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Helen Mining Co. v. Elliott

United States Court of Appeals, Third Circuit

June 14, 2017


          Argued: September 9, 2016

         On Petition for Review of an Order of the Benefits Review Board (BRB-1:15-0067 BLA)

          Christopher Pierson, Esq. (Argued) Burns White Attorney for Petitioner Helen Mining Co.

          Robert J. Bilonick, Esq. Heath M. Long, Esq. (Argued) Pawlowski Bilonick & Long Attorney for Claimant-Respondent James E. Elliott, Sr.

          Sean Bajkowski, Esq. (Argued) Rae Ellen James, Esq. Kathleen H. Kim, Esq. United States Department of Labor Office of the Solicitor Attorney for Federal Respondent Director, Office of Workers' Compensation Programs

          Before: JORDAN, VANASKIE, and KRAUSE, Circuit Judges.


          KRAUSE, Circuit Judge.

         The Black Lung Benefits Act (BLBA) confers on coal workers generally the right to claim workers' compensation benefits for disabilities arising out of coal dust exposure. 30 U.S.C. §§ 901-45. Typically, the burden of proof rests on the miner to establish each element necessary for entitlement to benefits. For miners who meet particular criteria, however, the BLBA provides that certain elements will be presumed, subject to rebuttal by the party opposing benefits, i.e., by the coal mine operator-employer, if identifiable, or, alternatively, by the Secretary of Labor. 30 U.S.C. § 921(c). At issue in this case is whether a 2013 regulation, specifying the standard a coal mine operator must meet to rebut the presumed element of disability causation, is ultra vires to the BLBA. See 20 C.F.R. § 718.305(d)(1) (2013). For the reasons set forth below, we agree with the Benefits Review Board's conclusion that operators are subject to the regulation's rebuttal standard because the regulation permissibly fills a statutory gap in the legislation. We also agree that the record adequately supports the ALJ's conclusion that the operator did not meet that rebuttal standard in this case. Accordingly, we will affirm the award of benefits and deny the operator's petition for review.

         I. Background

         Coal mine operator Helen Mining Company seeks review of an award of black lung benefits to Claimant-Respondent James E. Elliott, Sr. Before turning to the facts of this particular case, we briefly review the historical development of the relevant benefits scheme to give context to the challenges raised by Helen Mining in this appeal.

         A. Statutory and Regulatory Context

         In 1969, Congress passed Title IV of the Federal Coal Mine Health and Safety Act, also known as the BLBA, to provide benefits to coal miners whose exposure to coal dust has resulted in the crippling pulmonary condition of pneumoconiosis, commonly known as "black lung." Pub. L. No. 91-173, § 401, 83 Stat. 742, 792 (1969) (codified as amended at 30 U.S.C. § 901); see also Mullins Coal Co. of Va. v. Dir., OWCP, 484 U.S. 135, 138 (1987).[1] To prove entitlement to benefits, a miner must establish four elements: (1) disease, i.e., he has pneumoconiosis; (2) disease causation, i.e., the pneumoconiosis arose out of dust exposure from his coal mine employment; (3) disability, i.e., he has a totally disabling respiratory or pulmonary impairment that prevents him from performing coal mining or comparable work; and (4) disability causation, i.e., pneumoconiosis is a "substantially contributing cause" of his disability. 20 C.F.R. §§ 718.204(C)(1), 725.202(d)(2) (citing 20 C.F.R. §§ 718.201-718.204); see also Dir., OWCP v. Mangifest, 826 F.2d 1318, 1320 (3d Cir. 1987). BLBA benefits were initially administered by the Social Security Administration, pursuant to regulations promulgated by the then-Secretary of Health, Education, and Welfare, and were paid from federal funds. 30 U.S.C. §§ 921-24; Pauley v. BethEnergy Mines, Inc., 501 U.S. 680, 683-84 (1991). Today, such claims for BLBA benefits are administered by the Director of the Office of Workers' Compensation Programs, pursuant to regulations promulgated by the Secretary of Labor. 30 U.S.C. §§ 902(c), 932; Mullins, 484 U.S. at 139.

         Congress has amended the BLBA in numerous respects over the years, but three have particular relevance to this appeal. First, in an effort to relax the burden on miners to prove entitlement to benefits, the Black Lung Benefits Act of 1972 added a provision establishing that any miner who can prove he worked fifteen years or more in an underground coal mine and can establish the third element-that he is disabled-is entitled to "a rebuttable presumption that [he] is totally disabled due to pneumoconiosis" and is therefore entitled to black lung benefits. Pub. L. No. 92-303, § 4(c), 86 Stat. 150, 154 (codified at 30 U.S.C. § 921(c)(4)) (hereinafter "the § 921(c)(4) presumption"); Pauley, 501 U.S. at 685.[2] In essence, if a miner could prove qualifying employment and disability, then the other elements, including disability causation, would be presumed to be met as well, shifting the burden to the party opposing benefits-at that point in time, the Secretary-to rebut the presumption by means specified in § 921(c)(4). As to the element of disability causation, for example, § 921(c)(4) specified that the Secretary may rebut by "establishing that … [the miner's] respiratory or pulmonary impairment did not arise out of, or in connection with, employment in a coal mine." 30 U.S.C. § 921(c)(4)(B); see also Pauley, 501 U.S. at 685-86.[3]

         Second, the BLBA from its inception had anticipated a gradual transition to the processing of claims by approved state workers' compensation programs or, in the absence of an approved program, by the Secretary himself, with mine operators bearing financial responsibility for the payment of benefits. See Federal Coal Mine Health and Safety Act of 1969, § 422, 83 Stat. 741, 796-97 (codified as amended at 30 U.S.C. § 932). But the 1972 Act set the date for that transition as January 1, 1974, providing that all claims filed on or after that date would be paid not from federal funds, but by the private coal mine operator that employed the miner, see Black Lung Benefits Act of 1972, § 5(1), (2), 86 Stat. 150, 155 (codified as amended at 30 U.S.C. § 932), and a subsequent amendment ensured that if a responsible operator could not be identified, benefits would be paid by a fund, administered by the Secretary, into which mine operators would contribute.[4] Thus, from that point forward, the party opposing benefits would be not only the Secretary, but either the Secretary or the mine operator, depending on which was the payor.

         Finally, in another amendment passed in 1977, Congress expanded the definition of pneumoconiosis beyond the class of clinical diseases recognized as pneumoconiosis (so-called "clinical pneumoconiosis") to include "any chronic dust disease of the lung … arising out of coal mine employment" (now referred to as "legal pneumoconiosis"). Black Lung Benefits Reform Act of 1977, Pub. L. No. 95-239, sec. 2(a), § 402(b), 92 Stat. 95, 95 (codified at 30 U.S.C. § 902(b)); see 20 C.F.R. § 718.201(a). The upshot of this amendment, when considered together with § 921(c)(4), was that the disease and disease causation elements overlapped, so if the Secretary could not rebut the presumption by proving that the miner did not have a disease "arising out of coal mine employment" (elements one and two), 30 U.S.C. § 902(b); see supra note 3, then he could only rebut disability causation by showing that the miner's impairment did not result from that disease (element four). See 30 U.S.C. § 902(b).

         Soon after these amendments took effect, however, "the number of black lung benefit claims soared, " B & G Constr. Co. v. Dir., OWCP, 662 F.3d 233, 242 (3d Cir. 2011), leading Congress to reverse course and amend the § 921(c)(4) presumption so that it would no longer apply to claims filed on or after January 1, 1982, see Black Lung Benefits Revenue Act of 1981, Pub. L. No. 97, § 202(b)(1), 95 Stat. 1635, 1643. For the next several decades, miners applying for benefits under the Act could not claim the benefit of the § 921(c)(4) presumption.

         With the Patient Protection and Affordable Care Act, however, Congress changed its mind once more and revived the § 921(c)(4) presumption for all claims filed after January 1, 2005 that were still pending on or after March 23, 2010. Pub. L. No. 111-148, § 1556(a), (c), 124 Stat. 119, 260 (2010). For the reasons explained, the party opposing benefits at this point in time could be either the Secretary or the mine operator. However, when Congress reinstated § 921(c)(4), it did not alter the original language of that provision. Thus, while the presumption would apply to any qualifying miner as against any opposing party, the statute still specified only how "the Secretary"-originally, the only opposing party-could rebut the presumed elements, and made no explicit provision for rebuttal by operators.

         The following year, the Department of Labor promulgated a regulation to fill that gap and to expound on the rebuttal standard. 20 C.F.R. § 718.305 (2013) (hereinafter "the Regulation"); see also Regulations Implementing the Byrd Amendments to the Black Lung Benefits Act: Determining Coal Miners' and Survivors' Entitlement to Benefits, 78 Fed. Reg. 59, 102, 59, 106-07 (Sept. 25, 2013).[5]The Regulation thus prescribes the means of rebuttal for any "party opposing entitlement" to benefits, encompassing both the Secretary and mine operators. 20 C.F.R. § 718.305(d)(1) (2013). And to rebut the presumed element of disability causation, the Regulation specifies that, short of disproving the presence of disease, [6] such opposing party must "[e]stablish[] that no part of the miner's respiratory or pulmonary total disability was caused by pneumoconiosis." 20 C.F.R. § 718.305(d)(1)(ii) (2013). Put another way, the opposing party must "rule out" any connection between pneumoconiosis and a miner's disability. See Kline v. Dir., OWCP, 877 F.2d 1175, 1179 (3d Cir. 1989) (describing a regulation with similar "no part" language as imposing a "rule out" standard). The validity of the Regulation and, in particular, its imposition of the rule out standard on mine operators, is the central issue on appeal.

         B. Factual and Procedural History

         Elliott worked in a coal mine for over twenty-three years, until 1993. During that time, he developed a chronic cough, and about three or four years after his retirement, he developed more acute breathing problems characterized by shortness of breath and chest pain. Elliott timely filed a claim for benefits under the BLBA in September 2012, alleging that he suffered from respiratory difficulties due to his coal mine employment. The Director of the United States Department of Labor, Office of Workers' Compensation Programs, issued a proposed Decision and Order awarding benefits on June 4, 2013. Petitioner Helen Mining conceded it was the responsible employer, but it challenged Elliott's entitlement to benefits and requested a formal hearing before an Administrative Law Judge (ALJ).

         At an April 2014 hearing before an ALJ, the parties stipulated that Elliott suffered from a totally disabling respiratory impairment. Because Helen Mining thus conceded disability and because Elliott demonstrated a term of employment greater than fifteen years, [7] the ALJ determined that § 921(c)(4) applied and that the other elements, including disability causation, would be presumed. Elliott thus was presumed totally disabled due to pneumoconiosis, and the ALJ shifted the burden to Helen Mining to rebut the other elements as permitted by the Regulation.

         As part of its effort to rebut the presumption, Helen Mining offered the opinions of Doctors Gregory Fino and Samuel Spagnolo, both of whom attributed Elliott's respiratory impairment to a diagnosis of adult-onset asthma unrelated to coal dust exposure. The ALJ did not find their testimony persuasive and concluded that Helen Mining had failed to rule out coal dust-induced pneumoconiosis as a cause of Elliott's disability ...

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