C.F.R. » Title 20 » CHAPTER VI—OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR › SUBCHAPTER B—FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED › PART 718—STANDARDS FOR DETERMINING COAL MINERS' TOTAL DISABILITY OR DEATH DUE TO PNEUMOCONIOSIS › Subpart B—Criteria for the Development of Medical Evidence

20 C.F.R. § 718.104

Report of physical examinations

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(a) A report of any physical examination conducted in connection with a claim shall be prepared on a medical report form supplied by the Office or in a manner containing substantially the same information. Any such report shall include the following information and test results:

(1) The miner's medical and employment history;

(2) All manifestations of chronic respiratory disease;

(3) Any pertinent findings not specifically listed on the form;

(4) If heart disease secondary to lung disease is found, all symptoms and significant findings;

(5) The results of a chest X-ray conducted and interpreted as required by § 718.102; and

(6) The results of a pulmonary function test conducted and reported as required by § 718.103. If the miner is physically unable to perform a pulmonary function test or if the test is medically contraindicated, in the absence of evidence establishing total disability pursuant to § 718.304, the report must be based on other medically acceptable clinical and laboratory diagnostic techniques, such as a blood gas study.

(b) In addition to the requirements of paragraph (a), a report of physical examination may be based on any other procedures such as electrocardiogram, blood-gas studies conducted and reported as required by § 718.105, and other blood analyses which, in the physician's opinion, aid in his or her evaluation of the miner.

(c) In the case of a deceased miner, where no report is in substantial compliance with paragraphs (a) and (b), a report prepared by a physician who is unavailable may nevertheless form the basis for a finding if, in the opinion of the adjudication officer, it is accompanied by sufficient indicia of reliability in light of all relevant evidence.

(d) Treating physician. In weighing the medical evidence of record relevant to whether the miner suffers, or suffered, from pneumoconiosis, whether the pneumoconiosis arose out of coal mine employment, and whether the miner is, or was, totally disabled by pneumoconiosis or died due to pneumoconiosis, the adjudication officer must give consideration to the relationship between the miner and any treating physician whose report is admitted into the record. Specifically, the adjudication officer shall take into consideration the following factors in weighing the opinion of the miner's treating physician:

(1) Nature of relationship. The opinion of a physician who has treated the miner for respiratory or pulmonary conditions is entitled to more weight than a physician who has treated the miner for non-respiratory conditions;

(2) Duration of relationship. The length of the treatment relationship demonstrates whether the physician has observed the miner long enough to obtain a superior understanding of his or her condition;

(3) Frequency of treatment. The frequency of physician-patient visits demonstrates whether the physician has observed the miner often enough to obtain a superior understanding of his or her condition; and

(4) Extent of treatment. The types of testing and examinations conducted during the treatment relationship demonstrate whether the physician has obtained superior and relevant information concerning the miner's condition.

(5) In the absence of contrary probative evidence, the adjudication officer shall accept the statement of a physician with regard to the factors listed in paragraphs (d)(1) through (4) of this section. In appropriate cases, the relationship between the miner and his treating physician may constitute substantial evidence in support of the adjudication officer's decision to give that physician's opinion controlling weight, provided that the weight given to the opinion of a miner's treating physician shall also be based on the credibility of the physician's opinion in light of its reasoning and documentation, other relevant evidence and the record as a whole.

Notes of Decisions
Cited in 38 cases (4 in the last 5 years), 1987–2025 · leading case: Eastover Mining Co. v. Dorothy S. Williams & Dir., Off. of Workers' Comp. Programs, United States Dep't of Labor, 338 F.3d 501 (6th Cir. 2003).
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Eastover Mining Co. v. Dorothy S. Williams & Dir., Off. of Workers' Comp. Programs, United States Dep't of Labor, 338 F.3d 501 (6th Cir. 2003). · cites it 3× “See 20 C.F.R. § 718.104 (d)(2002). Rejecting “automatic acceptance” of the treating physician’s opinion, the DOL intended the rule “to force a careful and thorough assessment of the treating relationship.”
Black & Decker Disability Plan v. Nord, 538 U.S. 822 (2003). “, see 20 CFR § 718.104 (d)(5) (2002). One Court of Appeals, however, has rejected a treating physician rule for the assessment of claims of entitlement to veterans’ benefits for service-connected disabilities, see White v.”
Nat'l Mining Ass'n v. Dep't of Labor, 292 F.3d 849 (D.C. Cir. 2002). · cites it 5× “20 C.F.R. § 718.104 (d)(l)-(4). The regulation provides that in “appropriate cases,” the doctor-patient relationship “may constitute substantial evidence in support of the adjudication officer’s decision to give that physician’s opinion controlling weight,” but only when the…”
Sherman Greene v. King James Coal Mining, Inc., 575 F.3d 628 (6th Cir. 2009). · cites it 3× “20 C.F.R. § 718.104 (d)(5). Thus, “the weight to be accorded a treating physician’s opinion is based on its power to persuade.”
Energy West Mining Co. v. Oliver, 555 F.3d 1211 (10th Cir. 2009). · cites it 2× “20 C.F.R. § 718.104 (d). Second, if these factors warrant, the ALJ may choose “to give that physician’s opinion controlling weight, provided that the weight given to the opinion of a miner’s treating physician shall also be based on the credibility of the physician’s opinion in…”
Wolf Creek Collieries v. Dir., Off. of Workers' Comp. Programs, Dep't of Labor Evelyn Stephens, 298 F.3d 511 (6th Cir. 2002). · cites it 2× “Proposed regulation 20 C.F.R. § 718.104 (d) provides that the medical opinion of the treating physician may be entitled to controlling weight and that the administrative law judge must take into consideration the following factors: the nature and duration of the relationship,…”
Mingo Logan Coal Co. v. Erma Owens, 724 F.3d 550 (4th Cir. 2013). · cites it 2× “In our view, however, the ALJ followed the standards established in 20 C.F.R. § 718.104 (d) and gave appropriate consideration to the opinions of Dr.”
McCain v. Dir., Off. of Workers Comp. Programs, 58 F. App'x 184 (6th Cir. 2003). · cites it 2× “In determining the level of deference, we turn for guidance to 20 C.F.R. §§ 718.104 (d)(5), which delineates the criteria for the development of medical evidence in black lung proceedings: In appropriate cases, the relationship between the miner and his treating physician may…”
Peabody Coal Co. v. Wilma J. Groves Dir., Off. of Workers' Comp. Programs, United States Dep't of Labor, 277 F.3d 829 (6th Cir. 2002). “104 (d)(5), which delineates the criteria for the development of medical evidence in black lung proceedings: In appropriate cases, the relationship between the miner and his treating physician may constitute substantial evidence in support of the adjudication officer’s decision…”
Zurich Am. Ins. Grp. v. Duncan Ex Rel. Duncan, 889 F.3d 293 (6th Cir. 2018). “Moore's extensive treatment history of Raymond, including multiple physical examinations, the ALJ gave his opinion controlling weight pursuant to 20 C.F.R. § 718.104 (d)(5). Id. at A67 (ALJ Dec.”
Dir., Off. of Workers' Comp. Programs, United States Dep't of Labor v. August Mangifest, 826 F.2d 1318 (3rd Cir. 1987). “204(c) by providing that a judgment contained in a medical report “alone” may support a finding of total disability only if the report is in “substantial compliance” with a quality standard set out at 20 C.F.R. § 718.104 . That section mandates that a report include a medical…”
Jericol Mining, Inc. v. Napier, 301 F.3d 703 (6th Cir. 2002). · cites it 5× “The factors discussed in 20 C.F.R. § 718.104 (d)(5) are relevant for determining the appropriate weight that should be assigned to the opinions of treating physicians.”
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