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 C—Determining Entitlement to Benefits

20 C.F.R. § 718.202

Determining the existence of pneumoconiosis

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(a) A finding of the existence of pneumoconiosis may be made as follows in paragraphs (a)(1) through (4) of this section:

(1) A chest X-ray conducted and classified in accordance with § 718.102 may form the basis for a finding of the existence of pneumoconiosis. Except as otherwise provided in this section, where two or more X-ray reports are in conflict, in evaluating such X-ray reports consideration must be given to the radiological qualifications of the physicians interpreting such X-rays (see § 718.102(d)).

(2) A biopsy or autopsy conducted and reported in compliance with § 718.106 may be the basis for a finding of the existence of pneumoconiosis. A finding in an autopsy or biopsy of anthracotic pigmentation, however, must not be considered sufficient, by itself, to establish the existence of pneumoconiosis. A report of autopsy must be accepted unless there is evidence that the report is not accurate or that the claim has been fraudulently represented.

(3) If the presumptions described in § 718.304 or § 718.305 are applicable, it must be presumed that the miner is or was suffering from pneumoconiosis.

(4) A determination of the existence of pneumoconiosis may also be made if a physician, exercising sound medical judgment, notwithstanding a negative X-ray, finds that the miner suffers or suffered from pneumoconiosis as defined in § 718.201. Any such finding must be based on objective medical evidence such as blood-gas studies, electrocardiograms, pulmonary function studies, physical performance tests, physical examination, and medical and work histories. Such a finding must be supported by a reasoned medical opinion.

(b) A claim for benefits must not be denied solely on the basis of a negative chest X-ray.

(c) A determination of the existence of pneumoconiosis must not be made—

(1) Solely on the basis of a living miner's statements or testimony; or

(2) In a claim involving a deceased miner, solely on the basis of the affidavit(s) (or equivalent testimony) of the claimant and/or his or her dependents who would be eligible for augmentation of the claimant's benefits if the claim were approved.

[79 FR 21612, Apr. 17, 2014]
Notes of Decisions
Cited in 220 cases (16 in the last 5 years), 1981–2025 · leading case: Gunderson v. United States Dep't of Labor, 601 F.3d 1013 (10th Cir. 2010).
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Gunderson v. United States Dep't of Labor, 601 F.3d 1013 (10th Cir. 2010). · cites it 23× “It therefore does not meet the standards for x-rays set forth in 20 C.F.R. §§ 718.202 (a)(1); 718.102 (2002).”
Island Creek Coal Co. v. Dennis E. Compton Dir., Off. of Workers' Comp. Programs, United States Dep't of Labor, 211 F.3d 203 (4th Cir. 2000). · cites it 7× “20 C.F.R. § 718.202 (a) provides that [a] finding of the existence of pneumo-coniosis may be made as follows: (1) A chest X-ray conducted and classified in accordance with § 718.”
Dixie Fuel Co. v. Dir., Off. of Workers' Comp. Programs, 820 F.3d 833 (6th Cir. 2016). · cites it 4× “On'remand, the ALJ again concluded that Hensley was entitled to benefits under the Act. Dixie now raises numerous challenges to the ALJ’s decision and the Board’s affirmance.”
Morrison v. Tennessee Consol. Coal Co., 644 F.3d 473 (6th Cir. 2011). · cites it 6× “The ALJ found that none of the x-ray interpretations were positive for pneumoconiosis under 20 C.F.R. § 718.202 (a)(1). He also weighed the medical opinion evidence under 20 C.”
McCain v. Dir., Off. of Workers Comp. Programs, 58 F. App'x 184 (6th Cir. 2003). · cites it 8× “See generally 20 C.F.R. § 718.202 (a)(l)-(4) (1999) (describing the four methods of establishing pneumoconiosis).”
Westmoreland Coal Co. v. Cox, 602 F.3d 276 (4th Cir. 2010). · cites it 6× “While the ALJ did state that the 2005 biopsy established that Cox suffered from pneumoconiosis under 20 C.F.R. § 718.202 (a), 9 she did not state that it was sufficient to establish statutory complicated pneumoconiosis pursuant to 30 U.”
Consolidation Coal Co. v. Arthur O. Held Dir., Off. of Workers' Comp. Programs, United States Dep't of Labor, 314 F.3d 184 (4th Cir. 2002). · cites it 6× “The ALJ first noted that Held could not establish pneumoconiosis under either subsection (a)(2) or (a)(3) of 20 C.F.R. § 718.202 because there was no biopsy evidence and no applicable presumptions.”
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× “Under DOL regulations, a claimant may establish legal pneumoconiosis by any of four different methods of proof: (1) x-ray evidence; (2) autopsy or biopsy evidence; (3) evidence of complicated medical pneumoconiosis or progressive massive fibrosis; or (4) reasoned and documented…”
Sterling Smokeless Coal Co. v. Tammy Akers Dir., Off. of Workers' Comp. Programs, United States Dep't of Labor, 131 F.3d 438 (4th Cir. 1997). · cites it 2× “” 20 C.F.R. § 718.202 (a). In its written decision, and as a statutory prerequisite to its award of benefits, the ALJ concluded (1) that Mr.”
Peabody Coal Co. Old Repub. Ins. Co. v. Arthur E. Hill, 123 F.3d 412 (6th Cir. 1997). · cites it 5× “See 20 C.F.R. § 718.202 . Specifically, a claimant may demonstrate he suffers from a coal dust disease by a chest x-ray, a biopsy or autopsy, the presumptions described in §§ 718.”
Helen Mining Co. v. Dir. OWCP, 650 F.3d 248 (3rd Cir. 2011). · cites it 4× “On May 23, 1991, however, Administrative Law Judge Gerald Tierney denied the claim, pursuant to 20 C.F.R. § 718.202 (a)(l)-(4), discrediting Dr.”
Grayson Coal & Stone Co. v. Charles Teague, 688 F. App'x 331 (6th Cir. 2017). · cites it 5× “On September 18, 2014, the Administrative Law Judge found that the medical evidence established that Teague was totally disabled due in substantial part to pneumoconiosis pursuant to 20 C.F.R. § 718.202 (a)(4). Section 718.202(a)(4) is a federal regulation that sets out one of…”
Show all 220 citing cases →
— 20 C.F.R. § 718.202(a) — 2 cases
Calvin C. Nance v. Benefits Review Bd., United States Dep't of Labor Dir., Off. of Workers Comp. Programs, 861 F.2d 68 (4th Cir. 1988).
Peabody Coal Co. v. DOWCP (4th Cir. 1999).
— 20 C.F.R. § 718.202(a)(1) — 3 cases
Howard v. Valley Camp Coal Co., 94 F. App'x 170 (4th Cir. 2004).
Nora L. Collins v. Pond Creek Mining Co., 468 F.3d 213 (4th Cir. 2006).
Collins v. Pond Creek Mining Co., 468 F.3d 213 (4th Cir. 2006).
— 20 C.F.R. § 718.202(a)(1)(ii)(E) — 1 case
James Hall, Claimant-Petitioner v. Vance Coal Co. & Dir., Off. of Workers' Comp. Programs, U.S. Dep't of Labor, 921 F.2d 276 (6th Cir. 1990).
— 20 C.F.R. § 718.202(a)(2) — 2 cases
Consolidation Coal Co v. Dir. OWCP (3rd Cir. 2018).
Island Creek Coal Co v. Compton (4th Cir. 2000).
— 20 C.F.R. § 718.202(a)(4) — 5 cases
Elkay Mining Co. v. Hazel Smith, 712 F. App'x 222 (4th Cir. 2017).
Little T Coal Co. v. OWCP (6th Cir. 2023).
Island Creek Coal Co. v. OWCP (6th Cir. 2024).
R.F.I. Energy, Inc. v. Dir., Off. of Workers' Comp. Programs, 488 F. App'x 622 (3rd Cir. 2012).
Utah Power & Light Co. v. Dir., Off. Of Workers' Comp. Programs, 13 F.3d 408 (10th Cir. 1993).
— 20 C.F.R. § 718.202(a)(ii)(C) — 1 case
Copley v. Arch of WV Inc (4th Cir. 1998).
— 20 C.F.R. § 718.202(a)(l) — 1 case
Collins v. Pond Creek Mining Co., 468 F.3d 213 (4th Cir. 2006).
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