Coal workers' pneumoconiosis and the compensation dilemma.

Coal workers' pneumoconiosis is a preventable occupational disorder of the respiratory system resulting from exposure to and retention of respirable coal dust. It exists in two distinguishable forms: simple, which is seldom if ever disabling, and complicated, also known as progressive massive fibrosis (PMF), which is sometimes totally disabling and is associated with a high mortality rate. The disease affects a small proportion of active U.S. miners, and only a very small number develop PMF. In its more advanced stages, the disorder is characterized by shortness of breath. Scientific criteria for diagnosis are well established but are not followed in the U.S. because of Federal law and regulation. However, an acceptable scheme for classification of chest radiographs exists. Black lung benefits payable to miners, their survivors and dependents are approaching $2 billion annually, and regulations concerning eligibility for such benefits are intentionally slanted to make it possible for claimants to receive benefits in a manner not consistent with regulations governing similar payments to other occupationally employed persons or in accordance with established medical criteria.