Battling for Black Lung Benefits

It starts with a dry cough.

As black lung disease progresses, the coal miner begins to notice more and more shortness of breath until simple tasks like the walk from the car to the front door leaves them winded.

“That is such a scary feeling when you can’t catch a breath, and you realize that you’re going to die if you can’t catch a breath — but you still can’t,” says Deborah Wills, who has worked as a black lung benefits counselor at Valley Health Systems in West Virginia for more than 29 years.

Coal workers’ pneumoconiosis, commonly known as black lung disease, is a fatal, incurable condition caused by long-term exposure to coal and silica dust in and around coal mines. As the dust accumulates, lung tissue becomes inflamed and scarred. Over time this can develop into progressive massive fibrosis, or complicated black lung disease, which causes heavy scarring in the lungs that leads to difficulty breathing.

“Pretty much everybody in the community knows somebody with black lung or somebody that has died from black lung,” says Wills, whose grandfather and great-uncle died from the disease.

The U.S. Department of Labor estimates that black lung has killed more than 76,000 people since 1968. The number is almost certainly higher, as miners have historically had a difficult time getting properly diagnosed, in part due to coal company pressure.

Although diagnoses of the disease declined for years after the first federal mine safety regulations were passed in 1969, black lung has made a devastating comeback in the last two decades. According to an August study published in the American Journal of Public Health, today, one in 10 coal miners who have spent 25 years or more working underground suffer from black lung. In Central Appalachia, that number is one in five coal miners — the highest recorded rate in 25 years.

Treatment for the disease is costly. Aside from frequent doctor visits, some coal miners require lung transplants that can exceed $1 million. While some states like Kentucky offer workers compensation for people with black lung, federal law stipulates that the last coal company that employed the coal miner for at least one year is responsible for paying benefits. These federal benefits currently consist of full medical coverage related to the disease and a monthly stipend of $660.10, which can be increased to a maximum of $1,320.10 if the individual has three or more dependents. But if the company is unable to pay, usually due to bankruptcy, then benefits are obtained through the Black Lung Disability Trust Fund, a federal healthcare and disabled-worker fund set up in 1977.

More than $45 billion in federal compensation has been allocated to current and former coal miners and their surviving dependents through the fund. Coal companies are currently taxed $1.10 for every ton of underground coal mined and 55 cents for every ton of surface coal mined to finance the fund.

But in 2019, those rates are scheduled to drop to 50 cents per ton and 25 cents per ton, respectively. The fund is already approximately $4.3 billion in debt, according to a May 2018 report from the U.S. Government Accountability Office. If the excise tax is reduced, the office estimates the debt will exceed $15 billion by 2050.

“Without any congressional action, the trust fund’s debt is going to be far worse than it’s ever been in the past,” says Evan Smith, a staff attorney with the Appalachian Citizens’ Law Center, a nonprofit law firm. Smith notes that while this wouldn’t immediately affect coal miners and their families, it could have dire consequences in the near future.

Once the debt reaches “a scary-type level,” he says, then legislators from non-coal states “start saying ‘wait a minute, here’s a government program that’s bleeding out money every year; we’ve got to do something about this.’”

According to the Government Accountability Office report, raising the tax on coal companies by 25 percent would eliminate the fund’s debt by 2050.

“That’s the right thing to do, especially if we’re uncertain of how much coal production we’re going to have in the year 2050,” Smith says. “We should do everything we can to have the coal industry more or less pay its bill.”

Resolutions Passed

On Aug. 14, the town council of Big Stone Gap, Va., unanimously passed a resolution in favor of keeping the tax on the Black Lung Disability Trust Fund at its current level. It was the first town in the nation to do so.

“It’s not only a moral issue that a company takes care of its workers, but it’s also an economic issue,” says Big Stone Gap Councilman Tyler Hughes, whose grandfather suffers from black lung. “We live in a really impoverished portion of the commonwealth; and most people, regardless of where they live, have trouble paying for their healthcare whether they have black lung or not.”

The towns of Pennington Gap, Va., Dungannon, Va., Haysi, Va., and Benham, Ky., have since passed similar resolutions in support of keeping the excise tax at its current level.

“We are happy to see Big Stone Gap to be the first to step out on that,” says Pennington Gap Councilwoman Jill Carson. “[Cutting the excise tax] would just be so devastating for those families in what is already a poor, poor part of the country.”

In late September, Hughes and nearly 40 representatives from The Alliance for Appalachia — a coalition of grassroots organizations including Appalachian Voices, the publisher of this newspaper — traveled to Washington, D.C., to urge lawmakers to extend the black lung excise tax. They also pressed legislators to pass the RECLAIM Act, a bill that would accelerate the release of $1 billion in existing funds to clean up abandoned mine lands.

National Mining Association President Hal Quinn, however, argues that keeping the trust fund tax at its current rate would burden the industry. “Changing the schedule now would effectively impose a tax increase on an industry struggling to recover from the regulatory excesses of the past administration,” Quinn wrote in a June 2018 letter to two key U.S. House members, according to Reuters.

But Evan Smith states that the industry has offered no economic evidence to support that.

“The bottom line is that the [coal] market has week-to-week fluctuations that are greater than the tax that we’re talking about. … And so to ask those producers to pay just an extra 60 cents of that I think is a very modest cost to make sure that coal miners are taken care of,” Smith says. “Industry lobbyists are always going to say that anything that imposes a cost is a cost that they cannot bear. That’s what they get paid to say.”

Black Lung’s Resurgence

According to Reuters, Hal Quinn’s letter stated that black lung disease was in decline. But according to the National Institute for Occupational Safety and Health, black lung diagnoses have steadily climbed after a low point in the ‘90s.

Progressive massive fibrosis, or complicated black lung disease, has also grown, according to an August study. In 2014, 8.3 percent of miners filing for black lung benefits had the advanced stage of the disease, compared to 0.6 percent in 1988. And 84 percent of miners with progressive massive fibrosis most recently mined coal in Central Appalachia.

In February, researchers published findings that 416 coal miners were diagnosed with complicated black lung in three Southwest Virginia clinics operated by Stone Mountain Health Services between 2013 and 2017. The authors stated that this is “the largest cluster of [progressive massive fibrosis] reported in the scientific literature.”

Beverly May is a retired nurse practitioner in Eastern Kentucky who treated patients with black lung, and is currently working toward a doctorate in public health.

According to May, the recent rise of black lung disease can be partly attributed to thinner seams of coal. Since many of Central Appalachia’s coal-rich seams have been depleted, miners must cut through more rock than before to reach thinner seams of coal — which creates a much greater volume of dust. A 2012 joint investigation by National Public Radio and the Center for Public Integrity discovered that about 52 percent of mine dust samples between 1987 and 2012 showed dangerous levels of silica.

Additionally, May says that with less labor union presence in the region, miners have worked longer hours and more days per week. The NPR investigation found that the average workweek for coal miners had increased by 11 hours over the last 30 years.

“Worst of all, there was extensive tampering with the mechanisms for monitoring the dust,” says May. “What the miners said is that on a routine basis, after there were no more unions, they would get to work, they would do three or four cuts with the continuous miner [machine], and then the supervisor would come and take the personal dust monitor from them and then hang those dust monitors up in the air intake. And then they would proceed to make another 11 or 12 cuts with the continuous miner. So only a small portion of the dust that the miners were actually breathing during the course of that shift was represented in the personal dust monitors that were turned into [the U.S. Mine Safety and Health Administration].”

In July, eight former employees of the now-bankrupt Armstrong Coal Company in western Kentucky were federally charged with submitting forged dust monitoring results to the U.S. Mine Safety and Health Administration. All eight pleaded not guilty, and trial is set for June 19, 2019, according to WEVV-TV. Each faces five years in federal prison and a $250,000 fine.

To Deborah Wills with Valley Health Services, black lung is “a totally preventable disease.”

“Miners don’t have to die from black lung. If coal operators had appropriate ventilation systems in the mines and everyone went by the rules, there would be no black lung disease,” she says. “If people would worry more about workers’ health than production, we wouldn’t have black lung disease.”

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