MELISSA BLOCK, host:
Fatal mine explosions naturally grab attention. But many more miners, around 700, die each from black lung disease. And that number has been going up over the past decade.
Ailing miners apply to a special federal black lung program for benefits, but ultimately, it is the mining companies that pay. And overall compensation for black lung disabilities has been shrinking, even as the disease spreads.
NPR's Brenda Wilson explains why.
BRENDA WILSON: The miner who sets out to convince the federal black lung program that the mining company he worked for should compensate him for the damage done to his lungs had better be prepared for mountains of paper and hearings for about seven years on average.
(Soundbite of a treadmill)
Unidentified Man: Fifteen seconds.
WILSON: At Tug River clinic in Gary, West Virginia, federal caseworkers assist miners like Gerald French(ph) who started applying for black lung benefits when he was 62. He's now 73. This is the fourth time for a series of tests that include a fast-paced three minutes on the treadmill.
Unidentified Man: Let's take another listen to your lungs.
(Soundbite of breathing)
Unidentified Woman: Hard work, isn't it?
Mr. GERALD FRENCH: Yeah, it is.
(Soundbite of laughter)
Unidentified Man: Let's go ahead and sit down now.
WILSON: French says he wheezes at night and that there's a grayish sputum when he coughs. He worked in the mines for 40 years, most of that time in the preparation plant. That's where the coal is sorted, crushed and washed. Like most miners, he seldom wore a mask.
Mr. FRENCH: A lot of times you just cannot perform the work that you have to do with the respirator over your mouth because you will suffocate if you do. I don't care what you do, you're going to get that dust, a certain amount of it.
WILSON: To really do justice to what conditions were like in the preparation plant, listen to 57-year-old Robert Schultz(ph) who spent 20 years at the Hobet Mine.
Mr. ROBERT SCHULTZ: Nastiest place I've ever been in my life - dirtwise, dustwise, mudwise and waterwise. You wore a light in the daytime and I could possibly recognize you from this distance, possibly.
WILSON: That's just how much dust there was, he says. Schultz left coal mining in 2007 when doctors concluded he was disabled. On that much, that he is disabled, both the Department of Labor and the Hobet company doctors agree. But the company doctors say he has emphysema from a long history of heavy smoking, not black lung.
Shultz says otherwise.
Mr. SCHULTZ: When you work in a place, and I can't tell who you are, and we're four-foot away, but it's cigarettes did it, that's BS. You know it, and I know it. Everyone knows it.
WILSON: The company doctors say that if Schultz has black lung, it's not showing up on X-rays. Lung specialists like Dr. Randy Forehand have been certified by the National Institute of Occupational Safety and Health to distinguish the impairment caused by smoking from black lung.
Dr. RANDY FOREHAND (Pulmonologist): In emphysema there's nothing there, the tissue is gone. You don't see the normal lung markings. You don't see the blood vessels. You don't see the normal markings that you see on a normal X-ray, because the lung tissue has actually been destroyed in smoking.
WILSON: The Department of Labor doctors agreed that Schultz has emphysema, but the department's doctors disagreed on black lung. Ultimately, the district director of the federal black lung program in West Virginia sided with the company doctors and rejected his disability claim. But a judge has agreed to an appeal. This could go on for years and it usually does.
At Valley Health Systems in Cedar Grove, West Virginia, Debbie Wills has been helping miners file claims for black lung for 21 years. It's a rare case, she says, that companies don't fight.
Ms. DEBBIE WILLS (Program Coordinator and Outreach Worker, Valley Health Systems): They pretty much fight every claim as long and as hard as they can fight it. They appeal it to every level.
WILSON: She says the mining companies will say the miner has cancer, tuberculosis, anything but a work-related disease.
NPR tried to contact several mining companies including Hobet but was unsuccessful. A spokesman for the National Mining Association told NPR they couldn't comment for this story because of their focus on the investigations into the West Virginia mine explosion.
Debbie Wills says the companies probably wouldn't fight the miners so hard if there was only about paying a monthly disability stipend. It's all the other costs they'd be liable for.
Ms. WILLS: If a miner finds out that he has black lung disease, let's say at age 60, and we track his medical treatment until his death, we might be talking about a quarter of a million dollars. The quantity of medications or paying for in-home oxygen, that's where the huge expense to coal companies comes from.
WILSON: There was a time the government paid black lung benefits and a third of all claims were approved. Under President Ronald Reagan, paying became the responsibility of the companies. Since then, the proportion of claims approved has fallen by half.
Brenda Wilson, NPR News.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.