In March of 2018, Kentucky enacted a law that opponents feared would make it harder for miners to get compensation for black-lung disease. A review of state records shows that the share of Kentucky miners "diagnosed by state-approved experts as having the disease fell from 54 percent before the law change to just 26 percent," Sydney Boles reports for Ohio Valley ReSource, a public-radio consortium. "An analysis of state data by the Ohio Valley ReSource also suggests that the doctors now making decisions on claims more often side with coal companies than with coal miners."
To get black-lung benefits, a miner or family member files a claim with the state Labor Cabinet that includes evidence of diagnosis: a blood-gas analysis showing breathing impairment, and an X-ray showing evidence of black lung. "Once the claim is filed, the miner’s most recent employer’s insurance company can request to have an X-ray read by a physician of their choosing, and the judge overseeing the case can require a third reading from a 'designated evaluator,' whose analysis is presumed to be correct unless there is overwhelming evidence to the contrary," Boles reports.
Before the law was passed, radiologists were allowed to diagnose black lung, since evaluating X-rays is their specialty. But under the new law, only certain pulmonologists, doctors who specialize in the lungs, are allowed to diagnose it, Boles reports. At the time the law was passed, only six Kentucky pulmonologists had the federal certification to diagnose black lung, and four of them were routinely hired by coal companies or their insurers, Howard Berkes of NPR and Benny Becker of OVR reported at the time. The law also excluded out-of-state doctors from diagnosing the disease.
Only two pulmonologists, both with ties to the coal industry, chose to serve as designated evaluators. Data showed that both disagreed with an initial black lung diagnosis in 85.5% of cases, Boles reports.
"The changes to state law have not resulted in a backlog of cases, as opponents had feared. But state records indicate that the restrictions have had an impact on the share of miners who win their claims," Boles reports. "The ReSource found that 161 benefits claims were filed but only 16 coal miners were awarded black lung benefits in 2019. That’s the lowest ratio of claims awarded to claims dismissed in the past seven years." Boles notes that not all claims are resolved in the same calendar year in which they are filed.
To get black-lung benefits, a miner or family member files a claim with the state Labor Cabinet that includes evidence of diagnosis: a blood-gas analysis showing breathing impairment, and an X-ray showing evidence of black lung. "Once the claim is filed, the miner’s most recent employer’s insurance company can request to have an X-ray read by a physician of their choosing, and the judge overseeing the case can require a third reading from a 'designated evaluator,' whose analysis is presumed to be correct unless there is overwhelming evidence to the contrary," Boles reports.
Before the law was passed, radiologists were allowed to diagnose black lung, since evaluating X-rays is their specialty. But under the new law, only certain pulmonologists, doctors who specialize in the lungs, are allowed to diagnose it, Boles reports. At the time the law was passed, only six Kentucky pulmonologists had the federal certification to diagnose black lung, and four of them were routinely hired by coal companies or their insurers, Howard Berkes of NPR and Benny Becker of OVR reported at the time. The law also excluded out-of-state doctors from diagnosing the disease.
Only two pulmonologists, both with ties to the coal industry, chose to serve as designated evaluators. Data showed that both disagreed with an initial black lung diagnosis in 85.5% of cases, Boles reports.
"The changes to state law have not resulted in a backlog of cases, as opponents had feared. But state records indicate that the restrictions have had an impact on the share of miners who win their claims," Boles reports. "The ReSource found that 161 benefits claims were filed but only 16 coal miners were awarded black lung benefits in 2019. That’s the lowest ratio of claims awarded to claims dismissed in the past seven years." Boles notes that not all claims are resolved in the same calendar year in which they are filed.
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