Petition for Review of an Order of the Benefits Review Board. No. 06-BLA-0457.
The opinion of the court was delivered by: Flaum, Circuit Judge.
Before EASTERBROOK, Chief Judge, and FLAUM and EVANS, Circuit Judges.
Donald Beeler is a 76-year-old ex-smoker who spent a substantial portion of his career working in mines. After being diagnosed with lung disease, he applied for benefits under the Black Lung Benefits Act. An Administrative Law Judge ("ALJ") reversed an earlier decision by the Department of Labor and awarded Beeler benefits under the Act. The ALJ weighed conflicting medical evidence and concluded that Beeler's lung disease arose, in part, from his coal mine employment. Because the ALJ's decision was supported by substantial evidence, we affirm.
Beeler was an underground coal miner for at least 13 years, between 1961 and 1983. During that period of time, he spent ten years with Consolidation Coal Company ("Consolidation") and was last classified as a section foreman. When he was with Consolidation, he worked five to seven days per week averaging 12-hour workdays. His primary task was to make daily safety inspections of the mine faces. He also worked with the crew, lifting and carrying heavy supplies, helping with roof bolting, operating the shuttle car, and assisting with repairs. On average, he walked five to six miles per day. He was exposed to coal dust on a daily basis. What complicates this case is that Beeler was also a smoker. He started smoking cigarettes at age 18 or 19, averaging one to one-half pack per day at varying times. He quit at age 54, after about 35 years of smoking.
Beeler's only medical condition is severe lung disease, and he has testified that his breathing problems started while he was working for Consolidation. His symptoms included shortness of breath, the inability to lift heavy objects, and the inability to walk any significant distance. He was referred to a pulmonary specialist, Dr. Prabhu, in 1997. Dr. Prabhu gave Beeler inhalers (which he was already taking), and enrolled him in a pulmonary rehabilitation program which he was unable to complete. Beeler then began seeing Dr. Henkle, another pulmonary physician, in 2002. He ordered supplemental oxygen and prescribed nebulizer therapy. By 2005, Beeler was totally dependant on the supplemental oxygen and was taking three nebulizer treatments a day.
Beeler filed a claim for black lung benefits in August of 2001. He went through a Department of Labor examination with Dr. Drake, who found it reasonable that his ailment-chronic obstructive pulmonary disease ("COPD")-was related to both his smoking history and coal mining employment and that it disabled him.*fn1 Nevertheless, the Department of Labor denied the claim on August 12, 2002, finding that Beeler's lung disease did not qualify him for benefits. Beeler sought review before an ALJ. Before this hearing, the parties developed additional evidence, including expert witness reports. The ALJ ultimately awarded benefits to Beeler. He found the presence of legal pneumoconiosis (i.e., COPD arising out of coal mining employment) and total disability due to the pneumoconiosis based on the medical opinion submitted by Beeler's expert. The Benefits Review Board affirmed the award of benefits on February 28, 2007.
Consolidation raises a single issue on appeal: whether the ALJ's determination that Beeler has pneumoconiosis is supported by substantial evidence in the record. On petition for review from a decision of the Benefits Review Board, we examine the ALJ's decision to determine if it is rational, supported by substantial evidence, and in accordance with the law. Peabody Coal Co. v. Shonk, 906 F.2d 264, 267 (7th Cir. 1990). We accept findings of fact and corresponding conclusions when they are supported by substantial evidence in the record considered as a whole. Meyer v. Zeigler Coal Co., 894 F.2d 902 (7th Cir. 1990).
In order to establish entitlement benefits, a miner must show that he or she is totally disabled by pneumoconiosis arising out of coal mine employment. Midland Coal Co. v. Director, OWCP [Shores], 358 F.3d 486, 491 (7th Cir. 2004). Pneumoconiosis in this context can take two forms: clinical and legal. Clinical pneumoconiosis is a "condition characterized by permanent deposition of substantial amounts of particulate matter in the lungs and the fibrotic reaction of the lung tissue to that deposition caused by dust exposure." 20 C.F.R. § 718.201(a)(1). Legal pneumoconiosis, which is what is at issue in this case, is a broader concept. It is defined as any chronic lung disease arising out of coal mining employment including COPD, emphysema, and chronic bronchitis, which are characterized by airway dysfunction and are evidenced by a decrement in the miner's ability to exhale in a given amount of time.
30 U.S.C. § 902(b). Thus, Beeler had to prove in his proceedings below that his COPD was caused, at least in part, by his work in the mines, and not simply his smoking habit.
There were several medical opinions given in this case. Dr. Drake examined Beeler in 2002 as a part of the Department of Labor pulmonary evaluation. He diagnosed COPD-namely emphysema and chronic bronchitis-and total disability. He concluded that the condition was primarily due to smoking and found it reasonable that occupation exposure was contributory given that smoking could not account for the severity of the disability. In addition, Dr. Prabhu and Dr. Cady wrote letters in support of Beeler's black lung claim in 2002. Dr. Prabhu diagnosed COPD and both doctors determined that smoking history and coal dust contributed to the disease. Dr. Henkle also examined Beeler in 2002. His diagnosis was similar, and he concluded that coal dust exposure could have contributed to the development of the emphysema, as the smoking history was not particularly strong. Then, Dr. Tuteur examined Beeler at Consolidation's request in 2003; he diagnosed severe COPD solely due to smoking. He concluded that coal dust exposure did not cause or contribute to Beeler's lung disease, noting that miners with no smoking history rarely have COPD, while smokers have a one in five chance of developing a severe obstruction. Dr. Renn reviewed the medical records and issued a report in 2004 where he diagnosed COPD due solely to smoking. Finally, Dr. Cohen reviewed the medical records and issued a report of his findings in 2005. He attributed the lung disease to both occupational exposure and smoking.
The primary dispute in this case is whether the ALJ considered and weighed all of the medical opinions that address the etiology of Beeler's chronic obstructive lung disease. In order to qualify for benefits, Beeler had to demonstrate that his lung disease was caused, at least in part, by coal dust he inhaled while working as a miner. Dr. Drake and Dr. Cohen concluded that the lung disease was due to coal mine employment as well as smoking. Dr. Tuteur and Dr. Renn decided that coal mine employment was not a cause. The ALJ gave decisive weight to Dr. Cohen's opinion and found the others, on a relative basis, poorly reasoned. At the end of the day, "weighing conflicting medical evidence is precisely the function of the ALJ as fact-finder." Poole v. Freeman United Min. Co., 897 F.2d 888, 895 (7th Cir. 1990). The ALJ found Dr. Cohen's opinion most persuasive because he carefully discussed the substantial body of scientific evidence documenting the causal relationship between COPD and occupational ...