Richardson v. DOWCP ( 1996 )


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  • PUBLISHED
    UNITED STATES COURT OF APPEALS
    FOR THE FOURTH CIRCUIT
    ARLETTE RICHARDSON, widow of
    Stuart Richardson,
    Petitioner,
    v.
    No. 95-1859
    DIRECTOR, OFFICE OF WORKERS'
    COMPENSATION PROGRAMS, UNITED
    STATES DEPARTMENT OF LABOR,
    Respondent.
    On Petition for Review of an Order
    of the Benefits Review Board.
    (93-2497-BLA)
    Argued: June 5, 1996
    Decided: September 3, 1996
    Before WILLIAMS and MOTZ, Circuit Judges, and CURRIE,
    United States District Judge for the District of South Carolina,
    sitting by designation.
    _________________________________________________________________
    Reversed and remanded by published opinion. Judge Williams wrote
    the opinion, in which Judge Motz and Judge Currie joined.
    _________________________________________________________________
    COUNSEL
    ARGUED: Maureen Hogan Krueger, Jenkintown, Pennsylvania, for
    Petitioner. Christian P. Barber, Counsel for Appellate Litigation,
    UNITED STATES DEPARTMENT OF LABOR, Washington, D.C.,
    for Respondent. ON BRIEF: Thomas S. Williamson, Jr., Solicitor
    of Labor, Donald S. Shire, Associate Solicitor, Rodger Pitcairn,
    UNITED STATES DEPARTMENT OF LABOR, Washington, D.C.,
    for Respondent.
    _________________________________________________________________
    OPINION
    WILLIAMS, Circuit Judge:
    Arlette Richardson (Richardson) appeals an Administrative Law
    Judge's (ALJ) order denying benefits on her survivor's claim under
    the Black Lung Benefits Act (the Act), 30 U.S.C.A.§ 901-945 (West
    1986 & Supp. 1996). The Benefits Review Board (BRB) affirmed the
    denial of benefits, holding that the ALJ had acted within his discretion
    in rejecting the report of a physician who opined that pneumoconiosis
    substantially contributed to the death of her husband, a former coal
    miner. Because we find that the ALJ failed to recognize that legal
    pneumoconiosis in the form of chronic obstructive lung disease
    (COPD) arising from coal mine employment had been established and
    omitted from consideration potentially dispositive evidence support-
    ing Richardson's claim, we reverse and remand to the ALJ for further
    proceedings.
    I.
    Before Richardson filed her survivor's claim, Stuart Richardson,
    her husband and a coal miner for over twelve years, was awarded
    benefits on his lifetime claim approximately one year after his death
    in October 1986. In the order awarding benefits, the deputy commis-
    sioner found that Mr. Richardson had been totally disabled due to
    legal pneumoconiosis.1 The Director did not contest the deputy com-
    missioner's award of benefits. See 20 C.F.R.§ 725.419 (1995).
    _________________________________________________________________
    1 Correspondence from the Office of Workers' Compensation Programs
    submitted in the proceedings before the ALJ reveals that legal pneumo-
    coniosis "was proven pursuant to Regulation Section 718.202(a)(i)A by
    the presence of a chronic pulmonary or respiratory impairment diagnosed
    in the medical evidence as COPD, COLD, chronic bronchitis and emphy-
    sema." (J.A. at 116.)
    2
    Shortly thereafter, proceeding pro se, Richardson filed a survivor's
    claim, contending that she was entitled to benefits because her hus-
    band's "death was due to pneumoconiosis." 20 C.F.R. § 718.205(a)
    (1995). To support her claim before the ALJ, Richardson submitted
    the report of Dr. Vito Caselnova, a physician who treated Mr. Rich-
    ardson in two of the four hospitalizations in the final year of his life.
    In a brief, handwritten report, Dr. Caselnova opined:
    It was a well documented fact that the deceased, Mr. Stu-
    art Richardson suffered from pneumoconiosis as a result of
    working many years in the underground coal mines.
    The pre-existing pneumoconiosis (Black Lung) contrib-
    uted substantially by leaving his lungs in a severely compro-
    mised state prior to the onset of pulmonary cancer. In
    summary, it is a well documented fact that the pneumoconi-
    osis is a contributing factor markedly hastening the miner's
    demise.
    (J.A. at 24-25.) Accompanying Dr. Caselnova's report were hospital
    records, including a discharge report prepared by Dr. Caselnova dated
    July 25, 1986, that noted the presence of COPD.
    Additionally, Richardson submitted a discharge report, dated Octo-
    ber 5, 1986, and death certificate signed by Dr. H. Rizvi, the physi-
    cian who treated Mr. Richardson during his final two hospitalizations.
    In the discharge report, Dr. Rizvi noted the presence of COPD, and
    on the death certificate, he listed metastatic lung cancer and COPD
    as the causes of Mr. Richardson's death.
    Responding to Richardson's contentions, the Director offered into
    evidence the report of Dr. Leon Cander, a consultant for the Depart-
    ment of Labor. After reviewing the medical records, Dr. Cander con-
    cluded that Mr. Richardson's death was attributable solely to lung
    cancer:
    Although disabling pneumoconiosis, as defined by the Act,
    has been adjudicated to be present, there is no evidence that
    Mr. Richardson's chronic obstructive lung disease was a
    3
    contributing cause or factor leading to Mr. Richardson's
    death. There is no evidence that a complication of pneumo-
    coniosis was present which caused Mr. Richardson's death.
    (J.A. at 23.)
    The ALJ denied benefits on Richardson's survivor claim, conclud-
    ing that Dr. Caselnova's report was not reasoned or documented. The
    ALJ concluded that Dr. Caselnova's report was unreasoned because
    Dr. Caselnova never linked Mr. Richardson's COPD with his coal
    mine employment to establish the existence of legal pneumoconiosis.2
    See 20 C.F.R. § 718.201 (1995) (defining legal pneumoconiosis in
    part as "any chronic pulmonary disease resulting in respiratory or pul-
    monary impairment significantly related to, or substantially aggra-
    vated by, dust exposure in coal mine employment"). Additionally, the
    _________________________________________________________________
    2 Much confusion in this case stems from the failure of counsel and
    witnesses to specify, when they use the term "pneumoconiosis," whether
    they are referring to legal or clinical pneumoconiosis, and from the fail-
    ure of the ALJ to resolve the conflict when this ambiguity arises in the
    record. To make an accurate assessment of whether the ALJ's decision
    is supported by substantial evidence, see Jewell Smokeless Coal Corp. v.
    Street, 
    42 F.3d 241
    , 243 (4th Cir. 1994), the litigants and the ALJ alike
    must cooperate to provide a record free from this ambiguity. As we have
    observed, clinical pneumoconiosis is only a small subset of the compen-
    sable afflictions that fall within the definition of legal pneumoconiosis
    under the Act. See Barber v. Director, OWCP, 
    43 F.3d 899
    , 901 (4th Cir.
    1995). COPD, if it arises out of coal-mine employment, clearly is encom-
    passed within the legal definition of pneumoconiosis, even though it is
    a disease apart from clinical pneumoconiosis. See Warth v. Southern
    Ohio Coal Co., 
    60 F.3d 173
    , 175 (4th Cir. 1995).
    Without a clear record, review is difficult. For example, to determine
    properly whether a physician's opinion is supported by medical records,
    the distinction between legal and clinical pneumoconiosis must be made.
    In the instant case, Dr. Caselnova opined in his report that the miner suf-
    fered from "pneumoconiosis." After reviewing the medical records, how-
    ever, we find no specific reference to "pneumoconiosis," although we do
    find several to COPD. Therefore, because we do not know whether Dr.
    Caselnova was referring to medical or legal pneumoconiosis in his
    report, we cannot determine with assurance whether it is supported by
    the medical records.
    4
    ALJ concluded that even if the existence of legal pneumoconiosis
    were assumed, Dr. Caselnova's report could not establish that "pneu-
    moconiosis was a substantially contributing cause or factor leading to
    the miner's death or [that] the death was caused by complications of
    pneumoconiosis" because of the absence of documentation supporting
    the report. 20 C.F.R. § 718.205(c)(2). The ALJ made no mention of
    the death certificate signed by Dr. Rizvi that listed COPD as a cause
    of death. After an appeal by Richardson, the Benefits Review Board
    affirmed on the reasoning of the ALJ.
    II.
    In order to receive benefits under the Act, a miner's survivor must
    prove that the miner suffered from legal pneumoconiosis and that the
    pneumoconiosis "`serve[d] to hasten [the miner's] death in any way.'"
    See Shuff v. Cedar Coal Co., 
    967 F.2d 977
    , 979-80 (4th Cir. 1992)
    (quoting the Director's brief), cert. denied, 
    506 U.S. 1050
    (1993).
    Richardson asserts that (1) her husband's legal pneumoconiosis has
    been proved through the stipulation and concession of the Director,
    and (2) the ALJ improperly rejected Dr. Caselnova's report and failed
    to consider other evidence supporting a finding that legal pneumoco-
    niosis hastened Mr. Richardson's death. We review"the findings of
    the ALJ, as affirmed by the BRB, to determine [if they] are supported
    by substantial evidence and in accordance with the law." Jewell
    Smokeless Coal Corp. v. Street, 
    42 F.3d 241
    , 243 (4th Cir. 1994). We
    address each of Richardson's contentions in turn.
    A.
    Contrary to the opinion of the ALJ, Richardson contends that the
    existence of legal pneumoconiosis in the form of COPD arising out
    of coal mine employment has been legally established. We agree.
    Before the ALJ, the Director clearly stipulated to the findings of fact
    in the deputy commissioner's award of lifetime benefits. (See J.A. at
    83 ("[I]f I'm being asked to stipulate to the contents of [the award of
    benefits] I have no problem with that.").) Therefore, the Director
    agreed that "as a result of the conditions of coal mine employment
    [Mr. Richardson] ha[d] contracted a severe chronic respiratory dis-
    ease diagnosed as coal workers' pneumoconiosis, as that term is
    defined in the Act and Regulations." (J.A. at 20;) see Fisher v. First
    5
    Stamford Bank & Trust Co., 
    751 F.2d 519
    , 523 (2d Cir. 1984) ("[A]
    stipulation of fact that is fairly entered into is controlling on the par-
    ties and the court is bound to enforce it.") Moreover, in his brief, "the
    Director concede[d] that the deputy commissioner awarded benefits
    because [Mr. Richardson] suffered from totally disabling COPD aris-
    ing out of coal mine employment." (Appellee's Br. at 15.) The Direc-
    tor's stipulation and concession are binding on the parties and this
    court in this appeal.3 See Hagan v. McNallen (In re McNallen), 
    62 F.3d 619
    , 625 (4th Cir. 1995) (holding that concession before bank-
    ruptcy court was binding on appeal); American Title Ins. Co. v.
    Lacelaw Corp., 
    861 F.2d 224
    , 226 (9th Cir. 1988) (stating that stipu-
    lations and admissions are binding on the parties and the court on
    appeal as well as at trial). Combined, the stipulation and concession
    establish that at the time of his death Mr. Richardson suffered from
    legal pneumoconiosis in the form of COPD arising from coal mine
    employment.4 See Plesh v. Director, OWCP, 
    71 F.3d 103
    , 108 (3d
    _________________________________________________________________
    3 Misguidedly, the Director argues that the findings of fact and conclu-
    sions of law in the deputy commissioner's award of benefits in the
    miner's lifetime claim have no collateral estoppel effect in Richardson's
    survivor claim. The Director argues that because he did not contest the
    miner's entitlement to benefits in the lifetime claim, the issue of whether
    the miner's COPD was caused by coal-mine employment was never "ac-
    tually litigated." See Swentek v. USAIR, Inc. , 
    830 F.2d 552
    , 561 (4th Cir.
    1987) (quoting Otherson v. Department of Justice , 
    711 F.2d 267
    , 273
    (D.C. Cir. 1983)). Because we find that the Director stipulated to the
    contents of the award of benefits in the miner's claim during the proceed-
    ings before the ALJ in the survivor's claim, we need not decide whether
    the Director is collaterally estopped from litigating the issue of causation
    in the survivor's claim. But see Alexander v. Island Creek Coal Co., 12
    BLR 1-44 (1988) (holding that survivor was not collaterally estopped
    from relitigating whether miner was disabled by a chronic respiratory or
    pulmonary disease because of the different standards of proof applicable
    to miner's and survivor's claims); but cf. Lisa Lee Mines v. Director,
    OWCP, 
    86 F.3d 1358
    , 1363 (4th Cir. 1996) (en banc) (stating that in a
    successive claim under the Act, "[e]ach of the alternative holdings [on
    the miner's prior claim] is presumed to have been correct when made").
    4 As this is a case in which there is no responsible operator, we need
    not decide whether the Director's stipulation and concession would be
    binding on an employer who was not a party to either the stipulation or
    concession.
    6
    Cir. 1995) (noting that coal-dust inhalation causes permanent damage
    and that pneumoconiosis is a progressive and incurable disease).
    Thus, the first element satisfied, we turn now to the issue of whether
    substantial evidence supports the ALJ's conclusion that Mr. Richard-
    son's legal pneumoconiosis did not hasten his death under Shuff.
    B.
    Richardson contends that the ALJ erred in ruling that she had not
    proved legal pneumoconiosis hastened her husband's death under
    Shuff. Richardson supports her assertion by arguing that the ALJ
    failed to consider the discharge report and death certificate prepared
    by Dr. Rizvi and improperly rejected the report of Dr. Caselnova.
    While conceding that the ALJ did not consider the reports of Dr.
    Rizvi, the Director responds that the ALJ's failure to weigh those
    reports is harmless error and that the ALJ properly rejected Dr. Casel-
    nova's report as unreasoned and undocumented. We address these
    contentions seriatim.
    1.
    We cannot find that the failure of the ALJ to consider the discharge
    report and death certificate of Dr. Rizvi in making his causation deter-
    mination is harmless error. The Director argues that because the hos-
    pital records did not establish that Mr. Richardson's COPD arose
    from coal mine employment, the listing of COPD as a cause of death
    on the death certificate was insignificant. Without a connection
    between her husband's COPD and his coal mine employment, the
    Director asserts, Richardson is not entitled to benefits under the Act
    because she cannot prove that legal pneumoconiosis existed, much
    less that it was a substantially contributing cause or factor in her hus-
    band's death. See 20 C.F.R. §§ 718.201, 718.205(c)(2).
    The Director's argument completely ignores the established fact
    that Mr. Richardson suffered from legal pneumoconiosis in the form
    of COPD arising from coal mine employment. Although not manifest
    from the medical records, in his stipulation and concession, the Direc-
    tor himself provides the necessary link between Mr. Richardson's
    COPD and his coal mine employment to establish the existence of
    legal pneumoconiosis. If credited, the death certificate therefore rep-
    7
    resents relevant evidence that the ALJ failed to consider before con-
    cluding that legal pneumoconiosis did not hasten Mr. Richardson's
    death under Shuff. Thus, remand is appropriate for the ALJ to revisit
    the issue of whether Mr. Richardson's legal pneumoconiosis hastened
    his death in light of the death certificate prepared by Dr. Rizvi listing
    COPD as a cause of death.5 See Grigg v. Director, OWCP, 
    28 F.3d 416
    , 420 (4th Cir. 1994) (agreeing with the Director that remand was
    appropriate on ALJ's failure to weigh physician's opinion).
    2.
    Because of the Director's stipulation and concession, the ALJ also
    must reevaluate the report of Dr. Caselnova. The ALJ concluded first
    that the report of Dr. Caselnova was not well-reasoned because Dr.
    Caselnova never "link[ed] the diagnosis of COPD to a specific cause"
    (J.A. at 11), and second, that there was no evidence in the hospital
    records supporting Dr. Caselnova's conclusion that pneumoconiosis
    was a substantially contributing cause of Mr. Richardson's death. The
    Director has conceded, however, that Mr. Richardson's COPD arose
    from coal mine employment, the necessary logical connection to
    establish the existence of legal pneumoconiosis missing from the
    medical records. Thus, in addition to consideration of the death certif-
    icate prepared by Dr. Rizvi, we must remand for reconsideration of
    Dr. Caselnova's report to determine whether the hospital records sup-
    port his finding that pneumoconiosis hastened Mr. Richardson's
    death. See King v. Califano, 
    615 F.2d 1018
    , 1020 (4th Cir. 1980)
    (remanding case for proper consideration of the evidence because
    "[e]ven if legitimate reasons exist for rejecting or discounting certain
    evidence, the Secretary cannot do so for no reason or for the wrong
    reason").
    We are unable to conclude whether the ALJ's finding that Dr.
    Caselnova's report is not adequately documented is supported by sub-
    stantial evidence. In reevaluating the report of Dr. Caselnova, the ALJ
    must resolve whether Dr. Caselnova's use of "COPD" in the hospital
    records corresponded with his use of "pneumoconiosis" in his report
    prepared in connection with Richardson's claim. In opining that Mr.
    _________________________________________________________________
    5 Indeed, we find it puzzling that Dr. Cander, after reviewing the medi-
    cal evidence, including the death certificate, found no evidence that
    COPD was a contributing cause or factor leading to the miner's death
    when the death certificate listed COPD as a cause of death.
    8
    Richardson suffered from pneumoconiosis and that pneumoconiosis
    hastened his death, Dr. Caselnova failed to specify whether he was
    referring to clinical pneumoconiosis or legal pneumoconiosis when he
    stated that Mr. Richardson's "pre-existing pneumoconiosis (Black
    Lung) contributed substantially" to his death. 6 (J.A. at 24-25.) Thus,
    once he resolves this issue, the ALJ will be in a better position to
    evaluate whether Dr. Caselnova's report is adequately supported by
    the hospital records that were originally attached to the report and to
    explain on remand his reasons for crediting or discrediting Dr. Casel-
    nova's report.
    III.
    In summary, we conclude that the ALJ's decision is not supported
    by substantial evidence because the Director has through his stipula-
    tion and concession established that at the time of his death Mr. Rich-
    ardson suffered from legal pneumoconiosis in the form of COPD
    arising from coal mine employment; consequently, the ALJ erred in
    omitting from consideration the death certificate prepared by Dr.
    Rizvi and discrediting Dr. Caselnova's report for its failure to connect
    the COPD to coal mine employment. Furthermore, because of the
    lack of clarity in the record, we are unable to review the ALJ's con-
    clusion that Dr. Caselnova's report is inadequately documented.
    Because of the unclear record and the conflicting evidence on the
    issue of whether legal pneumoconiosis hastened Mr. Richardson's
    death, we remand so that the ALJ may revisit his causation determina-
    tion, taking into account the reports of Dr. Rizvi and reviewing Dr.
    Caselnova's report in light of the Director's concession of the exis-
    tence of legal pneumoconiosis in the form of COPD arising from coal
    mine employment.
    REVERSED AND REMANDED
    _________________________________________________________________
    6 If Dr. Caselnova's report refers to the particular medical affliction
    known in medical circles as "coal workers' pneumoconiosis," see Hobbs
    v. Clinchfield Coal Co., 
    45 F.3d 819
    , 821 (4th Cir. 1995), the record
    before us does not support his conclusion that pneumoconiosis hastened
    Mr. Richardson's death. The hospital records do not contain any evi-
    dence of a diagnosis of medical pneumoconiosis, nor does the Director
    concede that Mr. Richardson suffered from medical pneumoconiosis. See
    discussion supra note 2.
    9