42 C.F.R. § 37.52

Proficiency in the use of systems for classifying the pneumoconioses

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(a) First or A Readers:

(1) Approval of a physician as an A Reader continues indefinitely if established prior to October 15, 2012.

(2) Physicians who desire to become A Readers must demonstrate their proficiency in classifying the pneumoconioses by either:

(i) Submitting to NIOSH from the physician's files six sample chest radiographs which are considered properly classified by one or more individuals selected by NIOSH from the panel of B Readers. The six radiographs must consist of two without pneumoconiosis, two with simple pneumoconiosis, and two with complicated pneumoconiosis (these may be the same radiographs submitted for facility approval pursuant to §§ 37.43 and 37.44). The films will be returned to the physician. The classifications must be on the Chest Radiograph Classification Form (CDC/NIOSH 2.8); or

(ii) Satisfactory completion, since June 11, 1970, of a course approved by NIOSH on the ILO International Classification of Radiographs of Pneumoconioses.

(b) Final or B Readers:

(1) Approval as a B Reader established prior to October 1, 1976, is hereby terminated.

(2) Proficiency in evaluating chest radiographs for radiographic quality and in the use of the ILO Classification for interpreting chest radiographs for pneumoconiosis and other diseases must be demonstrated by those physicians who desire to be B Readers by taking and passing a specially-designed proficiency examination given on behalf of or by NIOSH at a time and place specified by NIOSH.

(i) Each physician who desires to take the digital version of the examination will be provided a complete set of the current NIOSH-approved standard reference digital radiographs.

(ii) Physicians who qualify under this provision need not be qualified under paragraph (a) of this section.

(c) Physicians who wish to participate in the program must familiarize themselves with the necessary components for attainment of reliable classification of chest radiographs for the pneumoconioses 2 and apply using a Physician Application for Certification Form (CDC 2.12(E)).

2 NIOSH Safety and Health Topic, Chest Radiography: Radiographic Classification, http://www.cdc.gov/niosh/topics/chestradiography/radiographic-classification.html.

[81 FR 73284, Oct. 24, 2016]

Notes of Decisions

Cited in 11 cases (1 in the last 5 years), 1975–2025 · leading case: Gary Adams v. American Optical Corporation

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Gary Adams v. American Optical Corporation (2020) ca4 “” 42 C.F.R. § 37.52 (b)(2). 4 and informed him that he was eligible to transfer to a less dusty area of the mine.”

James H. Whitman v. Joseph A. Califano, Jr., Sec. Of Health, Education and Welfare (1980) ca4 · cites it 3× “The government’s brief concedes that pursuant to 42 C.F.R. § 37.52 the B readers’ initial positive interpretations “could have been final.”

Bernie Hatfield v. Secretary of Health and Human Services (1984) ca6 “Although the term “certified reader” was not more precisely defined in that opinion, it is not illogical to conclude a comprehensive definition was intended encompassing both Board certified radiologists as well as physicians certified by AL-OSH under 42 C.F.R. § 37.52 . This…”

Carl M. Hill v. Joseph A. Califano, Jr., Secretary of Health Education and Welfare (1979) ca6 “Under 42 C.F.R. § 37.52 an X-ray interpretation by a “B” reader is given finality for classification purposes over interpretations by “A” readers.”

John S. Vintson v. Joseph A. Califano, Jr., Secretary of Health, Education and Welfare (1979) ca5 “42 C.F.R. § 37.52 provides: All chest roentgenograms interpreted by “A” readers will be submitted .”

Stewart v. Mathews (1975) vawd “The Secretary cites 42 C.F.R. § 37.52 which provides' that interpretations of “B” readers will be considered “final” and further, that an original reading by a “B” reader will preclude any necessity for additional readings.”

Evelyn Winfrey v. Joseph A. Califano, Jr., Secretary of Health, Education and Welfare (1980) ca4 · cites it 2× “In this case, 42 C.F.R. § 37.52 is not controlling, and we think the fact that two additional “B” readers read Winfrey’s most recent film as negative provided an expert, rational basis for resolving the conflict between the serial rereadings of Drs.”

Bashinsky v. Mathews (1977) paed “In addition, 42 C.F.R. § 37.52 provides that: “All chest roentgenograms interpreted by A readers will be submitted .”

Hoffman v. Califano (1978) paed “42 C.F.R. § 37.52 . 3 . Indeed, we have serious doubts whether the Appeals Council in fact applied the presumption in question.”

McLane v. Califano (1977) vaed “1975); 42 CFR 37.52. However, this Court notes that when there is conflicting evidence, it is up to the Secretary to resolve the conflicts by procuring additional evidence.”

Ronald Hardy v. 3M Company (2025) wva “See 42 C.F.R. § 37.52 (establishing system for classifying pneumoconiosis) 32 of it.”

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