Lawmakers ask feds to investigate black lung; Obamacare repeal could be obstacle to benefits

Progressive massive fibrosis in underground miners
 with more than 25 years experience (Coal Workers’
 Health Surveillance Program, Ky.,Va.,W.Va,1974–2015)

Reports that black-lung disease among coal miners in Central Appalachia is significantly higher than federal records show has led to requests for more accurate reporting of the disease, Howard Berkes reports for NPR. Sen. Bob Casey (D-Pa.) and Rep. Bobby Scott (D-Va.) want the National Institute for Occupational Safety and Health, the U.S. Department of Labor Coal Mine Workers' Compensation Program, and black lung clinics funded by the Health Resources and Services Administration to work together do a better job obtaining counts of progressive massive fibrosis, the most progressive form of black lung.

Scott and Casey sent NIOSH a letter asking it to lead a study of complicated black lung cases identified by its own national testing program, by the Coal Mine Workers' Compensation Program and by HRSA, which doesn't require its clinics to report cases of progressive massive fibrosis, Berkes reports.

An NPR survey of black lung clinics across Appalachia—11 responded—found 962 cases "of what is also known as 'complicated' black lung so far this decade," Berkes writes. "In roughly the same time period, NIOSH reported just 99 cases nationwide." A report by the federal Centers for Disease Control and Prevention found that an Eastern Kentucky radiologist contacted NIOSH about finding 60 active or former coal mining patients in Pike County from Jan. 1, 2015 to Aug. 17, 2016 that were consistent with progressive massive fibrosis.

Another concern is that repeal of the Patient Protection and Affordable Care Act could make it difficult for coal miners to get benefits for black-lung disease, Eric Boodman reports for Stat, the national health-and-science website of The Boston Globe. The 2010 reform law "shifted the burden of proof from the miners onto the mining companies." Before the law, 19 percent of black lung disease claims were successful. In 2015, 28 percent of claims were successful. The law says someone who spent at least 15 years in the mines and can prove they have breathing issues ... is presumed to have black lung "unless a company can prove otherwise," reports Angela Reighard of WYMT-TV in Hazard, Ky.