Court Opinion

ID: 9963608
Source: CourtListenerOpinion
Date Created: 2024-04-25 21:00:46.109115+00
Date Added: 2024-06-11T08:24:54.442141
License: Public Domain

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                                            UNPUBLISHED

                              UNITED STATES COURT OF APPEALS
                                  FOR THE FOURTH CIRCUIT

                                              No. 20-1888

        ISLAND CREEK COAL COMPANY,

                            Petitioner,

                     v.

        DANIEL LOONEY; DIRECTOR, OFFICE OF WORKERS’ COMPENSATION
        PROGRAMS, UNITED STATES DEPARTMENT OF LABOR,

                            Respondents.

        On Petition for Review of an Order of the Benefits Review Board. (19-0266 BLA)

        Argued: October 26, 2023                                       Decided: April 24, 2024

        Before GREGORY and AGEE, Circuit Judges, and Robert S. BALLOU, United States
        District Judge for the Western District of Virginia, sitting by designation.

        Petition for review granted; Benefits Review Board decision vacated and remanded by
        unpublished opinion. Judge Ballou wrote the opinion in which Judge Gregory and Judge
        Agee joined.

        ARGUED: William Steele Mattingly, JACKSON KELLY PLLC, Lexington, Kentucky,
        for Petitioner. Brad Anthony Austin, WOLFE, WILLIAMS & REYNOLDS, Norton,
        Virginia; William M. Bush, UNITED STATES DEPARTMENT OF LABOR,
        Washington, D.C., for Respondents. ON BRIEF: Jeffrey R. Soukup, JACKSON KELLY
        PLLC, Lexington, Kentucky, for Petitioner. Elena S. Goldstein, Deputy Solicitor, Barry
        H. Joyner, Associate Solicitor, Jennifer L. Feldman, Deputy Associate Solicitor, Gary K.
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        Stearman, Counsel for Appellate Litigation, Cynthia Liao, Office of the Solicitor, UNITED
        STATES DEPARTMENT OF LABOR, for Respondent Director, Office of Workers’
        Compensation Programs.

        Unpublished opinions are not binding precedent in this circuit.

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        BALLOU, District Judge:

              Daniel Looney applied for benefits under the Black Lung Benefits Act, 30 U.S.C.

        §§ 901 et seq. (“Act”), claiming that he suffered from coal dust induced pneumoconiosis

        as a result of his work as a coal miner. The Administrative Law Judge (“ALJ”) considered

        conflicting medical evidence and determined that Looney was entitled to benefits. The

        Benefits Review Board (“BRB”) affirmed the ALJ’s decision. Island Creek Coal Company

        (“Island Creek”) petitions this court for review of the BRB’s decision affirming the ALJ’s

        award of benefits. Island Creek raises various challenges to the ALJ’s findings of both

        clinical and legal pneumoconiosis, and the BRB’s conclusion that alleged errors by the

        ALJ were harmless. Island Creek also argues that the ALJ’s decision violated the

        Appointments Clause in light of Lucia v. SEC, 585 U.S. 237 (2018), and that the BRB erred

        in deeming Island Creek’s Appointments Clause claim forfeited. We conclude that Island

        Creek forfeited its Appointments Clause claim by failing to timely raise it. We find

        reversible error in the BRB’s benefits analysis; accordingly, we grant the petition for

        review, vacate the BRB’s order, and remand to the BRB for further proceedings.

                                                    I.

                                                   A.

              Daniel Looney worked in coal mines from 1980 until 1994. It is undisputed that he

        has more than 10 but less than 15 years of coal mine employment for purposes of the Act.

        The ALJ found that Looney “ha[d] a 50 pack year smoking history” for purposes of the

        Act. J.A. 517.

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               Looney was diagnosed with chronic obstructive pulmonary disease by 2011 and in

        May of that year was diagnosed with a Mycobacterial Avium Complex (“MAC”) infection.

        From 2011 through 2014, Looney underwent multiple lung surgeries, including a right

        upper lobectomy, right lower lobe segmentectomy, and a left upper lobectomy. Looney

        was eventually placed on chronic oxygen therapy and inhaler treatment. It is undisputed

        that he has advanced lung disease and is totally disabled. Island Creek disputes that Looney

        has pneumoconiosis and, if he does, that his pneumoconiosis is a substantially contributing

        cause of his total disability.

                                                     B.

               To establish entitlement to living miner’s benefits under the Act, Looney must

        prove: “(1) that he has pneumoconiosis, in either its clinical or legal form; (2) that

        the pneumoconiosis arose out of coal mine employment; (3) that he is totally disabled by a

        pulmonary or respiratory impairment; and (4) that his pneumoconiosis is a substantially

        contributing cause of his total disability.” W. Va. CWP Fund v. Bender, 782 F.3d 129, 133

        (4th Cir. 2015) (internal quotation marks omitted); see 20 C.F.R. §§ 718.204(c)(1),

        725.202(d)(2). Under the Act, “pneumoconiosis” is defined as “a chronic dust disease of

        the lung and its sequelae, including respiratory and pulmonary impairments, arising out of

        coal mine employment,” and includes both “clinical” and “legal” pneumoconiosis. 20

        C.F.R. § 718.201(a). “‘Clinical pneumoconiosis’ consists of those diseases recognized by

        the medical community as pneumoconioses, i.e., the conditions characterized by permanent

        deposition of substantial amounts of particulate matter in the lungs and the fibrotic reaction

        of the lung tissue to that deposition caused by dust exposure in coal mine employment.”

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        20 C.F.R. § 718.201(a)(1). “‘Legal pneumoconiosis’ includes any chronic lung disease or

        impairment and its sequelae arising out of coal mine employment.” 20 C.F.R.

        § 718.201(a)(2). “Arising out of coal mine employment” means “significantly related to,

        or substantially aggravated by, dust exposure in coal mine employment.” 20 C.F.R.

        § 718.201(b).

               Looney bears the burden to establish the existence of pneumoconiosis by a

        preponderance of the evidence. 20 C.F.R. § 725.103. Pneumoconiosis may be established

        by chest x-rays, biopsy or autopsy, or medical opinion evidence. Id. at § 718.202(a). The

        ALJ must weigh all of the evidence together when determining whether Looney established

        the presence of pneumoconiosis. Sea “B” Mining Co. v. Addison, 831 F.3d 244, 249 (4th

        Cir. 2016).

                                                   C.

               The ALJ entered a decision awarding benefits to Looney. The ALJ determined that

        Looney has a totally disabling respiratory impairment, noting that all spirometry

        measurements show disabling results and no physicians in the record argue otherwise.

               When evaluating whether Looney established the existence of clinical

        pneumoconiosis, the ALJ reviewed conflicting medical evidence submitted by Looney and

        Island Creek, including chest x-ray interpretations, CT scans, narrative x-ray

        interpretations, pathology reports, and medical opinions. The ALJ considered each

        category of medical evidence separately, and then analyzed the evidence together as a

        whole to determine if Looney established clinical pneumoconiosis by a preponderance of

        the evidence. The ALJ reviewed eleven substantive chest x-ray interpretations; six that

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        diagnosed pneumoconiosis and five that did not. The ALJ found that the physicians

        interpreting x-rays as positive for pneumoconiosis had “relatively uniform x-ray

        interpretations” that routinely found emphysema, bullae, and low-level profusion. J.A. 533.

        The ALJ noted differences in the positive interpretations but found the x-ray readings

        uniform as a whole. Conversely, the ALJ found that the x-ray interpretations submitted by

        Island Creek reach differing conclusions and have contradictions which “hurt [Island

        Creek’s] case.” J.A. 534. The ALJ gave the positive x-ray interpretations more weight than

        those submitted by Island Creek and found that “the x-ray evidence, when evaluated as a

        whole, supports a finding that [Looney] has clinical pneumoconiosis.” Id.

               The ALJ evaluated the CT scan interpretations in the record and found them largely

        silent on clinical pneumoconiosis. The ALJ determined that on the whole the CT scan

        interpretations do not support a finding of clinical pneumoconiosis. J.A. 535.

               The ALJ found the narrative x-ray interpretations in the record “puzzling,” and

        noted that they do not specifically diagnose pneumoconiosis directly. The ALJ determined

        that the narrative x-rays cut against a finding of pneumoconiosis. Id.

               The ALJ reviewed the pathology reports in the record and found that they strongly

        support a finding of pneumoconiosis, noting that Looney had coal dust induced fibrosis in

        a biopsy slide, with pigment laden macrophages, and anthracosis. J.A. 536. The ALJ

        concluded that the pathology reports find that Looney has pneumoconiosis and he gave the

        pathology reports significant weight. Id.

               The ALJ reviewed medical opinions from four physicians, Drs. Habre and Akhrass

        who diagnosed clinical pneumoconiosis, and Drs. Spagnolo and Jarboe who did not. The

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        ALJ found the two medical opinions that did not diagnose pneumoconiosis problematic

        and unsupported by the record. J.A. 537–38. The ALJ determined that the reliable medical

        opinion evidence supported a finding of clinical pneumoconiosis. J.A. 538.

               The ALJ considered the medical evidence collectively and concluded that Looney

        had clinical pneumoconiosis, writing,

               I am specifically persuaded by the pathology reports in this case, which
               identified pigment bearing macrophages, anthracosis, and a coal dust nodule.
               These findings, coupled with the ILO x-ray interpretations, convince me by
               a preponderance of the evidence that Claimant has clinical pneumoconiosis.

        Id. (emphasis added).

               The ALJ also determined that Looney’s MAC infection qualifies as legal

        pneumoconiosis, relying on Dr. Akhrass’ opinion that pneumoconiosis predisposed

        Looney to the MAC infection. J.A. 542. The ALJ applied the rebuttable presumption that

        a miner who has 10 or more years of coal mine employment and suffers from

        pneumoconiosis is entitled to a presumption that the pneumoconiosis arose from his coal

        mine employment. J.A. 542–33; 20 C.F.R. § 718.302. The ALJ determined that Looney

        established that his total disability was caused by his legal pneumoconiosis. However, the

        ALJ did not find sufficient evidence to establish that Looney’s total disability was caused

        by clinical pneumoconiosis. J.A. 543. The ALJ awarded benefits based upon Looney’s

        totally disabling legal pneumoconiosis. Id.

                                                      D.

               On appeal to the BRB, Island Creek raised, for the first time, a constitutional

        challenge under the Appointments Clause, claiming that the ALJ had not been properly

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        appointed in light of Lucia. The BRB concluded that Island Creek forfeited its

        Appointments Clause argument by failing to raise it before the ALJ. J.A. 547.

               Island Creek also challenged, among other things, the ALJ’s evaluation of the

        substantive x-ray interpretations in determining that Looney established clinical

        pneumoconiosis. Island Creek asserted that the ALJ’s decision to credit the positive x-ray

        interpretations as “relatively uniform” and give them more weight than the negative x-ray

        interpretations was arbitrary, irrational, and unsupported by substantial evidence. Island

        Creek argued that the positive x-ray readings were not uniform and the ALJ failed to

        consider inconsistent diagnoses within the positive x-ray readings.

               The BRB affirmed the ALJ’s conclusion that Looney had clinical pneumoconiosis,

        stating, “[b]ecause it is supported by substantial evidence, we affirm the [ALJ’s] finding

        that the biopsy evidence establishes claimant has clinical pneumoconiosis and outweighs

        the contrary evidence of record.” J.A. 550. The BRB declined to address Island Creek’s

        allegations of error regarding the positive x-ray interpretations, stating in a footnote,

               Because we affirm the [ALJ’s] finding that the biopsy evidence establishes
               clinical pneumoconiosis and outweighs the contrary evidence, any errors in
               his crediting the positive x-ray readings and the opinions of Drs. Habre and
               Akhrass are harmless.

        J.A. 550 n.6.

               The BRB also affirmed the ALJ’s findings that Looney is totally disabled and that

        he was entitled to the presumption that his clinical pneumoconiosis arose out of his coal

        mine employment. J.A. 550–52.

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              The BRB diverged from the ALJ’s conclusions regarding legal pneumoconiosis.

        The BRB determined that it was unnecessary to find that Looney’s MAC infection was

        legal pneumoconiosis. J.A. 556. The BRB instead found that the evidence established a

        causal relationship between Looney’s MAC infection, his clinical pneumoconiosis, and his

        total disability. Thus, the BRB found that Looney was totally disabled as a result of his

        clinical pneumoconiosis and affirmed the ALJ’s award of benefits. J.A. 556–58.

                                                    II.

              We review an ALJ’s decision that has been affirmed by the BRB to determine

        whether it is in accordance with the law and supported by substantial evidence. E.

        Associated Coal Corp. v. Dir., Office of Workers’ Comp. Programs, 805 F.3d 502, 510

        (4th Cir. 2015). Our review is limited to considering “whether substantial evidence

        supports the factual findings of the ALJ and whether the legal conclusions of the [BRB]

        and ALJ are rational and consistent with applicable law.” Westmoreland Coal Co. v.

        Stallard, 876 F.3d 663, 668 (4th Cir. 2017) (internal quotation marks omitted). We review

        the legal conclusions of the BRB and the ALJ de novo. Edd Potter Coal Co. v. Dir., Office

        of Workers’ Comp. Programs, 39 F.4th 202, 206 (4th Cir. 2022). In so doing, our review

        is confined exclusively to the grounds upon which the BRB based its decision. E.

        Associated Coal, 805 F.3d at 510.

                                                    III.

                                                    A.

              As a threshold matter, we first address Island Creek’s contention that the ALJ who

        issued the decision in Looney’s case was not properly appointed in accordance with the

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        Constitution’s Appointments Clause. The Supreme Court held in Lucia that one who makes

        a timely and proper challenge to the constitutional validity of the appointment of the

        hearing ALJ is entitled to a new hearing before a different (and properly appointed) ALJ.

        585 U.S. at 251–52 (emphasis in original). Here, Island Creek did not raise this issue before

        the ALJ hearing the case, but rather, asserted the Appointment Clause challenge for the

        first time on appeal to the BRB.

               We recently confirmed that the black lung regulations require exhaustion of a legal

        challenge to the appointment of the ALJ before both the ALJ and BRB. Edd Potter Coal,

        39 F.4th at 207–10. Applying that rule, we determined that an employer forfeited its

        Appointments Clause challenge under Lucia by failing to timely raise the issue before the

        ALJ and the BRB, and instead addressing it for the first time on remand to the ALJ. Id. at

        205, 207, 210–11.

               The employer in Edd Potter Coal asked us to excuse its forfeiture under the futility

        exception, arguing that exhaustion before the ALJ was futile because the ALJ could not

        grant the relief sought. The employer also argued that its forfeiture should be excused

        because Lucia was an intervening change in the law. We disagreed on both points, finding

        that exhaustion was not futile because both the ALJ and the BRB can hear Appointments

        Clause challenges and both can grant the requested relief of reassignment to a properly

        appointed ALJ. Id. at 211. We also rejected the intervening-law exception argument,

        noting that it only applies when an issue was previously not available. Id. We held that

        Appointments Clause challenges were available before the Supreme Court decided Lucia

        and that many black lung litigants pressed the point before Lucia; thus, forfeiture was not

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        excused. Id. at 212 (“Raising it did not require clairvoyance. It only required awareness,

        and this is what Edd Potter lacked.”).

               Here, it is undisputed that Island Creek raised the Appointments Clause issue for

        the first time before the BRB and has, thus, forfeited this challenge because of its failure

        to raise it with the ALJ. The only remaining issue is whether Island Creek’s forfeiture

        should be excused. Island Creek argues that exhaustion would have been futile, arguing

        that the ALJ lacked authority to resolve the Appointments Clause issue. This argument was

        rejected in Edd Potter Coal and we will not reconsider it here. Id. at 211 (“Both ALJs and

        the [BRB] can grant the requested relief of reassignment to a different ALJ.”).

               Island Creek also argues that its forfeiture should be excused because the agency

        inconsistently required exhaustion of Appointments Clause challenges prior to its decision

        in Kiyuna v. Matson Terms., Inc., BRB No. 19-0103, 2019 WL 2881243 (B.R.B. June 25,

        2019). However, as we noted in Edd Potter Coal, “[b]efore the ALJ, issue exhaustion is

        plainly one of the rules of the game.” 39 F.4th at 208. Island Creek was on notice that it

        must raise all issues before the ALJ or risk forfeiture. Indeed, “both ALJs and the [BRB]

        did in fact grant that relief in ‘legions’ of other black lung cases when the Appointments

        Clause challenge was ‘properly raised.’” Edd Potter Coal, 39 F.4th at 211 (quoting Joseph

        Forrester Trucking v. Dir., Office of Workers’ Comp. Programs, 987 F.3d 581, 591–92

        (6th Cir. 2021)). Further, Island Creek acknowledged during oral argument that it raised

        Appointments Clause issues before ALJs in other cases and it was not prevented from

        doing so here. Island Creek’s assertion that it avoided raising the Appointments Clause

        issue so as not to “annoy” the ALJ suggests that Island Creek made a strategic decision not

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        to advance the issue before the ALJ. See Stokes v. Stirling, 64 F.4th 131, 141 (4th Cir.

        2023) (declining to excuse forfeiture where party made a conscious, strategic decision not

        to litigate the issue on appeal).

               Overall, Island Creek’s arguments to excuse its forfeiture in this case are

        unpersuasive. We affirm the BRB’s conclusion that Island Creek forfeited its

        Appointments Clause challenge.

                                                    B.

               Island Creek objects to the BRB’s holding that any error in the ALJ’s analysis of

        the substantive x-ray interpretations was harmless. Island Creek notes that the ALJ relied

        upon pathology evidence “coupled with” the x-ray interpretations to find clinical

        pneumoconiosis by a preponderance of the evidence. Island Creek argues that it is

        unknown whether the ALJ would reach the same conclusion if the x-ray evidence did not

        support a finding of clinical pneumoconiosis. We agree that the ALJ’s clinical

        pneumoconiosis analysis was based on both the x-ray and pathology evidence, and an

        alleged error by the ALJ in assessing the x-ray evidence would not be harmless.

               Administrative adjudications are subject to the same harmless error rule that

        generally applies to civil cases. Sea “B” Mining, 831 F.3d at 253. Reversal on account of

        error is not automatic but requires a showing of prejudice. Id. The harmless error rule

        considers the likelihood that the result would have been different absent error. Id. at 253–

        54.

               When evaluating clinical pneumoconiosis, the ALJ was required to consider each

        category of evidence separately and then weigh the different types of evidence together to

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        determine whether a preponderance of all the evidence establishes pneumoconiosis. Island

        Creek Coal Co. v. Compton, 211 F.3d 203, 208–09 (4th Cir. 2000); 30 U.S.C. §923(b).

        “Although the regulations group the forms of permissible evidence into discrete categories,

        an ALJ must weigh all of the evidence together when determining whether the miner has

        established the presence of pneumoconiosis.” Sea “B” Mining, 831 F.3d at 249. Here, the

        ALJ properly evaluated each category of evidence separately and then weighed the

        evidence together as a whole. When considering the evidence collectively, the ALJ

        explicitly relied on both the pathology reports and the weight of the positive x-ray

        interpretations to find clinical pneumoconiosis by a preponderance of the evidence. See

        J.A. 538 (“I am specifically persuaded by the pathology reports in this case…[t]hese

        findings, when coupled with the ILO x-ray interpretations, convince me by a

        preponderance of the evidence that [Looney] has clinical pneumoconiosis.”).

               On appeal, the BRB affirmed the ALJ’s finding of clinical pneumoconiosis, but

        based its holding solely on the pathology evidence. The BRB held that the biopsy evidence

        “outweigh[ed] contrary evidence of record,” and declined to consider any error in the

        ALJ’s analysis of the x-ray interpretations. The BRB’s inaccurate inference that the ALJ

        relied solely upon biopsy evidence to establish clinical pneumoconiosis is problematic for

        several reasons. The BRB was charged with reviewing the ALJ’s findings of fact and

        conclusions of law and was not at liberty to affirm the ALJ’s conclusion on an alternate

        ground. Edd Potter Coal Co., 39 F.4th at 208 (the BRB “is not empowered to engage in a

        de novo proceeding or unrestricted review of a case brought before it…the [BRB] is only

        authorized to review the conclusions of law on which the decision or order appealed from

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        was based.”) (internal quotations and citations omitted); See v. Washington Metro. Area

        Transit Auth., 36 F.3d 375, 382 (4th Cir. 1994) (“Regardless of its perception of the

        appropriate inferences arising from the evidence, the BRB cannot … substitute its own fact

        findings and judgment for that of the ALJ.”) (citing Mijangos v. Avondale Shipyards, Inc.,

        948 F.2d 941, 944–45 (5th Cir. 1991)).

               Further, we have previously rejected the idea that if the evidence relevant to one

        subsection of evidence supports a finding of pneumoconiosis, other evidence bearing on a

        different subsection can be ignored. Compton, 211 F.3d at 208–09; see Consolidation Coal

        Co. v. Held, 314 F.3d 184, 186–87 (4th Cir. 2002) (error for ALJ to rely solely on medical

        opinion evidence without weighing all categories of evidence together). In Compton, we

        clarified that while one category of evidence may be sufficient to establish

        pneumoconiosis, the ALJ must still weigh all categories of evidence together. 211 F.3d at

        208–09. Under this framework, the BRB was obligated to consider all categories of

        evidence the ALJ relied upon to find clinical pneumoconiosis.

               Given these circumstances, the BRB incorrectly determined that any error by the

        ALJ in evaluating the positive x-ray interpretations was harmless. If, on review, the BRB

        found that the ALJ’s analysis of the positive x-ray interpretations as “uniform” was

        irrational and arbitrary, it would eliminate the ALJ’s sole basis to credit the positive x-ray

        interpretations over the negative x-ray interpretations. This would result in the x-ray

        evidence potentially joining the other categories of evidence that weighed against

        pneumoconiosis and conflicted with the pathology evidence. Because the ALJ considered

        contradictory evidence when evaluating clinical pneumoconiosis, any error regarding the

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        x-ray interpretations could materially affect the ALJ’s decision and would not be harmless.

        Compare Sea “B” Mining, 831 F.3d at 255 (error is not harmless when the record contains

        contradictory evidence and the error may materially affect the ALJ’s decision) with

        BethEnergy Mines, Inc. v. Cunningham, 104 F. App’x 881, 888 (4th Cir. 2004) (ALJ’s

        failure to weigh all categories of evidence together when considering pneumoconiosis is

        harmless where the various categories of evidence do not conflict). We cannot say whether

        the ALJ would find that Looney established clinical pneumoconiosis by a preponderance

        of the evidence if the pathology evidence and x-ray interpretations conflict. 1

               The appropriate remedy is to remand to the BRB to consider Island Creek’s

        allegation of error relating to the positive x-ray interpretations in the first instance. Trump

        v. E. Assoc. Coal Corp., 737 F. App’x 156, 161 (4th Cir. 2018) (where BRB declined to

        consider ALJ’s reasoning, remedy is remand to the BRB to review the ALJ’s decision in

        the first instance). Although we are reluctant to remand Mr. Looney’s claim given his

        uncontested total disability and the strong pathology evidence, we are obliged to “confine

        our review to the grounds upon which the BRB based its decision.” E. Associated Coal,

        805 F.3d at 510. On remand, the BRB may well conclude that the ALJ properly credited

               1
                  Island Creek also asserts that the BRB incorrectly determined that any alleged
        error in the ALJ’s decision to credit the medical opinions of Drs. Habre and Akhrass was
        harmless. We disagree with Island Creek’s contention. Because the ALJ’s clinical
        pneumoconiosis finding was ultimately based upon the x-ray interpretations and pathology
        reports, and not the medical opinion evidence, any error in the weight the ALJ gave those
        medical opinions would not change the ALJ’s clinical pneumoconiosis finding and is
        harmless.

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        the positive x-ray interpretations; however, the BRB must consider this allegation of error,

        rather than dismiss it as harmless. 2

                                                        C.

               We address two additional issues raised by Island Creek that may be relevant to the

        BRB’s analysis of clinical pneumoconiosis on remand. Island Creek argues that the ALJ

        and BRB erred in determining that Dr. Akhrass’ medical opinion regarding the connection

        between Looney’s pneumoconiosis and MAC infection was well-reasoned. Island Creek

        also asserts that the BRB erred in concluding that the ALJ adequately explained his reasons

        for crediting Dr. Akhrass’ opinion on that issue. While we find substantial evidence in the

        record to support the ALJ’s finding that Dr. Akhrass’ opinion was well-reasoned, we agree

        with Island Creek that the ALJ’s explanation for crediting Dr. Akhrass’ opinion is deficient.

               When evaluating whether Looney established legal pneumoconiosis, the ALJ relied

        upon Dr. Akhrass’ medical opinion connecting Looney’s pneumoconiosis and his MAC

        infection, stating, “Dr. Akhrass, the only physician to provide a well-reasoned opinion in

               2
                 Island Creek also contends that the BRB improperly upheld the ALJ’s decision to
        discredit the medical opinions of Drs. Spagnolo and Jarboe, which did not diagnose clinical
        pneumoconiosis. We agree with the BRB that the ALJ sufficiently explained his decision
        to discredit Dr. Spagnolo’s opinion because it relied on a view of the pathology evidence
        inconsistent with the ALJ’s findings. “When an ALJ explains his or her reasoning and does
        not rely on an impermissible basis, we must defer to her or his discretion and judgment in
        assessing the conflicts in the evidence.” Sewell Coal Co. v. Triplett, 253 F. App’x 274, 278
        (4th Cir. 2007). The ALJ also permissibly discredited Dr. Jarboe’s opinion because it was
        based in part upon an x-ray interpretation that was excluded from the evidence. An ALJ
        has discretion to give reduced or no weight to a medical opinion that relies on excluded
        medical evidence. See Sewell Coal Co. v. Dempsey, 429 F. App’x 311, 315–16 (4th Cir.
        2011).

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        this matter, plainly stated that [Looney’s] black lung predisposed him to MAC.” J.A. 542.

        The BRB held that substantial evidence supported the ALJ’s finding that Dr. Akhrass’

        opinion is well-reasoned, and that the ALJ “acted within his discretion in finding Dr.

        Akhrass’s opinion on the relationship between [Looney’s] clinical pneumoconiosis and his

        MAC infection better reasoned than the opinions of [Island Creek’s] experts.” J.A. 553,

        558. The BRB determined that Dr. Akhrass’ opinion established that clinical

        pneumoconiosis substantially contributed to Looney’s disability. J.A. 558.

               It is the province of the ALJ to evaluate a physician’s opinion. Compton, 211 F.3d

        at 211. As the trier of fact, the ALJ is not bound to accept the opinion or theory of any

        medical expert. Id. However, an ALJ must conduct “an appropriate analysis of the evidence

        to support his conclusion.” Millburn Colliery Co. v. Hicks, 138 F.3d 524, 529 (4th Cir.

        1998). “The ALJ must examine the reasoning employed in a medical opinion in light of

        the objective material supporting that opinion, and also must take into account any contrary

        test results or diagnoses.” Compton, 211 F.3d at 211 (citing Dir., Office of Workers’ Comp.

        Programs v. Rowe, 710 F.2d 251, 255 (6th Cir. 1983)). Further, for a reviewing court to

        overturn an ALJ’s finding that an opinion is reasoned, it must find as a matter of law that

        no reasonable mind could have interpreted and credited the physician’s opinion. Piney

        Mountain Coal Co. v. Mays, 176 F.3d 753, 764 (4th Cir. 1999).

               Here, Dr. Akhrass based his diagnoses and opinion on Looney’s medical history,

        his experience as Looney’s treating physician over a period of years, and biopsy, x-ray and

        pulmonary function test results. J.A. 525–26. Dr. Akhrass’ opinion satisfies the regulation

        requirement that it be based on “objective medical evidence,” and Dr. Akhrass provided

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        reasoning to support his conclusions. 20 C.F.R. § 718.202(a)(4). Given this, substantial

        evidence supports the ALJ’s finding that Dr. Akhrass’ opinion is well reasoned. See

        Compton, 211 F.3d at 212 (evidence supports ALJ’s conclusion that medical opinion was

        well reasoned where physician based diagnosis on claimant’s medical history, a physical

        examination, and pulmonary function test results).

               However, the BRB’s conclusion that the ALJ adequately explained why he credited

        Dr. Akhrass’ opinion is problematic. The ALJ is required “to adequately explain why he

        credited certain evidence and discredited other evidence.” Sea “B” Mining, 831 F.3d at

        253 (quoting Hicks, 138 F.3d at 533). While this requirement “is not intended to be a

        mandate for administrative verbosity,” the reviewing court must be able to “discern what

        the ALJ did and why he did it.” Mays, 176 F.3d at 762 n.10.

               Regarding Dr. Akhrass’ opinion, the ALJ stated: “Dr. Akhrass’s opinion lacks the

        full documentation that was available to Drs. Jarboe and Spagnolo. However, unlike the

        other doctors in this case, Dr. Akhrass has been treating [Looney] for his pulmonary

        condition for years, which helps bolster his opinion despite the relative scarcity of

        documentation.” J.A. 540. Thus, as Island Creek observes, the ALJ appears to rely

        principally on Dr. Akhrass’ status as Looney’s treating physician as a basis for crediting

        his opinion. This explanation, without more, is insufficient. Although a treating physician

        opinion may be entitled to special consideration, an ALJ may not give a physician’s opinion

        greater weight solely due to his or her treating status. Consolidation Coal v. Held, 314 F.3d

        184, 187–88 (4th Cir. 2002) (citing Grizzle v. Pickands Mather and Co., 994 F.2d 1093,

        1097–98 (4th Cir. 1993)).

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              Further, when the BRB affirmed the ALJ’s decision to credit Dr. Akhrass’ opinion,

        the BRB inappropriately provided reasons in the record supporting Dr. Akhrass’ opinion

        that were not stated in the ALJ’s decision. J.A. 553–56. See Westmoreland Coal Co. v.

        Amick, 123 F. App’x 525, 533 (4th Cir. 2004) (“Although the Board’s conclusions about

        the credibility of the doctors might be supported by substantial evidence, it is the ALJ’s

        factual findings that we must review.”) Thus, the ALJ’s explanation for crediting Dr.

        Akhrass’ opinion that Mr. Looney’s pneumoconiosis predisposed him to the MAC

        infection warrants further consideration by the BRB on remand.

                                                   IV.

              Accordingly, we grant Island Creek’s petition for review, vacate the BRB’s

        decision, and remand to the BRB for further proceedings consistent with this opinion.

                                                                    PETITION GRANTED;
                                                               VACATED AND REMANDED.

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