Nora Collins v. Pond Creek Mining Company ( 2014 )


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  •                                 PUBLISHED
    UNITED STATES COURT OF APPEALS
    FOR THE FOURTH CIRCUIT
    No. 13-1702
    NORA COLLINS, widow of Johnnie Collins,
    Petitioner,
    v.
    POND CREEK MINING COMPANY; DIRECTOR, OFFICE OF WORKERS'
    COMPENSATION PROGRAMS, UNITED STATES DEPARTMENT OF LABOR,
    Respondents.
    On Petition for Review of an Order of the Benefits Review Board.
    (12-0230 BLA)
    Argued:   March 20, 2014                     Decided:   May 1, 2014
    Before WILKINSON, KING, and FLOYD, Circuit Judges.
    Reversed and remanded by published opinion.      Judge Wilkinson
    wrote the opinion, in which Judge King and Judge Floyd joined.
    ARGUED: Leonard Joseph Stayton, Inez, Kentucky, for Petitioner.
    Rita Ann Roppolo, UNITED STATES DEPARTMENT OF LABOR, Washington,
    D.C., for Respondent Director, Office of Workers' Compensation
    Programs, United States Department of Labor. Kathy Lynn Snyder,
    JACKSON KELLY, PLLC, Morgantown, West Virginia, for Respondent
    Pond Creek Mining Company.       ON BRIEF: M. Patricia Smith,
    Solicitor of Labor, Rae Ellen Frank James, Associate Solicitor,
    Gary K. Stearman, Counsel for Appellate Litigation, Office of
    the Solicitor, UNITED STATES DEPARTMENT OF LABOR, Washington,
    D.C., for Respondent Director, Office of Workers' Compensation
    Programs, United States Department of Labor.
    WILKINSON, Circuit Judge:
    This case is the latest chapter in a long-running dispute
    between    Nora    Collins   (“Mrs.        Collins”)      and   Pond       Creek   Mining
    Company     (“Pond      Creek”)    regarding        her    claim       to    survivor’s
    benefits under the Black Lung Benefits Act, 30 U.S.C. §§ 901-945
    (the “Act”). Mrs. Collins petitions for review of an April 2013
    decision    of    the   Benefits        Review   Board    (“BRB”)      affirming      the
    denial of benefits by an Administrative Law Judge (“ALJ”). She
    challenges the ALJ’s ruling that she failed to prove that her
    husband’s       pneumoconiosis     hastened      his     death.      For    the    reasons
    that follow, we reverse the BRB’s decision and remand for an
    award of benefits.
    I.
    A.
    Johnnie Collins (“Mr. Collins”) worked in various mining-
    industry jobs for more than thirty-six years between 1943 and
    1983, including at Pond Creek for the last eleven. He was also a
    regular smoker during this time, though he later quit. When he
    stopped working for Pond Creek in 1983, Mr. Collins filed a
    claim for lifetime benefits under the Act.
    Five    years      later,    ALJ    Lawrence      ruled    in    his    favor.   See
    Collins v. Pond Creek Coal Co., No. 85-BLA-5349 (Feb. 25, 1988).
    Under     the     Act’s    implementing          regulations,          a     miner    has
    2
    pneumoconiosis if he meets one of two conditions. He must either
    have   “clinical           pneumoconiosis”           (a    particular       set    of    diseases
    recognized by the medical community) or “legal pneumoconiosis”
    (a   broader        category        that   includes            any   chronic      lung    disease
    arising out of coal mine employment). See 20 C.F.R.
    § 718.201(a); Barber v. Director, OWCP, 
    43 F.3d 899
    , 901 (4th
    Cir. 1995). The ALJ determined that although the x-rays did not
    show Mr. Collins to have clinical pneumoconiosis, the miner did
    have     a        chronic      respiratory            condition         known      as     Chronic
    Obstructive             Pulmonary    Disease         (“COPD”).         Moreover,        the     best
    evidence          indicated       that     his    work         in    the    coal      mines     had
    contributed to this condition. As a result, he was afflicted
    with pneumoconiosis for purposes of the Act. Determining that
    the pneumoconiosis had totally disabled Mr. Collins, the ALJ
    ruled him entitled to benefits. Pond Creek did not appeal, and
    the mining company provided Mr. Collins the required payments
    until his death in 1997.
    Shortly after Mr. Collins died, Mrs. Collins applied for
    survivor’s          benefits      pursuant       to       30   U.S.C.      § 922(a)(2).         Pond
    Creek opposed an award to the widow and asked for a hearing
    before       an    ALJ.     ALJ   Morgan     ruled        in    2001    that    the      1988    ALJ
    Decision was not entitled to collateral estoppel on the issue of
    whether           Mr.     Collins        suffered         from       pneumoconiosis.            Upon
    reweighing the evidence, he concluded that Mr. Collins did not
    3
    suffer     from      pneumoconiosis.                 After     several        additional
    administrative rulings, Mrs. Collins petitioned this court for
    review.
    We vacated the ALJ’s denial of benefits. See Collins v.
    Pond Creek Mining Co., 
    468 F.3d 213
    (4th Cir. 2006). We held
    that the doctrine of collateral estoppel did indeed apply to the
    holding of the 1988 ALJ Decision that Mr. Collins suffered from
    pneumoconiosis      due     to    coal        dust    exposure.      Furthermore,      we
    rejected ALJ Morgan’s alternate holding, affirmed by the BRB,
    that even if Mr. Collins had suffered from pneumoconiosis, Mrs.
    Collins had failed to establish that Mr. Collins’s death was due
    to the disease. See 
    Collins, 468 F.3d at 223-24
    . We remanded for
    further proceedings to determine if pneumoconiosis contributed
    to Mr. Collins’s death.
    In the nearly eight years since our decision, this matter
    has continued to bounce back and forth in the administrative
    process.   There     have    been          three     different      decisions    by   two
    different ALJs and three decisions by the BRB. Most recently,
    ALJ   Lesniak     determined          in   2012      that    Mrs.   Collins     was   not
    entitled to survivor’s benefits. He found that the physicians’
    opinions   relied    upon        by    Mrs.       Collins    were    not   sufficiently
    reasoned or documented to support a finding that Mr. Collins’s
    pneumoconiosis      caused       his       death.     The    ALJ    also   refused    to
    consider   as   supportive        of       Mrs.    Collins    the    opinions    of   two
    4
    doctors for Pond Creek who found that Mr. Collins’s death was in
    fact   hastened      by   COPD,    although          they   believed      the   COPD   was
    caused by smoking, not pneumoconiosis. The BRB affirmed this
    ruling in 2013, echoing the analysis advanced by the ALJ. Mrs.
    Collins has petitioned this court for review.
    B.
    The arguments of the parties center on the proper weight to
    be accorded the various medical opinions in the case. A brief
    review of these opinions is thus necessary.
    Dr.    Maan      Younes,        a     board     certified       internist       and
    pulmonologist, was Mr. Collins’s treating physician for the last
    three years of his life. During that period, Dr. Younes often
    stated in his treatment notes that Mr. Collins suffered from
    COPD   and    pneumoconiosis.          In    Mr.   Collins’s      death    certificate,
    completed less than a week after he died, Dr. Younes stated that
    his    patient    had     died    of       “cardiac    arrest”     due    to    or   as   a
    consequence of “respiratory failure,” and that “coal workers’
    pneumoconiosis” had contributed to the death. J.A. at 194.
    Expanding on the earlier form less than two months later,
    Dr. Younes explained in a letter to the Department of Labor that
    Mr. Collins had severe coal workers’ pneumoconiosis and COPD
    when he died, requiring hospitalization once or twice a month.
    He died at home, one day after he insisted on being released
    from    the      hospital        after       his      condition     had     temporarily
    5
    stabilized.      Dr.     Younes    added       that         “Mr.    Collins         had     Severe
    Respiratory Disability from his Coal Workers’ Pneumoconiosis and
    there is no question that his severe Pneumoconiosis is a major
    contributing factor to his death.” J.A. at 162. Dr. Younes then
    stated the evidence for pneumoconiosis: Mr. Collins’s decades of
    work in the coal mines, the content of his chest x-rays, and his
    severe pulmonary disease.           Hospital records from just nine days
    before    Mr.    Collins’s      death     noted         the       severity      of     his       lung
    condition,       described         his         history             of        coal         workers’
    pneumoconiosis,        and    recommended          that       doctors         not     administer
    aggressive      cardiac      treatment     because           of    the       severity       of   his
    pulmonary problems.
    Following      Mr.      Collins’s        death,        the    Department          of    Labor
    asked    Dr.    Dominic      Gaziano,     a       board      certified         internist         and
    pulmonologist,      to    review    the       miner’s        file       in    early    1998      and
    answer a questionnaire regarding the circumstances of his death.
    He filled out the form provided to him, indicating that although
    the miner did not die from pneumoconiosis, he was disabled by it
    and that the disease played a role in Mr. Collins’s death.                                       Dr.
    Gaziano further stated in the comments section of the form that
    Mr. Collins “died as a result of cardio-pulmonary failure in a
    background of severe heart and lung diseases. I believe C.W.P.
    [coal    workers’      pneumoconiosis]            was   a    significant            contributing
    factor in his death.” J.A. at 195.
    6
    For its part, Pond Creek asked seven medical experts to
    examine Mr. Collins’s medical records. Each of the seven doctors
    found that Mr. Collins did not have pneumoconiosis. Six of the
    seven reported that Mr. Collins had severe pulmonary disease due
    to    smoking,      with     at   least    five    of    those    doctors     explicitly
    classifying the pulmonary disease as COPD. Four of the doctors -
    - Dr. Gregory Fino, Dr. George Zaldivar, Dr. A. Dahhan, and Dr.
    Samuel   Spagnolo       –-    stated      that    the    death   was   due    purely    to
    cardiac causes.
    Representative of the opinions is that of Dr. Fino, a board
    certified internist and pulmonologist. Dr. Fino reported that
    Mr. Collins’s x-rays did not show signs of pneumoconiosis, and
    that his totally-disabling COPD was caused by cigarette smoking,
    not his work in the mines. Dr. Fino further argued that Mr.
    Collins’s death was due to heart disease, and that even if he
    had been afflicted with pneumoconiosis, the lung disease would
    not    have       exacerbated     the     particular       cardiac     condition     that
    caused      the     death.    Dr.   Fino     thus       found    not   only   that     Mr.
    Collins’s COPD was unrelated to coal dust exposure, but also
    that the COPD did not hasten his death.
    Of particular note were the opinions of Dr. Thomas Jarboe
    and   Dr.     W.K.C.    Morgan,     both    of    whom    Pond    Creek     enlisted    to
    evaluate Mr. Collins’s file. Dr. Jarboe stated that Mr. Collins
    was totally disabled by COPD, though the COPD was caused by
    7
    smoking and not exposure to coal mine dust. He then concluded
    that Mr. Collins died from a “combination” of his COPD and his
    cardiac disease. Dr. Morgan also stated that Mr. Collins’s COPD
    was due to smoking. He believed that the miner’s death was due
    to a heart arrhythmia, and that the arrhythmia was exacerbated
    by an oxygen deficiency known as hypoxemia, which was caused by
    COPD.   Both     doctors       thus    agreed          that    Mr.   Collins’s      COPD
    contributed to his death.
    II.
    Under the Act, we evaluate whether an ALJ’s decision that
    has   been   affirmed     by    the    BRB       was    supported      by    substantial
    evidence and in accordance with the law. See Collins v. Pond
    Creek   Mining     Co.,    
    468 F.3d 213
    ,    217    (4th        Cir.   2006).
    “Substantial evidence consists of sufficient relevant evidence
    to convince a reasonable mind that the evidence is adequate to
    support a conclusion.” Scott v. Mason Coal Co., 
    289 F.3d 263
    ,
    267 (4th Cir. 2002). We review the ALJ’s and BRB’s conclusions
    of law de novo. 
    Id. In order
    for Mrs. Collins to prevail under the Act, she
    must show that (1) she was the surviving spouse of a miner who
    suffered from pneumoconiosis, (2) the miner’s pneumoconiosis was
    due at least in part to coal mining employment, and (3) the
    miner’s death was due to pneumoconiosis. See U.S. Steel Mining
    8
    Co. v. Director, OWCP, 
    187 F.3d 384
    , 388 (4th Cir. 1999) (citing
    relevant regulations). Our previous decision in this case held
    that the miner had pneumoconiosis due at least in part to his
    exposure to coal dust. See 
    Collins, 468 F.3d at 223
    . The parties
    thus agree that the sole issue before this court is the last of
    the three prongs: whether Mr. Collins’s pneumoconiosis caused
    his death. A coal miner’s death is “due to” pneumoconiosis if
    the    disease      was   a    “substantially        contributing       cause”       of    the
    death. See Bill Branch Coal Corp. v. Sparks, 
    213 F.3d 186
    , 190
    (4th    Cir.    2000)      (quoting     20    C.F.R.      §   718.205).      Moreover,       a
    claimant can prove causation by establishing that pneumoconiosis
    “actually hastened the miner’s death.” 
    Id. (quoting Shuff
    v.
    Cedar Coal Co., 
    967 F.2d 977
    , 979-80 (4th Cir.1992)).
    Pond    Creek      argues    that     the    ALJ   correctly     held    that       the
    opinions       of   Dr.    Younes     and    Dr.     Gaziano    were       neither    well-
    reasoned nor well-documented. As a result, those opinions could
    not support a finding that Mr. Collins’s pneumoconiosis hastened
    his death. Furthermore, the mining company argues, the ALJ was
    also correct in refusing to credit the opinions of Dr. Jarboe
    and Dr. Morgan as supportive of Mrs. Collins’s claim. Because
    these    experts       found     that   Mr.        Collins    did    not     suffer       from
    pneumoconiosis, but instead suffered from COPD due to cigarette
    smoking, their views could not provide support for a finding
    that    Mr.     Collins’s       pneumoconiosis            hastened     his     death.      We
    9
    disagree      with    Pond      Creek   and    find    that    the   ALJ’s     decision
    misapplied our case law and was not supported by substantial
    evidence.
    Our previous decision in this dispute drives our present
    holding. There, we singled out two critical considerations for
    an ALJ when evaluating medical evidence. First, we emphasized
    the   importance       of    the   miner’s      treating      physician’s      opinion,
    noting       that,    in    a    similar      case,    “[w]e    were      particularly
    concerned with the ALJ’s wholesale rejection of the diagnosing
    physician’s causation opinion and corresponding overreliance on
    the   non-diagnosing         physicians’       contrary    views.”     
    Collins, 468 F.3d at 224
    ; see also 20 C.F.R. § 718.104(d) (instructing ALJs
    to    give    added    consideration       to    the   opinions      of    a   treating
    physician, and in particular to focus on the nature and duration
    of the doctor-patient relationship and the frequency and extent
    of treatment).
    Second, we noted that “even a poorly documented” causation
    opinion that properly diagnoses pneumoconiosis should carry more
    weight than those opinions that have denied the presence of the
    disease. 
    Collins, 468 F.3d at 224
    (quoting 
    Scott, 289 F.3d at 270
    ). For instance, in Toler v. Eastern Associated Coal Co., 
    43 F.3d 109
    (4th Cir. 1995), we stated:
    [A]n ALJ who has found (or has assumed arguendo) that
    a claimant suffers from pneumoconiosis and has total
    pulmonary disability may not credit a medical opinion
    10
    that the former did not cause the latter unless the
    ALJ can and does identify specific and persuasive
    reasons for concluding that the doctor's judgment on
    the question of disability causation does not rest
    upon her disagreement with the ALJ's finding as to
    either or both of the predicates in the causal chain.
    
    Id. at 116.
    Toler further advises that the opinions of those
    doctors who did not properly diagnose pneumoconiosis can carry,
    at most, “little weight.” 
    Id. Notwithstanding Toler,
    the ALJ found that he could not give
    any    weight    to    the     opinions      of       Dr.    Younes      or    Dr.   Gaziano,
    believing himself constrained by our decision in Sparks, 
    213 F.3d 186
    .    In    that     case,       we    found      a    doctor’s       explanation
    insufficient where he had merely written on a death certificate
    “[c]oal workers pneumoconiosis, simple” in the blank asking for
    “[o]ther       significant      conditions            contributing        to    death,”     and
    noted        without     explanation             on     an       autopsy       report       that
    pneumoconiosis was present at the time of death. 
    Id. at 192.
    We
    found that the doctor “provided no explanation of how, or if,
    Mr. Sparks’s pneumoconiosis hastened his death.” 
    Id. Absent any
    treatment records or justification, the doctor simply provided
    an    “insufficient,”         “bald    conclusion”           devoid      of    the   necessary
    reasoning. 
    Id. The ALJ
        described       the   opinions         of    Dr.     Younes     and   Dr.
    Gaziano as “similarly conclusory,” J.A. at 777, but such a view
    ignores the significant differences between the explanation and
    11
    documentation in Sparks and in this case. Here, Mr. Collins had
    been found to be totally disabled by pneumoconiosis nearly ten
    years before his death, and had been in and out of the hospital
    regularly due to his severe COPD in the years prior to his
    death. His treating physician Dr. Younes had compiled copious
    treatment   notes    during      the   three      years    he    was    Mr.   Collins’s
    doctor, which show both the seriousness of the miner’s pulmonary
    condition and the toll it had taken on his body. In his letter
    to the Department of Labor, Dr. Younes laid out the details of
    Mr.   Collins’s     final     weeks         and   months,        demonstrating        his
    intricate   understanding        of    his    patient’s         worsening     state    of
    health. Meanwhile, Dr. Gaziano stated that his opinion was based
    on a review of the case file, which at the time included Mr.
    Collins’s treatment history, death certificate, and additional
    hospital records.
    Unlike in Sparks, where a doctor with no significant ties
    to    the   patient       decreed      in     a    few     cryptic          words    that
    pneumoconiosis      had   been    a    contributing        cause       of   death,    Dr.
    Younes’s    explanatory     letter      relied      upon    a    lengthy      treatment
    history and his first-hand observations of the damage the coal-
    dust-triggered pulmonary disability inflicted upon his patient.
    The ALJ was mistaken to equate these two fundamentally different
    situations so as to find that Sparks applied.
    12
    Unconstrained      by        the     mistaken    analogy        to   Sparks,      an
    evaluation of the opinions of Dr. Younes and Dr. Gaziano shows
    that    they    provide      sufficient           evidence    that      Mr.     Collins’s
    pneumoconiosis hastened his death. It is true that Dr. Gaziano
    could have explained in more detail the exact manner in which
    Mr. Collins’s pneumoconiosis contributed to his respiratory and
    cardiac failure. But the opinions, and certainly that of Dr.
    Younes,      were   not   poorly          documented.    Whatever       their     alleged
    deficiencies, our decisions in Collins and Scott counsel that
    the physicians’ explanations were adequate and entitled to more
    weight than those physicians for Pond Creek who mistakenly found
    no presence of the disease at all. Indeed, as the Director has
    noted, if the opinions were insufficient as a matter of law to
    prove death causation, as the ALJ claimed, there would have been
    no reason for us to remand this case for a finding of death
    causation in our 2006 decision. See Br. of Director, Office of
    Workers’     Compensation       Programs,         at   25-26.    The    ALJ     erred    in
    according      no   weight     to    the     opinions    of     Dr.    Younes    and    Dr.
    Gaziano.
    Furthermore, we note that Dr. Younes and Dr. Gaziano were
    not    the   only    doctors        whose    opinions    provide       support     for    a
    finding that Mr. Collins’s COPD hastened his death. Dr. Jarboe
    and Dr. Morgan also both explained the connection between Mr.
    Collins’s COPD and his death. Dr. Jarboe stated that the miner
    13
    died due to a combination of severe respiratory problems brought
    on by COPD and heart disease. Dr. Morgan, meanwhile, determined
    that Mr. Collins had died from an arrhythmia, which was worsened
    by his hypoxemia, which was in turn caused by his COPD. Both
    doctors     agreed    that   the   COPD    hastened        Mr.    Collins’s    death,
    though both believed that it was caused by his cigarette smoking
    and not his work in the mines.
    Our    ruling     in   Collins       that      the    1988     ALJ   decision
    established that Mr. Collins’s COPD was caused in part by his
    pneumoconiosis renders the opinions of Dr. Jarboe and Dr. Morgan
    incorrect     regarding      the    presence         of     pneumoconiosis.      But
    crucially, although Dr. Jarboe and Dr. Morgan disagreed with Dr.
    Younes and Dr. Gaziano about what caused Mr. Collins’s COPD,
    their opinions are in accord that the COPD hastened the miner’s
    death.      Under our decision in Toler, these opinions, which did
    not find the presence of pneumoconiosis, can be accorded only
    lesser weight. Still, the weight they do carry acts to support
    the   findings   of    Dr.   Younes    and     Dr.   Gaziano       regarding    death
    causation. All four doctors agree that Mr. Collins had COPD and
    that it hastened his death. And crucially, we have earlier held
    that his COPD qualified as pneumoconiosis. See 
    Collins, 468 F.3d at 224
    (noting that due to the 1988 ALJ Decision’s finding that
    Mr. Collins’s COPD was caused in part by his work in the coal
    mines,       “Mrs.     Collins        established           the      presence      of
    14
    pneumoconiosis”). Thus, contrary to Pond Creek’s arguments and
    the ALJ’s ruling below, Dr. Jarboe and Dr. Morgan provide at
    least some additional support for a finding that Mr. Collins’s
    pneumoconiosis hastened his death.
    In fact, the ALJ confirmed multiple times in his opinion
    that Mr. Collins’s COPD was a cause of his death. See J.A. at
    776-77. After our 2006 decision, there is no dispute that the
    miner was totally disabled by pneumoconiosis. The ALJ argued,
    however, that “it is not a foregone conclusion that this same
    pulmonary impairment caused miner’s death; in fact, many of the
    physicians in the present case opined that miner’s death was
    purely cardiac, despite his respiratory failure.” J.A. at 777.
    This reasoning is flawed in two ways. First, there is no
    support in the record that Mr. Collins suffered from a different
    pulmonary impairment beyond the COPD that we have already held
    to be pneumoconiosis. The ALJ’s observation that some doctors
    opined that Mr. Collins’s death was purely cardiac in nature
    provides no support for the presence of a second respiratory
    problem   that   may   have   contributed   to   his   death.   Second,   the
    relationship     between   severe   pulmonary    impairment     and   cardiac
    functioning is well known. The body is an integrated organism. A
    part can drag down the whole. The ALJ was right to dismiss the
    possibility of a purely cardiac death, stating that “there is no
    disputing that miner suffered from, and died of, respiratory
    15
    failure.” J.A. at 777. It is only by relying on this rejected
    explanation of an exclusively cardiac event that it is possible
    to avoid the finding of death causation mandated by the record.
    III.
    Unlike after our previous decision in this case, no factual
    issues remain to be determined by an ALJ. Mrs. Collins was 62
    years old when she first filed her claim. She is now 78. We
    hold, better late than never, that she has satisfied the test
    for survivor’s benefits: she is the surviving spouse of a miner
    whose death was hastened by pneumoconiosis due at least in part
    to coal mine employment. The ravages of her husband’s long years
    in the mines should yield at least the legacy of provision for
    his    surviving    spouse.    No     further   factual   development   is
    necessary. We reverse the BRB’s order and remand with directions
    to    award   benefits   without    further   administrative   proceedings.
    See Scott v. Mason Coal Co., 
    289 F.3d 263
    , 270 (4th Cir. 2002).
    REVERSED AND REMANDED
    16