Black lung is a legal term for a preventable, occupational lung disease. It is more formally known as coal workers’ pneumoconiosis (CWP), and is caused by prolonged exposure to coal dust. Once coal dust is inhaled into the body it cannot be removed or discharged. It progressively builds up in the lungs and can lead to inflammation, fibrosis, even necrosis. There are two forms of the disease: “simple CWP” and “complicated CWP” (or progressive massive fibrosis).
Black lung is a common affliction among coal miners, both in deep mines and surface mines. It is estimated that 10% of all miners with 25 years experience develop the disease. It is debilitating and usually fatal. Approximately 1500 miners die each year from black lung, and because of the insidious nature of the disease, their deaths are almost always slow and agonizing. There is no cure and no effective medical treatment.
The symptoms are shortness of breath and a constant cough that often yields a black mucus. As these grow worse, the miner faces the dilemma of whether or not to pursue benefits. Diagnosis is fairly straightforward: (1) an exposure history to coal dust; (2) a chest X-ray; and (3) the exclusion of other causes.
In 1969, Congress passed the Federal Coal Mine Health and Safety Act which established a compensation system for victims of black lung. The law also set up standards to reduce coal dust. Two years later, Congress created the Black Lung Disability Trust Fund and funded it with a federal tax on coal production. In this law, the coal industry agreed to a system designed to ease the identification of the disease and to guarantee compensation. If a miner had worked ten years and had medical proof—either an X-ray or autopsy evidence of severe black lung—then in theory he was to be awarded benefits. Also, a miner still working with black lung was to be transferred to a job with less exposure to dust without the loss of pay, benefits, or seniority. As of July 1, 2008, a miner with black lung receives $900 a month from the Trust.
The intent of the new federal law was to sharply reduce exposure to coal dust. Tough standards were soon in place and miners were offered free chest X-rays every five years. The X-rays showed 4 in 10 miners tested had some level of black lung. But in the years after the law took effect, new cases of black lung plunged by 90 percent. Doctors and experts predicted the disease would be eradicated. However, by 1995 government studies began to indicate an increase in the rate of the disease; then an even bigger increase. Just as troublesome, the disease appeared to progress more rapidly and it was showing up in the lungs of younger miners. Experts share two theories for this: (1) miners are working longer shifts, and thus are exposed to more dust; and (2) coal operators are exposing miners to illegal concentrations of coal dust.
Black lung is now epidemic in the coalfields, and the only possible reason is a prolonged exposure to more dust than the law allows. For decades the coal companies have resisted efforts to strengthen the standards, and they have been successful.
The law does not allow a miner to pay a lawyer; therefore, a typical miner with a claim must try to navigate the federal black lung system by himself. The coal industry is harshly resistant to claims, regardless of the proof offered by the miner. The companies fight the claims with experienced attorneys who skillfully manipulate the system. For a miner who prevails, his process usually takes about five years.
For Thomas Wilcox, the ordeal lasted twelve years. He was born near Brady, Virginia, in 1925, fought in the war, was wounded twice, decorated, and upon his return home he got married and went to work in the mines. He was a proud miner, a staunch union man, a loyal Democrat, and a fine husband and father. In 1974, he was diagnosed with black lung disease and filed a claim. He had been sick for several years and was almost too weak to work. His chest X-ray clearly showed complicated CWP. He had worked underground for 28 years and had never smoked. His claim was initially approved, but the award was appealed by the coal company. In 1976, at the age of 51, Thomas had no choice but to retire. He continued to deteriorate and he was soon on oxygen around the clock. With no income, his family scrambled to support themselves and cover his medical expenses. He and his wife were forced to sell the family home and live with an older daughter. His black lung claim was thoroughly choked up deep within the federal system by crafty attorneys working for the coal company. At the time, he was due about $300 a month, plus medical care.
By the end, Thomas was a shriveled skeleton, stuck in a wheelchair and gasping for breath as the final days passed and his family prayed for a merciful end. He could not speak and was fed baby food by his wife and daughters. Through the generosity of friends and neighbors, and the tireless efforts of his family, the supply of oxygen was never depleted. He weighed 104 pounds when he died in 1986, at the age of 61. An autopsy yielded incontrovertible proof of black lung.
Four months later the coal company dropped its appeal. Twelve years after he filed his claim, his widow received a lump sum settlement for back benefits.
Note: Thomas Wilcox was my father. He was a proud war hero, though he never talked about his battles. He was a son of the mountains and loved their beauty, history, and way of life. He taught us all how to fish the clear streams, camp in the caves, and even hunt deer for food He was an active man who slept little and preferred to read late into the night. We watched him gradually slow down as the disease took its grip. Every miner fears black lung, but he never thinks it will happen to him. As reality set in, Thomas lost his energy and began to brood. The simple tasks around the farm became more difficult. When he was forced to quit the mines, he went into a prolonged period of deep depression. As his body grew weaker and smaller, talking became too strenuous. He needed all of his energy just for breathing. In his final days, we took turns sitting with him and reading his favorite books. Often, he had tears in his eyes.
MATTIE WYATT, JULY 1, 2008
It was in the last section of the thick binder of seminar materials, and had obviously been added later. Samantha had not noticed it before. She put away the binder, found her running shoes, and went for a long walk around Brady. It was after eleven on Sunday night, and she did not see another person outdoors.