UNPUBLISHED
UNITED STATES COURT OF APPEALS
FOR THE FOURTH CIRCUIT
No. 04-1497
SEA “B” MINING COMPANY,
Petitioner,
versus
CALVIN DUNFORD; DIRECTOR, OFFICE OF WORKERS’
COMPENSATION PROGRAMS, UNITED STATES
DEPARTMENT OF LABOR,
Respondents.
____________________
JAMES PHEMISTER, Professor,
Amicus Supporting Respondent Dunford.
On Petition for Review of an Order of the Benefits Review Board.
(03-495-BLA; 02-161-BLA)
Argued: November 30, 2005 Decided: June 27, 2006
Before MICHAEL and DUNCAN, Circuit Judges, and Walter D. KELLEY,
Jr., United States District Judge for the Eastern District of
Virginia, sitting by designation.
Affirmed by unpublished per curiam opinion.
ARGUED: Timothy Ward Gresham, PENN, STUART & ESKRIDGE, Abingdon,
Virginia, for Petitioner. Matthew L. Trinidad, WASHINGTON & LEE
UNIVERSITY, School of Law, Lexington, Virginia; Jeffrey Steven
Goldberg, UNITED STATES DEPARTMENT OF LABOR, Office of the
Solicitor, Washington D.C., for Respondents. ON BRIEF: Howard M.
Radzely, Solicitor of Labor, Donald S. Shire, Associate Solicitor,
Patricia M. Nece, Counsel for Appellate Litigation, Sarah M.
Hurley, Attorney, UNITED STATES DEPARTMENT OF LABOR, Office of the
Solicitor, Washington, D.C., for Federal Respondent. James M.
Phemister, WASHINGTON & LEE UNIVERSITY, School of Law, Lexington,
Virginia, Amicus Supporting Respondent Dunford.
Unpublished opinions are not binding precedent in this circuit.
See Local Rule 36(c).
2
PER CURIAM:
After twenty-two (22) years of litigation, respondent Calvin
Dunford finally convinced an Administrative Law Judge ("ALJ") to
award him black lung benefits pursuant to the Black Lung Benefits
Act (the "Act"), 30 U.S.C. §§ 901 et seq. The Benefits Review
Board (the "Board") affirmed the award of benefits, so the company
that owns the mine in which respondent formerly worked, petitioner
Sea "B" Mining Company, now appeals to this Court. Because our
review of the record discloses that the Board's decision was based
on substantial evidence and applied the proper standards, we
affirm.
I.
Dunford concluded a 32-year career as a coal miner in February
1979. He filed his first claim for black lung benefits in August
of that year. By Decision and Order dated October 1981, ALJ
Nicodemo De Gregorio denied Dunford's claim. The Board affirmed
this denial. Dunford v. Jewell Ridge Coal Corp., No. 81-2205-BLA
(BRB Sept. 28, 1984).
A claimant may file a new petition for modification within one
year of the denial of the claimant's previous modification
petition, Betty B. Coal Co. v. Director, OWCP, 194 F.3d 491, 498
(4th Cir. 1999); see 20 C.F.R. § 725.310(a), and customary
principles of finality do not apply to claims for black lung
3
benefits, Consolidation Coal Co. v. Borda, 171 F.3d 175, 180 (4th
Cir. 1999); Jessee v. Director, OWCP, 5 F.3d 723, 725 (4th Cir.
1993). Dunford took advantage of this lenity to file in April 1985
a new claim for benefits, which was treated as a request for
modification. Almost five years later, in January 1990, ALJ John
S. Patton issued a Decision and Order denying Dunford's request for
modification. The Board and this Court affirmed ALJ Patton's
decision. See Dunford v. Jewell Ridge Coal Corp., No. 92-2071 (4th
Cir. Sept. 3, 1993) (unpublished); Dunford v. Jewell Ridge Coal
Corp., No. 90-645-BLA (BRB Jan. 28, 1992).
Dunford sought benefits again in December 1993 when he
requested modification on the basis of "new evidence of a worsening
medical condition." ALJ De Gregorio denied Dunford's modification
request in May 1996, but the Board vacated his Decision and Order
and remanded the case for further consideration. See Dunford v.
Jewell Ridge/See "B" Mining Co., No. 96-1085-BLA (BRB May 16,
1997).
On remand, Dunford's case was reassigned to ALJ Anne B.
Torkington. Like the ALJs before her, ALJ Torkington assessed
plaintiff's claims under the "interim regulations" of the Act, 20
C.F.R. §§ 727.1 through 727.405. As the claimant, Dunford bore the
initial burden of proving entitlement to an interim presumption
that he is totally disabled due to pneumoconiosis arising from his
coal mine employment. See 20 C.F.R. § 727.203(a); Lane Hollow Coal
4
Co. v. Director, OWCP, 137 F.3d 799, 803 (4th Cir. 1998). Once
Dunford established entitlement to the interim presumption, Sea "B"
bore the burden of rebuttal.1 See 20 C.F.R. § 727.203(b); Lane
Hollow Coal Co., 137 F.3d at 803. Sea "B" could rebut the interim
presumption by establishing that:
(1) the miner is doing his usual coal mine work or
comparable and gainful work;
(2) the miner is able to do his usual coal mine or
comparable work;
(3) the total disability of the miner did not arise in
whole or in part out of his coal mine employment; or
(4) the miner does not have pneumoconiosis.
20 C.F.R. § 727.203(b).
ALJ Torkington denied Dunford's claim for benefits in a
Decision and Order on Remand issued in February 1998. ALJ
Torkington found that while Dunford was entitled to the interim
presumption, Sea "B" successfully rebutted that presumption
pursuant to 20 C.F.R. § 727.203(b)(3) by proving that Dunford's
respiratory impairment and disability did not arise in whole or in
part from his coal mine employment. ALJ Torkington further found
that Dunford did not suffer from pneumoconiosis, thus rebutting the
presumption pursuant to 20 C.F.R. § 727.203(b)(4).
ALJ Torkington based her rulings on the opinions of Sea "B"'s
expert physicians: Gregory J. Endres-Bercher, M.D., Kirk E.
1
Only rebuttal pursuant to 20 C.F.R. §§ 727.203(b)(3) and
(b)(4) is at issue in the present appeal.
5
Hippensteel, M.D., J. Dale Sargent, M.D., and Gregory J. Fino, M.D.
Each employer physician opined that Dunford did not have
pneumoconiosis and that his employment in the coal mines did not
contribute to his respiratory impairment. ALJ Torkington noted
that Dr. Sargent examined Dunford on two occasions and reviewed his
past medical history. ALJ Torkington further noted that Dr. Fino
had the opportunity to review Dunford's entire medical record while
Dunford's expert physician, Corrado Ugolini, M.D., did not review
any of Dunford's pre-1988 medical records. It was during 1988 that
Dunford underwent a lobectomy to remove a cancerous portion of his
lung. ALJ Torkington found that Dunford did not show any
respiratory impairment in the time period between his departure
from coal mine employment in 1979 and his lung surgery in 1988.
Additionally, ALJ Torkington found the opinions of Dunford's
expert physicians, including Emory H. Robinette, M.D. and L. Dow
Strader, M.D., to be unpersuasive and equivocal concerning the
cause of Dunford's respiratory impairment. ALJ Torkington noted
that another of Dunford's expert physicians, Dr. V. D. Modi, had
diagnosed Dunford as suffering from disabling pneumoconiosis
"despite blood gas and pulmonary function studies with values which
exceed those set forth in the regulations indicating total
disability."
ALJ Torkington stated in her decision that Sea "B"'s expert
physicians, Drs. Fino, Sargent, Endres-Bercher, and Hippensteel,
6
had excellent qualifications and possessed considerable experience
and expertise. She found that these doctors "presented better
reasoned and documented medical opinions" than did Dunford's expert
physicians. ALJ Torkington concluded that the evidence in the
record demonstrated "a slight improvement" in Dunford's condition,
rather than a deterioration.
After the Board affirmed ALJ Torkington's Decision and Order
on Remand denying Dunford's claim for benefits, Dunford v. Jewell
Ridge/Sea "B" Mining Co., No. 98-0704-BLA (BRB Feb. 18, 1999),
Dunford filed yet another request for modification of the denial of
his claim. This time he found success. In October 2001, yet
another ALJ, Alice M. Craft, issued a Decision and Order Awarding
Benefits on Modification. In the course of ruling that Dunford was
entitled to benefits beginning in June 1987, ALJ Craft found that
ALJ Torkington made a mistake in fact2 when she found that Sea "B"
2
The ALJ's are not required to defer to each other's
decisions. The "modification procedure is extraordinarily broad,
especially insofar as it permits the correction of mistaken factual
findings." Betty B. Coal Co., 194 F.3d at 497. The ALJ has "broad
discretion to correct mistakes of fact, whether demonstrated by
wholly new evidence, cumulative evidence, or merely further
reflection on the evidence initially submitted." Jessee, 5 F.3d at
724 (quoting O'Keeffe v. Aerojet-General Shipyards, Inc., 404 U.S.
254, 256 (1971)); see also Betty B. Coal Co., 194 F.3d at 497.
The ALJ may correct any mistake of fact, including the
ultimate issue whether the claimant is eligible for benefits.
Betty B. Coal Co., 194 F.3d at 497; see Jessee, 5 F.3d at 724-25 &
n.2. "There is no need for a smoking-gun factual error, changed
conditions, or startling new evidence." Jessee, 5 F.3d at 725; see
also Borda, 171 F.3d at 181. The "claimant may simply allege that
the ultimate fact –- disability due to pneumoconiosis –- was
mistakenly decided." Jessee, 5 F.3d at 725; see also Borda, 171
7
had rebutted the interim presumption pursuant to 20 C.F.R. §§
727.203(b)(3) and (b)(4). Specifically, ALJ Craft determined that
ALJ Torkington made a mistake in fact in finding rebuttal pursuant
to 20 C.F.R. § 727.203(b)(3) because Sea "B" had failed to rule out
the causal relationship between Dunford's total disability and his
coal mine employment.
ALJ Craft also found that ALJ Torkington made a mistake in
fact by finding rebuttal under 20 C.F.R. § 727.203(b)(4) because
Sea "B" had failed to establish that Dunford did not suffer from
"legal pneumoconiosis." ALJ Craft concluded that Sea "B" did not
meet its burden of rebuttal because the opinions of Drs. Fino and
Ugolini were in "equipoise" concerning the presence of "legal
pneumoconiosis." In the alternative, ALJ Craft found that ALJ
Torkington made a mistake in fact by finding an absence of "legal
pneumoconiosis" because employer expert physician Dr. Fino's
opinion on the subject was "hostile" to the Act.
Sea "B" appealed to the Board, which affirmed ALJ Craft's
award of benefits to Dunford but vacated her finding concerning the
commencement date of that award. See Dunford v. Sea "B" Mining
Coal Co., No. 02-0161-BLA (BRB Oct. 30, 2002). On remand, ALJ
Craft determined that Dunford was entitled to benefits beginning in
August 1988. Sea "B" appealed to the Board, which affirmed ALJ
F.3d at 181.
8
Craft's Decision and Order on Remand. See Dunford v. Sea "B"
Mining Coal Co., No. 03-0495-BLA (BRB Feb. 25, 2004). Sea "B" now
appeals to this Court.
II.
It is well established that our review of the Board's Decision
and Orders is limited. See Lewis Coal Co. v. Director, OWCP, 373
F.3d 570, 575 (4th Cir. 2004). We conduct an independent review of
the record to determine whether the Board correctly found that the
ALJ's factual findings were supported by substantial evidence in
the record. Consolidation Coal Co. v. Held, 314 F.3d 184, 186 (4th
Cir. 2002); Scott v. Mason Coal Co., 289 F.3d 263, 267 (4th Cir.
2002); Island Creek Coal Co. v. Compton, 211 F.3d 203, 207 (4th
Cir. 2000). "Substantial evidence is more than a mere scintilla."
Consol. Edison Co. v. NLRB, 305 U.S. 197, 229 (1938); see also
Compton, 211 F.3d at 207-08; Piney Mountain Coal Co. v. Mays, 176
F.3d 753, 756 (4th Cir. 1999); Milburn Colliery Co. v. Hicks, 138
F.3d 524, 528 (4th Cir. 1998). Rather, it is "such relevant
evidence as a reasonable mind might accept as adequate to support
a conclusion." Consol. Edison Co., 305 U.S. at 229; see also
Scott, 289 F.3d at 267; Compton, 211 F.3d at 208; Mays, 176 F.3d at
756.
In conducting our review of the ALJ's decision for substantial
evidence, we must "uphold decisions that rest within the realm of
9
rationality." Mays, 176 F.3d at 756. We may not reweigh the
evidence, substitute our judgment for that of the ALJ, or set aside
an inference merely because we find the opposite conclusion more
reasonable or because we question the factual basis. See id.; Lane
v. Union Carbide Corp., 105 F.3d 166, 170 (4th Cir. 1997); Doss v.
Director, OWCP, 53 F.3d 654, 659 (4th Cir. 1995). We review the
ALJ's findings to determine whether the ALJ considered all relevant
evidence and sufficiently explained her rationale in crediting
certain evidence. Bill Branch Coal Corp. v. Sparks, 213 F.3d 186,
190 (4th Cir. 2000); Milburn Colliery Co., 138 F.3d at 528; see
Sterling Smokeless Coal Co. v. Akers, 131 F.3d 438, 439-40 (4th
Cir. 1997).
In particular, we must defer to the ALJ's evaluation of the
proper weight to accord conflicting medical opinions. Lane, 105
F.3d at 172; Stiltner v. Island Creek Coal Co., 86 F.3d 337, 342
(4th Cir. 1996). However, we review de novo the ALJ's and Board's
conclusions of law to determine whether they are rational and
consistent with applicable law. Milburn Colliery Co., 138 F.3d at
528; see Held, 314 F.3d at 186; Compton, 211 F.3d at 208.
III.
Sea "B" does not dispute in this appeal that Dunford
established the interim presumption pursuant to 20 C.F.R. §
727.203(a)(2) by producing ventilatory studies which established
10
the presence of a chronic respiratory or pulmonary impairment. Sea
"B" instead argues that ALJ Craft erred when she ruled that ALJ
Torkington made a "mistake in fact" in determining that Sea "B" had
successfully rebutted the interim presumption pursuant to 20 C.F.R.
§§ 727.203(b)(3) and (b)(4). Sea "B" asserts, among other things,
that ALJ Craft failed to consider all the relevant evidence in the
record and that her findings are not supported by substantial
evidence, are not rational, and are not in accordance with the
applicable law. Sea "B" further contends that ALJ Craft
incorrectly determined August 1988 to be the commencement date for
Dunford's benefits. Sea "B"'s arguments are unpersuasive.3
A. Rebuttal of the Interim Presumption
1. Rebuttal under subsection 203(b)(3)
Rebuttal of the interim presumption under 20 C.F.R. §
727.203(b)(3) is difficult. Lane Hollow Coal Co., 137 F.3d at 804;
Grigg v. Director, OWCP, 28 F.3d 416, 418 (4th Cir. 1994). To
carry its burden of rebutting the presumption, Sea "B" was required
to rule out the causal relationship between Dunford's total
disability and his coal mine employment. Borda, 171 F.3d at 184-
3
The Director, Office of Workers' Compensation Programs, has
filed a brief in support of ALJ Craft's determination that Dunford
is entitled to black lung benefits as of August 1988 and her
decision to discredit Dr. Fino's opinion concerning the absence of
legal pneumoconiosis as "hostile" to the spirit of the Act. The
Director takes no position on the merits of Dunford's claim.
11
85; Lane Hollow Coal Co., 137 F.3d at 804; Grigg, 28 F.3d at 418.
Sea "B" could have accomplished this task with evidence proving
either that Dunford "has no respiratory or pulmonary impairment of
any kind . . . or that such impairment was not caused in whole or
in part by his coal mine employment." Borda, 171 F.3d at 185.
Substantial evidence supports ALJ Craft's determination that
Sea "B" failed in this difficult task. As an initial matter, ALJ
Craft understandably could not reconcile the various conflicting
opinions of Sea "B"'s expert physicians. In November 1979,
employer expert physician Dr. Hippensteel questioned whether
Dunford suffered from coal workers' pneumoconiosis and determined
that he had only "minimal pulmonary impairment." In a June 1980
deposition, Dr. Hippensteel testified that Dunford did not suffer
from any pulmonary disability due to lung disease, regardless of
its etiology. In June 1987, employer expert physician Dr. Endres-
Bercher found no evidence of pulmonary impairment due to coal dust
exposure, cigarette smoking, or "any other etiologic factor."
Another employer expert physician, Dr. Fino, contradicted Drs.
Hippensteel's and Endres-Bercher's conclusion that Dunford had no
pulmonary impairment. In an April 1989 report, Dr. Fino diagnosed
Dunford as suffering from both a "restrictive" and an "obstructive"
respiratory impairment.4 Dr. Fino determined that Dunford's
4
A restrictive lung disease diminishes the patient's ability
to inhale air into the lungs, whereas an "obstructive" disease
diminishes the patient's ability to expel air from the lungs. Gulf
12
restrictive impairment was caused by Dunford's lobectomy and not by
exposure to coal dust.5 Dr. Fino concluded that Dunford's "mild
obstructive ventilatory defect" was not related to industrial
bronchitis or coal dust inhalation because those conditions result
in "irreversible" airway obstruction, whereas Dunford's condition
showed signs of reversibility. While Dr. Fino was unsure whether
Dunford's obstructive impairment was related to his prior history
of smoking cigarettes, he concluded that Dunford's obstructive
impairment "may very well be related to the development of asthma,"
which results in a reversible airway obstruction.
A fourth employer expert physician also contradicted Drs.
Hippensteel's and Endres-Bercher's conclusion that Dunford had no
pulmonary impairment. In a May 1989 medical report, employer
expert physician Dr. Sargent diagnosed Dunford as suffering from a
"moderate" ventilatory impairment, but attributed it to Dunford's
previous lung surgery and not the result of coal dust exposure. In
October 1994, Dr. Sargent concluded that Dunford now suffered from
"very minimal, if any," respiratory impairment, which he attributed
& W. Indus. v. Ling, 176 F.3d 226, 229 n.6 (4th Cir. 1999). An
obstructive impairment can be caused by coal mine employment. See
20 C.F.R. § 718.201(a)(2); Stiltner, 86 F.3d at 341; Warth v. S.
Ohio Coal Co., 60 F.3d 173, 174-75 (4th Cir. 1995).
5
In September 1988, a lobe of Dunford's right lung was removed
as part of his treatment for lung cancer (adenocarcinoma). Dr.
Sargent, Dr. Fino, and James R. Castle, M.D., opined that there is
no evidence linking lung cancer to coal dust exposure. Dunford
does not challenge their opinions concerning the lack of such a
causal link.
13
to Dunford's prior lung surgery. In a May 1995 deposition, Dr.
Sargent testified that Dunford suffered from a "mild resting
hypoxemia" respiratory impairment that resulted from Dunford's
lobectomy.
In a June 2000 medical report, employer expert physician Dr.
Castle stated that there was no evidence that Dunford suffered from
a restrictive respiratory impairment. However, Dr. Castle did
diagnose Dunford as suffering from an "obstructive" respiratory
impairment. Specifically, Dr. Castle opined that "Dunford may be
permanently and totally disabled as a result of his mild, partially
reversible airway obstruction." Dr. Castle determined that
Dunford's obstructive impairment was most likely related to his
asthmatic bronchitis and "contributed to somewhat" by his prior
history of smoking.6
In deposition testimony, Dr. Castle described Dunford's
obstructive respiratory impairment as "a mild significantly
reversible respiratory impairment that is related to his previous
tobacco smoking history and asthmatic bronchitis." Dr. Castle
concluded that Dunford's obstructive impairment was not related to
his coal dust exposure.
6
The various medical reports indicate that Dunford smoked
approximately one pack of cigarettes per day for about 20 years.
Dunford ceased smoking in 1962, 15 years before he quit working in
the coal mines.
14
ALJ Craft discredited Dr. Castle's attribution of Dunford's
cigarette smoking history as a partial cause of his obstructive
respiratory impairment. ALJ Craft explained that she had
"difficulty accepting" Dr. Castle's explanation concerning the
causation of the obstructive impairment because Dunford had ceased
smoking tobacco 15 years before he quit his coal mine employment
and removed himself from the accompanying exposure to coal dust.
Because Sea "B" was unable to explain fully the cause of Dunford's
obstructive impairment, ALJ Craft appropriately concluded that Sea
"B" had failed to rule out the causal relationship between
Dunford's total disability and his coal mine employment.
ALJ Craft's conclusion is supported by the 1995 medical report
of Dunford's expert physician, Dr. Ugolini. In his report, Dr.
Ugolini noted that "the National Institute for Occupational Safety
and Health (NIOSH) is of the opinion, based on available scientific
data, that coal mine dust causes obstructive lung disease,
bronchitis with or without significant obstruction, and
emphysema."7 Dr. Ugolini opined that the "notion that coal dust
produces only the classic restrictive pattern of lung disease is
now obsolete, in light of the current epidemiological research."
Dr. Ugolini stated that "[c]umulative coal dust exposure" in the
amount suggested by Dunford's employment history is "well known to
7
Dunford had been diagnosed as suffering from, among other
things, chronic obstructive pulmonary disease, emphysema, and
asthmatic bronchitis.
15
cause pulmonary impairment similar to the one found in Mr.
Dunford." Dr. Ugolini concluded that while Dunford's "remote"
smoking history was the "only other exposure" that could possibly
have contributed to Dunford's obstructive lung disease, it was his
opinion to a reasonable degree of medical certainty that Dunford's
exposure to coal dust "significantly contributed" to Dunford's
obstructive impairment, chronic bronchitis, and emphysema.
Dr. Ugolini's report and the internally contradictory opinions
of Sea "B"'s experts provide substantial evidence to support ALJ
Craft's determination that Sea "B" did not rebut the interim
presumption under 20 C.F.R. § 727.203(b)(3) because it could not
show that Dunford had no respiratory or pulmonary impairment of any
kind or that such impairment was not caused in whole or in part by
his coal mine employment. See Borda, 171 F.3d at 185.
2. Rebuttal under subsection 203(b)(4)
Substantial evidence also supports ALJ Craft's determination
that Sea "B" failed to rebut the interim presumption under 20
C.F.R. § 727.203(b)(4) by showing an absence of "legal
pneumoconiosis."8 ALJ Craft considered the conflicting opinions of
8
The Act defines "pneumoconiosis" as "a chronic dust disease
of the lung and its sequelae, including respiratory and pulmonary
impairments, arising out of coal mine employment. This definition
includes both medical, or 'clinical', pneumoconiosis and statutory,
or 'legal', pneumoconiosis." 20 C.F.R. § 718.201(a). The Act
defines "legal pneumoconiosis" as "any chronic lung disease or
impairment and its sequelae arising out of coal mine employment.
16
Drs. Fino and Ugolini, both of whom addressed the issue of whether
Dunford suffered from "legal pneumoconiosis." ALJ Craft examined
the physicians' curriculum vitae and found that employer expert
physician Dr. Fino's credentials did not entitle his opinions to
any greater weight than those of Dunford's expert physician, Dr.
Ugolini. ALJ Craft noted that the research publications of Dr.
Fino did not appear to concern pneumoconiosis whereas Dr. Ugolini
was associated with NIOSH when that organization conducted studies
concerning the relationship between chronic lung disease and coal
dust exposure. Because ALJ Craft found the physicians' opinions to
be "equally documented with reference to pertinent studies," she
concluded that their opinions were, at best, in "equipoise." ALJ
Craft thus properly determined that Sea "B" had failed to carry its
burden of rebutting the interim presumption pursuant to 20 C.F.R.
§ 727.203(b)(4).
In the alternative, ALJ Craft discredited certain of Dr.
Fino's opinions that she determined to be "hostile" to the Act. An
ALJ may properly discount an expert physician's opinion as
"hostile" to the Act when the opinion is based on a premise that is
This definition includes, but is not limited to, any chronic
restrictive or obstructive pulmonary disease arising out of coal
mine employment." 20 C.F.R. § 718.201(a)(2). The term "legal
pneumoconiosis" is broader than "medical" or "clinical"
pneumoconiosis because it "also encompasses 'diseases whose
etiology is not the inhalation of coal dust, but whose respiratory
and pulmonary symptomatology have nonetheless been made worse by
coal dust exposure.'" Lewis Coal Co., 373 F.3d at 577 (quoting
Clinchfield Coal Co. v. Fuller, 180 F.3d 622, 625 (4th Cir. 1999)).
17
fundamentally at odds with the statutory and regulatory scheme.
See Lewis Coal Co., 373 F.3d at 580; Mays, 176 F.3d at 760 n.7;
Lane, 105 F.3d at 173; Warth v. S. Ohio Coal Co., 60 F.3d 173, 174
n.* (4th Cir. 1995); Thorn v. Itmann Coal Co., 3 F.3d 713, 719 (4th
Cir. 1993). Dr. Fino's opinion that Dunford does not suffer from
legal pneumoconiosis was based on two premises that are hostile to
the Act.
First, Dr. Fino concluded in a June 1995 medical report that
Dunford's obstructive impairment could not be attributed to coal
dust inhalation because he did not have any ventilatory impairment
when he left his employment in the mines in 1979. Dr. Fino stated
that "[i]f a miner has no functional impairment due to coal mine
dust inhalation at the time he leaves the mines, then that worker
will not develop a functional impairment due to coal workers'
pneumoconiosis in the absence of further coal mine dust exposure."
This premise directly conflicts with the Act's premise that coal
workers' pneumoconiosis is a "latent and progressive disease which
may first become detectable only after the cessation of coal mine
dust exposure." 20 C.F.R. § 718.201(c).
Second, Dr. Fino opined that "obstruction is not a clinically
significant abnormality arising out of the inhalation of coal mine
dust." Dr. Fino further stated, "[c]ertainly the epidemiologic
data that is available at this time, and all of the epidemiologic
research, has not documented a disabling respiratory abnormality of
18
an obstructive nature arising out of coal mine dust exposure." Dr.
Fino thus concluded that Dunford's obstructive impairment could not
have been caused by his coal mine employment. This conclusion,
however, conflicts with the Act's premise that an obstructive
impairment can be caused by coal mine employment. See 20 C.F.R. §
718.201(a)(2); Stiltner, 86 F.3d at 341; Warth, 60 F.3d at 174-75.
Because ALJ Craft properly found these two opinions to be
hostile to the Act, she appropriately discredited Dr. Fino's
opinion in her determination whether Sea "B" had proved that
Dunford does not suffer from legal pneumoconiosis.
B. Reversibility of Pneumoconiosis
Contrary to Sea "B"'s arguments, ALJ Craft properly considered
the evidence of reversibility in the record. Employer expert
physician Dr. Castle described Dunford's obstructive impairment as
only "partially reversible" in his medical report. Thus, Dunford's
obstructive impairment was partially irreversible. As previously
noted, ALJ Craft permissibly rejected Dr. Castle's opinion that
Dunford's prior smoking history was a contributing cause of the
obstructive impairment. Accordingly, the evidence in the record
supports ALJ Craft's conclusion that Sea "B" failed to rule out
Dunford's coal mine employment as a contributing cause of Dunford's
partially irreversible obstructive impairment.
19
Further, ALJ Craft fully considered the results of Dunford's
pulmonary function studies, which revealed indications of
reversibility.9 ALJ Craft noted that Dunford achieved qualifying
scores in the pulmonary function studies administered between
August 1988 and January 1999.10 ALJ Craft further noted that
Dunford's FEV1 scores improved after the administration of
bronchodilators.11 While this improvement suggests some
reversibility of Dunford's impairment, Dunford still received
qualifying FEV1 scores both before and after the administration of
the bronchodilators.12 Two minor exceptions to the qualifying
9
A pulmonary function study measures the obstruction in the
airways of the patient's lungs and the degree of pulmonary function
impairment. The greater the resistance to airflow, the greater the
degree of the patient's lung impairment. Pulmonary function tests
include forced expiratory volume in one second (FEV1) and maximum
voluntary ventilation (MVV). FEV1 measures the amount of air a
patient can exhale in one second using maximum effort, and is
expressed in terms of liters per second. MVV measures the maximum
volume of air that can be moved by the patient's respiratory
apparatus in one minute, and is expressed in terms of liters per
minute. In order to invoke the interim presumption pursuant to 20
C.F.R. § 727.203(a)(2), a claimant of Dunford's age and height must
have a "qualifying" FEV1 score of 2.70 or less and a "qualifying"
MVV score of less than or equal to 108.
10
Dunford's March 1996 pulmonary function study cannot be
considered as qualifying for the interim presumption because no MVV
was recorded.
11
A bronchodilator is a medication that relaxes the bronchial
muscles and thus expands the air passages of the bronchi.
12
While Dunford achieved a qualifying score before the
administration of bronchodilator medication in the January 1994
pulmonary function study, no post-bronchodilator results were
obtained.
20
scores occurred in August 1988 and October 1994, when Dunford
achieved post-bronchodilator scores of 2.76 and 2.77, respectively.
ALJ Craft rationally disregarded these two scores because they were
close to the qualifying FEV1 score of 2.70.
ALJ Craft found that the opinions of most of the physicians
who had diagnosed Dunford as suffering from a coal dust related
disease supported the conclusion that Dunford's pre-bronchodilator
FEV1 scores accurately reflected his capacity to perform in his
coal mine employment. ALJ Craft further found Dunford's pulmonary
function studies to be "consistently qualifying, with the rare and
close exceptions described above." Accordingly, substantial
evidence supports ALJ Craft's conclusion that the evidence in the
record failed to rule out coal mine employment as a cause of
Dunford's total disability.
C. Start Date for Benefits
Substantial evidence also supports ALJ Craft's determination
pursuant to 20 C.F.R. § 725.503(b) that Dunford was entitled to
benefits beginning in August 1988.13 She selected this date because
13
That regulation provides, in relevant part:
Benefits are payable to a miner who is entitled beginning
with the month of onset of total disability due to
pneumoconiosis arising out of coal mine employment.
Where the evidence does not establish the month of onset,
benefits shall be payable to such miner beginning with
the month during which the claim was filed.
21
it was the month of onset of his total disability due to
pneumoconiosis. See 20 C.F.R. § 725.503(b). ALJ Craft found that
all of Dunford's pulmonary function test results since that time,
with the exception of the two "rare and close" post-bronchodilator
FEV1 scores described above, qualified Dunford for the rebuttable
presumption, which Sea "B" had failed to rebut.
Further, ALJ Craft found that the "opinions of most of the
physicians who diagnosed coal dust related disease support the
conclusion that the pre-bronchodilator values accurately reflected
Mr. Dunford's capacity to perform coal mine work." For example, in
March 1987, a full year and one-half prior to Dunford's September
1988 surgery for lung cancer, one of Dunford's expert physicians,
Dr. Modi, examined Dunford and diagnosed him as suffering from an
"interstitial pulmonary fibrosis secondary to exposure to coal
dust." Dr. Modi concluded that Dunford was "totally impaired and
disabled due to coal dust inhalation."
Similarly, in February 1989, Dunford's expert physician Dr.
Robinette examined Dunford and diagnosed him as having "an
obstructive airway disorder." Dr. Robinette stated that while
Dunford's condition "shows partial reversibility," he anticipated
it to be a "chronic and irreversible" condition.
Dunford's expert physician Dr. Strader examined him in August
1993 and determined that he suffered from pneumoconiosis. Dr.
20 C.F.R. § 725.503(b).
22
Strader concluded that Dunford's condition "probably" arose from
his coal mine employment and that Dunford was "probably disabled
from doing coal mine work." In a May 1995 medical report,
Dunford's expert physician Dr. Ugolini also concluded that Dunford
suffered from coal workers' pneumoconiosis.
After considering the medical opinions of Drs. Modi, Strader,
Robinette, and Ugolini in conjunction with Dunford's pulmonary
function test results, ALJ Craft concluded that "the record
establishes that Mr. Dunford was totally disabled due to
pneumoconiosis by the month of August 1988, when his pulmonary
function tests first resulted in qualifying values." This
determination was rational, supported by substantial evidence, and
in accordance with the applicable law.
IV.
After considering the joint appendix, the briefs, and the
arguments of counsel, we find no reversible error. We hold that
ALJ Craft appropriately considered all the relevant evidence and
that her award of benefits to Dunford on modification and her
determination of the onset date of that award are supported by
substantial evidence, rational, and in accordance with the law. We
therefore affirm the Board's Decision and Orders affirming the
23
award of benefits to Dunford. Sea "B"'s petition for review is
denied.
AFFIRMED
24