Miners and their allies rally on the steps of the U.S. Capitol in 1975 in support of changes in the federal black lung program. The Black Lung Benefit Act, sponsored by Representative Carl Perkins (D Ky.) and others, died in committee that year.

[imgcontainer right] [img:black_lung_march_on_capitol.JPG] [source]Photo by Earl Dotter[/source] Miners and their allies rally on the steps of the U.S. Capitol in 1975 in support of changes in the federal black-lung program. The Black Lung Benefit Act, sponsored by Representative Carl Perkins (D-Ky.) and others, died in committee that year. [/imgcontainer]

I am a resident of the coalfields. My surroundings include mountaintop-removal strip mines, deep mines, overweight coal trucks and miners with every stage of black lung.

Do you know black lung disease is as much a part of the coalmine culture as mountains, hollows and coal? I do.

Do you know the disease was supposed to be “eradicated” by legislation in 1969? Federal law mandated that the industry maintain dust levels that would prevent miners from getting the disease. But that was in theory only.

Do you know that since the early 1990s black lung clinics and private doctors trained to diagnose black lung are finding a disturbing resurgence in the disease? Black lung has re-emerged in a more severe form and among younger miners.

Black lung is a debilitating disease coal miners get by inhaling fine particles of coal dust. This dust, once in the lungs, cannot be removed or destroyed. Instead, the disease steadily progresses, causing damage as it spreads throughout the lungs even after exposure to the dust has ended. The particles cause tissue thickening and scarring that renders the lungs less efficient in getting oxygen into the blood. As the disease advances, the miner may develop enlargement and strain of the right side of the heart, which can result in heart failure.

Symptoms include shortness of breath, hacking up black phlegm, wheezing and a tingling sensation throughout the body. Black lung is an incurable disease. For 9,000 coal miners since 1999, death has been the only relief.

The Federal Coal Mine Health and Safety Act of 1969 limits the legal amount of coal dust in the mines to 3 mg per cubic meter, later to be reduced to 2 mg per cubic meter. The act provided benefits to those who already had black lung. This health-safety act that was intended to protect the miner has turned into a money-changing game where coal companies pay big bucks wherever needed to bar their disabled miners from receiving benefits to which miners are entitled.

 “Breathless and Burdened,” an investigative series by the Center of Public Integrity, shows the rest of the nation what Appalachians already knew about the actions of some doctors and lawyers. To coalfield residents this is one more example of coal companies’ long history of abuse and bullying of miners.

During the 1920s, coal companies hired Baldwin-Felts detectives who wore fake deputy badges and carried guns to keep miners under their thumbs. When miners were suspected of labor organizing, the agents evicted women and children on a cold, snowy January day from coal company houses, busting up furniture and forcing the families out in the cold with only the clothes on their backs.

Now, coal companies funnel generous payments to medical centers like Johns Hopkins University to enlist their help in defeating claims of miners with black lung. According to Center for Public Integrity investigation, Johns Hopkins has not disappointed its clients – big coal. Dr. Paul Wheeler, head of the division responsible for reading 3,400 X-rays since 2000, found not one single case of complicated black lung despite. Biopsies and autopsies later showed the complex form of the disease — the worst variety — in more than 100 of those cases. The X-ray reading program Dr. Wheeler directs has been suspended while the hospital reviews it. But how will Johns Hopkins behave when money from big coal companies stops pouring into the institution’s coffers?

[imgcontainer left] [img:Wheeler+1.jpg] [source]Photo by Earl Dotter[/source] Johns Hopkins Medical Institutions suspended the black-lung X-ray reading program managed by Dr. Paul Wheeler after the Center for Public Integrity’s report raised questions about its fairness. [/imgcontainer]

This deliberate action by a high-ranked medical center to prevent workers from receiving what the law entitles them to is unimaginable and is a breach in their contract to uphold high medical standards. Another troubling fact is West Virginia Senator Jay Rockefeller’s wife, Sharon, serves on the board of directors at Johns Hopkins. Was she aware of what was happening in the black lung division? If not, why? In 2011 West Virginia was the largest coal producer east of the Mississippi.

Our faith is shaken.

Coalmine communities still believe in the tradition of looking out for each other. But what do we do when one of our own turns on us? The Jackson Kelly law firm, named in Center for Public Integrity investigation, has offices in the middle of our coalfields, home to our traditions, home to our riches and home to our disabled miners with black lung. This prominent law firm, staffed with homegrown attorneys educated at West Virginia University Law School, represents big coal companies. These lawyers actions against miners, who are working in the hills a heartbeat away, display a lack of moral conscience and concern for fellow community members. It’s a sacred mountain tradition broken.

The Center for Public Integrity reported that these attorneys have admitted to withholding key evidence in cases where the miners would qualify for benefits. It is difficult to win when the enemy is in your camp.

Our hope is gone.

Who will help the miner suffering from black lung?

The Presumption Clause

If there is a glimmer of hope beside this public awareness of the discriminatory practices against miners, it’s the provision within the Affordable Care Act (also called “Obamacare”) that our late West Virginia Senator Robert Byrd pushed through.

The provision says that if a person has worked as an underground coal miner or was employed in conditions substantially similar to underground coal mine employment for at least 15 years and suffered from the effects of pneumoconiosis (black lung), the presumption would be that coal dust caused the ailment and the coal miner would be entitled to benefits. Now the coal company has to prove otherwise. Before, that burden of proof rested on the miner.

A Call for Federal Investigation

U. S. Representatives George Miller (D-California) and Joe Courtney (D-Connecticut) have called for a federal investigation of black lung benefits program., They want Labor Secretary Scott S. Dahl to investigate claims, including possible misconduct by doctors at Johns Hopkins and lawyers at the Jackson Kelly law firm.

This news is bitter-sweet. I think of the miners who died not only of black lung disease but of a broken spirit caused by coal companies’ betrayal.

These were men like John Adkins, who had to rest his fragile bones in the cracks in the couch so as not to put pressure on them. He suffered more than I can imagine, and yet even worse emotional pain came in the defeat of his black lung benefits claim.

There’s miner Clifford McMann, who was forced to submit to coal company doctor’s examination after he was on life support.

And miner Cecil Butcher, a man who survived a violent attack during a coal strike but died strapped to an oxygen tank because of black lung.

Betty Dotson-Lewis is from West Virginia and is the author of several books on Appalachian heritage and social issues.

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