Coal miner's 2nd claim for benefits justified by material change in condition

In the 7th Circuit, where a miner's black lung benefits claim was denied in an initial application, he can still receive benefits if he can demonstrate a material change in one of the conditions in a subsequent application.

Case name: RAG American Coal Co. v. Office of Workers' Compensation Programs and Buchanan, No. 08-1653 (7th Cir. 08/05/09).

Ruling: The 7th U.S. Circuit Court of Appeal affirmed an award of benefits, finding the miner demonstrated he had a substantial lung problems that had materially changed from the time he filed his first petition for benefits and were attributable to his exposure to coal dust.

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What it means: In the 7th Circuit, where a miner's black lung benefits claim was denied in an initial application, he can still receive benefits if he can demonstrate a material change in one of the conditions in a subsequent application.

Summary: A miner filed an application for black lung benefits. The claim was denied based on a finding that the miner stopped working because of his back condition and cigarette smoking and not a work-related lung disease. He filed a second application approximately five years later, and his employer argued the miner was not totally disabled by lung disease. The miner was awarded benefits based on a finding that his condition had substantially worsened since the first application. The 7th Circuit affirmed the benefits award. It noted that the award was granted based on medical testimony establishing the existence of a serious lung impairment. The court upheld the finding that the miner's pulmonary condition had progressively and substantially worsened over the last four to five years from the time the first application was filed.

The employer argued the miner could not file a second identical claim, as the claim was already denied and thus barred from relitigation. The 7th Circuit rejected the argument, reasoning that because the first denial was based on a finding that there was no lung disease present and the miner was not total disabled, the miner could avoid the automatic denial by showing a material change in either claim. The court noted the treating doctor's testimony established the existence of lung disease and a decline in his pulmonary health to the point that he was totally disabled. This established a material change from the first application's denial sufficient to allow the subsequent claim and entitle the miner to benefits.

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September 25, 2009

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