Changes give miners greater access to health info, improve claims safeguards
WASHINGTON – (ENEWSPF)–April 25, 2016. The U.S. Department of Labor’s Office of Workers’ Compensation Programs today issued a final rule to strengthen safeguards for the health of coal workers. The rule makes significant revisions to the regulations implementing the Black Lung Benefits Act that will give miners greater access to their health information, bolster the accuracy of claims decisions, and require coal mine companies to pay all disability or survivor’s benefits due in a claim before modification can challenge the award.
No worker should have to sacrifice their health to provide for their family, including the thousands of men and women who work in coal mines across the country to meet the nation’s energy needs. These hardworking Americans deserve to know the full scope of their medical condition, and the new rule ensures that they have full access to information about their health, by requiring all parties to exchange any medical information that they develop in connection with a claim, even if they do not intend to submit the information into evidence. Previously, parties generally kept any medical information that they did not submit into evidence confidential.
“This rule makes clear that coal miners have a right to know a full picture of their health. No workers should lose their lives because of known dangers that were kept from them in the interest of their employers,” said Office of Workers’ Compensation Programs Director Leonard Howie. “We have carefully considered this rule and I am confident that these changes will bring transparency and improve claims safeguards for our nation’s coal miners.”
Ensuring that all parties have access to the most relevant medical evidence will prevent the type of tragic outcome for vulnerable coal miners like Gary Fox who filed a claim for black lung benefits after working in the coal mines for more than 30 years. Fox filed a claim in 1999 after a chest X-ray and a biopsy showed a mass in his right lung. Fox did not have legal representation when he filed his claim, and the coal company submitted reports from radiologists and four pulmonologists who all concluded that he did not have coal workers’ pneumoconiosis. However, the company had developed two additional pathologists’ opinions, both of which showed that Fox had complicated pneumoconiosis, an advanced stage of black lung disease. The company did not share these reports with either Fox or even the doctors whose reports they put into evidence, and an Administrative Law Judge denied his first claim for benefits.
Without access to this vital health information, Fox chose to keep working until he left the mines in 2006 at the age of 56 when he could no longer breathe well enough to do his job. He filed a second claim for benefits that same year, but this time he was represented by an attorney who was able to obtain an order requiring the coal company to turn over the medical reports the company had not shared during the first claim proceeding. Even then, the coal company refused and did not turn over the information until 2008. Eventually, the company admitted that Fox was entitled to benefits. He later succumbed to the disease while awaiting a lung transplant in 2009.
“Under the new provisions, any miner in a situation like Gary Fox’s will be able to make an informed decision regarding continuing to work and caring for their lung condition,” said Solicitor of Labor M. Patricia Smith. “Making sure that coal miners have all the information regarding their health will put all parties on equal footing regardless of representation and will lead to better, more accurate claims decisions for coal miners across the country.”
Parties who fail to share any medical data they develop about the miner are subject to sanctions. Additionally, the final rule reinforces coal mine companies’ obligations to pay benefits under existing orders while the modification proceedings to challenge orders are underway. The rule allows coal companies one year from the last payment of benefits to seek reconsideration of an effective order awarding disability or survivor’s benefits. Although they are legally obligated to pay benefits while challenging these awards, coal companies commonly refuse to do so. The final rule requires the operator to pay before they can challenge the award through the act’s modification procedures.
Finally, the rule makes several changes to existing regulations. To support miners who submit multiple physicians’ reports for the same claim, the rule clarifies that those supplemental reports are a continuation of the physician’s earlier report for the purpose of department’s evidence-limiting rules. The rule also includes a change allowing the U.S. Department of Labor to participate fully in the adjudication process when a liable coal operator stops its participation due to adverse financial developments, such as bankruptcy or insolvency.
The Federal Register published the Final Rule on April 25, 2016, and it is available at: https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-09525.pdf.
The mission of the Division of Coal Mine Workers’ Compensation, the federal Black Lung Program, is to administer claims filed under the Black Lung Benefits Act. The act provides compensation to coal miners who are totally disabled by pneumoconiosis arising out of coal mine employment, eligible survivors of miners whose death was attributable to or hastened by pneumoconiosis and survivors of miners who were entitled to benefits at the time of their death. The act also provides eligible miners with coverage for medical treatment of lung diseases arising out of coal mine employment. More information is available at: http://www.dol.gov/owcp/dcmwc/