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Miner's surviving spouse eligible for black lung benefits under PPACA

Miner's surviving spouse eligible for black lung benefits under PPACA

A deceased miner's spouse is not required to establish cause of death to receive benefits for black lung disease under the Patient Protection and Affordable Care Act, a U.S. appeals court ruled Thursday.

Thursday's decision in U.S. Steel Mining Co. L.L.C. v. Director, OWCP represents the second time in one day in which federal appeals courts found against employers and awarded benefits under changes the PPACA made in eligibility requirements for federal black lung benefits programs launched in the early 1970s.

In 1978, Congress ordered that when a miner receiving the benefits died, their survivors would not have to file a new claim or revalidate an existing claim in order to receive survivor benefits.

But in 1981, Congress once again changed course, requiring survivors to file new claims and show that the miner died because of pneumoconiosis, also known as black lung disease.

In 2010, the PPACA changed the law once again by eliminating the 1981 language that required survivors to file new claims showing the miner died because of pneumoconiosis.

That change applied retroactively to claims that were filed after Jan. 1, 2005, but were still pending on March 23, 2010.

In the case at hand involving U.S. Steel, an administrative law judge in 2000 awarded black lung benefits to Elijah Starks, a coal miner of 44 years. U.S. Steel paid the benefits, and Mr. Starks died in 2006.


His surviving spouse then filed for the benefits he had received. But an administrative law judge denied the benefits after finding Ms. Starks failed to provide a preponderance of evidence that Mr. Starks died because of pneumoconiosis.

Ms. Starks filed a motion to modify that order when the PPACA became effective, and an administrative law judge agreed she was eligible for benefits without having to show Mr. Starks died of black lung.

A federal Benefits Review Board upheld that finding, and U.S. Steel appealed to the Atlanta-based 11th U.S. Circuit Court of Appeals.

U.S. Steel argued that Ms. Starks is still required to prove her husband died due to pneumoconiosis; that the PPACA's retroactivity refers to miners' claims, not surviving spouses' claims; and that the retroactive application of the PPACA violates due process requirements under the Fifth Amendment.

But the appeals court unanimously disagreed and said Congress made a rational, legislative choice to provide survivors an improved opportunity to obtain benefits. It found that the PPACA eliminated the need for survivors to prove that their miners died due to pneumoconiosis and that the retroactive application does not violate Fifth Amendment rights.

The court upheld the Federal Benefits Review Board's finding.

Also on Thursday, the U.S. Circuit Court of Appeals in Chicago ruled that a coal miner is entitled to black lung benefits because of changes afforded under the PPACA.

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