Sickened coal miners plead for their black lung benefits as cases surge

Coal Miners Encounter Extended Appeals in Federal Black Lung Benefits Program as Disease Prevalence Increases

A man carries coal samples at a plant outside Welch, West Virginia. Spencer Platt/Getty Images

For 38 years, Josh Armes worked as a coal miner in West Virginia and Virginia. After retirement, Armes, 74, of Grundy, Virginia, received a diagnosis of coal workers’ pneumoconiosis, a condition resulting from prolonged inhalation of coal dust that causes irreversible lung damage. He has used supplemental oxygen for approximately four years and relies on an albuterol inhaler during episodes of breathing difficulty. He also attends regular medical appointments. These limitations restrict his physical activities.

In 2014, Armes was notified that a coal operator had appealed the federal black lung benefits he had received for more than three years. The family has remained in the appeals process for 12 years without restored benefits while his condition continues.

The federal black lung program, established in 1969, provides monetary compensation and medical coverage to miners disabled by the disease. The Armes case illustrates challenges some claimants face with appeals and processing times. A Government Accountability Office report issued in May 2025 examined the program after a 2023 request from Democratic senators Mark Warner, John Hickenlooper, Tim Kaine, and John Fetterman. Those senators also introduced legislation aimed at modifying the benefits system.

The GAO report stated that 7,709 miners received black lung benefits in 2024. In fiscal year 2025, approximately 22,500 individuals, including miners, dependents, and survivors, received benefits. Between 2013 and 2024, coal operators disputed 40 percent of claims initially approved by the Department of Labor. The median duration of appealed claims reached three years or longer. From January 2013 through mid-August 2024, 390 beneficiaries initially approved later had claims denied on appeal and became responsible for repaying prior benefits. Among 53,000 closed claims in that period, 11 took more than 10 years to resolve. The report recorded statements from miners that operators were “waiting for them to die” or “waiting for them to give up.”

Armes stated that a medical determination of first- and second-stage disease should suffice for benefits. His daughter, Crystal Armes, described costs for medical testing and legal representation. She noted that the burden of proof rests on the miner and that repeated appeals and examinations add expense and travel. Coal operators maintain the right under existing law to contest claims through administrative appeals when they question whether medical evidence establishes total disability caused by coal dust exposure. The GAO report documented these procedural steps without attributing motive beyond the legal framework.

Data published in August in the American Journal of Respiratory and Critical Care Medicine by researchers at the National Institute for Occupational Safety and Health indicated that 32.5 percent of veteran underground coal miners in central Appalachia have coal workers’ pneumoconiosis. This prevalence matches levels last recorded in 1978. Between 2020 and 2023, more than 1,700 coal miners in the United States died from the disease. Studies link the recent increase to higher exposure to respirable crystalline silica in thinner coal seams currently mined.

The Mine Safety and Health Administration finalized a rule in April 2024 under the prior administration setting a lower permissible exposure limit for respirable crystalline silica at 50 micrograms per cubic meter for most miners, with engineering and ventilation controls required. Congressional action in June 2024 blocked dedicated funding for implementation. In April 2025, MSHA indicated it would delay enforcement pending judicial review and requested an abeyance in related litigation. A spokesperson for MSHA stated that the agency continues to enforce the prior limit of 100 micrograms per cubic meter until the litigation and any related rulemaking conclude.

Rebecca Shelton of the Appalachian Citizens’ Law Center stated that a stronger silica standard should already be in effect if protection of miners were the priority. Brian Sanson, president of the United Mine Workers of America, said each day of delay allows additional miners to contract an incurable disease and that company profit margins should not override miners’ ability to breathe. The United Mine Workers of America has advocated for enforcement of the 2024 rule.

The White House referred inquiries to the Department of Labor. The National Institute for Occupational Safety and Health did not respond to requests for comment. Armes family members continue to await resolution of their appeal while covering medical costs without current benefits. The GAO report noted that some miners viewed repeated examinations and appeals as barriers, while the administrative process permits operators to present contrary medical evidence before administrative law judges.

The Department of Labor administers the claims process through its Office of Workers’ Compensation Programs. Claimants may seek representation, and operators may retain counsel or medical experts during hearings. Between 2013 and 2024, the volume of disputed claims reflected operators’ use of available appeal rights under the Black Lung Benefits Act. No aggregate data from the GAO report quantified the proportion of appeals upheld or overturned in favor of operators versus miners.

Miners and families have described the cumulative effect of prolonged proceedings on household finances and health management. The program’s structure requires demonstration that coal dust exposure constitutes the primary cause of disability, a standard that can involve multiple medical opinions. Current enforcement of silica exposure limits remains at the pre-2024 level while litigation proceeds.