimony by doctors for both the claimant and the coal company that the qualifying ratios may have been adversely affected, and no evidence that it was not. Although the ALJ reasoned that Dr. Ali's statement inferred that Boyles was not adversely affected, we are aware that vague statements made by treating physicians may be given to accommodate their patients. Peabody Coal Co. v. Helms, 901 F.2d 571, 574 (7th Cir.1990). Therefore, substantial evidence does not support the ALJ's decision, and we remand this action to the ALJ for a further fact-finding on this issue. 2