Consolidation Coal Company v. Everett Galusky

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UNPUBLISHED AUTHORED OPINION filed. Originating case number: 14-0187-BLA,11-5535-BLA Copies to all parties and the district court/agency. [999818071].. [15-1302]

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Appeal: 15-1302 Doc: 43 Filed: 05/10/2016 Pg: 1 of 17 UNPUBLISHED UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT No. 15-1302 CONSOLIDATION COAL COMPANY, Petitioner, v. EVERETT D. GALUSKY; DIRECTOR, OFFICE OF WORKERSʹ COMPENSATION PROGRAMS, UNITED STATES DEPARTMENT OF LABOR, Respondents. On Petition for Review of an Order of the Benefits Review Board. (14-0187-BLA; 11-5535-BLA) Argued: March 22, 2016 Decided: May 10, 2016 Before SHEDD, THACKER, and HARRIS, Circuit Judges. Petition for review denied by unpublished opinion. Judge Harris wrote the opinion, in which Judge Shedd and Judge Thacker joined. ARGUED: William Steele Mattingly, JACKSON KELLY PLLC, Lexington, Kentucky, for Petitioner. Heath M. Long, PAWLOWSKI, BILONICK & LONG, Ebensburg, Pennsylvania, for Respondent. ON BRIEF: Kevin M. McGuire, Amy Jo Holley, JACKSON KELLY PLLC, Lexington, Kentucky, for Petitioner. Unpublished opinions are not binding precedent in this circuit. Appeal: 15-1302 Doc: 43 Filed: 05/10/2016 Pg: 2 of 17 PAMELA HARRIS, Circuit Judge: Consolidation Coal Company (“CONSOL”) petitions for review of a decision awarding black lung benefits to Everett Galusky. An administrative law judge (“ALJ”) found that Galusky was entitled to rely on the “fifteen-year presumption,” a statutory provision that presumes eligibility for benefits if an applicant has worked in coal mines for at least fifteen years and suffers from a totally disabling respiratory or pulmonary impairment. The ALJ then presumption by held that showing CONSOL either had that failed to Galusky rebut that not have does pneumoconiosis — commonly known as black lung disease — or that his pneumoconiosis did not cause his total disability. The Benefits Review Board affirmed the ALJ’s decision. On appeal, CONSOL argues primarily that the ALJ used the wrong standard presence of in considering pneumoconiosis, whether improperly it had disproved requiring it to the “rule out” any connection between Galusky’s coal dust exposure and Galusky’s condition. record. Because inappropriate We think this reflects a misreading of the the standard ALJ of did proof, not and err by because applying an substantial evidence supports the ALJ’s decision, we deny CONSOL’s petition for review. 2 Appeal: 15-1302 Doc: 43 Filed: 05/10/2016 Pg: 3 of 17 I. A. The Black Lung Benefits Act, 30 U.S.C. §§ 901–44, awards benefits to “coal pneumoconiosis,” miners popularly U.S.C. § 901(a). who are known as totally black disabled lung due disease. to 30 Under the Act, a miner can prove entitlement to benefits by showing through medical evidence that “he has pneumoconiosis arising from coal mine employment, and that this disease is a substantially contributing cause of [a] totally disabling respiratory or pulmonary impairment.” LLC v. Epling, 783 F.3d 498, 501 (4th Cir. Hobet Mining, 2015) (footnote omitted). 1 For certain miners, Congress has made it easier to show an entitlement to benefits. Id. A claimant with at least fifteen years of underground coal employment and a “totally disabling respiratory or pulmonary impairment,” 30 U.S.C. § 921(c)(4), may invoke presume the Act’s both “fifteen-year prongs of the presumption,” showing under required for which “we benefits eligibility: that the claimant has pneumoconiosis arising from coal mine employment, and that this disease is a substantially 1 The statutory definition of “pneumoconiosis” encompasses not only the diseases clinically known as pneumoconiosis, but also “legal pneumoconiosis,” defined as “any chronic lung disease or impairment” “arising out of coal mine employment.” 20 C.F.R. § 718.201(a)(2); see 30 U.S.C. § 902(b). 3 Appeal: 15-1302 Doc: 43 Filed: 05/10/2016 Pg: 4 of 17 contributing cause of his disability.” See Epling, 783 F.3d at 502. That presumption may be rebutted in two ways. First, a coal mine operator may establish that the claimant does not have pneumoconiosis “arising out of coal mine employment.” § 718.305(d)(1)(i); see Epling, 783 F.3d at 502. 20 C.F.R. Under the governing regulations, a lung disease or impairment “arises out of coal mine employment” if it is “significantly related to, or substantially aggravated by,” coal dust exposure. § 718.201(b). So to satisfy this first rebuttal 20 C.F.R. method, an operator must prove the converse: that a miner’s impairment is not “significantly related to, or substantially aggravated by,” the fifteen years or more spent in coal mines. Second, an employer may show that “no part of the miner’s respiratory or pulmonary pneumoconiosis.” added). heavy 20 total C.F.R. disability was § 718.305(d)(1)(ii) caused by (emphasis Known as the “rule-out” standard, this burden is a one. It is not enough for an operator to show that pneumoconiosis is a “minor or even an incidental cause” of a miner’s disability. 143 (4th Cir. 2015). W. Va. CWP Fund v. Bender, 782 F.3d 129, Instead, an operator must show that the miner’s disability is caused exclusively by something other than pneumoconiosis, “rul[ing] out any connection between a miner’s 4 Appeal: 15-1302 Doc: 43 Filed: 05/10/2016 Pg: 5 of 17 pneumoconiosis and his disability.” Id. at 135 (emphasis added) (internal quotation marks omitted). B. Galusky was a coal miner for at least working in coal mines in 1995 for CONSOL. 2 26 years, last After unsuccessfully applying for black lung benefits about a decade before, Galusky reapplied in approved his 2010, and claim. this time CONSOL the opposed Department of Galusky’s claim Labor and requested a hearing in front of an ALJ. In the proceedings before the ALJ, the parties presented evidence that included medical tests and studies, x-ray readings, and, most critically, the reports and opinions of four physicians: Doctors Andrzej J. Jaworski; Joseph J. Renn, III; Christopher agreed Begley; that and Galusky Stephen suffered G. Basheda. from a While totally all four disabling impairment, only Jaworski diagnosed Galusky with pneumoconiosis. Renn, Begley, conditions pulmonary and like disease, Basheda pulmonary and instead diagnosed emphysema, asthma, and Galusky chronic all three with obstructive attributed Galusky’s impairment either entirely or primarily to Galusky’s 2 As Galusky’s last coal employer, CONSOL is liable for benefits potentially owed to Galusky, a fact that it does not contest. See generally 20 C.F.R. §§ 725.490, 725.495. 5 Appeal: 15-1302 Doc: 43 Filed: 05/10/2016 decades-long smoking Pg: 6 of 17 habit, rather than his coal mine employment. After conducting a hearing and evidence, the ALJ awarded benefits. reviewing the medical Because Galusky had worked for more than fifteen years in coal mines and suffered from a totally disabling respiratory impairment, the ALJ invoked the fifteen-year presumption. CONSOL does not dispute that this presumption applies, and so we presume, as did the ALJ, both that Galusky has pneumoconiosis arising from coal mine employment and that his total disability is substantially caused by his pneumoconiosis. The ALJ went on to find that based on the medical evidence and physician presumption. opinions, CONSOL had failed to rebut the According to the ALJ, CONSOL could not satisfy the first rebuttal method: showing that Galusky did not suffer from legal pneumoconiosis, or a lung impairment “significantly related to, or substantially aggravated by, dust exposure in coal mine employment.” pneumoconiosis); acknowledged see that id. doctors J.A. at 296 Begley, 297 (defining n.23 (same). Basheda, and diagnosed Galusky with pneumoconiosis. Renn legal The had ALJ not But neither Begley nor Basheda, the ALJ noted, had been able to “rule out” coal dust as a contributing cause to Galusky’s impairment. See J.A. 290 (quoting Begley’s deposition testimony that he “could not ‘rule 6 Appeal: 15-1302 out’ Doc: 43 Filed: 05/10/2016 exposure to coal dust Pg: 7 of 17 as a contributor”); J.A. 301 (discussing Begley’s testimony); J.A. 303 (discussing Basheda’s testimony). Moreover, though both Basheda and Renn had diagnosed Galusky with asthma, the ALJ observed, neither had considered the possibility that coal dust exposure could have aggravated that definition asthma, of legal which might bring pneumoconiosis. it within the the ALJ Finally, discredited the opinions of Basheda and Renn on the ground that the doctors had made statements questioning the progressive nature of pneumoconiosis that were inconsistent with the Act and the preamble to its regulations, and, in Basheda’s case, for suggesting without record support that most of Galusky’s mining work occurred only after certain coal dust controls had been implemented. The ALJ then determined that CONSOL could not satisfy the second rebuttal pneumoconiosis Citing method: did longstanding not demonstrating contribute Fourth to Galusky’s total disability. his that Circuit precedent, the ALJ discredited the disability-causation opinions of the experts who had failed to determination diagnose — Basheda, pneumoconiosis, Renn, and contrary Begley. to The his ALJ own also reiterated his concerns about statements by Basheda and Renn deemed inconsistent regulations. with the Act and the preamble to its Having accorded little weight to these physicians’ 7 Appeal: 15-1302 Doc: 43 Filed: 05/10/2016 Pg: 8 of 17 opinions, the ALJ determined that CONSOL had failed to rebut the presumption that Galusky’s pneumoconiosis caused his total disability, and accordingly held that Galusky was entitled to benefits. On appeal, the Benefits Review Board affirmed the ALJ’s decision. As to the first presumption — that Galusky suffers from pneumoconiosis — the Board rejected CONSOL’s argument that the ALJ provided invalid reasons for discounting the views of doctors Renn and Basheda. According to the Board, the ALJ acted within his discretion in concluding that both doctors failed to explain why Galusky’s many years of coal dust exposure were not an aggravating cause of his asthma. The Board also endorsed the ALJ’s rationale for discrediting the views of doctors Renn and Basheda as to the existence of pneumoconiosis. Both doctors, the Board determined, had made statements inconsistent with the principle that pneumoconiosis is a progressive and irreversible disease, as reflected in the Act and the preamble to its regulations; and Basheda’s claim that Galusky’s work occurred primarily after the imposition of dust-control measures was “factually unsupported by any evidence in the record,” J.A. 321. Finally, as to the second presumption — that Galusky’s pneumoconiosis is a substantial cause of his total disability — the Board held that the ALJ properly analyzed the question under the rule-out standard, and appropriately 8 discounted the Appeal: 15-1302 Doc: 43 Filed: 05/10/2016 Pg: 9 of 17 disability-causation views of doctors who had failed to diagnose pneumoconiosis in the first instance. CONSOL timely petitioned this court for review. II. In black lung cases, our review is highly deferential. ask only “whether substantial evidence supports the We factual findings of the ALJ and whether the legal conclusions of the Board and ALJ are rational and consistent with applicable law.” Bender, 782 F.3d at 144 (internal quotation marks omitted). We are mindful that “it is for the ALJ, as the trier of fact, to make factual and credibility determinations, and we therefore defer to the ALJ’s evaluation of the proper weight to accord conflicting medical opinions.” Epling, 783 F.3d at 504 (citation and internal quotation marks omitted). A. As described above, an operator may rebut the fifteen-year presumption in one of two ways: (1) by showing that a claimant does not have pneumoconiosis arising out of coal mine employment (“pneumoconiosis rebuttal”), or (2) by showing that even if the claimant does have pneumoconiosis, that disease did not cause his total disability (“disability-causation rebuttal”). C.F.R. § 718.305(d)(1). See 20 Under the first rebuttal prong, the standard of proof requires an operator to show that a miner’s 9 Appeal: 15-1302 Doc: 43 Filed: 05/10/2016 Pg: 10 of 17 respiratory or pulmonary condition is not “significantly related to, or substantially aggravated by, dust exposure in coal mine employment.” Id. § 718.201. of proof is higher: operator to show But under the second, the standard Here, the rule-out standard requires an that “no caused by pneumoconiosis. part” of a miner’s disability is Id. § 718.305(d)(1)(ii); see Bender, 782 F.3d at 141 (describing application of rule-out standard to second rebuttal prong). Before this court, CONSOL’s primary argument is that the ALJ committed legal error by applying the rule-out standard to its efforts to disprove pneumoconiosis, extending the rule-out standard from the second rebuttal prong to the first. 3 the ALJ’s opinion differently. We read The regulatory framework here is technical and a bit cumbersome, and the ALJ’s opinion is long and complex. Nevertheless, it is clear that the ALJ correctly distinguished the governing standards of proof, applying each to the appropriate inquiry. to pneumoconiosis demonstrate the In the section of his opinion devoted rebuttal, absence of the legal 3 ALJ required CONSOL pneumoconiosis, to properly Before the Board, CONSOL’s argument was that the ALJ improperly applied the strict rule-out standard to the second rebuttal prong, and that it should have been permitted to rebut disability causation under a more lenient standard. Our court recently affirmed the regulatory rule-out standard in West Virginia CWP Fund v. Bender, 782 F.3d 129 (4th Cir. 2015), and CONSOL no longer presses that argument. 10 Appeal: 15-1302 Doc: 43 defined as a substantially employment.” Filed: 05/10/2016 lung Pg: 11 of 17 impairment aggravated J.A. 297. “significantly by, dust related exposure in to, coal or mine In analyzing disability causation, on the other hand, the ALJ expressly invoked the rule-out standard, explaining that relationship an between operator a “must miner’s ‘rule disability employment” under the second rebuttal prong. added). out’ and his any causal coal mine J.A. 308 (emphasis All of that is indisputably correct. To suggest that the ALJ nevertheless applied the rule-out standard to pneumoconiosis rebuttal, improperly requiring CONSOL to disprove even the slightest connection between Galusky’s coal mine employment and his lung impairment, CONSOL points to two references to the phrase “rule out” in the ALJ’s discussion of the existence of pneumoconiosis. In the first, the ALJ notes that Begley “could not rule out a coal dust etiology,” or cause, for Galusky’s lung impairment, J.A. 301, and in the second, that Basheda “could not 100% rule out a coal dust contribution” to Galusky’s lung condition, J.A. 303. In context, however, it is apparent that the ALJ is not referring to the so-called rule-out standard of 20 C.F.R. § 718.305(d)(1)(ii), but instead using “rule out” in its everyday sense — precisely as it was used by the two doctors in their depositions, in the very passages from which the ALJ is quoting when he in turn uses the phrase in his opinion. See J.A. 201 (Begley testifying that “we can’t rule 11 Appeal: 15-1302 out Doc: 43 that Filed: 05/10/2016 [Galusky’s] Pg: 12 of 17 exposure to coal dust could have contributed” to his lung disease); J.A. 242 (Basheda testifying that “you can never a hundred percent rule out” a different causal factor, “but [Galusky’s] medical condition and findings are [very] typical of tobacco use”). The ALJ’s allusions to “ruling out,” in other words, come directly from the doctors’ testimony as to the causes of Galusky’s lung disease, and not from the regulatory rule-out standard. Nor do we detect any substantive error in the ALJ’s consideration of the doctors’ testimony on this point. It is indeed the case that under the first rebuttal prong, the burden is on the operator to “rule out,” colloquially speaking, the possibility that coal mine employment is “significantly related to” or has impairment. “substantially 20 C.F.R. § aggravated” 718.201(b). a lung And disease while or Begley and Basheda opined that Galusky’s smoking habit was the “majority,” J.A. 246 (Basheda), or “primar[y],” J.A. 202 (Begley), cause of Galusky’s lung condition, neither could say that coal dust exposure might not also play a contributing or aggravating part, J.A. 241 (Basheda), J.A. 201 (Begley). prerogative” experts’] to “determine testimony,” Bender, the 782 “It was within the ALJ’s persuasiveness F.3d at 144, of and [these to take account of the doctors’ uncertainty on this point in determining whether CONSOL had met its burden of demonstrating that coal 12 Appeal: 15-1302 Doc: 43 Filed: 05/10/2016 Pg: 13 of 17 mine employment was not significantly related to and did not substantially aggravate Galusky’s lung disease. B. In the alternative, CONSOL argues that the ALJ and Board erred as rebuttal a factual showing. matter in assessing According to the CONSOL, strength substantial of its evidence does not support the determination that it failed to meet its burden under either of the rebuttal prongs. Again, we disagree. As to the first rebuttal prong — disproving pneumoconiosis — CONSOL argues that the opinions of doctors Renn and Basheda are sufficient significantly to show related that to or Galusky’s lung substantially condition aggravated mine employment, pursuant to 20 C.F.R. § 718.201(b). is by not coal Both Renn and Basheda diagnosed Galusky with a tobacco-induced condition — for Renn, pulmonary emphysema and a severe obstructive ventilatory defect; and for Basheda, severe chronic obstructive pulmonary According disease to (“COPD”) CONSOL, by — with tying an Galusky’s asthma lung component. impairment to emphysema and COPD arising from tobacco use rather than coal dust, this expert testimony disproves coal mine employment as a significant contributor to Galusky’s impairment. The problem, as both the ALJ and Board noted, is that neither expert explained why the asthma component of Galusky’s condition was not aggravated by exposure to coal dust. 13 CONSOL Appeal: 15-1302 Doc: 43 Filed: 05/10/2016 Pg: 14 of 17 does not dispute that whether coal mine employment substantially exacerbated rebuttal. Galusky’s asthma is relevant to its burden on Rather, it argues that the ALJ misread the record, and that its experts in fact did assess whether Galusky’s asthma was aggravated by coal dust, and explained why it was not. But as the noted above, it is for the ALJ to determine persuasiveness of expert testimony, see Bender, 782 F.3d at 144, and we cannot say that the ALJ erred in concluding that Renn and Basheda failed to explain whether coal dust exposure could have aggravated Galusky’s asthma. CONSOL directs us to deposition passages in which an expert distinguishes Galusky’s asthma from pneumoconiosis or from emphysema caused by coal dust, see J.A. 124–25, 127; diagnoses asthma, J.A. 231; or states without discussion that Galusky’s conditions are caused by tobacco use rather than coal dust exposure, J.A. 139. there anything that an ALJ would be Nowhere, however, is obliged to treat as a reasoned and persuasive explanation of why Galusky’s prolonged exposure to coal dust did not “substantially aggravate[]” the asthma component of his impairment. We have explained already that in analyzing pneumoconiosis rebuttal, the ALJ was entitled to consider that experts Begley and Basheda were unable to state definitively that coal mine employment, Galusky’s while lung not in condition, their did 14 view not the play primary some cause of significant Appeal: 15-1302 Doc: 43 Filed: 05/10/2016 contributing role. Pg: 15 of 17 And for the reasons given above, the ALJ also was entitled to discount the testimony of Basheda and Renn because they failed to provide a reasoned explanation of whether coal dust exposure might have aggravated Galusky’s asthma. Finally, CONSOL does not challenge on appeal the ALJ’s decision, affirmed by the Board, to discredit Basheda’s opinion because there is no factual support for Basheda’s claim that Galusky performed most of his mining work after dust-control measures were imposed. deferential evidence In light of all of those factors, and under our standard supports of the review, we determination find of that the ALJ substantial that CONSOL failed to rebut the fifteen-year presumption by disproving the existence of pneumoconiosis. 4 As to the second rebuttal prong — showing that “no part” of Galusky’s total disability was caused by his pneumoconiosis under 20 C.F.R. § 718.305(d)(1)(ii) — CONSOL offers the same arguments discussed above, contending that the ALJ simply incorporated by reference his flawed analysis of its experts’ 4 Accordingly, we need not decide whether the ALJ properly discredited doctors Basheda and Renn on the additional ground that they had made statements questioning the progressive nature of pneumoconiosis that were inconsistent with the Act and the preamble to its regulations. With or without that alternative reason for discounting the opinions of Basheda and Renn, there is substantial record evidence to support the ALJ’s determination that CONSOL did not meet its burden under the first rebuttal prong. 15 Appeal: 15-1302 Doc: 43 Filed: 05/10/2016 Pg: 16 of 17 testimony regarding the existence of pneumoconiosis. addressed those arguments already. We have And in any event, the ALJ’s analysis under this prong rests critically on a different point: Under well-established Fourth Circuit law, an expert’s opinion on whether a claimant’s disability is caused by pneumoconiosis “can carry little weight” if that expert does not believe the claimant even has pneumoconiosis, contrary to a determination by the ALJ. See J.A. 311 (quoting Toler v. E. Associated Coal Co., 43 F.3d 109, 116 (4th Cir. 1995)). In fact, “opinions that erroneously fail to diagnose pneumoconiosis may not be credited at all, unless an ALJ is able to identify specific and persuasive reasons for concluding that the doctor’s judgment on the question of disability predicate misdiagnosis.” quotation marks and causation Epling, alterations does 783 not F.3d rest at omitted). 505 Here, upon the (internal there is nothing to suggest that the view of Renn, Basheda, and Begley that pneumoconiosis independent of pneumoconiosis did their at all, not cause view and that CONSOL Galusky’s Galusky does not disability does argue not is have otherwise. Accordingly, the ALJ was well within his discretion in assigning little or no weight to these experts’ views on disability causation, and the ALJ’s determination that CONSOL failed to meet its rebuttal burden is supported by substantial evidence. 16 Appeal: 15-1302 Doc: 43 Filed: 05/10/2016 Pg: 17 of 17 III. For the foregoing reasons, we deny CONSOL’s petition for review. PETITION FOR REVIEW DENIED 17

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