Mr. Massey smoked 50 packs of cigarettes per year since
1944. In addition, he had a history of coronary artery disease, chronic
obstructive pulmonary disease ("COPD"), pneumoconiosis, peptic ulcer disease,
chronic problems with his right knee, a history of transischemic attacks, colon
cancer, a lumbar laminectomy, and a bilateral hernia repair. He was also
diagnosed with bone cancer and myelodysplastic syndrome, a disease which causes
damage to the bone marrow. He died from complications due to pneumonia and
myelodysplastic syndrome.
Massey's First Application For Benefits
The first time Massey applied for black lung benefits was
in May 1996, and an ALJ awarded benefits. On review, however, the BRB determined
that the ALJ did not take into consideration x-ray evidence showing that Massey
did not have pneumoconiosis, and remanded the case for reconsideration of the
evidence. While the BRB reversed the ALJ's finding that the pneumoconiosis
caused Massey's total respiratory disability, it affirmed the ALJ's conclusion
that Massey suffered from a totally disabling respiratory disease.
On remand, the ALJ examined the additional evidence and
concluded that Massey suffered from pneumoconiosis but found that the
pneumoconiosis did not cause his disability. According to the ALJ, smoking was
the sole cause of his disability, and Massey failed to prove that the
pneumoconiosis was a contributing cause. After submitting new evidence, Massey
filed a petition for reconsideration in December 2000. The ALJ considered the
new evidence with the old evidence and concluded that Massey failed to prove
that he had pneumoconiosis. Consequently, the ALJ found that the Massey did not
prove that his respiratory illness was caused by pneumoconiosis.
Massey's Wife's Application for Benefits
When Robert Massey died, his wife continued to pursue his
claim and filed an additional claim for survivorship benefits. The claims were
consolidated and submitted to an ALJ who received new evidence in the form of an
autopsy of Mr. Massey's lungs and other medical records. Dr. Tomislav M. Jelic
performed the autopsy and found that Massey contracted coal miner's
pneumoconiosis, chronic silicosis, extensive interstitial fibrosis, marked
emphysema, acute exacerbation of chronic bronchitis, extensive adhesions between
the lung and chest wall, and acute and organizing pneumonia. Dr. Jelic opined
that the pneumoconiosis contributed to Mr. Massey's death. Two other
pathologists examined Mr. Massey's lung tissue and reached opposing conclusions.
In one doctor's opinion, pneumoconiosis was the major contributing factor in Mr.
Massey's death, while the smoking and myelodysplastic syndrome were significant
contributing factors. The other doctor disagreed and found only minimal evidence
of coal worker's pneumoconiosis, concluding that Mr. Massey's cigarette smoking
made a seven-fold greater contribution to his lung ailments than his prolonged
exposure to coal dust.
After reviewing the evidence that Mrs. Massey presented,
the ALJ found that the autopsy reports clearly showed that Robert Massey had
coal worker's pneumoconiosis. However, the ALJ also found that Mr. Massey's COPD
was due exclusively to his smoking history. In addition, the ALJ found that
Massey's clinical pneumoconiosis was not the cause of his total respiratory
disability, nor did it cause or contribute to his death. Deciding the issue of
death and disability causation, the ALJ agreed with the medical opinions of the
doctors who did not focus on Massey's emphysema and COPD, which the ALJ found
was caused exclusively by his smoking. The ALJ also found that the coal dust
exposure did not contribute to Massey's respiratory disability. Massey appealed
the ALJ's opinion to the BRB. The BRB vacated the ALJ's order on the ground that
the ALJ failed to clearly explain why he discounted the doctors who opined that
the coal dust exposure contributed to Massey's COPD.
On remand, the ALJ reconsidered the evidence but maintained
his position that the evidence did not support a finding that Massey had
pneumoconiosis. The ALJ based his decision on the finding that the doctors who
attributed Massey's respiratory ailments to smoking had well-reasoned opinions
that were supported by medical literature. In addition, the ALJ's findings on
the issues of death and disability causation remained unaffected. In accordance
with his findings, the ALJ again denied benefits. After Mrs. Massey filed a
Motion for Reconsideration, the ALJ issued another decision stating that the
doctors supporting Mrs. Massey failed to distinguish the effects of smoking and
coal dust exposure on developing COPD while the other doctors explained the
distinction. Mrs. Massey appealed this decision, and the BRB affirmed, holding
that the ALJ had sufficiently explained why he rejected the opinion of the
doctors. Mrs. Massey appealed the BRB's order denying benefits alleging that the
ALJ did not perform his statutory duty to explain the basis of his decision deny
benefits as required by the Administrative Procedure Act ("APA"), 5 U.S.C. §
557(C)(3)(A) (2000). She also contended that the ALJ did not apply the proper
standard for assessing causation of total disability and death.
Mrs. Massey's Appeal to the Fourth Circuit
The United States Court of Appeals for the Fourth Circuit
reviewed the findings of the ALJ and the BRB. The Fourth Circuit's review of
factual findings in a claim for benefits under the Black Lung Benefits Act is
deferential. The Fourth Circuit's role on appeal is to determine whether
substantial evidence in the record supports the ALJ's decision. Substantial
evidence is more than a scintilla and is only relevant evidence that a
reasonable mind would accept to support a conclusion. The Court first addressed
Mrs. Massey's contention that the ALJ did not adequately explain the rationale
for the factual findings. While the APA requires the ALJ to include a statement
of findings and conclusions, the "duty of explanation" is not a mandate for the
ALJ to be verbose in its explanation.
The Court found that the ALJ provided sufficient and
numerous explanations to satisfy the statutory duty. The Court looked to the
three separate opinions issued by the ALJ that explained the conclusions he drew
from the medical records. Furthermore, the ALJ issued two more decisions
addressing the basis on which he found one group of doctors more persuasive
after the BRB remanded the claim. The ALJ is only required to make clear what he
did and why. The ALJ fulfilled his duty of explanation in this case.
In response to Massey's contention that the ALJ improperly
applied the standard of causation for death and disability, the Fourth Circuit
viewed the record in its entirety and concluded that the ALJ applied the correct
standard in determining that pneumoconiosis did not cause or contribute to Mr.
Massey's death or disability. Moreover, the Court found that its conclusion
found support in substantial evidence from the record. Accordingly, the Fourth
Circuit denied Mrs. Massey's petition for review.
Top
