Consolidation Coal Co v. Director OWCP ( 2018 )


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  •                                                      NOT PRECEDENTIAL
    UNITED STATES COURT OF APPEALS
    FOR THE THIRD CIRCUIT
    _____________
    No. 17-2067
    _____________
    CONSOLIDATION COAL COMPANY,
    Petitioner
    v.
    DIRECTOR OFFICE OF WORKERS COMPENSATION PROGRAMS,
    UNITED STATES DEPARTMENT OF LABOR;
    FRANCES FUNKA, on behalf of and as survivor of
    JOHN FUNKA,
    Respondents
    ______________
    On Petition for Review of a Decision and
    Order of the Benefits Review Board
    (BRB No. 16-0184 BLA)
    _______________
    Submitted Under Third Circuit LAR 34.1(a)
    January 12, 2018
    Before: JORDAN, ROTH, Circuit Judges and MARIANI*, District Judge
    (Filed: July 12, 2018)
    _______________
    OPINION
    _______________
    *
    Honorable Robert D. Mariani, United States District Court Judge for the Middle
    District of Pennsylvania, sitting by designation.
    
    This disposition is not an opinion of the full court and, pursuant to I.O.P. 5.7,
    does not constitute binding precedent.
    MARIANI, District Judge
    Consolidation Coal Company (“Consolidation”) petitions for review of a decision
    of the United States Department of Labor Benefits Review Board (“BRB”), affirming an
    award of disability benefits to a deceased miner, John Funka, and an award of survivor’s
    benefits to Mr. Funka’s widow, Frances Funka, under the Black Lung Benefits Act
    (“BLBA”), 30 U.S.C. §§ 901-944. For the reasons discussed below, we will deny
    Consolidation’s Petition for Review.
    I.     Background
    John Funka worked underground in coal mines for at least forty years. Mr. Funka
    spent the first twenty years of his career as a maintenance supervisor and section
    mechanic for Matthews Coal Company, now owned by Consolidation, before becoming a
    deep mine electrical inspector for the Office of Deep Mine Safety. Prior to retiring on
    December 13, 1991, Mr. Funka began experienced breathing difficulties. The problem
    steadily worsened and, by 1993, Mr. Funka was receiving medical treatment to address
    his breathing.
    On June 5, 2003, Mr. Funka filed a claim for benefits under the BLBA. After the
    district director proposed awarding benefits, Consolidation requested a formal hearing.
    On September 23, 2005, after conducting a formal hearing, Administrative Law Judge
    (“ALJ”) Michael Lesniak issued a Decision and Order denying benefits. Mr. Funka
    appealed ALJ Lesniak’s decision to the BRB. On December 11, 2005, before the BRB
    issued a decision on his appeal, Mr. Funka died. Mrs. Funka then filed a survivor’s claim
    on August 7, 2006.
    2
    In a Decision and Order issued on November 15, 2006, the BRB affirmed in part,
    vacated in part, and remanded the matter. On remand, Mr. Funka’s claim was
    consolidated with Mrs. Funka’s claim and ALJ Lesniak remanded both claims to the
    district director to reopen the evidentiary record and consider, among other things, the
    autopsy evidence and death certificate. The district director proposed awarding benefits
    on both claims and Consolidation timely requested a formal hearing. The case was
    reassigned to ALJ Ralph Romano, who held a formal hearing and issued a Decision and
    Order awarding benefits on March 4, 2008. Consolidation appealed the decision to the
    BRB and, on March 26, 2009, the BRB vacated the award of benefits and remanded the
    matter for further consideration.
    In a Decision and Order issued on December 20, 2011, ALJ Romano once again
    awarded benefits on both the miner’s claim and the survivor’s claim. Consolidation
    appealed. During the proceedings before the BRB, Mrs. Funka raised the issue of
    whether Consolidation improperly exceeded the evidentiary limitations found in 20
    C.F.R. § 725.414 by submitting three medical opinions. On January 30, 2013, the BRB
    affirmed in part, vacated in part, and remanded. As part of its order, the BRB directed
    the ALJ to evaluate whether a report authored by Dr. Oesterling constituted rebuttal
    autopsy evidence pursuant to 20 C.F.R. § 725.414.
    On remand, the matter was reassigned to ALJ Theresa Timlin. ALJ Timlin
    directed the parties to submit “an evidence summary form designating evidence in the
    living miner’s claim and a separate evidence summary form designating evidence in the
    survivor’s claim.” (App. at 79.) Over Consolidation’s objections, ALJ Timlin issued an
    3
    order on November 12, 2015, identifying what evidence would be considered in
    connection with the pending claims.
    On December 10, 2015, ALJ Timlin issued a Decision and Order awarding
    benefits on both the miner’s claim and the survivor’s claim. Noting that no regulatory
    presumption of pneumoconiosis applied to Mr. Funka’s claim1 and that the BRB had
    already affirmed ALJ Romano’s finding that pneumoconiosis was not established through
    X-ray evidence, ALJ Timlin evaluated the autopsy evidence. After reviewing the autopsy
    report of Dr. James Holimon and Dr. Everett Oesterling, ALJ Timlin credited Dr.
    Oesterling’s opinion that the autopsy did not reveal pneumoconiosis. Turning to the
    physician opinion evidence, ALJ Timlin outlined the findings of the three doctors who
    submitted medical reports: Dr. Joseph Tomashefski, Dr. Gregory Fino, and Dr. Francis
    Green.
    Dr. Tomashefski, who is board-certified in anatomic and clinical pathology,
    reviewed twenty of Mr. Funka’s autopsy slides and Mr. Funka’s medical records. Dr.
    Tomashefski concluded that Mr. Funka died as a result of diffuse end state interstitial
    1
    Twenty C.F.R. § 718.305 creates a regulatory presumption that a miner has
    pneumoconiosis if certain criteria are met. This presumption, however, applies only to
    claims filed after January 1, 2005. 20 C.F.R. § 718.305(a). As ALJ Timlin correctly
    concluded, Mr. Funka was not entitled to the § 718.305 presumption because Mr. Funka
    filed his claim on June 5, 2003. Further, although this presumption did apply to Mrs.
    Funka’s claim, which was filed on August 7, 2006, ALJ Timlin never analyzed the merits
    of the survivor’s claim. Instead, after awarding benefits on Mr. Funka claim, ALJ Timlin
    automatically awarded benefits on Mrs. Funka’s claim. See 30 U.S.C. § 932(l) (“In no
    case shall the eligible survivors of a miner who was determined to be eligible to receive
    benefits under this subchapter at the time of his or her death be required to file a new
    claim for benefits, or refile or otherwise revalidate the claim of such miner.”).
    4
    fibrosis. The doctor opined that Mr. Funka did not have coal workers’ pneumoconiosis
    based upon the lack of coal macules and micronodules. Dr. Tomashefski also noted
    minimal black pigment in the slides of Mr. Funka’s lungs and observed that the
    pigmentation was consistent with the amount one would expect to find in the lungs of
    someone who had never worked in coal mines. Ultimately, Dr. Tomashefski diagnosed
    Mr. Funka with idiopathic pulmonary fibrosis. Dr. Tomashefski cited to several articles
    to support his conclusion, including articles authored by Dr. Green. At his deposition,
    Dr. Tomashefski testified that several rationales supported his diagnosis, including that
    (1) Mr. Funka’s pulmonary function decreased more rapidly between 2003 and 2005 than
    would be expected in a retired coal miner, (2) the honeycombing in Mr. Funka’s lungs
    was inconsistent with coal mine dust exposure, and (3) the regional variability of fibrosis
    in Mr. Funka’s lungs was inconsistent with pneumoconiosis.
    Dr. Fino, who is board-certified in internal medicine and pulmonary medicine,
    offered his opinion based on a review of Mr. Funka’s medical records and two pathology
    reports. Dr. Fino also diagnosed Mr. Funka with idiopathic pulmonary fibrosis because
    Mr. Funka had diffuse interstitial pulmonary fibrosis and Dr. Fino’s review of the
    medical literature found no support for a link between this type of fibrosis and coal dust
    inhalation. Dr. Fino noted that in the few studies that connect pulmonary fibrosis to
    pneumoconiosis, the fibrosis was heavily pigmented. Thus, because Dr. Fino found
    minimal anthracotic pigment, he opined that coal mine dust did not cause Mr. Funka’s
    disability or death. Dr. Fino supported his conclusion with citation to the medical
    literature including a book and article authored by Dr. Green. At his deposition, Dr. Fino
    5
    also noted that Mr. Funka’s disease progressed rapidly, unlike what would be expected
    with pulmonary fibrosis induced by coal dust exposure. Dr. Fino also noted the presence
    of honeycombing in Mr. Funka’s lungs and testified that coal mine dust does not cause
    honeycombing.
    Dr. Green, who is board-certified in anatomic pathology, offered an opinion based
    upon his review of Mr. Funka’s autopsy slides and medical records. Dr. Green described
    fibrosis that had been present for many years and showed some, but minimal,
    pigmentation. He opined that the lack of pigmentation was likely due to Mr. Funka’s
    lungs clearing the coal mine dust. The doctor noted the presence of coal dust macules
    and micronodules in parts of the lungs and rounded opacities in the upper lung consistent
    with pneumoconiosis. Dr. Green diagnosed minimally severe simple coal worker
    pneumoconiosis and opined that pneumoconiosis was the direct cause of Mr. Funka’s
    death. Based upon the advanced state of the interstitial fibrosis in 2003, Dr. Green
    estimated a “conservative” onset date of 1998. (App. at 102.) The doctor noted that
    idiopathic pulmonary fibrosis is rare in the general population. Citing to the medical
    literature, Dr. Green provided three reasons why idiopathic pulmonary fibrosis was an
    improper diagnosis: (1) several experts have determined that idiopathic pulmonary
    fibrosis is an inappropriate diagnosis for those who have a history of fibrogenic dust
    exposure; (2) Mr. Funka lived significantly longer than would be typical for someone
    diagnosed with idiopathic pulmonary fibrosis; and (3) recent studies have indicated that
    idiopathic pulmonary fibrosis is usually due to dust and fume exposure. At his
    deposition, Dr. Green explained that coal mine induced fibrosis and idiopathic pulmonary
    6
    fibrosis are clinically indistinguishable. That is, doctors cannot distinguish the two
    conditions “radiologically or by pulmonary function testing.” (App. at 397.) According
    to Dr. Green, the only notable difference is that a longer survival rate is associated with
    coal mine induced fibrosis.
    ALJ Timlin found that “Dr. Green’s opinion on legal and clinical pneumoconiosis
    merits significant probative weight because it is well reasoned and well documented.”
    (App. at 105.) The ALJ afforded less weight to the opinions of Dr. Tomashefski and Dr.
    Fino, finding that both doctors’ opinions were contrary to the BLBA’s regulations and
    ignored the possibility of legal pneumoconiosis. Thus, based on Dr. Green’s opinion,
    ALJ Timlin concluded that Mr. Funka suffered from pneumoconiosis. Next, finding that
    Mr. Funka’s years of coal mine employment entitled him to a regulatory presumption that
    his pneumoconiosis arose out of his coal mine employment,2 the ALJ concluded that
    Consolidation failed to rebut this presumption. Finally, the ALJ concluded that Mr.
    Funka was totally disabled due to pneumoconiosis caused pulmonary fibrosis. Having
    made these findings, ALJ Timlin awarded benefits both on Mr. Funka’s claim and Mrs.
    Funka’s survival claim.
    2
    This regulatory presumption, found in 20 C.F.R. § 718.203(b), should not be
    confused with the § 718.305 regulatory presumption discussed above. Section 718.305
    concerns a rebuttable presumption that miners who meet certain criteria have established
    that they have pneumoconiosis. Section 718.203(b), in contrast, provides that once a
    miner establishes that he or she has pneumoconiosis, there is “a rebuttable presumption
    that the pneumoconiosis arose out of” coal mine employment if the miner “was employed
    for ten years or more in one or more coal mine.”
    7
    Consolidation appealed the ALJ’s decision to the BRB. The BRB affirmed the
    award of benefits on March 15, 2017, finding that the ALJ did not abuse her discretion in
    ordering the evidence re-designated and that she did not err in weighing the respective
    medical opinions. Consolidation then petitioned for review by this Court.
    II.    Standard of Review
    We have jurisdiction under 30 U.S.C. § 932(a), which incorporates the review
    procedures of the Longshore and Harbor Workers’ Compensation Act, 33 U.S.C. §
    921(c), in pneumoconiosis cases involving coal miners. See Labelle Processing Co. v.
    Swarrow, 
    72 F.3d 308
    , 310 (3d Cir. 1995). “We review the [BRB]’s decision to
    determine whether it committed an error of law and whether it adhered to its scope of
    review. In performing the latter function, we must independently review the record and
    decide whether the ALJ’s findings are supported by substantial evidence.” Wensel v.
    Dir., Office of Workers’ Comp. Programs, 
    888 F.2d 14
    , 16 (3d Cir. 1989) (quotation
    marks omitted). “Substantial evidence has been defined as ‘such relevant evidence as a
    reasonable mind might accept as adequate to support a conclusion.’” Hill v. Dir., Office
    of Workers’ Comp. Programs, 
    562 F.3d 264
    , 268 (3d Cir. 2009) (quoting Mancia v. Dir.,
    Office of Workers’ Comp. Programs, 
    130 F.3d 579
    , 584 (3d Cir. 1997)). “The [BRB]’s
    decisions on matters of law are subject to plenary review.” Marmon Coal Co. v. Dir.,
    Office of Workers’ Comp. Programs, 
    726 F.3d 387
    , 391 (3d Cir. 2013).
    III.   Discussion
    “Benefits are provided under the [BLBA] for or on behalf of miners who are
    totally disabled due to pneumoconiosis, or who were totally disabled due to
    8
    pneumoconiosis at the time of death.” 20 C.F.R. § 718.204(a). “[A] miner shall be
    considered totally disabled if the miner has a pulmonary or respiratory impairment which,
    standing alone,” meets certain regulatory criteria. 20 C.F.R. § 718.204(b)(1). “A miner
    shall be considered totally disabled due to pneumoconiosis if pneumoconiosis . . . is a
    substantially contributing cause of the miner’s totally disabling respiratory or pulmonary
    impairment.” 20 C.F.R. § 718.204(c)(1). An eligible survivor is automatically entitled to
    benefits if the miner was eligible for benefits at the time of the miner’s death. 30 U.S.C.
    § 932(l). Here, there is no dispute that Mr. Funka was totally disabled from a pulmonary
    impairment. Instead, the dispute centers on whether Mr. Funka had pneumoconiosis and
    whether his disability was due to pneumoconiosis.
    The regulations enacted pursuant to the BLBA define pneumoconiosis as “a
    chronic dust disease of the lung and its sequelae, including respiratory and pulmonary
    impairments, arising out of coal mine employment.” 20 C.F.R. § 718.201(a). The
    regulations recognize both “Clinical Pneumoconiosis,” defined as “those diseases
    recognized by the medical community as pneumoconioses, i.e., the conditions
    characterized by permanent deposition of substantial amounts of particulate matter in the
    lungs and the fibrotic reaction of the lung tissue to that deposition caused by dust
    exposure in coal mine employment,” and “Legal Pneumoconiosis,” defined as “any
    chronic lung disease or impairment and its sequelae arising out of coal mine
    employment.” 20 C.F.R. § 718.201(a)(1)-(2). “[P]neumoconiosis may be shown through
    1) a chest x-ray; 2) a biopsy; 3) statutory presumptions . . . ; 4) a physician’s evaluation.”
    9
    Penn Allegheny Coal Co. v. Williams, 
    114 F.3d 22
    , 23 (3d Cir. 1997) (citing 20 C.F.R. §
    718.202). 3
    Broadly speaking, Consolidation raises two issues on appeal. First, Consolidation
    claims that ALJ Timlin committed various errors when she credited Dr. Green’s medical
    opinion and rejected the medical opinions of Dr. Tomashefski and Dr. Fino. Second,
    Consolidation argues that ALJ Timlin abused her discretion when she ordered certain
    evidence withdrawn on remand. We will address each issue in turn.
    A.     Weighing of the Medical Opinions
    Consolidation’s arguments largely concern whether ALJ Timlin committed errors
    when she credited Dr. Green’s medical opinion that Mr. Funka had legal and clinical
    pneumoconiosis and rejected the contrary opinions of Dr. Tomashefski and Dr. Fino. An
    “ALJ has broad discretion to determine the weight accorded each doctor’s opinion.”
    Balsavage v. Dir., Office of Workers’ Comp. Programs, 
    295 F.3d 390
    , 396 (3d Cir.
    2002). “In reaching a decision, an ALJ should set out and discuss the pertinent medical
    evidence presented.” Kertesz v. Crescent Hills Coal Co., 
    788 F.2d 158
    , 163 (3d Cir.
    1986). “The ALJ is not bound to accept the opinion or theory of any medical expert, but
    may weigh the medical evidence and draw its own inferences.” 
    Id. “Moreover, the
    ALJ
    3
    To be eligible for benefits, a claimant must also show “that the miner’s
    pneumoconiosis arose at least in part out of coal mine employment.” 20 C.F.R. §
    718.203(a). “If a miner who is suffering or suffered from pneumoconiosis was employed
    for ten years or more in one or more coal mines, there shall be a rebuttable presumption
    that the pneumoconiosis arose out of such employment.” 20 C.F.R. § 718.203(b). ALJ
    Timlin’s finding that this presumption was applicable and unrebutted by Consolidation is
    not specifically challenged on appeal.
    10
    should reject as insufficiently reasoned any medical opinion that reaches a conclusion
    contrary to objective clinical evidence without explanation.” 
    Id. Initially, Consolidation
    contends that ALJ Timlin’s decision is internally
    inconsistent because it both credits Dr. Oesterling’s opinion that the autopsy evidence
    does not prove that Mr. Funka had pneumoconiosis and also credits Dr. Green’s opinion
    that the autopsy evidence did reveal pneumoconiosis. This argument, however,
    misconstrues the ALJ’s decision.
    Under 20 C.F.R. § 718.202, an ALJ may find that a miner has pneumoconiosis on
    the strength of one of several categories of evidence, including a chest X-ray, a biopsy or
    autopsy, or a physician’s “reasoned medical opinion” if such opinion is “based on
    objective medical evidence.” 20 C.F.R. § 718.202(a)(1)-(4). Here, ALJ Timlin found
    that Dr. Holimon’s diagnosis of clinical pneumoconiosis based upon his autopsy findings
    lacked credibility for a variety of reasons. The ALJ also found that Dr. Oesterling’s
    opinion that the autopsy did not show pneumoconiosis was “well reasoned and well
    documented” based in part on Dr. Oesterling’s finding that the autopsy showed “minimal
    anthracotic pigment” in Mr. Funka’s lungs. (App. at 95.) Thus, the ALJ concluded that
    “Claimant failed to establish that Miner had pneumoconiosis by a preponderance of the
    autopsy evidence.” (App. at 96.) When evaluating the medical opinions—a wholly
    separate category of evidence on which a finding of pneumoconiosis may be based under
    20 C.F.R. § 718.202(a)—the ALJ credited Dr. Green’s diagnosis of clinical and legal
    pneumoconiosis. In doing so, the ALJ found that Dr. Green provided a well-supported
    and reasoned explanation of why Mr. Funka “could have had an advanced form of
    11
    interstitial fibrosis despite a limited amount of black pigment in his lungs.” (App. at
    106.)
    Contrary to Consolidation’s argument, these findings are not contradictory or
    inconsistent. The ALJ found that the autopsy evidence alone was insufficient to establish
    that Mr. Funka had pneumoconiosis but that Dr. Green’s medical opinion, which was
    based upon the autopsy evidence and other medical evidence, did establish that Mr.
    Funka had pneumoconiosis.
    Similarly, Consolidation argues that the ALJ erred when she credited Dr. Green’s
    diagnosis of coal dust-induced fibrosis based upon Dr. Green’s finding that Mr. Funka
    had black pigment within his lungs. Consolidation argues that black pigment is not
    sufficient to base a diagnosis of coal workers’ pneumoconiosis. Consolidation cites to 20
    C.F.R § 718.202, which provides, in part, that “[a] finding in an autopsy or biopsy of
    anthracotic pigmentation . . . must not be considered sufficient, by itself, to establish the
    existence of pneumoconiosis.” 20 C.F.R § 718.202(a)(2). This provision, however,
    relates to biopsy or autopsy evidence. As discussed above, ALJ Timlin concluded that
    Mr. Funka had legal and clinical pneumoconiosis based on medical opinion evidence, not
    on autopsy evidence. Further, as Consolidation admits, Dr. Green’s diagnosis was based
    on the “presence of black pigment and birefringent particles, as well as the presence of
    macules and micronodules consistent with pneumoconiosis in areas less affected by the
    fibrosis.” (Petitioner’s Br. at 37) (emphasis added). Thus, Consolidation acknowledges
    that Dr. Green did not base his opinion solely on the presence of black pigmentation in
    12
    Mr. Funka’s lungs, but instead considered the pigmentation in conjunction with other
    evidence.4
    Next, Consolidation argues that the ALJ erred when she found that Mr. Funka had
    a pulmonary disability prior to 2003 based upon Mr. Funka’s testimony about his
    shortness of breath in the 1990s. Pointing to 20 C.F.R. § 718.204(d)(3), Consolidation
    further contends that even if the ALJ was permitted to draw this inference from the lay
    evidence, it was improper for her to use this conclusion to credit Dr. Green’s diagnosis.
    Under 20 C.F.R. § 718.204,
    affidavits (or equivalent sworn testimony) from persons knowledgeable of
    the miner’s physical condition shall be sufficient to establish total disability
    due to pneumoconiosis if no medical or other relevant evidence exists which
    addresses the miner’s pulmonary or respiratory condition; however, such a
    determination shall not be based solely upon the affidavits or testimony of
    any person who would be eligible for benefits (including augmented
    benefits) if the claim were approved.
    20 C.F.R. § 718.204(d)(3). This regulation was violated, Consolidation argues, because
    Mr. Funka was a person eligible for benefits if his claim was approved and his testimony
    was used to establish his disability.
    4
    Nor did the ALJ engage in inconsistent reasoning by discrediting the opinions of
    Dr. Tomashefski and Dr. Fino that Mr. Funka did not have coal workers’ pneumoconiosis
    because those opinions were based on the absence of black pigmentation and macules or
    micronodules in Mr. Funka’s lungs. As the ALJ correctly noted, the regulations do not
    require anthracotic pigment or pneumoconiotic macules or micronodules to support a
    pneumoconiosis finding. Thus, even if Mr. Funka did not have anthracotic pigment or
    pneumoconiotic macules or micronodules in his lungs, it would not necessarily follow
    that Mr. Funka did not have coal workers’ pneumoconiosis. Therefore, the ALJ
    permissibly concluded that the opinions of Dr. Tomashefski and Dr. Fino were not well-
    reasoned.
    13
    Consolidation’s argument once again misconstrues the ALJ’s decision. ALJ
    Timlin did not establish that Mr. Funka was disabled based upon his lay testimony.
    Indeed, the ALJ did not even determine Mr. Funka’s disability onset date based upon lay
    testimony. The ALJ specifically noted, “[t]he record does not disclose when Miner first
    became totally disabled due to pneumoconiosis.” (App. at 111.) ALJ Timlin simply
    credited Dr. Green’s medical opinion that Mr. Funka was disabled due to pneumoconiosis
    and then found that the doctor’s opinion about the disease’s progression was consistent
    with Mr. Funka’s testimony about when he started experiencing symptoms. Section
    718.204(d)(3) provides that a total disability cannot be established based solely on a
    claimant’s testimony; it does not prohibit an ALJ from using lay testimony to determine
    when a claimant first became symptomatic. Thus, it was entirely permissible for the ALJ
    to evaluate whether Dr. Green’s medical opinion was corroborated by Mr. Funka’s lay
    testimony. See Soubik v. Dir., Office of Workers’ Comp. Programs, 
    366 F.3d 226
    , 230,
    238 (3d Cir. 2004).
    Relying on United States Steel Mining Company, Inc. v. Director, Office of
    Workers’ Compensation Programs, 
    187 F.3d 384
    (4th Cir. 1999), Consolidation next
    argues that the ALJ erred in crediting Dr. Green’s “highly speculative” opinion about the
    absence of black pigment in Mr. Funka’s lungs. (Opening Br. at 41-43.) In United States
    Steel, the Fourth Circuit held that a doctor’s statement that “it is possible that [the
    claimant’s] death could have occurred as a consequence of his pneumonia superimposed
    upon . . . his occupational pneumoconiosis” was insufficient “to establish by a
    preponderance of the evidence that there was a causal link between [the claimant]’s
    14
    pneumoconiosis and his death.” United States 
    Steel, 187 F.3d at 390
    , 391 (second
    alteration in original). Consolidation argues that Dr. Green’s opinion regarding the lack
    of significant amounts of black pigment in Mr. Funka’s lungs is similarly speculative as
    he used uncertain words and phrases such as “can” and “could in part be due to.”
    (Opening Br. at 41-43.)
    This argument, however, relies on a selective reading of Dr. Green’s report and
    deposition testimony and ignores Dr. Green’s overall conclusions. Dr. Green explained
    that
    [t]he most likely diagnosis, in my opinion, is that this is the variant of simple
    coal worker’s pneumoconiosis characterized by interstitial fibrosis (Green
    and Vallyathan, 1998). . . . [A]lthough some of the interstitial fibrosis was
    pigmented (as shown in Figures 5 and 6), a majority was not (Figure 1). The
    lack of pigmentation could in part be due to clearance of coal mine dust from
    the lungs following retirement from the mining industry in 1992, a period of
    13 years. In addition, episodes of congestive cardiac failure can enhance
    clearance of a dust from the interstitium (Green and Vallyathan, 1998).
    Variability of pigmentation appears to be a feature of this form of coal
    worker’s pneumoconiosis (Green and Vallyathan, 1998; McConnochie et al.,
    1998).
    Silica exposure can also produce interstitial fibrosis (Craighead et al., 1982;
    Honma et al., 1993) and evidence of significant silica exposure was shown
    by the presence of large confluent silicotic nodules in the tracheo-bronchial
    lymph nodes. Thus, it is my opinion that the interstitial fibrosis was causally
    related to coal mine dust exposure which included the silica component.
    (App. at 265-266) (emphasis added.) Unlike United States Steel where the doctor could
    not opine with any definiteness that the claimant’s pneumoconiosis was related to his
    death, Dr. Green opined that Mr. Funka’s interstitial fibrosis was caused by his exposure
    to coal dust and further diagnosed him with coal workers’ pneumoconiosis. He supported
    his conclusions with citations to the medical literature, his own findings, and his
    15
    explanations of the evidence that appeared to contradict his diagnosis. The mere fact that
    Dr. Green used some less than definite language before coming to his ultimate conclusion
    does not mean that the ALJ was not entitled to credit his medical opinion and diagnosis.
    Indeed, “a testifying physician need not express his conclusions in terms of reasonable
    degree of medical certainty to be credited by the ALJ; the ALJ must instead accept a
    documented opinion of a physician exercising reasoned medical judgment.” Mancia v.
    Dir., Office of Workers’ Comp. Programs, 
    130 F.3d 579
    , 588 (3d Cir. 1997) (alteration
    and quotation marks omitted).5
    Relatedly, we find no merit in Consolidation’s contention that the ALJ
    impermissibly credited Dr. Green’s interpretation of a particular research study, the
    McConnochie study, over the interpretations of Dr. Fino and Dr. Tomashefski, simply
    because Dr. Green was a co-author of the study. As the ALJ correctly pointed out,
    neither party placed the McConnochie study in the record. While the ALJ certainly could
    have directed either party to place the study into evidence, the ALJ permissibly credited
    Dr. Green’s interpretation of the study over that of Dr. Fino and Dr. Tomashefski on the
    basis that Dr. Green co-authored the study and therefore had a more in-depth
    understanding of the study’s conclusions and implications.
    5
    Consolidation also argues that the ALJ improperly found legal pneumoconiosis
    in connection with Mr. Funka’s bronchitis because Dr. Green only stated that Mr.
    Funka’s bronchitis was “probably” related to his coal mine dust exposure. (App. at 395.)
    Such a finding, however, was not necessary to award benefits because the ALJ also
    concluded that Mr. Funka had both clinical and legal pneumoconiosis with respect to his
    pulmonary fibrosis. Thus, even assuming the ALJ did err in this respect, any such error
    was harmless.
    16
    Consolidation also puts forth a variety of arguments as to why the ALJ erred in
    assigning little weight to the medical opinions of Dr. Tomashefski and Dr. Fino. Having
    already concluded that the ALJ did not err in her analysis of Dr. Green’s medical opinion
    and therefore permissibly assigned that opinion significant probative weight, we see no
    error in the comparative weight that the ALJ assigned to the opinions of Dr. Tomashefski
    and Dr. Fino. ALJ Timlin reviewed all the evidence in the record and explained that she
    assigned little probative weight to the opinion of Dr. Tomashefski because, among other
    reasons, (1) his conclusion that Mr. Funka did not have pneumoconiosis was based on the
    absence of pigmentation and macules or micronodules, the presence of which are not
    required to support a diagnosis of pneumoconiosis under the BLBA regulations, (2) he
    provided no explanation or citation to the medical literature to support his claim that coal
    mine dust induced fibrosis does not cause honeycombing, (3) his interpretation of the
    McConnochie study to support his conclusion was contradicted by the study’s co-author,
    and (4) he failed to address the possibility that Mr. Funka could have legal
    pneumoconiosis. Further, the ALJ noted that Dr. Tomashefski’s opinion that Mr. Funka
    had idiopathic pulmonary fibrosis was in conflict with Dr. Green’s explanation,
    supported by citations to the medical literature, that such a diagnosis was inappropriate
    for individuals with a history of coal dust exposure. Despite this conflict, the ALJ
    explained that “Dr. Tomashefski did not discuss why Miner’s fibrosis was idiopathic in
    light of Miner’s coal dust exposure history.” (App. at 108.)
    These were all permissible considerations for ALJ Timlin to take into account
    when weighing the competing medical opinions. See 
    Kertesz, 788 F.2d at 163
    (“[T]he
    17
    ALJ should reject as insufficiently reasoned any medical opinion that reaches a
    conclusion contrary to objective clinical evidence without explanation.”). The ALJ
    adequately explained why she assigned Dr. Tomashefski’s opinion less weight and
    substantial evidence in the record supports the ALJ’s findings.
    Likewise, ALJ Timlin assigned little probative weight to Dr. Fino’s opinion that
    Mr. Funka did not have pneumoconiosis because (1) Dr. Fino based his conclusion on
    findings of minimal to no anthracotic pigment and his assertion that coal mine induced
    fibrosis is usually associated with heavy anthracotic pigment within the fibrosis, a finding
    which is not required to support a diagnosis of pneumoconiosis under the BLBA
    regulations, (2) Dr. Fino’s assertion that Mr. Funka’s pulmonary fibrosis began in 2003
    was contradicted by both Mr. Funka’s testimony and medical reports from 2003 showing
    that Mr. Funka already had advanced pulmonary fibrosis at that time, and (3) Dr. Fino did
    not explain why his diagnosis of idiopathic pulmonary fibrosis was appropriate in light of
    Mr. Funka’s history of significant coal dust exposure. Once again, the ALJ adequately
    explained why she rejected Dr. Fino’s opinion as insufficiently reasoned and not well
    supported. In light of the facts discussed above, we find that substantial evidence in the
    record supports the ALJ’s findings with respect to Dr. Fino’s opinion.6
    6
    Additionally, Consolidation argues that ALJ Timlin failed to address matters the
    BRB directed her to consider on remand. As Consolidation readily admits, however, it
    did not raise this argument before the BRB. Because Consolidation did not raise this
    argument before the BRB, we deem it waived. See Penn Allegheny Coal Co. v.
    Mercatell, 
    878 F.2d 106
    , 110 (3d Cir. 1989).
    18
    In sum, we find that ALJ Timlin did not err in her evaluation of the medical
    opinions and that her findings were supported by substantial evidence.
    B.       Withdrawing Evidence
    Finally, Consolidation argues that ALJ Timlin abused her discretion and violated
    Consolidation’s due process rights to a full and fair hearing when it ordered certain
    evidence withdrawn from the record. Pursuant to 20 C.F.R. § 725.414, parties are limited
    in the amount of medical evidence they may submit in support of their cases.7 When this
    matter reached the BRB for the third time, Mrs. Funka argued that Consolidation
    exceeded the limitations found in § 725.414. The BRB instructed that, on remand, the
    ALJ should determine whether Dr. Oesterling’s report constituted rebuttal evidence, thus
    falling outside of the evidentiary limitations. In response, ALJ Timlin ordered the parties
    to submit a summary which designated their evidence with respect to the § 725.414
    limitations. According to Consolidation, this had the effect of forcing Consolidation to
    withdraw evidence that it had relied on over the duration of the litigation. Consolidation
    objected, but ALJ Timlin found that the “evidentiary limitations are mandatory and not
    7
    For example, under the regulation,
    The claimant is entitled to submit, in support of his affirmative case, no more
    than two chest X-ray interpretations, the results of no more than two
    pulmonary function tests, the results of no more than two arterial blood gas
    studies, no more than one report of an autopsy, no more than one report of
    each biopsy, and no more than two medical reports.
    20 C.F.R. § 725.414(a)(2)(i).
    19
    waivable” and that Consolidation failed to “show[ ] good cause for including evidence in
    excess of the evidentiary limitations.” (App. at 81.) The BRB affirmed.
    Consolidation argues that it was prejudiced by being forced to comply with the
    limitations contained in § 725.414. To be clear, Consolidation does not argue that §
    725.414 is itself problematic. Instead, Consolidation contends that it litigated this matter
    over the course of many years and relied on the evidence that it submitted when
    fashioning its arguments. Thus, Consolidation argues that when the § 725.414 limitations
    were enforced at such a late stage, Consolidation’s right to a full and fair hearing was
    violated.
    We discern no error in the ALJ’s enforcement of the § 725.414 evidentiary
    limitations under these facts. Although Consolidation argues that the ALJ sua sponte
    ordered evidence withdrawn, the record shows that Consolidation was afforded a full
    opportunity to decide what evidence it wished to submit in support of its case within the
    confines of the § 725.414 limitations. Further, although Consolidation makes generalized
    and conclusory allegations of prejudice, Consolidation fails to identify any specific
    argument that was foreclosed to it or any other specific prejudice it suffered as a result of
    ALJ Timlin’s Order.
    IV.    Conclusion
    For the reasons discussed above, we will deny Consolidation Coal Company’s
    Petition for Review.
    20