Nora Collins v. Pond Creek Mining Company

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.
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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
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