Rufus Hendrix v. Best Coal, Incorporated (Board decision, September 23, 2025)

BRB interlocutory order. The Benefits Review Board affirmed the finding that complicated pneumoconiosis was not established, but vacated the denial of benefits and remanded for new findings on total respiratory disability. Entitlement remains unresolved. A final Board decision ordinarily becomes final 60 days after issuance absent timely judicial review or reconsideration under 20 C.F.R. § 802.406; a party may request Board reconsideration within 30 days under § 802.407.

Plain-English summary

Rufus Hendrix appealed a denial of black lung benefits without counsel. The Board upheld the judge's finding that conflicting x-rays, a CT scan, and the medical opinions did not establish complicated pneumoconiosis. But the judge had said a doctor did not address total disability even though his report stated that Hendrix could not meet the physical demands of coal mine work. The Board also held that the judge needed to compare treatment records describing his limits with the demands of his usual mine job. It vacated the disability finding and benefits denial and returned the case for new findings.

Decision snapshot

• Authority: Total respiratory disability under 20 C.F.R. § 718.204(b)(2); complicated pneumoconiosis under § 718.304.
• Outcome: Complicated pneumoconiosis finding affirmed; disability finding and denial vacated; case remanded.
• Key point: The judge must assess the doctor's express disability opinion and compare recorded limits with the miner's usual job duties.

Full text (DOL BRB public release)

U.S. Department of Labor Benefits Review Board 200 Constitution Ave. NW
Washington, DC 20210-0001

BRB No. 25-0039 BLA

RUFUS HENDRIX
)
)
Claimant-Petitioner
)
)
v. )
)
BEST COAL, INCORPORATED
)
)
and
)
NOT-PUBLISHED
)
ROCKWOOD CASUALTY INSURANCE
)
COMPANY
) DATE ISSUED: 09/23/2025
)
Employer/Carrier-
)
Respondents
)
)
DIRECTOR, OFFICE OF WORKERS’
)
COMPENSATION PROGRAMS, UNITED
)
STATES DEPARTMENT OF LABOR
)
)
Party-in-Interest
)
DECISION and ORDER
Appeal of the Decision and Order Denying Benefits of Willow Eden Fort, Administrative Law Judge, United States Department of Labor.

Rufus Hendrix, Evarts, Kentucky.

John C. Webb, V and Aaron D. Ashcraft (Lloyd, Gray, Whitehead & Monroe, P.C.), Birmingham, Alabama, for Employer.

Before: ROLFE and JONES, Administrative Appeals Judges, ULMER, Acting Administrative Appeals Judge.
PER CURIAM:

Claimant appeals, without the assistance of counsel, 1 Administrative Law Judge (ALJ) Willow Eden Fort’s Decision and Order Denying Benefits (2023-BLA-05697) rendered on a claim filed on June 11, 2021, pursuant to the Black Lung Benefits Act, as amended, 30 U.S.C. §§901-944 (2018) (Act).

The ALJ found Claimant did not establish complicated pneumoconiosis and therefore could not invoke the irrebuttable presumption of total disability due to pneumoconiosis at Section 411(c)(3) of the Act. 30 U.S.C. §921(c)(3); see 20 C.F.R.
§718.304. She further found he failed to establish a totally disabling respiratory or pulmonary impairment, 20 C.F.R. §718.204(b), an essential element of entitlement, and denied benefits.2

On appeal, Claimant generally challenges the denial of benefits. Employer responds in support of the denial of benefits. 3 The Acting Director, Office of Workers’ Compensation Programs, declined to file a response brief.

In an appeal that a claimant files without the assistance of counsel, the Board considers whether the Decision and Order below is supported by substantial evidence. Hodges v. BethEnergy Mines, Inc., 18 BLR 1-84, 1-86 (1994). We must affirm the ALJ’s findings of fact and conclusions of law if they are rational, supported by substantial evidence, and in accordance with applicable law.4 33 U.S.C. §921(b)(3), as incorporated

1 On Claimant’s behalf, Robin Napier, a benefits counselor with Stone Mountain Health Services of St. Charles, Virginia, requested the Benefits Review Board review the ALJ’s decision, but Ms. Napier is not representing Claimant on appeal. See Shelton v. Claude V. Keen Trucking Co., 19 BLR 1-88 (1995) (Order).
2 The ALJ did not consider the length of Claimant’s coal mine employment.

3 The Board issued an acknowledgement letter on December 10, 2024, giving the

parties thirty days from receipt of the letter to file response briefs. On August 21, 2025, Employer filed Operator’s Response to Claimant’s Petition for Review accompanied by a Motion for Leave to File Brief. Counsel for Employer states they did not receive the Board’s acknowledgement letter until they contacted the Board on July 24, 2025, and that service of the letter was sent to an incomplete address. Thus Employer requests the Board excuse the late filing and accept its response brief. No objections have been filed. We grant Employer’s Motion for Leave to File Brief.
4 The Board will apply the law of the United States Court of Appeals for the Eleventh Circuit because Claimant performed his last coal mine employment in Alabama.
2 by 30 U.S.C. §932(a); O’Keeffe v. Smith, Hinchman & Grylls Assocs., Inc., 380 U.S. 359, 361-62 (1965).

Invocation of the Section 411(c)(3) Presumption – Complicated Pneumoconiosis

Section 411(c)(3) of the Act, 30 U.S.C. §921(c)(3), provides an irrebuttable presumption that a miner is totally disabled due to pneumoconiosis if he suffers from a chronic dust disease of the lung which: (a) when diagnosed by x-ray, yields one or more large opacities greater than one centimeter in diameter that would be classified as Category A, B, or C; (b) when diagnosed by biopsy or autopsy, yields massive lesions in the lung; or (c) when diagnosed by other means, would be a condition that could reasonably be expected to yield results equivalent to (a) or (b). See 20 C.F.R. §718.304. In determining whether a claimant has invoked the irrebuttable presumption, the ALJ must consider all evidence relevant to the presence or absence of complicated pneumoconiosis. See Pittsburg & Midway Coal Mining Co. v. Director, OWCP [Cornelius], 508 F.3d 975, 983, 987 (11th Cir. 2007); Melnick v. Consolidation Coal Co., 16 BLR 1-31, 1-33 (1991) (en banc).

The ALJ found the x-ray, computed tomography (CT) scan, and medical opinion evidence insufficient to support a finding of complicated pneumoconiosis,5 and thus the relevant evidence weighed together does not establish complicated pneumoconiosis. 20 C.F.R. §718.304(a)-(c); Decision and Order at 4-9. Substantial evidence supports the ALJ’s findings.

X-ray Evidence - 20 C.F.R. §718.304(a)

The ALJ considered seven interpretations of two x-rays dated February 17, 2021 and July 13, 2021. Decision and Order at 4-5. Drs. Crum and Ramakrishnan read the February 17, 2021 x-ray as positive for complicated pneumoconiosis, Category A, whereas Drs. Seaman and Tarver read the x-ray as negative for the disease. Director’s Exhibits 17, 19; Employer’s Exhibits 2, 3. Dr. Crum read the July 13, 2021 x-ray as positive for complicated pneumoconiosis, Category A, while Drs. DePonte and Meyer read the x-ray as negative. Director’s Exhibits 14 at 15, 18; Employer’s Exhibit 1.

See Shupe v. Director, OWCP, 12 BLR 1-200, 1-202 (1989) (en banc); Director’s Exhibit 3; Hearing Tr. at 25-26.
5 The ALJ accurately found the treatment records do not contain any evidence of

complicated pneumoconiosis, Claimant’s Exhibits 2, 3, and the record contains no biopsy or autopsy evidence. 20 C.F.R. §718.304(b), (c); Decision and Order at 9.

3
The ALJ permissibly assigned equal weight to the physicians’ readings because they are all dually-qualified as Board-certified radiologists and B readers. Staton v. Norfolk & Western Ry. Co., 65 F.3d 55, 59 (6th Cir. 1995); Decision and Order at 5. She permissibly found the February 17, 2021 x-ray inconclusive for the presence of complicated pneumoconiosis because an equal number of dually-qualified radiologists read the x-ray as positive and negative for the disease. See Director, OWCP v. Greenwich Collieries [Ondecko], 512 U.S. 267, 281 (1994); Sea “B” Mining Co. v. Addison, 831 F.3d 244, 256- 57 (4th Cir. 2016); Staton, 65 F.3d at 59; Wojtowicz v. Duquesne Light Co., 12 BLR 1-162, 1-165 (1989); Decision and Order at 5-6. She also rationally found the July 13, 2021 x- ray is negative for complicated pneumoconiosis because a greater number of dually- qualified radiologists read it as negative for the disease. See Addison, 831 F.3d at 256-57; Staton, 65 F.3d at 59; Wojtowicz, 12 BLR at 1-165; Decision and Order at 7. As she found one x-ray is inconclusive for complicated pneumoconiosis and one is negative, the ALJ found the x-ray evidence is negative for complicated pneumoconiosis. Id.

Because the ALJ conducted both a qualitative and quantitative assessment of the conflicting x-ray interpretations, and her determination is supported by substantial evidence, we affirm her finding that the x-ray evidence is negative for complicated pneumoconiosis and does not support a finding of the disease. 20 C.F.R. §718.304(a); Decision and Order at 7.

Other Medical Evidence - 20 C.F.R. §718.304(c)

CT Scans

The ALJ considered Dr. Absher’s reading of a March 9, 2021 CT scan, the only CT scan of record. Decision and Order at 7-8. Dr. Absher identified several scattered noncalcified pulmonary nodules bilaterally in the right upper lobe, a nodule in the right and left lower lobes, groundglass opacities predominantly in “the upper lobes likely related to fibrosis,” and bronchiectasis in the right middle lobe. Claimant’s Exhibit 1 at 2. He noted the scattered pulmonary nodules measure less than four millimeters and are “indeterminate and can be seen with prior granulomatous infection or silicosis.” Id. Because Dr. Absher’s CT scan reading does not diagnose complicated pneumoconiosis consistent with 20 C.F.R.
§718.304(c), we discern no error in the ALJ’s finding the CT scan evidence does not support a finding of the disease. Decision and Order at 8.

Medical Opinions

The ALJ weighed Dr. Harris’s medical opinion. Decision and Order at 8-9. Dr.
Harris diagnosed progressive massive fibrosis based on Claimant’s twenty-year coal mine employment history and the “multiple” x-ray readings showing “advanced profusion with coalescence into large [Category] A [opacities].” Director’s Exhibit 48 at 2. The ALJ 4 permissibly discredited Dr. Harris’s diagnosis of complicated pneumoconiosis as contrary to her determination that the weight of the x-ray evidence overall is negative for complicated pneumoconiosis. See Island Creek Coal Co. v. Compton, 211 F.3d 203, 211- 12 (4th Cir. 2000) (ALJ erred in relying on a physician’s opinion of simple clinical pneumoconiosis because it was based on a positive x-ray which the ALJ had discredited); Furgerson v. Jericol Mining Inc., 22 BLR 1-216, 1-226 (2002) (en banc) (reliability of a physician’s opinion may be “called into question” when the diagnostic tests upon which the physician based his diagnoses have been undermined); Decision and Order at 8-9.

As the record does not contain any other evidence relevant to the presence of complicated pneumoconiosis, progressive massive fibrosis, or massive lesions, we affirm the ALJ’s finding that Claimant failed to establish the existence of complicated pneumoconiosis and invoke the irrebuttable presumption at Section 411(c)(3). 20 C.F.R.
§718.304(a)-(c); see Westmoreland Coal Co. v. Cox, 602 F.3d 276, 283 (4th Cir. 2010); Melnick, 16 BLR at 1-33-34.

Invocation of the Section 411(c)(4) Presumption - Total Disability

To invoke the Section 411(c)(4) presumption, Claimant must establish he has a totally disabling respiratory or pulmonary impairment. 20 C.F.R. §718.305(b)(1)(iii). A miner is totally disabled if his respiratory or pulmonary impairment, standing alone, prevents him from performing his usual coal mine work and comparable gainful work. See 20 C.F.R. §718.204(b)(1). A claimant may establish total disability based on qualifying pulmonary function or arterial blood gas studies, 6 evidence of pneumoconiosis and cor pulmonale with right-sided congestive heart failure, or medical opinions. 20 C.F.R.
§718.204(b)(2)(i)-(iv). The ALJ must weigh all relevant supporting evidence against all relevant contrary evidence. See Defore v. Ala. By-Products Corp., 12 BLR 1-27, 1-28-29 (1988); Rafferty v. Jones & Laughlin Steel Corp., 9 BLR 1-231, 1-232 (1987); Shedlock v. Bethlehem Mines Corp., 9 BLR 1-195, 1-198 (1986), aff’d on recon., 9 BLR 1-236 (1987) (en banc).

6 A “qualifying” pulmonary function study or blood gas study yields results equal to or less than the applicable table values listed in Appendices B and C of 20 C.F.R. Part 718, respectively. A “non-qualifying” study yields results exceeding those values. See 20 C.F.R. §718.204(b)(2)(i), (ii).

5
The ALJ determined the pulmonary function study, arterial blood gas study, medical opinion, and treatment record evidence does not support a finding of total disability. 7 Decision and Order at 9-11.

The record contains one pulmonary function study and one arterial blood gas study dated July 12, 2023. Director’s Exhibits 45, 46. The ALJ correctly noted neither test produced qualifying values. 20 C.F.R. §718.204(b)(2)(i), (ii); Decision and Order at 10. Thus we affirm her determination that the pulmonary function and arterial blood gas study evidence does not support a finding of total disability. Decision and Order at 10.

The ALJ also considered Dr. Harris’s medical opinion. Director’s Exhibit 48. She found he diagnosed a restrictive lung disease based on Claimant’s non-qualifying pulmonary function study, but determined he “did not find Claimant totally disabled from a respiratory or pulmonary impairment.” Decision and Order at 10. Thus she found his opinion does not support Claimant’s burden of proof. Id. The ALJ erred.

Dr. Harris noted Claimant “has two decades in coal mining” and symptoms of dyspnea on exertion, and that his chest x-ray is positive for progressive massive fibrosis. Director’s Exhibit 48. He opined Claimant’s pulmonary function study shows moderate restrictive lung disease and concluded that, “[g]iven [Claimant’s] severe pulmonary impairment he would not be expected to be able to complete the exertional requirements of any coal [mining] job.” Id.

Because Dr. Harris opined Claimant is totally disabled, the ALJ’s finding that the doctor did not opine regarding total disability is not supported by substantial evidence. See U.S. Steel Mining Co. v. Director, OWCP [Jones], 386 F.3d 977, 984 (11th Cir. 2004); see also Mingo Logan Coal Co. v. Owens, 724 F.3d 550, 557 (4th Cir. 2013) (substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion). We therefore vacate the ALJ’s determination that the medical opinion evidence does not support a finding of total disability.
20 C.F.R.
§718.204(b)(2)(iv); Decision and Order at 10.

The ALJ also considered various treatment records spanning from December 16, 2020 to February 22, 2022. Decision and Order at 10-11. The records from Mountain Heart Center, PSC, note Claimant’s chest pain with shortness of breath, dizziness, fatigue, and palpitations are worse with exertion, and that he is physically limited by shortness of breath and dizziness. Claimant’s Exhibit 2. The records from Jonesville Family Health Center also document shortness of breath on exertion including walking, chronic coughing

7 The ALJ accurately noted there is no evidence of cor pulmonale with right-sided

congestive heart failure. 20 C.F.R. §718.204(b)(2)(iii); Decision and Order at 9.

6 with mucus production, and wheezing, and that Claimant’s symptoms have gotten progressively worse. Claimant’s Exhibit 3. The records repeatedly state “Exercise tolerance-Dyspnea on Exertion: yes [ten] feet.” Id. Additionally, they state Claimant “comes to the clinic today complaining of chronic onset of shortness of breath [which] started when [he] was walking.” Id.

The ALJ found the treatment records are insufficient to establish total disability because she “cannot infer respiratory or pulmonary disability from generalized statements about a miner’s condition without additional support.” Decision and Order at 11. We are unable to affirm this finding.

Contrary to the ALJ’s determination, a physician need not phrase his or her opinion in terms of “total disability” to support a finding of total disability pursuant to 20 C.F.R.
§718.204(b)(2)(iv). See Black Diamond Coal Co. v. Benefits Review Board [Raines], 758 F.2d 1532, 1534 (11th Cir. 1985) (“[i]t is not essential for a physician to state specifically that an individual is totally impaired . . . .”). Treatment records may support a finding of total disability if they provide sufficient information from which the ALJ can reasonably infer Claimant is unable to do his last coal mine job. See Cornett v. Benham Coal, Inc., 227 F.3d 569, 578 (6th Cir. 2000); Scott v. Mason Coal Co., 60 F.3d 1138, 1141 (4th Cir. 1995) (physical limitations described in doctor’s report sufficient to establish total disability); Poole v. Freeman United Coal Mining Co., 897 F.2d 888, 894 (7th Cir. 1990); McMath v. Director, OWCP, 12 BLR 1-6, 1-9 (1988). Even a mild pulmonary impairment may be totally disabling, depending on the exertional requirements of a miner’s usual coal mine employment. See Cornett, 227 F.3d at 578.

Thus the ALJ must determine the exertional requirements of a miner’s usual coal mine work and then consider them in conjunction with the medical evidence in assessing the extent of his impairment. See McMath, 12 BLR at 1-10 (ALJ must identify the miner’s usual coal mine work and then compare evidence of the exertional requirements of the miner’s usual coal mine employment with the medical opinions as to his work capabilities). As the ALJ did not make a finding on the exertional requirements of Claimant’s usual coal mine work and compare them to the limitations set forth in the treatment records, she has not rendered the necessary factual findings. See McMath, 12 BLR at 1-10. Because she did not adequately render findings that comport with the Administrative Procedure Act (APA),8 we must vacate her determination that the treatment records do not support a finding of total disability. 20 C.F.R. §718.204(b)(2)(iv); Decision and Order at 10-11.

8 The Administrative Procedure Act provides every adjudicatory decision must include “findings and conclusions, and the reasons or basis therefor, on all the material 7
As we have vacated the ALJ’s findings the medical opinion and treatment record evidence does not support a finding of total disability, we also vacate her conclusion that Claimant failed to establish total disability based on the evidence as a whole. 20 C.F.R.
§718.204(b)(2)(iv); see Rafferty, 9 BLR at 1-232. Consequently, we also vacate the ALJ’s denial of benefits and remand the case for further consideration.

Remand Instructions

On remand, the ALJ must reconsider whether the medical opinion evidence and treatment records support a finding of total disability. 20 C.F.R. §718.204(b)(2)(iv). In so doing, she must first determine the exertional requirements of Claimant’s usual coal mine employment. See McMath, 12 BLR at 1-10. She must then reweigh Dr. Harris’s opinion and the treatment record evidence, taking into account the exertional requirements of Claimant’s usual coal mine employment when weighing the evidence. Id. (ALJ must identify the miner’s usual coal mine work and then compare evidence of the exertional requirements of the miner’s usual coal mine employment with the medical opinions as to the miner’s work capabilities); Budash v. Bethlehem Mines Corp., 9 BLR 1-48, 1-51-52 (1986) (en banc) (description of physical limitations in performing routine tasks may be sufficient to allow the ALJ to infer total disability). She must fully explain the reasons for her credibility determinations considering the physicians’ explanations for their medical findings, the documentation underlying their medical judgments, and the sophistication of, and bases for, their diagnoses. See Jones, 386 F.3d at 992; Jordan v. Benefits Review Board, 876 F.2d 1455, 1460 (11th Cir. 1989). The ALJ must then weigh all relevant evidence together to determine whether Claimant is totally disabled. See Rafferty, 9 BLR at 1-232; Shedlock, 9 BLR at 1-198; 20 C.F.R. §§718.204(b)(2), 718.305.

If the ALJ finds Claimant established total disability she must determine the length and nature of his coal mine employment. If she determines Claimant has at least fifteen years of qualifying coal mine employment, he will have invoked the Section 411(c)(4) presumption.9 30 U.S.C. §921(c)(4) (2018); 20 C.F.R. §718.305(b). She must then determine whether Employer has rebutted the presumption.
See 20 C.F.R.
§718.305(d)(1)(i), (ii). If Claimant does not establish fifteen years of qualifying coal mine

issues of fact, law, or discretion presented . . . .” 5 U.S.C. §557(c)(3)(A), as incorporated into the Act by 30 U.S.C. §932(a).
9 Section 411(c)(4) provides a rebuttable presumption that a miner is totally disabled

due to pneumoconiosis if he has at least fifteen years of underground or substantially similar surface coal mine employment and a totally disabling respiratory or pulmonary impairment. 30 U.S.C. §921(c)(4) (2018); see 20 C.F.R. §718.305.

8 employment, the ALJ must consider if he has established entitlement under 20 C.F.R. Part

718. 20 C.F.R. §§718.202, 718.203, 718.204.

     If Claimant fails to establish total disability, an essential element of entitlement, the
     ALJ may reinstate the denial of benefits. Anderson v. Valley Camp of Utah, Inc., 12 BLR 1-111, 1-112 (1989); Trent v. Director, OWCP, 11 BLR 1-26, 1-27 (1987).

     Accordingly, we affirm in part and vacate in part the ALJ’s Decision and Order
     Denying Benefits and remand this case to the ALJ for further consideration consistent with this opinion.

     SO ORDERED.

                                         JONATHAN ROLFE
                                         Administrative Appeals Judge
     
                                         MELISSA LIN JONES
                                         Administrative Appeals Judge
     
                                         GLENN E. ULMER
                                         Acting Administrative Appeals Judge
     
                                            9