Court Opinion

ID: 9480245
Source: CourtListenerOpinion
Date Created: 2023-08-05 07:42:06.103663+00
Date Added: 2024-06-11T17:47:33.690103
License: Public Domain

WELLFORD, Circuit Judge,
dissenting:
The notice of election card, after denial of a Part B claim, serves an explicit Congressional purpose as evidenced by the amendments to the Black Lung Act and the legislative history of those amendments. The purpose of the card is to set in motion the review process so that the Part B denied claims can be reviewed to determine whether the claimant would now be entitled to benefits for medical problems for which the claimant was then suffering under more lenient standards than under which the claim was originally decided. In 1977, the Act was amended to create a Trust Fund in response to the increasing amount of money that it was costing the federal government to pay benefits. Originally, the Trust Fund was to pay benefits to miners who did not engage in coal mine employment after December 31, 1969 or where the responsible employer could not be “found.” The Fund was financed by collecting excise taxes on coal and requiring coal operators to contribute a certain percentage to the Fund. The 1977 amendments also included the adoption of more lenient standards for determining whether a claimant was entitled to benefits. A claimant who previously had a Part B claim denied could elect to have their claim reviewed under these new more lenient standards. (Review was automatic for those claimants who had their Part C claims denied. 30 U.S.C. § 945(b)(1)).
Congress again amended the Act in 1981 in light of “the Trust Fund’s increasing indebtedness to the Treasury.” Old Ben Coal Co. v. Luker, 826 F.2d 688, 694 (7th Cir.1987). These 1981 amendments increased the tax on coal and “the interest rate on operator liabilities to the Trust Fund, ...” Id. More important, (for purposes of this case),
[a] transfer of liability provision, section 205, was also enacted ... to provide relief to a certain class of coal operators and insurers from unexpected, retroactive liability arising from the 1977 amendments.
Id. (emphasis added). Because there was concern that this transfer liability provision would actually increase the Trust Fund’s indebtedness, “legislators specifically requested information on how many claims would transfer, which claims they were and what their cost would be.” Id.
The Department of Labor promulgated regulations which provide that a claimant must file a request for review with SSA in order for the liability to transfer. Although not discussed by either of the parties to this appeal, the regulations also provide that where an individual has had more than one pre-March 1, 1978 claim denied,
unless such claims were required to be merged by the agency’s regulations, the procedural history of each claim must be considered separately to determine whether the claim is subject to the transfer of liability provisions.
20 C.F.R. § 725.496(c) (emphasis added). Only those claims that Congress intended to be transferred were to be actually transferred to the trust fund.
I would agree with Luker that an individual must ordinarily seek review of the previously denied Part B claim in order to satisfy the condition precedent for transfer liability. The purpose behind the statutory scheme is to require an evaluation, under different standards, of the Part B claim, particularly if a claimant’s medical condition may have changed after March 1, 1978.
In this case, claimant Bellomy filed claims in 1970 and 1972, both of which were denied. He continued to work in the mines until August of 1978 and filed another claim in April 1979. I would find the transfer of liability from the responsible operator to the Trust Fund should not take place until there has been a review under Reform Act standards of the earlier Part B *539claim in 1972. (Bellomy conceded he did not “carry through” with his earliest claim).
The decision in this case grants Quarto Mining Co. an undeserved windfall. Bello-my will receive his Part C payments with an eligibility date of April 1, 1979, on his Part C claim, in any event. I would not relieve Quarto of liability until there has been a reevaluation of Bellomy’s Part B claim under appropriate standards to determine Quarto Mining’s liability.
I would, therefore, remand the matter for reevaluation of the Part B claim insofar as Quarto’s potential liability is concerned. This would not adversely affect Bellomy who is, and has been, receiving black lung benefits for some ten years now. It would, instead, properly resolve the question of liability between the Director and Quarto Mining Co. in this unusual situation where it is uncertain, under the statute, whether Bellomy ever properly exercised his right to review the original Part B denials.