holding it was not essential for physician to state that claimant was totally disabled when his report listed claimant’s physical limitations, the ALJ was then required to compare the exertional requirements of claimant’s coal mine work with his capabilities
How later courts described this case
- holding it was not essential for physician to state that claimant was totally disabled when his report listed claimant’s physical limitations, the ALJ was then required to compare the exertional requirements of claimant’s coal mine work with his capabilities
- appellate court "may neither fill in the gaps in the ALJ's reasoning ... nor decide the facts anew"
- reversing denial of black lung benefits where BRB applied wrong legal standard
- "With respect to questions of law, however, our standard of review is de novo."
Written by the judges who cited it.
The opinion
COFFEY, Circuit Judge, dissenting.
In remanding this case to the AU, the majority has required the application of the “contributing cause” or “necessary condition” standard established in this court’s decisions in Shelton v. Director, OWCP, 899 F.2d 690 (7th Cir.1990) and Hawkins v. Director, OWCP, 907 F.2d 697 (7th Cir. 1990). For reasons more fully discussed in my Compton concurrence, Compton v. Inland Steel Coal Co., 933 F.2d 477 (7th Cir.1991) (Coffey, J., concurring), I am convinced that the all-inclusive Shelton-Hawkins standard is inconsistent with Congress’ clear intent that a miner establish that his total disability was primarily due to pneumoconiosis. See also Collins v. Director, OWCP, 932 F.2d 1191 (7th Cir. 1991) (Coffey, J., concurring). Rather, I believe that a miner should be required to demonstrate that pneumoconiosis constituted at least 51 percent of the cause of his total disability, as this standard implements Congress’ intent that only those who suffered from a medically documented pneu-moconiosis-caused total disability should recover black lung benefits. See 20 C.F.R. § 718.402 (requiring medical evidence adequate to support claim). A requirement of less than 51 percent of causation, such as the Shelton-Hawkins standard, is so all expansive that it improperly permits recovery of black lung benefits when a miner’s total disability was not “due to” pneumoco-niosis but may have been “due to” a number of other unrelated medical problems and/or physical infirmities, such as emphysema, tuberculosis, cigarette smoking, obesity, hypertension, alcoholism, kidney failure, asbestos-related diseases, heart disease or diabetes. The Shelton-Hawkins standard would permit recovery of black lung benefits in cases where pneumoconio-sis was as little as five or perhaps even three percent of the cause of total disability, as long as coal mining was deemed “necessary” to the pneumoconiosis, and pneumoconiosis was deemed “necessary” to the miner’s total disability. This amorphous and all-inclusive standard fails to give AUs or other fact finders guidance in accordance with the congressional intent to limit benefits to miners where total disability was more than 50 percent attributable to pneumoconiosis. A miner conceivably could recover full benefits even if his total disability were ninety-five percent attributable to cirrhosis of the liver or cancer of the pancreas and only five percent attributable to pneumoconiosis. If we are to protect the assets of the funds for truly deserving claimants, the mere fact of having been employed in a coal mine should not be a basis for recovery of disability benefits when the medical evidence present fails to demonstrate that pneumoconiosis was the major (51 percent) but not 100 percent of the contributing cause of a miner’s total disability. Furthermore, the “51 percent” standard effectively conforms to the legislative intent underlying the Black Lung Benefits Act, including the 1981 amendments, in which Congress stated its intent to tighten eligibility requirements to safeguard the Black Lung Trust Fund for those *510 truly deserving benefits m order to alleviate and control the expanding deficit in the Trust Fund.
The facts in the case before us illustrate the permissive and ambiguous nature of the Shelton-Hawkins “necessary condition” or “contributing cause” standard of causation, as it permits the AU to find disability “due to” pneumoconiosis in a case where the majority states, in regard to the only medical evidence of causation, “Dr. Rao’s report can be read as showing that. Mr. Shelton’s total disability results from a combination of pneumoconiosis, angina pectoris, and hypertension,” Majority Opinion at 508, without any percentage of causation noted. In contrast, the objective “percentage” standard would clearly prevent Shelton from receiving benefits on the basis of Dr. Rao’s unquantified report. Adopting such an objective standard would lead to consistent treatment of applicants as well as to stability of the Black Lung Benefits Trust Fund. Thus, on the basis of the record made before the AU, I would hold as a matter of law that Shelton’s failure to demonstrate that his purported total disability was “due to” pneumoconio-sis renders harmless any alleged error in the AU’s consideration of whether Shelton was totally disabled. The AU’s rejection of Shelton’s claim should be affirmed.