Court Opinion

ID: 9467229
Source: CourtListenerOpinion
Date Created: 2023-08-05 01:42:15.795432+00
Date Added: 2024-06-11T17:40:14.318152
License: Public Domain

MERRITT, Circuit Judge,
dissenting.
I agree with the Court that the 1977 Amendments should not be applied retroactively, but I disagree that the claimant is not entitled to the § 921(c)(4) presumption. I think it is clear that this man has a totally disabling lung disease and that the evidence to the contrary is insubstantial.
Claimant Moore is a 65-year-old ex-coal miner who worked in underground coal mines for almost a quarter of a century until his retirement in November of 1970. On January 19, 1971, he applied to the Secretary of HEW for black lung benefits.
Claimant submitted copious evidence of totally disabling pneumoconiosis to the administrative law judge. Claimant testified that he cannot exert himself because of shortness of breath, from which he has suffered since 1962. He also testified that he coughs up thick sputum. Reports by Dr. Selby Coffman, Jr. and Dr. Neil Calhoun interpreted x-rays as positive for simple pneumoconiosis (black lung). Two pulmonary function studies showed pneumoconio-sis. Reports of two physicians who both personally examined the claimant indicate that he has a chronic disabling lung disease.
According to one of these physicians, Dr. Neil Calhoun:
With the patient undressed to the waist we immediately see that this patient’s chest is markedly deformed with chronic lung disease and we note deep cavities between the patient’s clavicles, neck and shoulder muscles on either side indicating that the bony thorax has been elevated, enlarged and drastically deformed due to chronic lung disease . . . [Bjreath sounds with inspiration are low, distant, hard to hear and at the end of the inspiratory cycle the patient has some fine moist rales and with expiration the breath sounds are also low, distant, hard to hear and last only a short duration and are wheezy at the end of the respiratory cycle. All of the changes we have just described are characteristic of severe, chronic, pulmonary disease.
According to . .. [pulmonary function] studies [taken at our request] the patient is disabled according to HEW by their own standards as set forth in a table under “What Constitutes Total Disability By Pneumoconiosis” .... [W]e are certain from the history and physical examination and pulmonary function studies and chest x-rays that this patient has coal miner’s pneumoconiosis that is causing him disability 100%.
The record also contains reports containing negative rereadings of the same x-rays, two negative pulmonary function studies and reports that claimant suffers from a disabling heart condition. On the basis of the negative readings, the negative pulmonary function studies, and reports of claimant’s heart condition, the ALJ and our Court have found that claimant had not *736proven the existence of a totally disabling chronic respiratory or pulmonary impairment that would invoke the § 921(c)(4) presumption.
The portion of the record on which the Court relies is insubstantial. It consists of negative x-rays, negative pulmonary studies, and reports concerning claimant’s heart condition. Where there is substantial evidence of totally disabling chronic lung disease, these first two types of evidence cannot alone be used to prevent the § 921(c)(4) presumption from arising. See Conn v. Harris, 621 F.2d 228 (6th Cir. 1980); Morris v. Mathews, 557 F.2d 563, 565-66 (6th Cir. 1977).
The record does contain several reports that indicate claimant had a disabling heart condition. Dr. Calhoun in his report indicated, however, that
[rjegardless of this patient’s heart disease ... it is obvious .. . that this patient’s chronic lung disease ... is ... crippling and disabling this patient 100%.
It is unfortunate that this patient has heart disease also but it is a good possibility in all likelyhood [sic] or it may be possible that this patient’s heart disease has developed secondary to a high pulmonary system resistance caused by coal miner’s pneumoconiosis that is causing him disability 100%.
I interpret this to mean that pneumoconio-sis is the primary cause of disability. There is no medical evidence in the record contradicting such an affirmation. ' Even assuming that claimant is totally disabled due to heart disease, none of the reports on heart disease state that pulmonary impairment has not caused total disability.
I do not agree with the Court that Van Hooser’s reports constitute substantial evidence that no disabling lung disease existed before June 30, 1973, when set alongside the reports of Drs. West, Fisher and Calhoun. Moore came to Van Hooser complaining of heart trouble. Van Hooser did not look specifically for lung disease, so he did not find it. Nor did he look specifically for the cause of the heart disease. On the other hand, West, Fisher and Calhoun examined Moore for the distinct purpose of determining whether he had lung impairment. West and Calhoun both stated unequivocally that Moore has totally disabling, chronic lung disease. Fisher stated that Moore has chronic lung disease without commenting on disability.
I do not see where the record indicates that Van Hooser was a “treating” as opposed to a mere “examining” physician. Nor does the record reveal that Van Hooser was any more familiar with Moore’s health than was Calhoun. In fact, the record suggests just the opposite. Calhoun was the treating physician (p. 157). Consequently, it simply is not reasonable for the Secretary to accept one doctor’s opinion who was not looking for the disease in question when there are three other doctors who specifically state the disease exists.
I do not think there is any inherent conflict between the reports of Drs. West, Fisher and Calhoun on the one hand, and those of Dr. Van Hooser. A plausible synthesis of these reports is that, as of the Van Hooser examination of 1973,' Moore suffered from a chronic respiratory impairment that manifested itself only through a totally disabling heart condition and perhaps also shortness of breath. This respiratory impairment worsened by October 1973, when Dr. Fisher observed wheezing. Finally, by the summer of 1974, both Drs. Calhoun and West detected rales and wheezes. Dr. Calhoun also noted outward physical deformities. There is no direct and unequivocal statement in Van Hooser’s reports that expressly contradicts the West/Fisher/Calhoun diagnoses. We cannot assume, contrary to other substantial evidence, that lung impairment did not exist simply because Van Hooser did not record it in his reports. Under this interpretation of the record, uncontradicted medical evidence shows that Moore had a heart impairment before June 30,1973, and that this *737impairment was caused by chronic lung disease. Accordingly, I would award benefits.