Two Sixth Circuit Decisions Regarding Subsequent Claims (Consolidation Coal Co. v. Maynes & Arkansas Coals, Inc. v. Lawson)
Last week the U.S. Court of Appeals for the Sixth Circuit released two for-publication decisions in black lung benefits cases which each considered different issues that arise in subsequent claims. Both decisions are favorable to miners and their survivors.
1. Consolidation Coal Co. v. Maynes – Consistent with other circuits, the Sixth Circuit holds that a previous denial in a survivor’s claim does not bar a subsequent claim that is eligible under the Byrd Amendments.
In Consolidation Coal Co. v. Maynes, (decision here) the primary issue before the Sixth Circuit was whether a survivor who was previously denied survivor’s benefits could become eligible based on changes to the Black Lung Benefits Act made by the Affordable Care Act (changes known as the “Byrd Amendments.”) The Byrd Amendments removed the requirement that eligible survivors prove that a miners’ death was caused by black lung when the miner was receiving black lung benefits at the time of his death. Instead, survivors are automatically entitled to benefits. The Sixth Circuit held that survivors who are eligible under the Byrd Amendments can file a new claim and receive benefits, even if their previous claim was denied.
The Facts
Lorene Maynes is the widow of Cleving Maynes, a miner who was receiving black lung benefits when he died of respiratory failure in 2003. Shortly after Mr. Maynes’s death, Mrs. Maynes sought survivor’s benefits but was denied because she could not prove that Mr. Maynes’s respiratory failure was related to his black lung. Following a round of appeals, Mrs. Maynes’s 2003 claim was finally denied in October 2009. Following passage of the Affordable Care Act in March 2010, Mrs. Maynes refiled, seeking benefits under the more favorable law.
Consolidation Coal challenged Mrs. Maynes’s claim, arguing that because the denial of her 2003 claim was final, the doctrine of res judicata bars her 2010 claim.
The Court’s Holdings
The Sixth Circuit joined the Third and Fourth Circuits by rejecting this argument. The Court (via a published opinion authored by Judge Donald and joined by Judges Daughtry and Gibbons) explained that because Mrs. Maynes no longer had to prove that her husband’s death was due to black lung—but rather only had to prove that he was receiving black lung benefits when he died—her subsequent claim was not the same cause of action, and thus, res judicata was not a barrier to her subsequent claim. Relatedly, the Court also rejected Consolidation Coal’s argument that Congress’s changes to the Act which allow new claims violate separation of powers by nullifying the Court’s previous denial. The Court explained that because the question in Mrs. Maynes’s subsequent claim was different than the issue in her first claim, awarding her subsequent claim did nothing to overturn her prior denial.
Although not the primary issue on appeal, the Court also held that the Benefits Review Board has authority to modify the commencement date of benefits in the administrative law judge’s order, even if the claimant does not cross-appeal from the administative law judge’s order. This was relevant in Mrs. Maynes’s claim because the administrative law judge used March 2010 (the month that the Affordable Care Act passed) as the date that her benefits began and the Board corrected this error by substituting October 2009 (the month that Mrs. Maynes’s prior claim was finally denied) for March 2010. This provided Mrs. Maynes with six more months’ worth of benefits.
The two take-aways from Consolidation Coal Co. v. Maynes are: (1) all Courts of Appeals to consider the issue agree that neither res judicata nor separation of powers bars subsequent survivors’ claims that are eligible under the Byrd Amendments, and (2) the Board has authority to modify ALJ orders in a claimant’s favor even if the claimant does not cross-appeal from the ALJ’s decision.
Neither holding is a surprise, but both are favorable to claimants. Congratulations to John Grigsby of AppalReD in Barbourville, KY for his work on behalf of Mrs. Maynes.
2. Arkansas Coals, Inc. v. Lawson – A prior ALJ’s dicta stating that a company is not the “responsible operator” is not binding on a subsequent ALJ who determines that a claimant is eligible for benefits.
In Arkansas Coals, Inc. v. Lawson, (decision here) the primary issue before the Court was whether in a subsequent claim, an ALJ is bound by a prior ALJ’s determination that a company is not the “responsible operator” that must pay benefits, when the prior ALJ also denied the miner’s claim for benefits for medical reasons.
The Court (via a published opinion authored by Judge McKeague and joined by Judge Stranch and Chief Judge Collier of the U.S. District Court for the Eastern District of Tennessee) held that the crucial fact is that the miner’s prior claim was denied. Accordingly, at that time no one had to pay Mr. Lawson benefits so the ALJ’s determination of who would have to pay was not necessary to the decision and was dicta. Because the prior “responsible operator” determination was not necessary, the doctrine of collateral estoppel did not bar the relitigation of this issue in Mr. Lawson’s subsequent claim. The Court also held that reconsideration of the “responsible operator” provision was proper under the Department of Labor’s regulations and that the second ALJ’s “responsible operator” determination was supported by substantial evidence.
The Sixth Circuit’s decision is good for the black lung benefits system because Arkansas Coals’s position that an ALJ’s dicta in a prior case is binding would invite needless preventative litigation that would bog down the system. The Court’s decision conserves legal, administrative, and judicial resources, all of which are in short-supply and plague the black lung benefits system with delays. The Court’s decision avoided further delays that would do nothing but give defense attorneys more to bill for.
Congratulations to Jonathan P. Rolfe and Gary K. Stearman of the Solicitor’s Office in the Department of Labor.
One Response to “Two Sixth Circuit Decisions Regarding Subsequent Claims (Consolidation Coal Co. v. Maynes & Arkansas Coals, Inc. v. Lawson)”
[…] Previously this year, the Sixth Circuit issued a holding on this issue in Consolidation Coal Co. v. Maynes, 739 F.3d 323, 325 (6th Cir. 2014), (see previous post here). […]
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