April 19, 2018 Celeste Monforton, DrPH, MPH 3Comment

Kentucky Governor Matt Bevins may be a “friend of coal” but he’s not a friend of coal miners. Bevins signed a bill last week that will make it more difficult than ever for coal miners with black lung disease to receive workers’ compensation for their respiratory disease.

The new law comes at a time when more than 2,000 cases of advanced black lung disease have been diagnosed in Kentucky, Virginia and West Virginia. A NIOSH researcher calls the situation an epidemic and local health care providers say they’ve never seen anything like it.

The law signed by Bevins earlier this month made a number of changes to Kentucky’s workers’ compensation system. The insurance program is designed to reimburse workers for medical care costs and lost wages caused by work-related injuries and illnesses. When applying for compensation for black lung disease, coal miners will no longer be able to use chest x-ray evidence provided by a radiologist who is a NIOSH-certified “B-reader.” That bears repeating: Radiographic findings from a  physician who is a specialist in radiology will no longer be accepted as valid evidence by Kentucky’s workers’ compensation system. The law signed by Bevins says that evidence must come only from a pulmonologist who is a “B reader.”

The change is not sitting well with lung disease specialists. The American College of Radiologists is asking Kentucky to repeal the new law. The organization’s CEO, Dr. William T. Thorwarth Jr., told National Public Radio’s Howard Berkes:

“To have that established process superseded by legislators and a political process is inappropriate. We hope that the Kentucky legislature will rescind this new law and work with the medical provider community to save more lives. This is a matter of life and death for many people and politics should be left out of it.”

Bill Bruce, the executive director of the American College of Occupational and Environmental Medicine told Berkes

“There is no rationale for limiting X-ray interpretation to pulmonary physicians. Qualified physicians in other specialties should be allowed to do so if they have demonstrated competency.”

Radiologist Kathleen DePonte, MD, told Berkes

“It is curious to me that the legislators feel that the pulmonologist is more qualified to interpret a chest radiograph than a radiologist is. This is primarily what radiologists do. It is radiologists who receive all the special training in reading X-rays and other imaging.”

Berkes notes that there are only six pulmonologists in the entire state of Kentucky who are “B-readers.” Four of the six typically work for coal companies. Those physicians more often than not assist the coal operators with their efforts to deny miners compensation for their work-related lung disease.

The sponsor of the bill who made the change is Rep. Adam Koenig. He’s a realtor by profession and member of the legislature’s Pro-Life Caucus. He says he only wants to make sure that qualified doctors are providing evidence about black lung disease. He offered this remark

“If the radiologists feel slighted, we’re going to talk about it. And if they’re right, we’ll fix it.”

Feeling slighted?

This is not a problem of radiologists feeling slighted. It’s about coal miners getting screwed.

Earlier this year, Ohio Valley Resource Benny Becker interviewed several Appalachian coal miners who are suffering from black lung disease. The remarks of Edward Brown, 55, resonates again with me after I read about the change to Kentucky’s law.

Brown told Becker

“As long as you’re on the job, you’re okay. But when you get disabled to work, you’re just another number.”

Being “just a number” already made it difficult for miners to secure workers’ compensation protections for black lung disease. Now the task for Kentucky coal miners will be harder than ever.


3 thoughts on “Kentucky screws miners who have black lung disease

  1. From Herr Koenig’s website: “Starting to put this state back on sound fiscal footing, fair workers compensation reform and a host of other pro-business pro-job legislation. Apr 16, 2018”

    While so far I find no reporting suggesting whether or not the appropriate legislative committee held any hearings, which one might think would allow a range of experts to offer their comments, Koenig fails as a representative of the jurisdiction he represents. That he apparently is not “aware of NIOSH” and that he believes that “radiologists feel slighted” indicate the man needs to get humble and get educated.

    Thanks for posting, Doctor.

    Bill in Fredericksburg, VA

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