explaining that determinations to credit or discredit medical opinions based on whether they are sufficiently documented and reasoned is a credibility matter that must be left to the ALJ
How later courts described this case
- explaining that determinations to credit or discredit medical opinions based on whether they are sufficiently documented and reasoned is a credibility matter that must be left to the ALJ
- discussing how a doctor’s opinion was “insufficient to rule out occupational coal dust exposure as a ‘contributing cause’ to [claimant’s respiratory disability” (emphasis added) to rebut a presumption under 20 C.F.R. § 725.203(b)(3) which had an identical “did not arise in whole or in part out of coal mine employment” standard
- noting that a proper avenue for rebuttal under 20 C.F.R. Sec. 727.203(b)(4) is to prove that the claimant's disability is not "significantly" related to coal dust
- The ALJ should generally "accept a 'documented opinion of a physician exercising reasoned medical judgment.' "
Written by the judges who cited it.
The opinion
WELLFORD, Circuit Judge,
dissenting.
My disagreement with the majority opinion is not with its analysis of the tangled procedural situation in this case regarding the applicability of the interim regulations *188 in Part 727 of the Black Lung Benefits Act. Rather, I dissent from part II of the opinion because I believe Tennessee Consolidated Coal Company (TCC) did rebut the presumption applicable to Crisp under the statute by reason of rebuttal provisions in 20 C.F.R. § 727.203 (b)(3).
The Administrative Law Judge (ALJ) held that TCC failed to prove that Crisp’s disabling respiratory ailment did not arise from his coal mine employment. 1 I believe that medical evidence in this case establishes by “reasoned medical judgment” that Crisp’s condition arose from his persistent heavy cigarette smoking not by reason of coal mine employment. Dr. Mitchell indicated by checking the box on the form provided him that the “diagnosed condition” of emphysema did not relate “to dust exposure in the patient’s coal mine employment.” He had earlier indicated that this condition related “presumably” only to smoking. The AU and the Board therefore improperly rejected Dr. Mitchell’s opinion after an examination of Crisp; it was “of sufficient medical certainty” not only to be credible but set out that the origin of Crisp’s condition was not due to coal mining conditions of employment. In my view, Moseley v. Peabody Coal Co., 769 F.2d 357 (6th Cir.1985), is not a basis of support for claimant’s position, nor authority to ignore Dr. Mitchell’s opinion. 2
Dr. Gilley conducted a thorough examination and made tests on Crisp before concluding that Crisp’s “major problem is chronic obstructive lung disease,” which he attributed to cigarette smoking as the “major etiological factor.” He found “little, if any, objective evidence of coal workers’ pneumoconiosis.” Dr. Gilley amplified his report by deposition testimony about Crisp’s condition of emphysema, and he made a direct response that he was not disabled because of pneumoconiosis. Giving the claimant the “benefit of doubt,” on cross examination, Dr. Gilley felt that there may have been “maybe 10 percent ... possible contribution” of coal mine “environment” on Crisp’s condition. For all practical purposes, absent a hypertechnical reading of the proof, this medical testimony would be sufficient to establish rebuttal under 727.203(b)(3).
To hold otherwise under the proof in this case is to utilize a literal, unrealistic reading of the regulation and to ignore practical realities. I agree with TCC that use of this type of approach imposes an almost impossible burden upon the employer to disprove even insignificant or minimal causation. Gibas v. Saginaw Mining Co., 748 F.2d 1112, 1120 (6th Cir.1984), held, among other things, that “[T]he Black Lung Benefits Act requires payment of benefits only for total disability due to pneumoconio-sis." (emphasis added) It later indicated that pneumoconiosis must be shown by the claimant to be a “contributing cause” of the claimed total disability. Id. at 1120 . That coal mine environmental conditions may possibly have brought about Crisp’s emphysema is not enough to establish entitlement.
I would find that TCC rebutted the interim presumption in this case. It should not be called upon to demonstrate with 100% accuracy that coal mine environment could not possibly have been a factor in an emphysema case where there is “little, if any, objective evidence of pneumoconiosis.” 3
I therefore respectfully dissent.
. There is no dispute but that Crisp suffers from a totally disabling respiratory condition.
. Moseley held for the employer on whether coal mine exposure was a "contributing cause" for disability despite evidence from five physicians that claimant suffered from pneumoconio-sis.
.According to the decision of the Deputy Commissioner in this case, the only other doctor referred to in the record, Dr. W.S. Cole, "denies the existence of Pneumoconiosis." The Deputy Commissioner found that Crisp had "emphysema, not pneumoconiosis ... relatable to his many years of cigarette smoking.”