Appellate Court Upholds Denial of Coal Miner's Claim

Friday, June 20, 2014 | 0

In a positive decision which effects numerous employers in the state of Illinois, the Illinois Appellate Court, Workers’ Comp Division upheld the Workers' Compensation Commission's denial of benefits based upon the statute of limitations. In Carter v. IWCC, the Appellate Court upheld the Commission’s denial of a claim for COPD, or chronic obstructive pulmonary disease, under Section 6(c) as time-barred as it was not filed within the three-year statute of limitations.

In Carter, the claimant was a 22-year coal miner who had worked mainly underground during that period. The mine in question closed on Sept. 24, 2004, which was also the claimant’s last day at the mine and last exposure to coal dust. While he told his foreman he was having breathing problems/congestion, he never mentioned that he had black lung or coal workers’ pneumoconiosis. Claimant filed an application for adjustment of claim with the IWCC on Sept. 3, 2008, nearly four years after the last claimed exposure.
 
Competent medical evidence presented by respondent, which included chest X-rays negative for coal workers’ pneumoconiosis, revealed the claimant was diagnosed with COPD. While the diagnosis did confirm Carter’s COPD was secondary to the inhalation of coal dust along with his smoking history, there was no diagnosis of pneumoconiosis. It is important to note claimant’s own treater also diagnosed COPD and not pneumoconiosis.
 
In March 2009, the Department of Labor issued an SSAE in connection with Carter’s concurrent claim for federal black lung benefits indicating he did not have coal workers’ pneumoconiosis and did not have a totally disabling respiratory or pulmonary impairment caused in part by pneumoconiosis. Clearly the DOL had no other logical alternative upon reflection of the medical evidence. Accordingly the Labor Department denied federal benefits.
 
The arbitrator denied benefits under the Illinois Occupational Disease Act as untimely as the act places a three-year statute of limitations on benefits with an exception for pneumoconiosis, which extended the statute to five-years.
 
Pursuing benefits under the Occupational Disease Act, petitioner presented a case in chief in which his expert opined no distinction could be made between COPD and coal workers’ pneumoconiosis and argued that as such one could not deny the claim as untimely. Claimant argued that based upon this argument, the five-year statute must include COPD caused by exposure to coal dust.
 
The Appellate Court disagreed, holding the plain terms of the exception to the statute of limitations was for coal miners’ pneumoconiosis and not COPD. The court held the exception clearly does not apply to all disabilities caused by exposure to coal dust and had the Legislature intended to include all disabilities to do so, they could have done so. The court went on to distinguish claimant’s expert noting that his doctor had not provided any scientific reason to apply different limitation periods to coal miners alleging COPD, as opposed to pneumoconiosis and that claimant’s own doctor agreed with respondent’s expert in his diagnosis.
 
The court also rejected an equal protection argument that by setting the statute of limitations as it has been set, miners with COPD were being treated differently than “similarly situated” miners with coal workers’ pneumoconiosis. The court held that the two diagnosis were clearly shown to be different and therefore claimant was not similarly situated as with coal workers’ pneumoconiosis.
 
The author notes this to be a solid decision in which the Appellate Court upheld the plain reading of Section 6(c), rather than re-interpreting the legislative intent. The decision also appears to continue a recent, positive trend in which the commission, the circuit courts along with the Appellate Court have resisted an urge to reverse well-thought-out opinions by arbitrators which are supported by the manifest weight of the evidence.

James F. Egan is an attorney for the Keefe, Campbell, Biery & Associates workers' compensation defense firm in Chicago. This column was reprinted with permission from the firm's weekly client newsletter.