Opinion ID: 3010322
Heading Depth: 2
Heading Rank: 4

Heading: the director's evidence before the alj

Text: The Director's evidence in opposition to the widow's claim consisted of a two-page report of Dr. Leon Candor,5 and the aforementioned April 11, 1991 note from Dr. Manganiello. Dr. Candor never examined the miner. His report was based entirely upon his examination of certain medical records and the results of tests that Dr. Manganiello and other physicians had performed over the years. The Director also introduced the death certificate into evidence. Dr. Manganiello's April 11, 1991 note is addressed TO WHOM IT MAY CONCERN. The entirety of that note is as follows: In my opinion Mr. Angelo Mancia (sic) heart attack was a direct result of his severe anthracosilicosis with emphysema which hastened or progressed his underlying coronary artery disease. Dr. Candor's report details the various medical records he reviewed. They include x-rays and the results of tests that had been performed on Mancia during his lifetime. Based upon his review of those records, Dr. Candor concluded: _________________________________________________________________ 5. The Director's Brief states that Dr. Candor is a Board-certified internist. Director's Br. at 5. However, the ALJ's Decision recites that Dr. Candor is Board-eligible in pulmonary medicine. ALJ's Decision at 3. 8 1. As noted in Dr. Manganiello's letter of 4/11/91, the immediate cause of Mr. Mancia's death on 8/5/90 was an acute myocardial infarction with resultant cardiopulmonary arrest. The myocardial infarction (heart attack) was caused by underlying coronary artery disease. 2. The patient's coronary artery disease with resultant myocardial infarction were casually unrelated to pneumoconiosis. 3. Despite Dr. Manganiello's statement in his letter of 4/11/91, I know of no scientific evidence which indicates that anthracosilicosis or emphysema hasten the progress of coronary artery disease. 4. The normal arterial oxygen tension at rest and during exercise makes it most unlikely that the patient's chronic lung disease had any effect upon cardiac rhythm and function. 5. The available information provides no evidence that Mr. Mancia's chronic lung disease was a substantially contributing cause to his death caused by acute myocardial infarction or hastened his death.