Black Lungs Benefits Program

Also known as pneumoconiosis, black lung is a disease that affects the lungs and is caused by inhaling graphite or coal dust. It begins to develop when the immune system of the body tries to eliminate coal dust that gets deposited into the lungs. This process is so complex that eventually the body’s white blood cells get overwhelmed. When this happens, the cells release enzymes that harm the lungs by developing scar tissue. Slowly by slowly, the scarring accumulates to a point where it shrinks the lungs’ volume. This results in even bigger damage to the nearby tissue. The term ‘black lung’ originated from how the victim’s lungs will look like after the disease strikes (the lungs will develop black spots and ultimately turn black).

It is not always the case that exposure to coal dust is only possible when one is working underground. Exposure to coal dust can also occur above ground during processing or strip mining of the coal. Coal dust may spread throughout your lungs over a period of time. The longer you are exposed to this dust, and the more the dust you get exposed to, the higher the chances of the dust depositing in your lungs.

Dust from coal may block the air passage resulting in permanent scarring. It normally takes at the minimum 10 years for black lung disease to develop in a person. However, in other individuals, it may develop sooner than expected. For this reason, doctors advise that coal employees should conduct chest x-rays each year to help achieve timely detection of the disease so that it can be monitored.

Black lung disease has no cure. Thus, prevention is very important. Once the particles of coal dust enter the lungs, your body is incapable of expelling them.

Pneumoconiosis is classified into two;

• Simple coal workers’ pneumoconiosis
• Progressive massive fibrosis

In most cases, coal miners contract simple pneumoconiosis. Here, you will only experience slight symptoms like being short of breath and coughing. However, according to research, every year a minor percentage of these miners develop progressive mass fibrosis which is the most severe type of pneumoconiosis. When you develop this serious black lung disease, you will start developing large scars in your lungs as a result of the dust. Blood vessels found in lungs and lung tissues may be damaged by the scars.

Coal miners suffering from rheumatoid arthritis are at a high risk of contracting Caplan’s Syndrome. This is a disorder where large round nodules of scarring develop at a faster rate in the lungs.

Pneumoconiosis can advance without your knowledge. In the early stages, you may not experience any signs at all. The first signs you experience, for example, prolonged cough or shortness of breath may be due to smoking or you could be having other medical issues like asthma or heart disease.

Even worse, individuals with this condition are at a greater risk of suffering from emphysema or chronic bronchitis. Black lung disease often occurs alongside silicosis. Silicosis is a lung disease resulting from inhaling dust from silica. Ultimately, if simple coal workers’ pneumoconiosis advances to complicated pneumoconiosis, breathing becomes more and more difficult. This can cause heart or respiratory failure.

If you experience any of the above-mentioned symptoms, you should seek immediate medical care. Also, you can still go for regular lung checkup even if there are no symptoms yet. In Long Beach, we have The National Institute for Occupational Safety and Health (NIOSH) body that operates a Coal Workers’ Health Surveillance Program. The program offers free lung screening, chest x-rays, testing pulmonary function and many health valuations for coal employees.

Detecting black lung disease while it is in its initial stages is very important. It is the only way you can prevent it from advancing. This will mean you stop or limit coal dust exposure. The federal law provides that any coal miner who gets diagnosed with pneumoconiosis should be transferred to another post within the mining industry without his or her pay being compromised. The new place of transfer should have coal dust concentration below a certain level.

The Doctors diagnosis pneumoconiosis when they detect abnormalities (opacities) on a CT scan or chest x-ray. They can tell the extent of black lung progression depending on the size and number of the abnormalities. When the doctor diagnoses pneumoconiosis depending on positive chest x-ray results, they will want you to do arterial blood gas tests as well as testing the pulmonary function. These tests will indicate the degree of damage the disease has caused in your lungs.

Apart from minimizing coal dust exposure, black lung disease treatment options are limited. They are mainly focused on enabling the victim to breathe. Doctors may use inhalers and nebulizers to try and treat breathing difficulties. They may also use an oxygen tank in case the patient has a serious case in which the levels of oxygen in the blood are very low. Performing a lung transplant can also be another option. However, this will happen only if the patient is strong and healthy enough to undergo the procedure.

Several coal mine companies have attempted to enforce the use of respirators by coal miners as a way of enhancing mine safety but they have failed. The equipment does not make coal employees any less exposed and they are not safe. In many cases, these respirators have worsened the situation. For one, wearing respirators in a hot and stuffy mine for close to 12 hours daily is very uncomfortable. What makes it worse is that most of these respirators are defective since they clog up with dust coal thus intensifying the employee’s exposure to toxic substances and maximizing the chances of developing black lung disease.

The Black Lung Benefits Program is a form of federal workers’ compensation benefits program which provides medical benefits and monthly payments to coal employees that have been completely disabled from black lung disease as a result of working around or in the coal mines. The program also gives monthly benefits to dependent survivors of a miner if black lung disease led to the death of the miner.

What the Black Lung Disease Benefits Program Covers

This program covers medical service bills and expenses related to traveling for the treatment of the disease. Payment of medical services depends on the maximum permissible fee. However, the patient does not need to pay a copayment. Travel payments are restricted to reasonable charges.

After submitting an application for your benefits, you have to complete an evaluation of pulmonary function. This medical examination determines whether or not you are permanently disabled by pneumoconiosis. The law requires that the labor department conduct a non-chargeable examination in order to prove if you are entitled to pneumoconiosis benefits. The examination includes;

• A chest x-ray
• A physical examination conducted by a doctor
• An arterial blood gas test
• A pulmonary function test

Services Covered Under Black Lung Benefits Program

Under this program, current and ex-coal miners, any worker in the coal mine industry who has had coal dust exposure, and surviving dependents of coal miners who succumbed to black lung disease may seek compensation for monthly financial compensation and medical benefits.

The program also covers diagnostic testing services in order to confirm black lung presence and the extent of the related disability. Compensation can consist of lost monthly wages and medical bills that will cover hospitalization, prescription drugs, outpatient therapy, and long-lasting medical equipment. Listed below are services that this program will most likely cover for black lung disease treatment.

• Hospital visitations, consultations, and doctor’s office calls
• Outpatient and inpatient hospital bills. This includes emergency room visitations in the event of severe pneumoconiosis conditions, x-rays of the chest, and diagnostic lab testing
• Ambulance services restricted to transportation to the hospital in case of an emergency acute pneumoconiosis-related care
• Prescription drugs (both generic and brand name) approved by the program
• Travel to see the doctor, to the clinic, hospital, or any other medical facility. The program covers round trips of up to 200 miles

Costs Not Covered Under the Black Lung Benefits Program

These are among the charges that this program does not cover;

• Home health assistants
• Personal services that you are provided for in the hospital. For instance, telephone or television.
• Home use medical equipment that is not authorized by the program
• Nurse’s assistants (care provided by non-skilled nurses) at your home
• Eye care, dental care, and other x-rays apart from chest-related x-rays
• Medical care for the spouse or other family members of the patient
• Medication that you can obtain without a prescription of the doctor
• Travels to and from where you buy your drugs
• Medication for other issues apart from the black lung disease
• Treatment of diseases not associated with black lung disease. For instance, diabetes, arthritis and heart conditions
• Nursing home residence costs (board and room). Skilled nursing services are also not catered for
• Purchase or rental of an Intermittent Positive Pressure Breathing (IPPB) equipment meant for use at home

The process of claiming your benefits is handled by the Division of Coal Mine Workers’ Compensation (DCMWC) within the labor department.

After you have been diagnosed with pneumoconiosis you can file a compensation claim and receive your benefits. You may receive the benefits through California workers’ compensation system or a distinctive federal black lung program. This means you may file two separate claims.

If you have been diagnosed with pneumoconiosis, you should inform your current or former employer as soon as possible. The next step is seeking medical attention. Filing a compensations claim starts by filling out the claim form which your employer will provide you with. If the employer does not give you this form, download it from the DWC website.

Provide accurate information as requested in the claim form and submit it to your employer. Ensure you have a copy of the same form with you as proof that you completed the form. Your employer will then fill out the employer section of the form and issue a signed copy to you within a day. If you do not receive the signed copy from the employer you should inquire about getting it.

After your employer fills out the form, it is sent to the company’s insurance provider. The insurance company then reviews the details and sends you a response to the status of the claim through a letter. The letter should be sent within two weeks. As the law provides, the company has 90 days from the day of the filing of the claim to inform you if the claim was denied or accepted. If it doesn’t communicate, the claim is assumed to be accepted.

Among what you will be compensated for include;

• Past and current medical bills
• Temporary disability benefits
• Permanent disability benefits
• Supplemental job displacement benefits
• Lost wages compensation
• Death benefits in case the disease led to the death of a family member

When diagnosed with pneumoconiosis, the company you work for is held responsible and is supposed to compensate you for the damage. It is usually the latter company you have been working for in a span of one year or so that is held responsible. However, note that the company will only compensate you in case it meets various requirements of the law. If it doesn’t, the Black Lung Disability Trust Fund assumes the responsibility and compensates you.

The initial step in filing for Pneumoconiosis benefits is filling out the Miner’s Claim for the Benefits application form. In the form, you have to provide basic details about you and that of your family. In addition to the application form, you will fill out an employment record or otherwise known as a supplemental form. On the form, you will be required to provide information relating to your coal mining work, the period you have worked in coal mining, the coal mining companies you have worked for, and your other work apart from coal mining. The information is necessary as it helps determine whether or not you were a coal miner. It also helps to rule out whether or not a particular coal mining company will cover your benefits. Your workers’ compensation attorney can help you complete these forms appropriately.

Depending on the details in the above-mentioned forms, the Division of Coal Mine Workers’ Compensation (DCMWC) may need you to give more information. The information could include copies of your official documents like marriage certificate, death certificates, birth certificates of children, and documents proving that the children are enrolled in school. The information is important as it helps to establish simple facts concerning your eligibility to compensation or the eligibility of your family members.

When the processing of your compensation claim begins, you will be contacted to plan a full pulmonary evaluation session. You will be given the names of doctors who can conduct this test. All these doctors have to be located within the state of California or a neighboring state. From the list, you’ll be requested to pick a doctor of your choice but you will use the doctor within various limitations.

After pulmonary examination results have been received, DCMWC conducts an initial review of the results and determines whether or not they agree with you being awarded your claim. Note that the review isn’t final. A letter expounding on the results of the pulmonary evaluation will be sent to you. The letter will also explain the reasons for DCMWC’s opinion on your benefits entitlement. That is, why they think you qualify or do not qualify for the benefits. The letter is referred to as the Schedule for the Submission of Additional Evidence. It will notify you of the opportunity to add more evidence, the right to acquire more proof from a doctor of your choice and the timeframe for bringing in the evidence. If the coal company is responsible for your benefits, it has the right to choose a doctor who examines you. If you decline to be examined, the company may deny you your benefits even if you are entitled to them.

When applying for pneumoconiosis benefits, the most significant part is to obtain medical proof of your physical state. The Black Lungs Benefits Program limits the amount of medical proof that you and the coal mining company can provide to the DCMWC to determine whether or not you are eligible to benefits. It is important that before submitting any more medical proof to the labor department, you seek counsel from your workers’ compensation attorney. He or she will be able to advise on what evidence to and not to submit. Normally, the attorney’s fees are cleared by the company responsible for compensating you or the Black Lung Disability Trust Fund. The fee is paid only after your claim has been approved. However, there are situations where you might be responsible for paying the lawyer’s fees. You aren’t responsible for paying any attorney’s fees in the event that your claim is denied.

After the DCMWC has gotten and gone through all of your proof supporting your claim, it decides whether or not you claim must be denied or approved. After it has made a decision, it issues a proposed Decision and Order which explains the reasons for approval or denial of your claim. You will also be informed of the steps of challenging their resolution and the timeframe for pursuing the case any further. Steps that one could take include appealing with the labor department to reconsider its verdict or requesting a hearing before a judge.

Not that it is often difficult to be entitled to black lung benefits whether under California workers’ compensation system or through the federal program. This is because the mining sector together with companies’ insurance providers fights strongly these claims resulting in lengthy legal processes. For this reason, you need to have a workers’ compensation attorney who is familiar with work-related illnesses affecting coal mine employees by your side. You could consult with him or her and he/she can refer you to an expert doctor. The attorney will also fight to ensure your rights are upheld and may try to quicken the complicated process.

There are strict timeframes for notifying your employer of a work-related illness or injury and for filing a workers’ compensation claim. While the statute of limitations varies from one state to another, time usually starts running out depending on when you were last exposed to coal dust, when you start experiencing symptoms of the disease or when you get diagnosed with the condition. In California, you have 30 days from the time you learn of the black lung disease to notify your employer and up to one year to file a workers’ compensation claim.

At The Workers’ Compensation Attorney Group, we understand the emotional, financial, and even physical struggles that coal miners and their families go through when fighting black lung disease. Therefore, we are committed to helping our clients obtain fair compensation. If you are in Long Beach, California and you need to file a compensation claim through a California workers’ compensation system or through the federal Black Lung Benefits Program, please reach out to our Long Beach work injury attorney at 714-716-5933. Our skilled attorneys are ready to review and support your claim.