Before the black lung regulations took effect in the 1970s, one-third of long-term coal miners suffered from coal workers’ pneumoconiosis or black lung. Even with the coal mining regulations, cases of these illnesses began to rise drastically in the late 1990s. Researchers are expressing concern that some cases of the new generation of severe black lung disease progress far more rapidly than in the past. The new black lung cases are also being witnessed among younger miners including those 50 years or younger with even as little as 7.5 years of coal dust exposure.
Black lung disease is linked to a high disability rate among coal miners. The disease is incurable but medications help manage the symptoms and improve the quality of life. Access to health care remains a big challenge to miners due to the low success rate of black lung claims. Also, coal miners lack experienced legal representation to present their claims and win against the large coal mining companies. Most attorneys shy away from representing miners because of low and delayed payments associated with the black lung program. As a result, most miners do not get the benefits they deserve. However, some institutions, researchers, black lung lawyers, and health practitioners support miners by providing them with access to healthcare, and legal representation.
Black Lung Attorney Hugh Stephens
Hugh Stephens is one of the few attorneys in the country who have dedicated their careers to helping people affected by illnesses linked to workplace exposure get the compensation they deserve. He has obtains compensation from compensation programs run by the Department of Labor, Office of Workers Compensation Programs for employees and former employees affected by occupational exposures.
Filing a successful black lung claim requires the services of an experienced black lung attorney to battle large coal mining companies. The last mining company that employed the miner for at least one year is responsible for compensating miners affected by the black lung disease. Unfortunately, the legal processes involved in filing black lung claims do not favor miners who are already struggling with disabilities resulting from the illness. Hugh Stephens helps miners throughout the claim process and through appeals, if necessary.
Do you or a loved one suffer from black lung disease? Contact Black Lung attorney Hugh Stephens to help you file a claim for the Black Lung Benefits or to assist as you work your way through the often lengthy claim process.
Miners fight against black lung disease and the Coal Miners Act
Initially, CWP was diagnosed as silicosis until researchers determined with certainty that inhalation of coal dust could damage the lungs. Before the 1970s, about one-third of coal miners who had worked underground for more than 25 years suffered from black lung disease. This caused members of the United Mine Workers of America to go on strike in 1968 advocating for better working conditions.
In 1969 Congress passed the Federal Coal Mine Health and Safety Act, or Coal Act. The Coal Act created the Mine Safety and Health Administration and required that underground coal mines be inspected four times per year and surface mines twice a year. The Act also set coal dust exposure limits for coal miners and procedures for compensating miners disabled by CWP. A voluntary screening program, known as the Coal Workers’ Health Surveillance Program (CWHSP) was also created. the program researches respiratory diseases related to coal mine dust exposure and provides voluntary X-rays to miners every five years. It was through this program that the federal government came to learn about the resurgence of black lung among coal miners in Appalachia in the early 2000s.
The Federal Black Lung Clinics Program
The National Coalition of Black Lung & Respiratory Disease Clinics has been at the forefront of bridging the gap in providing fast and affordable healthcare to thousands of black lung victims across the country. The coalition was established in 1984 and it has a chain of medical clinics that treat respiratory illnesses related to mining. The Federal Black Lung Clinics Program funds the black lung and respiratory disease clinics in 14 states where coal mining is carried out. They also obtain funding from the federal government through grant programs. Their services which include outreach and educational programs have helped improve the quality of life for miners affected by coal mining diseases and their families. They also provide medical expertise, state-of-the-art medical equipment, and pulmonary rehabilitation programs to miners in rural areas. Federal Black Lung Clinics include:
Canyonlands Healthcare in Arizona; This facility provides free screening for coal mining-related illnesses to miners who have been working for at least six months and their families. They also offer other medical services including diagnosis, treatment, education, counseling, and preventive services.
Miners Clinic of Colorado; the clinic provides free health screening and education to current and former coal, metal, non-metal, and aggregate miners as well as historic uranium industry workers in Colorado and Arizona.
University of Illinois Chicago Black Lung Clinics Program in Illinois & Indiana; the institution provides education, training, and expert consultation. It is also a tertiary-level referral center for other black lung clinics nationally for complicated cases of coal mine dust lung disease.
Big Sandy Health Care Inc. in Kentucky; the healthcare facility assists current and former miners with their applications for black lung benefits free of charge.
Owensboro Health Muhlenberg Community Hospital in KY; the hospital has a Coal Miners’ Respiratory Clinic which has been in operation since 1975. The clinic’s mission is to minimize the effects of pulmonary impairment in coal miners and individuals with pulmonary disease.
Miners’ Colfax Medical Center in New Mexico; the health care facility provides outreach programs to Miners throughout New Mexico. Their services include in-depth screening, diagnosis, and treatment of Black Lung and other pulmonary diseases in a state-of-the-art mobile medical unit.
Genesis Healthcare System Ohio; the Genesis Healthcare black lung center was created to treat coal miners with black lung. It is funded by the federal government through the USA Department of Health and Human Services (HRSA) and the US Department of Labor. It provides free black lung screening, diagnosis, education, treatment, and rehabilitation to current or former coal miners. They also help patients file black lung claims.
PA Black Lung Coalition, at Lung Disease Foundation of Central PA; the clinic provides expert services in the diagnosis, treatment, and rehabilitation of patients with lung problems from coal mine dust exposure, as well as other occupational exposures. They offer specialized services in testing and benefits counseling, Lung Function and oxygen testing, and chest X-ray and CT scanning. They also have four on-site pulmonologists for referrals.
Lungs At Work in McMurray, Pennsylvania; it is a non-profit black lung and respiratory clinic. It offers free medical services, outreach and education, counseling, research, and lay advocacy to active, and former coal miners and other individuals with occupational lung disease. The staff also assist miners and their families with claims for Federal Black Lung disability benefits, including filing paperwork, gathering developing, and submitting the evidence necessary for their claim. They also represent claimants in court.
Centerville Clinic in PA; the health care facility serves anyone with a respiratory disorder including non-coal workers. They conduct blood tests, chest X-rays, EKGs, and breathing tests to provide a diagnosis. The Medical Director is specially trained in respiratory disorders and will examine your lungs and prescribe the necessary treatment and rehabilitation.
Community Health of East Tennessee Inc.; It is the only Black Lung Clinic in Tennessee and is funded by the federal government. It offers free services to miners, including the DOL exam and mileage reimbursement if travel is required. The facility also provides medical examination services to coal miners including chest X-rays, pulmonary function studies, and arterial blood gas tests. They also offer counseling services and lay representation through the black lung claim process.
Stone Mountain Health Services Virginia; the healthcare center conducts black lung case finding through outreach programs. It also provides screening, advanced testing, patient education, treatment, pulmonary rehabilitation, and black lung benefit counseling per the DOL guidelines.
West Virginia Department of Health and Human Resources; the West Virginia Black Lung Clinics Program is funded by the federal government and other community health centers. It offers a variety of affordable pulmonary and respiratory treatment services to coal miners with black lung disease. These services include screening, diagnosis, treatment, education, outreach rehabilitation, and benefits counseling.
Bluestone Health Association West Virginia; the clinic was created through a grant by the West Virginia Department of Health and the US Department of Health and Human Services. It provides medical evaluation, treatment, and pulmonary rehabilitation for active and inactive miners who suffer from the disease. It also educates patients and their families on how to cope with the disease and their quality of life.
Boone Memorial Hospital, West Virginia; the facility helps miners file for Federal and State Black Lung claims. They also provide the medical exam required to file for Black Lung benefits. These include B-Read Chest X-ray (specific to black lung), Spirometry Test (breathing capacity), EKG, and Exercise Stress Test. Their team of pulmonologists and registered respiratory therapists care for patients.
Cabin Creek Health Systems, West Virginia; the healthcare system has a Breathing Center at Cabin Creek’s Dawes location that incorporates a federally approved Black Lung Center. It provides broad services, including Department of Labor Federal Black Lung Testing, Pulmonary Function Testing, Pulmonary Rehabilitation, and Federal and State Black Lung Counseling.
Hygeia Facilities Foundation in West Virginia; the Primary Care Center and Black Lung Clinic provides priority treatment to Coal miners with black lung disease. It offers a variety of pulmonary and respiratory services at a sliding fee schedule. These services include screening, diagnosis, treatment, education, outreach rehabilitation, and benefits counseling.
New River Health Association in West Virginia; the Black Lung Clinic was established in 1982. The clinic provides testing, diagnosis, treatment, and rehabilitation for Black Lung patients and others with occupational pulmonary diseases. The facility charges patients without insurance coverage a sliding fee based on their annual income and number of dependents.
Preston Taylor Community Health Centers in WV; the clinic is part of the West Virginia Black Lung Clinics Program, the Division of Primary Care. The black lung clinic is also sponsored by Community Health Centers. It offers health care services for black lung disease and other respiratory illnesses on a sliding fee schedule. Their services include screening, diagnosis, treatment, education, outreach rehabilitation, and benefits counseling.
Rainelle Medical Center in WV; the Black Lung Center and Respiratory Disease Program provides affordable screening for occupational disease, and treatment to cases diagnosed with Black Lung or other Respiratory Diseases. The clinic also helps improve patients’ quality of Life through education, pulmonary rehabilitation, and benefits counseling.
Southern WV Health System in WV; the facility has integrated black lung specialized services in their health systems. Under this program, they provide medical services to active, inactive, retired, and disabled coal miners affected by respiratory problems and lung diseases. The Program also provides medical, outreach, educational, and benefits services to coal miners nationwide.
Tug River Health Association WV; it is a non-profit organization that helps diagnose coal miners with black lung symptoms, and assist them file a claim for benefits. They also provide black lung treatment to manage the symptoms as well as counseling services. Their treatment procedure involves medication, pulmonary rehabilitation, and oxygen therapy.
Valley Health Systems WV; the institution has a chain of clinics that offer specialized respiratory care and services for patients with occupational lung diseases, including black lung. It has three clinics located in Upper Kanawha, Harts, and Stepptown in West Virginia.
Reynolds Memorial Hospital in WV; this healthcare facility operates a one-stop clinic for black lung disease and other occupational lung diseases. Their services include screening, disease-specific education, diagnosis, blood and breathing tests, chest X-ray, and pulmonary rehabilitation services. It also offers other services including counseling, filing state and federal claims, and attorney services.
Northwest Community Action Programs of Wyoming (NOWCAP); it is a federally funded Black Lung and Respiratory Diseases Clinic with comprehensive cardio-pulmonary services focusing on miners suffering from black lung disease and their families. The facility has licensed/certified medical providers and utilizes modern, up-to-date medical equipment.
Akshay Sood contribution in the fight against the Black Lung Disease
Akshay Sood is one of the most celebrated black lung doctors in New Mexico and nationwide owing to his contribution to coal miners’ healthcare. Dr. Sood is a tenured professor in the Department of Medicine, Divisions of Pulmonary, Critical Care Medicine and Epidemiology at the University of New Mexico, Health Sciences Center School of Medicine, in Albuquerque, New Mexico.
Dr. Sood works with Miners Colfax to address pulmonary diseases associated with the coal and uranium mining industries. The professor specializes in caring for patients with black lung. He also teaches the “Miners’ wellness tele-ECHO” clinic which is focused on teaching various groups of professionals to care for miners, including clinicians, respiratory therapists, home health professionals, benefits counselors, and attorneys. The clinic is an extension for Community Health Outcomes, jointly provided by the University of New Mexico and a community hospital in New Mexico.
He recently received a $1.5 million gift from Miners Colfax Medical Center in Raton, NM, to research Coal worker pneumoconiosis (CWP) treatment. Dr. Sood also researches non-smoking host risk factors for obstructive lung diseases, such as inhalational dust exposure. His research is funded by the National Heart, Lung, and Blood Institute (NHLBI), Agency for Healthcare Research and Quality (AHRQ), National Institute of Environmental Health Sciences (NIEHS), National Center for Advancing Translating Sciences (NCATS), Patient-Centered Outcomes Research Institute (PCORI), as well as HRSA-funded and Foundation grants.
Professor Sood did his postdoctoral fellowship in Pulmonary, Critical Care, and Occupational and Environmental Medicine at Yale University, New Haven, Connecticut. He is the Assistant Dean of Mentoring and Faculty Retention at the University of New Mexico’s School of Medicine. Dr. Sood also holds the position of the Assistant Dean of Mentoring and Faculty Retention Activities at the UNM Health Science Center Office of Faculty Affairs and Career Development. He also chairs the UNM Health Science Center Faculty Mentor Development Program.
Coal dust exposure and black lung disease among miners
Coal mine dust particles vary in size and affect the lungs differently. When larger coal particles settle in the bronchi, they stimulate the production of mucus, which makes it easier for the person to cough them up. However, prolonged inhalation of coal dust can lead to chronic bronchitis. Coal dust particles are also very reactive, and may interact with body tissue creating an inflammatory response.
CWP occurs from the smaller respirable coal dust particles of 2.5 microns or less in diameter. These tiny particles can easily travel past the bronchi, into the bronchioles and alveoli creating an irritation in the site. The body’s immune system attacks the particles, creating inflammation in the region. This inflammation is meant to kill invading pathogens, but it can’t remove coal or silica from inhaled coal mine dust. As a result, these particles remain in place and may damage lung tissue. As the body responds to get rid of these external bodies it causes chronic inflammation which further damages the delicate lung tissue. These inflammations are seen on X-rays and CT scans as patches or scars on the lungs.
Smaller damages to the lungs might not damage the miner’s lung function. However, over time the patches spread creating 1 to 2 mm nodules of immune and inflammatory cells and collagen fibers often diagnosed as simple CWP. CWP symptoms include chronic cough, increased phlegm production, and shortness of breath. It also increases the risk of emphysema, which is common among miners.
Simple CWP may progress to complicated CWP, or progressive massive fibrosis (PMF), characterized by large, dense masses of fibrous tissue more than 1 cm in diameter, in the upper lungs. The lungs appear black and the fibrosis interferes with their functions causing chronic shortness of breath and may result in death.
These new severe infections are common in small mining operations in Kentucky, Virginia, and West Virginia. These cases are attributed to overexposure to coal dust and failure to comply with regulations. Some cases, as measured by spirometry indicated a disease three times more prevalent than CWP. Unfortunately, not all miners participate in the voluntary screening program resulting in underreporting of the cases. A 2014 NIOSH research study indicated that the original estimates of CWP prevalence among coal miners may have understated the true prevalence of black lung.
Summary
The fight against black lung disease requires collaboration among all stakeholders including the affected communities, coal mining companies, the government, and the healthcare system. With strategic community engagement, the help of committed black lung attorneys and a supportive healthcare system affected coal miners and their families can live a better life.