Section 203(a) of the Secretary of Labor's "interim regulations"
governing black lung benefits claims filed between July 1, 1973,
and April 1, 1980, provides that a claimant who engaged in coal
mine employment for at least 10 years is entitled to an "interim
presumption" of eligibility for disability benefits if he meets one
of four medical requirements: (1) a chest X-ray "establishes" the
presence of pneumoconiosis; (2) ventilatory studies establish the
presence of any respiratory or pulmonary disease of a specified
severity; (3) blood gas studies demonstrate an impairment in the
transfer of oxygen from the lungs to the blood; or (4) other
medical evidence, including the documented opinion of a physician
exercising reasonable medical judgment, establishes a totally
disabling respiratory impairment. Section 203(b) provides that "all
relevant medical evidence shall be considered" in the adjudication
of a claim, and that the interim presumption is rebutted if the
evidence establishes (1) that the claimant is doing his usual or
comparable work; (2) that he is capable of doing such work; (3)
that his disability did not arise, even in part, out of coal mine
employment; or (4) that he does not have pneumoconiosis. At the
hearing on respondent Ray's 1976 claim, the record proved that Ray
had 16 years of coal mine employment and contained one qualifying
and seven nonqualifying X-ray interpretations, two qualifying and
four nonqualifying ventilatory studies, and one qualifying and five
nonqualifying physicians' opinions. After weighing the evidence,
the Administrative Law Judge (ALJ) held that Ray was not entitled
to the benefit of the interim presumption, and issued an order
denying benefits, which the Benefits Review Board affirmed.
However, the Court of Appeals reversed, rejecting the Secretary's
position that § 203(a) requires the claimant to establish one of
the qualifying facts by a preponderance of the evidence. The court
held instead that a single item of qualifying evidence is always
sufficient to invoke the interim presumption, and, upon finding
that the presumption had been invoked in this case by the two
qualifying ventilatory studies and the qualifying physician's
opinion, remanded for the
Page 484 U. S. 136
ALJ to determine whether the presumption had been rebutted by
Ray's employer.
Held: Section 203(a) requires that the claimant
establish at least one of the qualifying facts by a preponderance
of the evidence. Pp.
484 U. S.
146-160.
(a) Section 203(a)'s plain language does not mandate that the
interim presumption be invoked on the basis of a single item of
qualifying evidence. The Court of Appeals' reading of § 203(a)(1)
as though it merely requires X-ray evidence of the presence of
pneumoconiosis ignores the fact that § 203(a)(1) expressly requires
an X-ray that actually "establishes" the presence of the disease.
It is not the X-ray in isolation that establishes that presence;
rather, the regulation must, at a minimum, have reference both to
the X-ray itself and to interpretations by qualified experts. The
Secretary's view of the regulation, which would render some
evidence inadmissible for certain aspects of rebuttal, is not
inconsistent with § 203(b)'s requirement that "all relevant
evidence shall be received" in adjudicating a claim, since nothing
in the Secretary's position prevents all relevant evidence from
being considered at some point in the proof process, and nothing in
the regulation requires that all relevant medical evidence be
considered at the rebuttal phase. Moreover, the Secretary's
interpretation is not rendered internally inconsistent by his
position that, if the claimant invokes the presumption by
establishing the existence of pneumoconiosis under § 203(a)(1), the
employer may not try to disprove the disease under § 203(b)(4),
since nothing in the regulation requires each rebuttal subsection
to be fully available in each case. Furthermore, the Secretary's
position will not permit an employer to prevail solely on a single
negative X-ray interpretation in violation of a statutory provision
prohibiting claim denials on that basis. Thus, the Secretary's
interpretation of § 203 is entirely consistent with the
regulation's text. Pp.
484 U. S.
146-152.
(b) The Court of Appeals erred in finding that the legislative
history of the black lung benefits statutes requires a
single-item-of-evidence invocation burden. Section 203(a)'s interim
presumption derives directly from, and is substantially similar to,
an interim presumption for black lung claims promulgated by the
Social Security Administration, under which ALJs have routinely
weighed the evidence at the invocation stage without judicial
objection, and often with explicit court approval. Pp.
484 U. S.
152-155.
(c) The fact that a single item of qualifying evidence may often
be sufficient to invoke the interim presumption does not compel the
conclusion that such evidence must always be sufficient. The
factual understanding underlying the presumption -- that it is
highly probable that a long-term coal miner is totally disabled by
pneumoconiosis arising from his employment if he can prove any of
the regulation's medical requirements
Page 484 U. S. 137
-- is not present when the claimant merely offers a single item
of qualifying evidence that is overcome by more reliable
conflicting evidence. Similarly, the policy concern underlying the
presumption -- that long-term miners who are truly diseased should
not have to undertake the difficult task of proving that their
diseases are totally disabling and coal mine related, or that they
are in fact pneumoconiosis -- is not implicated if a miner is not
actually suffering from the type of ailment with which Congress was
concerned. Thus, the Secretary's reading of the interim
presumption's invocation burden is eminently reasonable, and
deserving of substantial deference. Pp.
484 U. S.
156-160.
785 F.2d 424, reversed and remanded.
STEVENS, J., delivered the opinion of the Court, in which,
REHNQUIST, C.J., and WHITE, BLACKMUN, O'CONNOR, and SCALIA, JJ.,
joined. MARSHALL, J., filed a dissenting opinion, in which BRENNAN,
J., joined,
post, p.
484 U. S.
161.
JUSTICE STEVENS delivered the opinion of the Court.
In 1978, the Secretary of Labor promulgated "interim
regulations" to govern the processing of claims for black lung
benefits filed between July 1, 1973, and April 1, 1980.
See
Page 484 U. S. 138
20 CFR pt. 727 (1987). Section 203 of those regulations
prescribes five ways in which a claimant may prove that he is
entitled to an "interim presumption" of eligibility. The question
in this case concerns the burden of proof that the claimant must
satisfy to invoke the presumption. The Court of Appeals held,
Stapleton v. Westmoreland Coal Co., 785 F.2d 424 (CA4
1986) (en banc), that a single item of qualifying evidence is
always sufficient, whereas the Secretary of Labor contends that his
regulation requires the claimant to establish at least one of the
five qualifying facts by a preponderance of the evidence. Because
we are not persuaded that the Secretary has misread his own
regulation, we reverse.
I
Although some aspects of the black lung benefits program are
rather complex, its broad outlines and relevant statutory
provisions can be briefly described. Prolonged exposure to coal
dust has subjected hundreds of thousands of coal miners to
pneumoconiosis -- a serious and progressive pulmonary condition
popularly known as "black lung." The tragic consequences of this
crippling illness prompted Congress to authorize a special program
for the benefit of its victims in 1969. Because that program has
been developed through several statutory enactments, [
Footnote 1] different rules govern claims
filed during different periods of time. Those filed prior to July
1, 1973, were processed by the Social Security Administration (SSA)
pursuant to regulations promulgated by the Secretary of the
Department of Health, Education, and Welfare
Page 484 U. S. 139
(HEW); when allowed, these "Part B" claims were paid from
federal funds. [
Footnote 2]
"Part C" claims [
Footnote 3]
are those filed on or after July 1, 1973; they are paid by private
employers or by a fund to which the employers contribute, and they
are administered by the Director of the Office of Workers'
Compensation Programs (the Director) pursuant to regulations
promulgated by the Secretary of Labor (the Secretary). Part C of
the program includes two subparts: claims filed after April 1,
1980, which are governed by "permanent criteria," [
Footnote 4] and those filed prior to April 1,
1980, which are governed by the "interim regulations" at issue in
this case. Despite the "interim" designation, these regulations are
extremely important, because they apply to about 10,000 pending
claims.
There is no dispute about the Secretary's authority to
promulgate the interim regulations. [
Footnote 5] Nor is there any suggestion that they violate
any express statutory command. The statute does require the
Secretary to establish criteria for eligibility that "shall not be
more restrictive than" the criteria that the Secretary of HEW had
established for the administration of the Part B program, [
Footnote 6] but the Court of Appeals
did not hold that § 203 violates this standard. The statute also
requires that "all relevant evidence" shall be considered, but it
is clear that the regulation is consistent with that requirement
[
Footnote 7] -- the only
dispute is over how much of the
Page 484 U. S. 140
relevant evidence may be considered in determining whether the
interim presumption shall be invoked. Thus, there is no need to
parse statutory language to decide this case.
The Court of Appeals' holding rests, at bottom, on two
propositions: (1) the regulation's plain language mandates that the
presumption be invoked on the basis of a single item of qualifying
evidence; and (2) the Secretary's reading is not faithful to the
purposes of the program as reflected in its legislative history. We
shall consider each of these propositions after reviewing the
substance of the regulation and the facts of the one case that
presents the legal question we must decide. [
Footnote 8]
Page 484 U. S. 141
II
Disability benefits are payable to a miner if (a) he or she is
totally disabled, (b) the disability was caused, at least in part,
by pneumoconiosis, and (c) the disability arose out of coal mine
employment. All three of these conditions of eligibility are
presumed if the claimant was engaged in coal mine employment for at
least 10 years and if the claimant meets one of four medical
requirements: [
Footnote 9] (1)
a chest X-ray establishes the presence of pneumoconiosis; (2)
ventilatory studies establish the presence of a respiratory or
pulmonary disease -- not necessarily pneumoconiosis -- of a
specified severity; (3) blood gas studies demonstrate the presence
of an impairment in the transfer of oxygen from the lungs to the
blood; or (4) other
Page 484 U. S. 142
medical evidence, including the documented opinion of a
physician exercising reasonable medical judgment, establishes the
presence of a totally disabling respiratory impairment. [
Footnote 10]
Page 484 U. S. 143
It is noteworthy that only the first of the four alternative
methods of invoking the presumption requires proof that the
claimant's disease is in fact pneumoconiosis. None of the methods
requires proof of causation, and only the fourth requires proof of
total disability.
The second paragraph in the regulation describes how the
presumption may be rebutted. [
Footnote 11] It first provides that, in the adjudication
of a claim, "all relevant medical evidence shall be considered." It
then provides that the presumption is rebutted if the evidence
establishes that the claimant is doing or is
Page 484 U. S. 144
capable of doing his usual or comparable work, that his
disability did not arise, even in part, out of coal mine
employment, or that he does not have pneumoconiosis. Thus, in order
to rebut the interim presumption, the employer has the burden of
proving that at least one of the three conditions of eligibility is
not satisfied. [
Footnote
12]
III
Respondent Ray filed a claim for disability benefits with the
Secretary in 1976. At the hearing before the ALJ, he proved that he
had 16 years of coal mine employment. The ALJ placed 47 exhibits
from the Director's file into evidence, [
Footnote 13] and the employer introduced four
additional exhibits. The record contained one qualifying [
Footnote 14] X-ray interpretation,
two qualifying ventilatory studies, and one qualifying physician's
opinion. The record, however, also included seven
Page 484 U. S. 145
nonqualifying X-ray interpretations, four nonqualifying
ventilatory studies, and five nonqualifying physicians' opinions.
[
Footnote 15] After weighing
the X-ray evidence, the ALJ concluded that it did not establish
that Ray had pneumoconiosis, [
Footnote 16] and, after balancing all the ventilatory
studies, he concluded that they did not establish the presence of a
chronic respiratory or pulmonary disease. [
Footnote 17] Additionally, the ALJ found that
the other medical evidence, including documented physicians'
opinions, did not establish the presence of a totally disabling
respiratory or pulmonary impairment. [
Footnote 18] He therefore held
Page 484 U. S. 146
that Ray was not entitled to the benefit of the interim
presumption. [
Footnote
19]
The BRB affirmed the ALJ's order denying benefits. It first
noted that Ray's
"contention that subsection (a)(1) must be invoked where the
record contains a single positive X-ray has previously been
considered and rejected, [
Footnote 20]"
and it agreed with the ALJ's evaluation of the X-ray evidence
and ventilatory studies. Finally, while disagreeing with some of
the ALJ's reasoning, the Board reviewed and approved the ALJ's
weighing of the physicians' opinions in the employer's favor.
The Court of Appeals remanded for further proceedings. It held
that the interim presumption had been invoked under § (a)(2) by the
two qualifying ventilatory studies and under § (a)(4) by the one
qualifying physician's opinion. The court did not rely on the
positive X-ray interpretation, because it was not sufficiently
identified to satisfy the requirements for X-ray evidence under §
718.102(c) of the Secretary's regulation. The court reversed the
Board's denial of benefits, and remanded for the ALJ to determine
whether the presumption had been rebutted. We granted certiorari,
479 U.S. 1029 (1987), to resolve the question presented by this
case: whether one item of qualifying evidence is always sufficient
to invoke the interim presumption, and thereby shift the burden of
persuasion to the employer.
IV
The Court of Appeals held that
"the interim presumption under § 727.203(a)(1), (2), or (3) is
established when there is
Page 484 U. S. 147
credible evidence that a qualifying X-ray indicates the presence
of pneumoconiosis, a single qualifying set of ventilatory studies
indicates, pursuant to the regulatory standard, a chronic
respiratory or pulmonary disease, or a single qualifying set of
blood gas studies indicates, pursuant to the regulatory standard,
an impairment in the transfer of oxygen from the lungs to the
blood."
785 F.2d at 426. The principal basis for this holding was the
court's view that the plain language of the regulation makes it
clear that a single positive X-ray necessarily invokes the
presumption. In advancing that view, however, the court did not
pause to consider the significance of the word "establishes" in §
(a)(1). It read § (a)(1) as though it merely required a chest X-ray
that constitutes evidence of the presence of pneumoconiosis, rather
than one that actually "establishes" the presence of the
disease.
The Secretary's regulations, however, recognize the difference
between an X-ray that tends to prove the presence of pneumoconiosis
and one that can be said to establish it. Thus, in contrast to the
use of the word "establishes" throughout § 727.203(a), the
regulation defining the suitable quality of X-ray evidence refers
to an X-ray that "shall constitute evidence of the presence or
absence of pneumoconiosis." [
Footnote 21] The Court of Appeals read § 203(a)(1) as
though it merely required an X-ray that "constitutes evidence of
the presence of pneumoconiosis." Had that been the Secretary's
intent, presumably he would have used that language, as he did
elsewhere, to explain that meaning.
There is another reason why § (a)(1) cannot have been intended
to refer to a single item of evidence. For the ordinary trier of
fact -- even an ALJ who has heard many black lung benefit cases --
an X-ray may well be meaningless unless it is interpreted by a
qualified expert. What may be persuasive to the ALJ, then, is not
just the X-ray itself, but its interpretation
Page 484 U. S. 148
by a specialist. And, of course, different experts may provide
different readings of the same X-ray. As Judge Posner has
observed:
"Under the regulation, it is not the reading, but the Xray, that
establishes the presumption. If one doctor interprets an X-ray as
positive for black-lung disease, but 100 equally qualified doctors
interpret the same X-ray as negative for the disease, nothing in
the regulation requires the administrative law judge to disregard
the negative readings."
Cook v. DIrector, Office of Workers' Compensation
Programs, 816 F.2d 1182, 1185 (CA7 1987). Thus, it seems
perfectly clear that it is not the X-ray in isolation that
"establishes" the presence of the disease; rather, the regulation
must, at a minimum, have reference both to the X-ray itself and to
other evidence that sheds light on the meaning and significance of
the X-ray. [
Footnote 22]
Just as the ALJ must weigh conflicting interpretations of the same
X-ray in
Page 484 U. S. 149
order to determine whether it tends to prove or disprove the
existence of pneumoconiosis, there would seem to be no reason why
he must ignore all X-rays in a series except one. [
Footnote 23]
The Court of Appeals relied in large part on perceived internal
inconsistencies in the Secretary's interpretation. In the rebuttal
section, the regulation provides that, in "adjudicating a claim
under this subpart, all relevant medical evidence shall be
considered." The Court of Appeals interpreted this statement as
requiring all relevant evidence to be considered on rebuttal. Since
the Secretary's reading would make some evidence inadmissible for
certain aspects of rebuttal, [
Footnote 24] the Court of Appeals thought that reading
violated the requirement that "all relevant medical evidence shall
be considered."
We disagree, for two reasons. First, nothing in the Secretary's
position prevents "all relevant medical evidence" from being
considered at some point during the proof process. To understand
why this requirement was inserted at the beginning of the rebuttal
section, it is important to understand its derivation. After the
SSA adopted its interim presumption, its claims approval rate
increased, in part due, it is thought, to factfinders' failing to
consider all of the employers' relevant medical evidence. [
Footnote 25] To assure that this
problem would not infect adjudications under the new Labor interim
presumption,
Page 484 U. S. 150
the requirement of 30 U.S.C. § 923(b) that all relevant medical
evidence be considered in adjudicating SSA claims was explicitly
carried over into the Labor presumption's rebuttal section. Thus,
that the "all relevant medical evidence" requirement appears at the
beginning of the rebuttal section reflects the genesis of the
concern, and does not indicate that the drafters intended a more
limited evidentiary battle at the invocation stage. As long as
relevant evidence will be considered at some point by the ALJ, the
demand that the decision be made on the complete record is
satisfied.
Second, the cited provision refers to "adjudicating a claim
under this
subpart," and a "subpart" "may be used to group
related sections in a part." 1 CFR § 21.9(b) (1987). All of 20 CFR
§ 727.203 (1987), the interim presumption, is within subpart C of
part 727. Thus, nothing in the regulation requires all relevant
medical evidence to be considered at the rebuttal phase; such
evidence must simply be admissible at some point during the proof
process.
The Court of Appeals was persuaded as well that some of the
rebuttal provisions would be superfluous under the Secretary's
reading. For instance, if the claimant invokes the presumption by
establishing the existence of pneumoconiosis under § (a)(1), the
employer may not try to disprove pneumoconiosis under § (b)(4).
This limitation on rebuttal, according to the Court of Appeals,
renders the Secretary's position internally inconsistent.
Again, we are constrained to disagree. Nothing in the regulation
requires each rebuttal subsection to be fully available in
each case. As long as the employer can introduce, say,
nonqualifying X-rays at the invocation stage to oppose invocation
under § (a)(1), it has been given the chance to show the
nonexistence of pneumoconiosis. If the presumption is nonetheless
invoked, the employer can still try to disprove total disability or
causality. [
Footnote 26]
Page 484 U. S. 151
Finally, there is some concern that the Secretary's position
might permit a single negative X-ray interpretation to carry the
day for the employer, in violation of the statute's mandate that
"no claim for benefits . . . shall be denied solely on the basis of
the results of [an X-ray]." § 923(b) (made applicable to Part C
adjudications through § 902(f)(2)). The easy answer was provided by
the dissent below:
"a single negative X-ray may not . . . be drawn upon either as
the
sole basis for finding the invocation burden under
(a)(1) not carried nor as the
sole basis for finding the
rebuttal burden under (b)(4) carried."
785 F.2d at 445 (emphases added). Furthermore, in weighing
conflicting X-ray readings ALJs will undoubtedly keep in mind the
character of the black lung disease:
"Since pneumoconiosis is a progressive and irreversible disease,
early negative X-ray readings are not inconsistent with
significantly later positive readings. . . . This proposition is
not applicable where the factual pattern is reversed. In a
situation . . . where the more recent X-ray evidence is negative
and directly conflicting with
Page 484 U. S. 152
earlier positive X-rays, it may be weighed with less regard to
timing in light of the recognized principle that negative X-ray
readings are not a trustworthy indicator of the absence of the
disease."
Elkins v. Beth-Elkhorn Corp., 2 BLR 1-683, 1-686
(Ben.Rev.Bd.1979).
In sum, we find the Secretary's interpretation of his own
regulation entirely consistent with its text.
V
The Court of Appeals' holding that a single item of qualifying
evidence always suffices to carry a claimant's invocation burden
was based in part on its understanding of the legislative history
of the black lung benefits statutes. 785 F.2d at 457-461. This
conclusion is based on the clear congressional mandate for interim
presumptions to reduce the number of benefit denials by both the
SSA and Labor. While we agree that Congress did intend to ensure
fewer benefit denials, we are not persuaded either that that goal
has been frustrated by the Secretary's interpretation of the
regulation or that Congress intended more specifically to require
invocation of the presumption based solely on one item of a
claimant's proof.
In the early years of the benefits program, the SSA denied a
high number of claims because of a perceived lack of proof of
totally disabling pneumoconiosis due to coal mine employment.
Congress mandated liberalized standards, and the SSA established an
interim presumption to carry out this directive. § 410.490(b). In
so doing, the SSA explained the problems with the prior scheme and
the virtues of the new one:
"In enacting the Black Lung Act of 1972, the Congress noted that
adjudication of the large backlog of claims generated by the
earlier law could not await the establishment of facilities and
development of medical tests not presently available to evaluate
disability due to
Page 484 U. S. 153
pneumoconiosis, and that such claims must be handled under
present circumstances in the light of limited medical resources and
techniques. Accordingly, the Congress stated its expectancy that
the Secretary would adopt such interim evidentiary rules and
disability evaluation criteria as would permit prompt and vigorous
processing of the large backlog of claims consistent with the
language and intent of the 1972 amendments, and that such rules and
criteria would give full consideration to the combined employment
handicap of disease and age and provide for the adjudication of
claims on the basis of medical evidence other than physical
performance tests when it is not feasible to provide such tests.
The provisions of this section establish such interim evidentiary
rules and criteria. They take full account of the congressional
expectation that, in many instances, it is not feasible to require
extensive pulmonary function testing to measure the total extent of
an individual's breathing impairment, and that an impairment in the
transfer of oxygen from the lung alveoli to cellular level can
exist in an individual even though his chest roentgenogram (X-ray)
or ventilatory function tests are normal."
§ 410.490(a).
The SSA implemented this congressional desire to ease claimants'
proof burdens by promulgating the interim presumption that serves
as the antecedent to the one at issue in this case. The
presumption, applicable to claims filed with the SSA before July 1,
1973, provides that a miner is presumed to be totally disabled due
to pneumoconiosis if two conditions are met: first, either "[a]
chest . . . X-ray . . . establishes the existence of
pneumoconiosis" or
"[i]n the case of a miner employed for at least 15 years in
underground or comparable coal mine employment, ventilatory studies
establish the presence of a chronic respiratory or pulmonary
disease. . . ."
§ 410.490(b)(1); second, "[t]he impairment established in
accordance with [either of these medical requirements]
Page 484 U. S. 154
arose out of coal mine employment.
§ 410.490(b)(2). Additionally,
"a miner who meets the [ventilatory studies] medical
requirements . . . will be presumed to be totally disabled due to
pneumoconiosis arising out of coal mine employment . . . if he has
at least 10 years of the requisite coal mine employment."
§ 410.490(b)(3).
The SSA's interim rules further provide that the presumption can
be rebutted if either "[t]here is evidence that the individual is,
in fact, doing his usual coal mine work or comparable and gainful
work" or
"[o]ther evidence, including physical performance tests . . .
establish[es] that the individual is able to do his usual coal mine
work or comparable and gainful work."
§ 410.490(c).
As the SSA's claims approval rate increased, Labor's remained
low, in large part because of the absence of an interim presumption
by which a claimant would only have to prove one predicate fact.
The interim presumption at issue in this case, promulgated as a
result of congressional dissatisfaction with Labor's low claims
approval rate, is substantially similar to the SSA interim
presumption. It satisfies Congress' demand that Labor's criteria
"shall not be more restrictive than the criteria applicable to a
claim filed on June 30, 1973," 30 U.S.C. § 902(f)(2),
i.e., no more restrictive than the SSA's interim
presumption.
Since Labor's interim presumption derived so directly from the
SSA's, if the Court of Appeals' conclusion regarding single-item
invocation were correct, one would expect to find SSA ALJ decisions
permitting invocation in such a manner, and federal court opinions
indicating approval. Instead, federal court decisions routinely
referred to SSA ALJ invocation weighings without objection, and
often with explicit approval. [
Footnote 27] Thus,
Page 484 U. S. 155
the legislative history of the Labor interim presumption does
not establish that invocation must occur on a single piece of
qualifying evidence. [
Footnote
28]
Page 484 U. S. 156
VI
Under either the Court of Appeals' or the Secretary's
interpretation of the regulation, a single item of qualifying
evidence
may be sufficient to invoke the presumption.
Indeed, the authors of the regulation apparently expected that the
presumption would regularly be invoked on the basis of a single
item of qualifying evidence. [
Footnote 29] Reasoning from that
Page 484 U. S. 157
expectation, the Court of Appeals concluded that the presumption
must be invoked whenever the record contains a single item
of qualifying evidence. But as we have demonstrated above, that
conclusion is compelled by neither the text nor the history of the
regulation.
Nor is it compelled by the underlying basis for the presumption.
For black lung benefits presumptions, no less than any presumption
established or recognized in law, are the product of both factual
understandings and policy concerns. As a matter of fact, Congress
could reasonably have concluded that it is highly probable that a
person who engaged in coal mine employment for over a decade is
totally disabled as a result of pneumoconiosis arising from that
employment if he or she can prove any of the medical requirements
specified in the regulation. [
Footnote 30] That degree of probability
Page 484 U. S. 158
is not, however, present when the claimant is merely in a
position to offer a single item of qualifying evidence that is
overcome by more reliable conflicting evidence.
As a matter of policy, Congress was aware that it is difficult
for coal miners whose health has been impaired by the insidious
effects of their work environment to prove that their diseases are
totally disabling and coal mine related, or that those diseases
are, in fact, pneumoconiosis. Rather than merely providing a
benefit for those miners who could prove each of the relevant facts
by a preponderance of the evidence, Congress intended that those
long-term miners who can show that they are truly diseased should
have to prove no more. [
Footnote
31] But if a miner is not actually suffering from the type of
ailment with which Congress was concerned, there is no
justification for presuming that that miner is entitled to
benefits. For not only does that miner fall outside the class of
those who need the assistance of an interim presumption, but he
also is unlikely to be totally disabled from coal mine employment.
By requiring miners to show that they suffer from the sort of
medical impairment that initially gave rise to congressional
concern, and then by requiring employers to shoulder the remainder
of the proof burden, the Secretary's
Page 484 U. S. 159
reading of the interim presumption's invocation burden satisfies
both the purposes of the statute and the need for a logical
connection between the proven fact and the presumed conclusion.
[
Footnote 32]
In the end, the Secretary's view is not only eminently
reasonable, but also is strongly supported by the fact that Labor
wrote the regulation. The agency's interpretation, which is
deserving of substantial deference "unless it is plainly erroneous
or inconsistent with the regulation,"
Bowles v. Seminole Rock
& Sand Co., 325 U. S. 410,
325 U. S. 414
(1945), has been, with one exception, consistently maintained
through Board decisions. [
Footnote 33] Likewise, prior to the Court of Appeals'
decision in this case, the Courts of Appeals had routinely reviewed
for substantial evidence the factfinder's invocation determination
under a preponderance-of-the-evidence standard. [
Footnote 34] Accordingly,
Page 484 U. S. 160
there is no reason to downgrade the normal deference accorded to
an agency's interpretation of its own regulation.
Cf. Motor
Vehicle Mfrs. Assn. of the United States, Inc. v. State Farm Mutual
Automobile Insurance Co., 463 U. S. 29
(1983).
Page 484 U. S. 161
The judgment of the Court of Appeals is reversed, and the case
is remanded for further proceedings consistent with this opinion.
[
Footnote 35]
It is so ordered.
[
Footnote 1]
Title IV of the Federal Coal Mine Health and Safety Act of 1969,
83 Stat. 792, 30 U.S.C. § 801
et seq., was amended by the
Black Lung Benefits Act of 1972, 86 Stat. 150, 30 U.S.C. § 901
et seq., the Black Lung Benefits Revenue Act of 1977, 92
Stat. 11, the Black Lung Benefits Reform Act of 1977, 92 Stat. 95,
the Black Lung Benefits Amendments of 1981, 95 Stat. 1643, the
Black Lung Benefits Revenue Act of 1981, 95 Stat. 1635, and the
Consolidated Omnibus Budget Reconciliation Act of 1985, Pub.L.
99-272, § 13203(a)(d), 100 Stat. 312, 313.
[
Footnote 2]
Part B of the Act is codified at 30 U.S.C. § 921
et
seq.
[
Footnote 3]
Part C is codified at 30 U.S.C. § 931
et seq.
[
Footnote 4]
See 20 CFR pt. 718 and § 725.4(a) (1987).
[
Footnote 5]
See 30 U.S.C. § 902(f)(1). As the Court of Appeals
noted:
"The statute . . . leaves to the Secretary how the presumption
is to be triggered and rebutted and how the various burdens of
persuasion and production are to be allocated between the claimant
and the employer."
Stapleton v. Westmoreland Coal Co., 785 F.2d 424, 433
(CA4 1986) (en banc).
[
Footnote 6]
See 30 U.S.C. § 902(f)(2).
[
Footnote 7]
The statute provides, in part:
"In carrying out the provisions of this part, the Secretary
shall to the maximum extent feasible (and consistent with the
provisions of this part) utilize the personnel and procedures he
uses in determining entitlement to disability insurance benefit
payments under section 223 of the Social Security Act [42 U.S.C. §
423], but no claim for benefits under this part shall be denied
solely on the basis of the results of a chest roentgenogram
[X-ray]. In determining the validity of claims under this part,
all relevant evidence shall be considered, including,
where relevant, medical tests such as blood gas studies, X-ray
examination, electrocardiogram, pulmonary function studies, or
physical performance tests, and any medical history, evidence
submitted by the claimant's physician, or his wife's affidavits,
and in the case of a deceased miner, other appropriate affidavits
of persons with knowledge of the miner's physical condition, and
other supportive materials."
§ 923(b) (emphasis added).
The Court of Appeals was of the view that the regulation itself
requires all relevant evidence to be considered on rebuttal, and
that the Secretary's reading violated this requirement.
See
infra, at
484 U. S. 149.
To the extent that the presumption is made irrebuttable under the
Secretary's reading,
see infra, at
484 U. S.
149-150, and n. 26, the court thought the statutory
requirement that "all relevant evidence" shall be considered
violated as well.
See 785 F.2d at 434. This conclusion is
clearly incorrect, for the same reasons that the court's conclusion
regarding the regulation is incorrect.
See infra at
484 U. S.
149-150. In short, the opportunity, under the
Secretary's reading, to present relevant evidence at the invocation
stage satisfies the statutory requirement that "all relevant
evidence" shall be considered.
[
Footnote 8]
The resolution of the legal question apparently will not affect
two of the individual respondents. Even though the Administrative
Law Judge (ALJ) concluded that respondent Gerald R. Stapleton had
properly invoked the interim presumption, he also concluded that it
had been rebutted. The Court of Appeals majority agreed with that
analysis, and the dissent, adopting the Secretary's approach,
agreed with the result on the ground that the presumption should
not have been invoked. For respondent Glenn Cornett, the ALJ found
that the presumption had been properly invoked, and that it had not
been rebutted. Both the majority and the dissent agreed with those
conclusions. With respect to respondent Luke R. Ray, however, the
majority disagreed with the ALJ's determination that the
presumption had not been properly invoked, and remanded for a
determination whether the presumption was rebutted. The dissent
agreed with the ALJ, and would have affirmed the denial of
benefits.
We think it helpful at this point to add a note about the
posture of the parties to this case. The petitioners, who filed a
joint petition pursuant to this Court's Rule 19.4, are Mullins Coal
Co., the Old Republic Insurance Co., and Jewell Ridge Coal Corp.
Mullins and Jewell Ridge employed, respectively, respondents
Cornett and Ray, both of whom were victorious before the Court of
Appeals, but only one of whom, Ray, has filed a brief in this
Court. Old Republic is Mullins' black lung benefits insurance
carrier. In addition to Cornett and Ray, respondents are: the
Director, Office of Workers' Compensation Programs, who administers
the Department of Labor's (Labor) black lung benefits program and
whose brief lays out the Secretary's position challenging the Court
of Appeals' conclusion regarding a claimant's invocation burden;
Gerald R. Stapleton, whose benefits denial was affirmed by the
Court of Appeals,
see Stapleton v. Westmoreland Coal Co.,
supra, and who attacks that judgment as a respondent pursuant
to Rule 19.6; and Westmoreland Coal Co., who employed Stapleton and
is thus happy with the result below, but who is unhappy with the
ramifications of the Court of Appeals' decision, and has
accordingly filed a brief in support of petitioners, also pursuant
to Rule 19.6.
[
Footnote 9]
A fifth alternative, available in a death benefit claim, is not
at issue in this case.
See 20 CFR § 727.203(a)(5) (1987),
quoted in n.
10
infra.
[
Footnote 10]
The full text of § 727.203(a) reads as follows:
"(a)
Establishing interim presumption. A miner who
engaged in coal mine employment for at least 10 years will be
presumed to be totally disabled due to pneumoconiosis, or to have
been totally disabled due to pneumoconiosis at the time of death,
or death will be presumed to be due to pneumoconiosis, arising out
of that employment, if one of the following medical requirements is
met:"
"(1) A chest roentgenogram (X-ray), biopsy, or autopsy
establishes the existence of pneumoconiosis (see § 410.428 of this
title);"
"(2) Ventilatory studies establish the presence of a chronic
respiratory or pulmonary disease (which meets the requirements for
duration in § 410.412(a)(2) of this title) as demonstrated by
values which are equal to or less than the values specified in the
following table:"
Equal to or
less than --
FEV MW
67" or less . . . . . . . . . . . . . . . . . 2.3 92
68" . . . . . . . . . . . . . . . . . . . . . 2.4 96
69" . . . . . . . . . . . . . . . . . . . . . 2.4 96
70" . . . . . . . . . . . . . . . . . . . . . 2.5 100
71" . . . . . . . . . . . . . . . . . . . . . 2.6 104
72" . . . . . . . . . . . . . . . . . . . . . 2.6 104
73" or more . . . . . . . . . . . . . . . . . 2.7 108
"(3) Blood gas studies which demonstrate the presence of an
impairment in the transfer of oxygen from the lung alveoli to the
blood as indicated by values which are equal to or less than the
values specified in the following table:"
Arterial pCO2
equal to or
less than
(mm.Hg.)
Arterial pO2
30 or below. . . . . . . . . . . . . . . . . 70
31 . . . . . . . . . . . . . . . . . . . . . 69
32 . . . . . . . . . . . . . . . . . . . . . 68
33 . . . . . . . . . . . . . . . . . . . . . 67
34 . . . . . . . . . . . . . . . . . . . . . 66
35 . . . . . . . . . . . . . . . . . . . . . 65
36 . . . . . . . . . . . . . . . . . . . . . 64
37 . . . . . . . . . . . . . . . . . . . . . 63
38 . . . . . . . . . . . . . . . . . . . . . 62
39 . . . . . . . . . . . . . . . . . . . . . 61
40-45. . . . . . . . . . . . . . . . . . . . 60
Above 45 . . . . . . . . . . . . . . . . . . Any value
"(4) Other medical evidence, including the documented opinion of
a physician exercising reasoned medical judgment, establishes the
presence of a totally disabling respiratory or pulmonary
impairment;"
"(5) In the case of a deceased miner where no medical evidence
is available, the affidavit of the survivor of such miner or other
persons with knowledge of the miner's physical condition,
demonstrates the presence of a totally disabling respiratory or
pulmonary impairment."
[
Footnote 11]
The full text of § 727.203(b) reads as follows:
"(b)
Rebuttal of interim presumption. In adjudicating a
claim under this subpart, all relevant medical evidence shall be
considered. The presumption in paragraph (a) of this section shall
be rebutted if:"
"(1) The evidence establishes that the individual is, in fact,
doing his usual coal mine work or comparable and gainful work (see
§ 410.412(a)(1) of this title); or"
"(2) In light of all relevant evidence it is established that
the individual is able to do his usual coal mine work or comparable
and gainful work (see § 410.412(a)(1) of this title); or"
"(3) The evidence establishes that the total disability or death
of the miner did not arise in whole or in part out of coal mine
employment; or"
"(4) The evidence establishes that the miner does not, or did
not, have pneumoconiosis."
[
Footnote 12]
Petitioners agree that the employer's rebuttal burden is one of
proof, as well as production. The Secretary also takes the position
that the presumption should be invoked in cases of "true doubt" --
that is, if the claimant's and employer's invocation evidence is of
equal weight. Brief for Federal Respondent 33, 39. This position
ensures that the employer will win, on invocation or rebuttal, only
when its evidence is stronger than the claimant's. The Benefits
Review Board (BRB) "has consistently upheld the principle that,
where true doubt exists, that doubt shall be resolved in favor of
the claimant."
Lessar v. C.F. & I. Steel Corp., 3 BLR
1-63, 1-68 (1981).
[
Footnote 13]
Medical evidence is initially submitted to the Director by the
claimant and the employer, and through examinations and tests
ordered by the Director himself.
See §§ 725.2(b) and
725.404
et seq. When a hearing is requested or ordered,
all evidence previously submitted to the Director becomes part of
the hearing record.
See § 725.421(b)(4).
[
Footnote 14]
The Court of Appeals used the term "qualifying" to refer to
positive medical evidence that would suffice, absent contrary
evidence of the same type, to invoke the presumption. For example,
an X-ray that disclosed pneumoconiosis (§ (a)(1)) or ventilatory
studies that revealed a respiratory or pulmonary impairment of
sufficient magnitude (§ (a)(2)) would constitute qualifying
evidence. Conversely, negative X-ray results or ventilatory studies
that failed to reveal a great enough impairment would be deemed
"nonqualifying" evidence.
[
Footnote 15]
That Ray did not object to the nonqualifying evidence contained
in these exhibits is of no moment; what matters in this case is not
whether nonqualifying evidence may be introduced into the
record (all parties agree it may), but
when that evidence
may be considered. During Ray's hearing, the ALJ simply admitted
all relevant evidence and took testimony. It was only in his
written decision that the ALJ revealed whether he considered
nonqualifying evidence during invocation, or only on rebuttal.
[
Footnote 16]
"I give greatest weight to the seven negative X-rays, three of
which were read by qualified 'B' readers. (Dir. Exbs. 24, 25, 26) I
conclude that the X-ray evidence does not establish that Claimant
has pneumoconiosis. 20 CFR § 727.203(a)(1)."
App. to Pet. for Cert. 129a.
"'B' readers are radiologists who have demonstrated their
proficiency in assessing and classifying X-ray evidence of
pneumoconiosis by successful completion of an examination conducted
by or on behalf of the Department of Health & Human
Services."
Consolidation Coal Co. v. Chubb, 741 F.2d 968, 971, n.
2 (CA7 1984).
[
Footnote 17]
"The more recent ventilatory studies performed in 1977 and 1980
do not demonstrate the presence of a chronic respiratory or
pulmonary disease as defined by the aforementioned regulation.
(Dir. Exb.19; Emp. Exb. l.) These findings are supported by earlier
ventilatory studies in 1976 and 1975. (Dir. Exbs. 16, 17.) I
conclude that the weight of evidence necessitates a finding that
the ventilatory studies do not establish the presence of a chronic
respiratory or pulmonary disease."
App. to Pet. for Cert. 130a.
[
Footnote 18]
"In light of the other medical opinions [not finding a totally
disabling respiratory or pulmonary impairment], I do not find Dr.
Warden's opinion of total disability, as a result of obstructive
lung disease which is
probably related to dust exposure,
persuasive. Dr. Warden himself appears unsure that exposure to coal
dust caused the diagnosed lung disease."
Id. at 132a-133a (emphasis in original). We note that,
under § (a)(4), a qualifying physician's opinion need only conclude
that the claimant has a totally disabling respiratory or pulmonary
impairment, and need not also determine whether that impairment was
caused by exposure to coal dust.
[
Footnote 19]
The ALJ also considered three blood gas studies offered under §
(a)(3), but none achieved the values necessary to qualify as proof
of an impairment in the transfer of oxygen from the lung alveoli to
the blood. Ray has not challenged these findings.
[
Footnote 20]
Id. at 120a (citing
Bozick v. Consolidation Coal
Co., 5 BLR 1-574 (Ben.Rev.Bd.1983)).
[
Footnote 21]
Section 718.102(e) (1987) provides, in part:
"(e) No chest X-ray shall constitute evidence of the presence or
absence of pneumoconiosis unless it is in substantial compliance
with the requirements of this section and Appendix A. . . ."
[
Footnote 22]
The Court of Appeals' holding runs into trouble for § (a)(2) and
§ (a)(3) invocations, as well. Those subsections refer to
"ventilatory studies" and "blood gas studies;" facially, these
plural references are not consistent with the Court of Appeals'
reliance on the regulation's plain language. To finesse this
problem, the Court of Appeals concluded that "one
set of
qualifying ventilatory or blood gas studies" necessarily invokes
the presumption. 785 F.2d at 434 (emphasis added). It noted:
"[T]his interpretation is fully supported by the regulations
which define how ventilatory and blood gas tests are to be
conducted. These regulations demonstrate that each pulmonary
function study consists of several tests, and must be accompanied
by two to three tracings of each test performed. 20 CFR §§ 718.103;
410.430. Similarly, a blood gas study may also have separate
components, one reflecting the results obtained at rest, and the
other reporting the results of testing during exercise. 20 CFR §
718.105."
Ibid. Nevertheless, this reasoning does rely upon
adding the words "one set of" to the regulation; moreover, although
ventilatory and blood gas studies do consist of a series of tests,
the regulations on other occasions refer to such a series of tests
as a single "study."
See §§ 410.426(b) and 718.105(b) and
(c).
[
Footnote 23]
The ALJ's task is, of course, to weigh the quality, and not just
the quantity, of the evidence, before determining whether the
presumption has been invoked. In Ray's case, despite the fact that
nonqualifying X-rays and ventilatory studies, for example,
significantly outnumbered qualifying ones, the ALJ's opinion
focuses not on number, but on the uncertainty of the most recent
qualifying X-ray interpretation and the discounting of one of the
qualifying ventilatory studies by the doctor who administered
them.
[
Footnote 24]
E.g., negative X-ray interpretations that had already
been outweighed by positive readings in establishing the existence
of pneumoconiosis under § (a)(1) could not be used to show the
absence of pneumoconiosis under §;(b)(4).
See n 26,
infra.
[
Footnote 25]
See Solomons, A Critical Analysis of the Legislative
History Surrounding the Black Lung Interim Presumption and a Survey
of its Unresolved Issues, 83 W.Va.L.Rev. 869, 893-895 (1981)
(Solomons).
[
Footnote 26]
Under the Secretary's reading, a fact established at the
invocation stage
does "remain open" to challenge on
rebuttal, but "only to the extent there is relevant evidence
different in kind from that offered at the presumption stage."
Brief for Federal Respondent 25. So, under the Secretary's reading,
if the claimant invokes the presumption through "other medical
evidence" under § (a)(4), thus proving the ultimate fact of total
disability, the employer not only may attempt to disprove causality
under § (b)(3) or pneumoconiosis under § (b)(4), but also may try
to disprove total disability under § (b)(1) or § (b)(2) through
evidence that was not able to be introduced at the invocation
stage. However, as the Government also notes:
"Based on current medical knowledge, X-ray, biopsy, and autopsy
evidence are today the only reliable evidence for diagnosing
pneumoconiosis. Therefore, after a Subsection (a)(1) invocation,
the question of pneumoconiosis is effectively closed: the rebutting
party cannot, as a practical matter, attempt to show that the miner
does not suffer from some form of clinical pneumoconiosis."
Id. at 24, n. 22. Invocation under § (a)(2) or §
(a)(3), of course, involves proof of none of the three ultimate
facts of pneumoconiosis, total disability, or coal mine
relatedness; thus, under the Secretary's interpretation, after a §
(a)(2) or § (a) (3) invocation, the employer may attempt to
disprove any of the three ultimate facts, limited only by the
general rule that its proof may not include evidence of the sort
introduced (and outweighed) during invocation.
[
Footnote 27]
See, e.g., Padavich v. Mathews, 561 F.2d 142, 145-146
(CA8 1977) (medical evidence "contradictory and inconclusive;"
first set of X-rays negative, second set first interpreted
positive, then negative by different radiologists);
Bozwich v.
Mathews, 558 F.2d 475 (CA8 1977) (conflicting X-ray readings;
interim presumption not invoked);
Collins v. Mathews, 547
F.2d 795, 796 (CA4 1976) ("Although there were conflicting
interpretations of [the] X-rays, the [ALJ] determined the deceased
coal miner had simple pneumoconiosis");
Petrock v.
Califano, 444 F.
Supp. 872, 875 (ED Pa.1977);
Owens v.
Mathews, 435 F.
Supp. 200, 206 (ND Ind.1977);
Hill v.
Weinberger, 430 F.
Supp. 332, 334 (ED Tenn.1976) ("[T]he Appeals Council stated .
. . that it considers the interpretive opinions of all film
readers, and bases its judgment with respect to a particular X-ray
upon the credibility of the film readers . . .");
Padavich v.
Mathews, 416 F.
Supp. 1229, 1231 (SD Iowa 1976),
aff'd, 561 F.2d 142
(CA8 1977);
Ward v. Mathews, 403 F.
Supp. 95, 98 (ED Tenn.1975);
Zirkle v.
Weinberger, 401 F.
Supp. 945, 949 (ND W.Va.1975);
Blackmon v.
Weinberger, 400 F.
Supp. 1282, 1287 (ED Okla.1975);
Baker v. Secretary of
Health, Education, and Welfare, 383
F. Supp. 1095, 1099 (WD Va.1974).
Since the promulgation of the Labor interim presumption, the
Courts of Appeals have been nearly as uniform in sanctioning
invocation weighing under the SSA interim presumption.
See,
e.g., Hamrick v. Schweiker, 679 F.2d 1078, 1081 (CA4 1982);
Prater v. Harris, 620 F.2d 1074, 1084 (CA4 1980);
Pannell v. Califano, 614 F.2d 391, 393 (CA4 1980);
Staten v. Califano, 598 F.2d 328, 330 (CA4 1979);
Vintson v. Califano, 592 F.2d 1353, 1360 (CA5 1979);
Sharpless v. Califano, 585 F.2d 664, 667 (CA4 1978);
Gober v. Matthews, 574 F.2d 772, 775 (CA3 1978).
The Sixth Circuit stands alone in its view that, if a claimant's
first X-ray reading is positive, it necessarily invokes the
presumption, and may not be reread or contradicted by later
readings or X-rays, but that,
"when positive readings are contradicted by
prior
negative X-rays, there is substantial evidence to support a finding
by the Secretary that the evidence is in conflict, and the
Secretary may have the positive X-rays reread in order to determine
whether a claimant is disabled due to pneumoconiosis."
Couch v. Secretary of Health and Human Services, 774
F.2d 163, 168 (1985) (emphasis added);
see also Hatfield v.
Secretary of Health and Human Services, 743 F.2d 1150 (1984);
Haywood v. Secretary of Health and Human Services, 699
F.2d 277 (1983);
Lawson v. Secretary of Health and Human
Services, 688 F.2d 436 (1982);
Miniard v. Califano,
618 F.2d 405 (1980);
Dickson v. Califano, 590 F.2d 616
(1978).
[
Footnote 28]
The Court of Appeals also relied upon evidence that an early
draft of the regulation contained a provision that
"would have required the adjudicator to weigh all the medical
test evidence to determine whether the weight of this evidence
established total disability."
See Solomons, 897, n. 138. This provision was
eliminated in response to objections raised by congressional staff
members. The Court of Appeals concluded that this history
demonstrates that the final draft of the regulation was not
intended to require the weighing of any evidence before the
presumption may be invoked.
See 785 F.2d at 451-452, and
n. 5. We are not persuaded. First, the regulation quite plainly
does not require proof of total disability in order to invoke the
presumption under §§ (a)(1), (a)(2), or (a)(3). Second, the
rejected provision would have required, in determining total
disability, a weighing of "
all the medical
test
evidence" --
i.e., X-rays, ventilatory studies, and blood
gas studies. This
method of invocation appears simply to
have been scrapped in favor of permitting a claimant to meet one of
the enumerated medical requirements.
[
Footnote 29]
In responding to comments received after the notice of proposed
rulemaking urging that all relevant evidence
not be
considered in rebutting the interim presumption, the Secretary
stressed the statutory mandate requiring the evaluation of all
relevant evidence. He explained:
"[T]he Department cannot, as has been requested by some, look
for the single item of evidence which would qualify a claimant on
the basis of the interim presumption, and ignore other previously
obtained evidence. This does not mean that the single item of
evidence which establishes the presumption is overcome by a single
item of evidence which rebuts the presumption. The Act embodies the
principle that doubt is to be resolved in favor of the claimant,
and that principle plays an important role in claims
determinations, both under the interim presumption and
otherwise."
43 Fed.Reg. 36826 (1978).
The Court of Appeals interpreted this statement as "clearly
imply[ing] that it was intended that one item of qualifying
evidence would be sufficient to invoke the presumption." 785 F.2d
at 465. That is, the Court of Appeals read "the single item of
evidence which would qualify a claimant on the basis of the interim
presumption" and "the single item of evidence which establishes the
presumption" as referring to a separate, unspoken, and
uncontroverted proposition that a single item of qualifying
evidence
necessarily satisfies the claimant's invocation
burden.
Ibid.
While this reading is plausible, we think it ultimately
unsatisfactory. According to the Secretary, the first sentence of
his explanation merely proscribes Labor from making "the
presumption irrebuttable by singling out certain positive evidence
and overlooking other relevant evidence." Brief for Federal
Respondent 38. This reading focuses on the phrase "the Department
cannot . . . look for;" rather than operating as a referent to an
assumed invocation phase principle, the "single item of evidence .
. ." phrase instead names the thing that Labor may not do,
viz., pick and choose among the items of evidence in
adjudicating a miner's claim. Thus, the second sentence of the
explanation merely recognizes that, in some cases, the presumption
may be invoked by a single item of evidence, and that, in
such cases, a single item of equally probative contrary evidence
will not be sufficient to rebut the presumption.
[
Footnote 30]
Like all rules of evidence that permit the inference of an
ultimate fact from a predicate one, black lung benefits
presumptions rest on a judgment that the relationship between the
ultimate and the predicate facts has a basis in the logic of common
understanding.
"Inferences and presumptions are a staple of our adversary
system of factfinding. It is often necessary for the trier of fact
to determine the existence of an element of the crime -- that is,
an 'ultimate' or 'elemental' fact -- from the existence of one or
more evidentiary or 'basic' facts. . . . The value of these
evidentiary devices, and their validity under the Due Process
Clause, vary from case to case, however, depending on the strength
of the connection between the particular basic and elemental facts
involved and on the degree to which the device curtails the
factfinder's freedom to assess the evidence independently."
Ulster County Court v. Allen, 442 U.
S. 140,
442 U. S. 156
(1979).
[
Footnote 31]
The statute itself, of course, requires certain presumptions for
pre-July 1, 1973, SSA claims. For example, the statute presumes a
miner's pneumoconiosis to have arisen out of coal mine employment
if he has worked for 10 or more years in one or more coal mines. 30
U.S.C. § 921(c)(1);
see also §§ 921(c)(2), (3), and (4)
(other SSA claim presumptions). Since Labor's interim presumption
may be no less restrictive than the SSA's, these § 921(c)
presumptions apply indirectly to Labor claims as well.
[
Footnote 32]
Lurking beneath the surface of this case is the constitutional
concern that there be "some rational connection between the fact
proved and the ultimate fact presumed."
Mobile, J. & K. C.
R. Co. v. Turnipseed, 219 U. S. 35,
219 U. S. 43
(1910). There is some question whether pneumoconiosis, for example,
can be considered "proved" -- and therefore serve as the
constitutional predicate for presuming ultimate facts -- if
evidence tending to disprove pneumoconiosis is not permitted to be
considered at invocation.
See Usery v. Turner Elkhorn Mining
Co., 428 U. S. 1,
428 U. S. 28-29
(1976) (statutory presumption of causation, 30 U.S.C. § 921(c)(1),
is triggered only on "proof of pneumoconiosis" plus 10 years'
employment).
[
Footnote 33]
See, e.g., Elkins v. Beth-Elkhorn Corp., 2 BLR 1-683,
1-686 - 1-687 (Ben.Rev.Bd.1979) (approving weighing of X-ray
evidence under § (a)(1));
Strako v. Zeigler Coal Co., 3
BLR 1-136, 1-143 (Ben.Rev.Bd.1981) (factfinder "must weigh
conforming qualifying test reports with conforming nonqualifying
test reports, and he must resolve the conflict," under § (a)(2));
Lessar v. C.F. & I. Steel Corp., 3 BLR at 1-68
(requiring weighing of §(a)(3) evidence);
Meadows v.
Westmoreland Coal Co., 6 BLR 1-773, 1-779 (Ben.Rev.Bd.1984)
(approving weighing of conflicting medical reports under § (a)(4)),
overruling Stiner v. Bethlehem Mines Corp., 3 BLR 1-487,
1-490 (Ben.Rev.Bd.1981) (requiring invocation on basis of one
qualifying medical opinion).
[
Footnote 34]
See, e.g., Moseley v. Peabody Coal Co., 769 F.2d 357,
359-360, and n. 3 (CA6 1985) (approving ALJ's weighing of X-ray
interpretations before holding presumption invoked under § (a)(1));
Consolidation Coal Co. v. Chubb, 741 F.2d at 973
(approving ALJ's "according greater weight to the recent X-ray");
Drummond Coal Co. v. Freeman, 733 F.2d 1523 (CA11 1984)
(not objecting to ALJ's invocation after weighing evidence under §§
(a)(1), (2), and (4));
Whicker v. United States Dept. of Labor
Benefits Review Bd., 733 F.2d 346 (CA4 1984) (sanctioning §
(a)(1) weighing),
overruled, Stapleton v. Westmoreland Coal
Co., 785 F.2d 424 (CA4 1986);
Consolidation Coal Co. v.
Sanati, 713 F.2d 480 (CA4 1983) (requiring weighing of
physicians' opinions under §(a)(4)),
overruled in part,
Stapleton v. Westmoreland Coal Co., supra; Markus v. Old Ben Coal
Co., 712 F.2d 322, 324 (CA7 1983) (approving ALJ's accepting
more recent negative X-ray interpretations over older positive
ones).
After the Court of Appeals decision in this case, the Courts of
Appeals have adopted divergent views on the issue presented. The
Third Circuit is the only one to have plainly sided with the
Fourth.
Revak v. National Mines Corp., 808 F.2d 996
(1986). With some intracircuit confusion, the Sixth and Seventh
Circuits have followed the Secretary's interpretation.
Prater
v. Hite Preparation Co., 829 F.2d 1363 (CA6 1987)
(preponderance standard for §§ (a)(1), (2), and (3) invocations);
Patton v. National Mines Corp., 825 F.2d 1035 (CA6 1987)
(remand to Board to determine whether preponderance standard is
correct for § (a)(4) invocations);
Back v. Director, Office of
Workers' Compensation Programs, 796 F.2d 169 (CA6 1986)
(preponderance standard for § (a)(1) invocations);
Engle v.
Director, Office of Workers' Compensation Programs, 792 F.2d
63, 64, n. 1 (CA6 1986) ("The miner has the burden of establishing
by a preponderance of the evidence all the facts necessary to
invoke the interim presumption of 20 CFR § 727.203(a) . . .");
Cook v. Director, Office of Workers' Compensation
Programs, 816 F.2d 1182 (CA7 1987) (preponderance standard for
§ (a)(1) invocations) (
Amax Coal Co. v. Director, Office of
Workers' Compensation Programs, 801 F.2d 958 (CA7 1986), and
Kuehner v. Ziegler Coal Co., 788 F.2d 439 (CA7 1986),
distinguished on ground that they merely held that invocation is
permitted by one item of evidence; dissenting judge finds prior
cases indistinguishable). The Tenth Circuit, without discussing the
issue, simply approved an X-ray weighing that resulted in
noninvocation.
Plutt v. Benefits Review Bd., Dept. of
Labor, 804 F.2d 597 (1987).
[
Footnote 35]
Because we agree with petitioners that the regulation itself
requires a claimant to prove an invocation fact by a preponderance
of the evidence, we need not pass on petitioners' alternative
argument, namely, that § 7(c) of the Administrative Procedure Act,
5 U.S.C. § 556(d), requires a claimant to prove an invocation fact
by a preponderance of the evidence.
JUSTICE MARSHALL, with whom JUSTICE BRENNAN joins,
dissenting.
This case concerns the evidentiary threshold that a claimant of
black lung benefits must meet to invoke the interim presumption of
total disability due to pneumoconiosis under 20 CFR § 727.203(a)
(1987). The Director of the Office of Workers' Compensation
(Director) interprets the regulation to require that a claimant
prove by a preponderance of the evidence one of the four medical
requirements listed in § 727.203(a) to trigger the presumption. The
Court of Appeals, en banc, rejected the Director's proffered
interpretation, and held that the presumption is invoked once the
claimant has presented a single item of evidence meeting one of the
medical requirements -- that is, "one positive x-ray, one
qualifying set of ventilatory or blood gas studies, or one
physician's opinion."
Stapleton v. Westmoreland Coal Co.,
785 F.2d 424, 436 (CA4 1986). The Court chooses to embrace the
Director's view. Because I believe that the Director's
interpretation of the regulation contravenes its plain language and
creates a regulatory scheme that is unnecessarily complex and
internally inconsistent, I dissent.
I
The language and structure of the regulation provide the most
compelling evidence for rejecting the Director's interpretation.
The regulation sets up two evidentiary stages:
Page 484 U. S. 162
part (a), the presumption-invocation stage, and part (b), the
rebuttal stage. Part (a) provides that a "miner who engaged in coal
mine employment for at least 10 years will be presumed to be
totally disabled due to pneumoconiosis" as long as the miner meets
any one of four medical requirements. § 727.203(a). Part (b)
provides that the presumption is rebutted if the Administrative Law
Judge (ALJ) determines that the claimant is doing or could do his
usual coal mine work or comparable gainful work; that the
disability "did not arise in whole or in part out of coal mine
employment;" or that the "evidence establishes that the miner does
not, or did not, have pneumoconiosis." § 727.203(b).
Under §(a)(1), the presumption is triggered when "[a] chest
[X-ray], biopsy, or autopsy establishes the existence of
pneumoconiosis." Under § (a)(4), the presumption is triggered
when
"[o]ther medical evidence, including the documented opinion of a
physician exercising reasoned medical judgment, establishes the
presence of a totally disabling respiratory or pulmonary
impairment."
The regulation does not refer to "the X-ray evidence taken as a
whole," or "the weight of documented opinions of physicians" -- the
inquiry mandated by the Court's interpretation -- but, rather, to
an X-ray, or a physician's opinion. Moreover, the regulation does
not provide that a claimant who presents a single qualifying piece
of evidence
may be presumed to be totally disabled because
of pneumoconiosis, but rather provides that such a claimant
"
will be presumed" totally disabled because of the
disease. The regulation thus expressly commands that a single
qualifying X-ray or a single documented physician's opinion will
trigger the presumption. [
Footnote
2/1]
Page 484 U. S. 163
The Court attempts to evade the plain meaning of the regulation
by placing overriding emphasis on the regulation's use of the word
"establishes." The Court interprets "establish" to mean that a
claimant must prove each of the medical requirements by a
preponderance of the evidence. [
Footnote 2/2] Under this interpretation, an ALJ must
weigh conflicting like-kind evidence before invoking the
presumption. A more natural reading of "establish" in the context
of the presumption-invocation stage, however, is simply that the
ALJ must determine whether a claimant has come forward with an
X-ray, a set of ventilatory or blood gas studies, or a physician's
opinion that meets the requirements and standards of the
regulation. In other words, an ALJ determines whether the single
item of evidence "establishes the existence of pneumoconiosis" or
"establishes the presence of a totally disabling respiratory or
pulmonary impairment" by referring to the strict reliability and
authenticity requirements of the regulations,
see, e.g.,
20 CFR §§ 410.428, 727.206 (1987), and, with regard to ventilatory
and blood gas studies, to the qualifying standards set out in §
727.203(a).
The Court argues that § (a)(1) cannot have been intended to
refer to a single item of evidence, because an X-ray is probative
only when it is interpreted by a qualified expert. The Court
reasons that, because the presumption is invoked by an X-ray, and
not by an expert's reading, an ALJ may have to consider different
interpretations of the same X-ray. From this premise, the Court
concludes that,
"[j]ust as the ALJ must weigh conflicting interpretations of the
same X-ray, . . . there would seem to be no reason why he must
ignore
Page 484 U. S. 164
all X-rays in a series except one."
Ante at
484 U. S.
148-149 (footnote omitted). No reason except the
regulatory language. Whatever the merit of the Court's conclusion
that conflicting readings of the same X-ray must be weighed prior
to invoking the presumption (for that question is not before the
Court), the regulation's plain language requires that the
presumption be invoked when a single X-ray is read only as
positive. In addition, contrary to the Court's characterization,
additional X-rays that indicate the absence of pneumoconiosis are
not "ignored;" they are fully considered by the ALJ during the
rebuttal stage, when all evidence against the presumed existence of
pneumoconiosis is brought to bear. [
Footnote 2/3]
The Court of Appeals ruling that a single qualifying test or
medical opinion is sufficient to invoke the presumption is further
supported by the comments that the Secretary of Labor issued in
connection with the final promulgation of the regulations. In
addressing the standard of rebuttal, the Secretary stated:
Page 484 U. S. 165
"[T]he Department cannot, as has been requested by some, look
for the single item of evidence which would qualify a claimant on
the basis of the interim presumption, and ignore other previously
obtained evidence. This does not mean that
the single item of
evidence which establishes the presumption is overcome by a
single item of evidence which rebuts the presumption."
Notice of Final Rulemaking under the Black Lung Benefits Reform
Act of 1977, 43 Fed.Reg. 36826 (1978) (hereinafter Notice of
Rulemaking) (emphasis added). The Director's current position
conflicts with this strong evidence of regulatory intent.
Another compelling reason to reject the Director's
interpretation is that it conflicts with the requirement in part
(b), the rebuttal section, that, in "adjudicating a claim under
this subpart, all relevant medical evidence shall be considered." §
727.203(b). The Director's interpretation turns the regulation on
its head, requiring that all relevant medical evidence be submitted
and weighed at the invocation stage, but severely restricting the
consideration of medical evidence during the rebuttal stage. In the
Director's view, the presumption is triggered only when the weight
of evidence in one of the categories of medical evidence in part
(a) proves the fact specified in that category. For instance, the
"fact proved" under § (a)(1) is the existence of pneumoconiosis,
and, under § (a)(4), it is the presence of a totally disabling
respiratory or pulmonary impairment. Because these facts have been
proved in the invocation stage, relitigation in the rebuttal stage
through like-kind evidence is foreclosed. Brief for Federal
Respondent 14-15. Of course, nonmedical evidence could be presented
in these instances, but this hardly conforms to the mandate that
"all relevant medical evidence" be considered in the rebuttal
stage.
The Court argues that the placement of the "all relevant medical
evidence" requirement was inexact, and that the regulation requires
only that all relevant medical evidence be
Page 484 U. S. 166
considered at some point in the evaluation of a claim, whether
it be during the invocation or rebuttal stage. Yet, if the
Secretary intended that the "all relevant medical evidence"
language apply to both stages of the evaluation process, it is
remarkable that he placed the language in the introduction to the
rebuttal section. It would have been a simple matter, if such were
the Secretary's intent, to place the "all relevant medical
evidence" language at the beginning of § 727.200. I see no reason
to assume such inartful drafting. Moreover, comments by the
Secretary accompanying the final promulgation of the regulations
conflict with the Court's interpretation. The Secretary stated:
"The many comments which urge that all relevant evidence should
not be considered
in rebutting the interim presumption
must also be rejected. . . . [T]he Social Security regulations . .
. similarly do not limit the evidence which can be considered
in rebutting the interim presumption."
Notice of Rulemaking 36826 (emphasis added). These comments
demonstrate that the Secretary understood the language to apply
directly to the rebuttal section.
In addition, the Director's approach renders virtually useless
one of four grounds for rebuttal in part (b). Under § (b)(4),
eligibility for benefits is rebutted if all relevant medical
evidence establishes that the miner does not have pneumoconiosis.
Yet, in the Director's view, all relevant medical evidence has
already been considered at the presumption-invocation stage. It is
only when the evidence presented during the invocation stage is
mismatched, as for example when the claimant produces qualifying
blood-gas studies evidence and the mine operator produces negative
X-rays, that the presumption may be triggered and rebuttal evidence
under § (b)(4) is available that has not already been weighed.
Moreover, as the Director acknowledges, if a claimant invokes the
presumption under § (a)(1) by a preponderance of X-ray, biopsy, or
autopsy evidence, as a practical matter there is no further
evidence that the coal mine operator could submit to rebut the
presumed existence of pneumoconiosis
Page 484 U. S. 167
because such § (a)(1) evidence is the most reliable method of
diagnosing the disease.
See Brief for Federal Respondent
24, n. 22. The Court counters that "[n]othing in the regulation
requires each rebuttal subsection to be fully available in each
case."
Ante at
484 U. S. 150.
This is, of course, true. Yet it is extraordinary that the
regulation would intend to make the rebuttal stage an often useless
exercise with respect to the central aspect of a valid claim:
whether a miner suffers from pneumoconiosis.
II
In addition to running afoul of the regulatory language and
structure, the Director's reading of the regulation creates a
needlessly complex regulatory scheme that blurs the distinction
between the presumption-invocation and rebuttal stages. Under the
Director's interpretation, when the weight of evidence in one of
the medical evidence categories invokes the presumption, then the
same evidence cannot be considered during rebuttal to challenge the
existence of the fact proved, but it may be considered if relevant
to rebut one of the presumed elements of a valid claim for
benefits. The Director's approach subjects the ALJ to a mesmerizing
swirl of evidentiary rules. If the presumption is invoked under §
(a)(1), then X-ray evidence may not be considered regarding the
existence of pneumoconiosis, but may be considered, if relevant, on
the issues whether the miner is totally disabled or whether the
disease arose from coal mine employment. Similarly, if the
presumption is invoked under § (a)(4), then medical evidence,
including physicians' opinions, may not be considered on the issue
of total disability, although it may be considered on the issues of
the existence of pneumoconiosis and causation by coal mine
employment. Finally, if the presumption is invoked using blood gas
and ventilatory studies evidence under §(a)(2) and §(a)(3), the
same evidence may be considered again regarding each rebuttal
category, because the proved facts are not elements of a valid
claim for benefits. The Director's interpretation thus
Page 484 U. S. 168
creates a procedural morass that could not have been intended by
the regulation's two-step inquiry.
By contrast, the Court of Appeals interpretation is marked by
its simplicity. Under this approach the ALJ first determines
whether the claimant has come forward with a qualifying medical
test or physician's opinion and, if so, proceeds to the rebuttal
stage. At this point, all relevant evidence must be considered, and
the mine operators may rebut the presumed existence of
pneumoconiosis, total disability, and causation by coal mine
employment on the basis of all the grounds provided by §
727.203(b).
III
The Court's willingness to accept the Director's interpretation
of the regulation is based, I believe, on a misperception of the
problem Congress and the Department of Labor were trying to
alleviate with the interim presumption. Pneumoconiosis is an
elusive and progressive disease. Congress was deeply concerned
about the difficulty of diagnosing pneumoconiosis and the dearth of
medical testing facilities available to miners. Testimony before
congressional committees and by Members of Congress repeatedly
emphasized the unreliability of negative test results. As this
Court stated in
Usery v. Turner Elkhorn Mining Co.,
428 U. S. 1,
428 U. S. 31-32,
and n. 33 (1976),
"Congress was presented with significant evidence demonstrating
that X-ray testing that fails to disclose pneumoconiosis cannot be
depended upon as a trustworthy indicator of the absence of the
disease,"
whereas there was no "authoritative indications that X-ray
evidence of the presence of pneumoconiosis is untrustworthy."
[
Footnote 2/4] Juxtaposed with the
difficulties in diagnosing pneumoconiosis was evidence
Page 484 U. S. 169
that the disease was rife among long-term coal miners.
Congressman Paul Simon noted one study that found that autopsies of
400 coal miners with more than 20 years' experience showed that
90-95% of them had pneumoconiosis. House Committee on Education and
Labor, Black Lung Benefits Reform Act and Black Lung Benefits
Revenue Act of 1977, 96th Cong., 282-283 (Comm. Print 1979).
Testimony before the Senate estimated that as many as 50% of all
coal miners will eventually become disabled from pneumoconiosis.
See Hearings on S. 355
et al. before the
Subcommittee on Labor of the Senate Committee on Labor and Public
Welfare, 91st Cong., 1st Sess., pt. 2, pp. 641, 856 (1969)
(statements of Dr. I. E. Buff and Dr. Leon Cander).
The Court recognizes that Congress was especially concerned with
the difficulties miners face in showing they suffer from
pneumoconiosis. The Court reasons, however, that
"Congress intended that those long-term miners who can show that
they are truly diseased should have to prove no more. But if a
miner is not actually suffering from the type of ailment with which
Congress was concerned, there is no justification for presuming
that that miner is entitled to benefits."
Ante at
484 U. S. 158
(footnote omitted). Yet it is the difficulty in showing whether a
miner is "truly diseased" that Congress found so troubling. No one
disputes that the case file of a miner suffering from
pneumoconiosis may include negative X-rays, negative ventilatory
studies, negative blood gas studies, and negative opinions by
physicians. The interim presumption was designed to shift some of
the risk of faulty test results from the miner to the employer. The
evidence of high incidence of pneumoconiosis among long-term coal
miners, coupled with the difficulties encountered in diagnosing the
disease, gave the Department of Labor good reason for shifting this
burden by presuming total disability due to pneumoconiosis based on
findings of a single positive medical test or physician's opinion.
The Director's current
Page 484 U. S. 170
interpretation, which the Court today accepts, undermines that
policy decision.
IV
The Court is correct that the agency's interpretation of its own
regulations is entitled to deference.
See, e.g., Bowles v.
Seminole Rock & Sand Co., 325 U.
S. 410,
325 U. S. 414
(1945). But deference has its bounds. It is not a license for an
agency effectively to rewrite a regulation through interpretation.
An agency must abide by its regulations as written until it
rescinds or amends them.
See United States v. Nixon,
418 U. S. 683,
418 U. S.
695-696 (1974). The Director's interpretation of the
interim presumption is contrary to the plain language of the
regulation, conflicts with comments of the Secretary accompanying
the final promulgation of the regulation, and creates an
unnecessarily complex regulatory scheme. Because I view the
agency's interpretation as plainly inconsistent with the regulatory
language and history, I would not defer.
I accordingly dissent, and would affirm the judgment of the
Court of Appeals.
[
Footnote 2/1]
With respect to the medical requirements under §§ 727.203(a)(2)
and (a)(3), the regulation uses the plural, referring to
"ventilatory studies" and "blood gas studies." The use of the
plural, however, only reflects the fact that a qualifying
ventilatory and blood gas test consists of a set of many studies.
See 20 CFR §§ 718.103, 718.105 (1987). As with §(a)(1) and
§ (a)(4), the presumption is triggered when a claimant presents a
single set of ventilatory or blood gas studies that meet the
qualifying standards set out in part (a).
[
Footnote 2/2]
Both the Director and the Court state that the agency has
"long adhered to the 'true doubt' rule, which requires that the
claimant prevail on those issues as to which the evidence is in
equipoise."
Brief for Federal Respondent 16-17 (citation omitted). The
Director has failed to bring to our attention, however, one
instance in which the true-doubt rule actually has been applied by
an ALJ in evaluating a miner's claim.
[
Footnote 2/3]
The Court also argues that the Court of Appeals reads the
invocation section "as though it merely required an X-ray that
constitutes evidence of the presence of pneumoconiosis,'" and
asserts that,
"[h]ad that been the Secretary's intent, presumably he would
have used that language, as he did elsewhere to explain that
meaning."
Ante at 147. The Court notes that § 718.102(e), a
regulation defining standards required of X-rays, refers to an
X-ray "that shall constitute evidence of the presence or absence of
pneumoconiosis." This argument arises from the Court's
unwillingness to recognize that the meaning of "establish" is
informed by the requirements of the presumption-invocation stage.
The Court is correct that, in context of the presumption-invocation
stage, a single item of evidence that "constitutes evidence of
pneumoconiosis" will also "establish the existence of
pneumoconiosis." Given that the inquiry at the invocation stage is
whether a single item of evidence is qualifying, the functional
equivalence of these two terms is to be expected. As for the
regulation cited by the Court defining X-ray standards, it guides
the evaluation of all claims for black lung benefits, not just
claims that fall under the interim regulations. That these
standards speak of X-rays that "constitute evidence of
pneumoconiosis," rather than X-rays that "establish the existence
of pneumoconiosis," says nothing about whether these two terms have
identical meanings in the context of the presumption-invocation
stage.
[
Footnote 2/4]
For example, a study cited in a Senate Report found that
"approximately 25 percent of a random sample of some 200 coal
miners whose medical records based upon X-ray findings showed no
coalworker's pneumoconiosis were found on
post mortem
examination to have the disease."
S.Rep. No. 92-743, p. 12 (1972).