Reducing the Overburden: The Doris Coal Presumption and Administrative Efficiency Under the Black Lung Benefits Act

Coal dust build-up prevents many coal miners’ lungs from functioning properly. This condition, commonly referred to as black lung or pneumoconiosis, can make common activities nearly impossible. The Black Lung Benefits Act covers the cost of medical treatment for many affected miners, though procedural impediments often prevent miners from receiving care. The miner’s current or former employer, when identifiable, must pay for medical care relating to the miner’s black lung. Most disputes over miners’ claims for medical care arise when the miner has a history of cigarette smoking and the need for medical care could arise from either coal dust or tobacco smoke because both substances affect the same body systems. Coal companies prefer not to pay for medical care arising from cigarettes, while miners do not want their smoking history to prevent coverage of treatment for their occupational disease, especially when causation has not been clearly established. To receive payment for care, miners must prove to the Department of Labor through an often lengthy administrative process that the medical treatment met the eligibility requirements. Specifically, miners must assemble both medical documentation describing the treatment and the justification for the treatment in order to prevail in the administrative hearing.