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Is a 2018 black lung law benefitting patients or coal companies?

Medical professional
Posted at 4:57 PM, Mar 02, 2020
and last updated 2020-03-02 20:36:35-05

In 2018, Kentucky Representative Adam Koenig sponsored a law to attempt to streamline the process behind black lung diagnoses. Now, two years later, it's unclear whether that law has actually helped coal miners receive the medical assistance they need, or if it's only reducing the financial burden on coal mining companies.

By law, coal companies must pay into a federal fund that compensates miners diagnosed with black lung, or coal workers' pneumoconiosis (CWP). This means fewer cases of diagnosed black lung patients directly cuts down on the amount of money the companies have to provide.

In 2018, Koenig's law changed who in the medical industry makes those diagnoses: Radiologists with special training could read the miners' X-rays before the law and form a diagnosis. Now, only pulmonologists who are specially trained in CWP can diagnose the illness.

"There's been no complaints, either anecdotal complaints or actual evidence, that the system we've implemented is causing anyone any difficulty in having the opportunity to get diagnosed or get their benefits," said Koenig.

Koenig said he sponsored the law because doctors were diagnosing black lung at very different rates, and he sought to streamline the process. Critics of the law in 2018 argued it would make it harder for patients to get benefits.

"We just want people who are owed the benefits to get them and people who aren't owed the benefits to not get them," said Koenig.

An attorney for one CWP patient believes the pulmonologists are "too conservative," according to the Coal Workers' Health Surveillance Program.

In the first nine months after the law's implementation, pulmonologists diagnosed 65 out of 235 patients with black lung. When those patients took the case to a judge, their evaluators determined that 234 out of the 235 patients had positive readings.

"It's concerning because we want to get it right, but it's hard for a layman like myself to know what is and is not right," said Koenig.

In 2018, when Koenig sponsored the law, there were 261 CWP claims filed. That number dipped to 161 CPW claims filed in 2019, after the law went into effect.

WCPO has reached out to St. Elizabeth Hospital and the University of Cincinnati Medical Center to discuss changes in care within Tri-State hospitals, but are still waiting to hear back.