For Top-Ranked Hospital, Tough Questions About Black Lung and Money

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Hopkins said in a statement to ABC News that Wheeler and other doctors in the black lung unit had "confirmed thousands of cases to be compatible" with black lung over the last 40 years. Hopkins would not say how many of those findings identified the severe form of black lung that automatically qualifies miners for benefits.

"To our knowledge, no medical or regulatory authority has ever challenged or called into question any of our diagnoses, conclusions or reports," in black lung cases, said Hopkins in its statement.

READ: Johns Hopkins Full Statement to ABC News

In recent years, however, there have been repeated instances where administrative judges, federal officials, and other medical experts familiar with the work of Wheeler's black lung team have questioned the Hopkins findings.

One judge dedicated an entire section of his ruling in a black lung benefits case to the Johns Hopkins specialists. Wheeler and two colleagues "so consistently failed to appreciate the presence of [black lung] on so many occasions that the credibility of their opinions is adversely affected," Administrative Law Judge Stuart A. Levin wrote in 2009.

"Highly qualified experts can misread X-rays on occasion," Levin wrote. "But this record belies the notion that the errors by Drs. Wheeler [and two colleagues] were mere oversight."

The ABC News investigation found that doctors like the team from Johns Hopkins are part of a professional corps of lawyers and experts that have helped coal companies tamp down the number of black lung awards to mine workers. The most recent figures released by the U.S. Department of Labor indicate that only 14 percent of miners who claim to be sick are initially granted benefits. A 2008 study by the Government Accountability Office found that coal companies appeal about 80 percent of those cases. After appeals, about half of the miners who initially were awarded benefits – or less than 10 percent who initially applied – actually receive them.

Luke Popovich, a spokesman for the National Mining Association, declined to comment when reached by phone and would not respond to emailed questions.

The impact on the lives of coal miners has been dramatic, especially at a time when government researchers have documented that, after decades of decline, black lung disease is back on the rise. The incurable ailment, which is the result of damage to the lungs caused by dust particles churned up during underground mining activity, leaves miners gasping for breath in their living rooms, even after minimal amounts of exertion. The symptoms often grow progressively worse over time, and the disease is frequently a killer.

READ: Black Lung Basics, Inside the Miner's Malady

In the late 1960s, the federal government recognized the unique risk of sickness faced by coal miners and established a special form of workman's compensation to help offset the expense of treatment and loss of income black lung disease was causing. A government-run trust fund covers the initial payments if a miner wins the initial benefits claim and the company appeals, but ultimately, if a miner can prove he was debilitated by his coal mine work, the company where he last worked is responsible for payments that typically amount to about $1,000-a-month.

For years, coal companies have appealed the majority of black lung claims by their workers, according to John Cline, a West Virginia lawyer who helps miners navigate the complex claims process. In the administrative court system, companies are permitted to have their own doctors examine the miners who file claims.

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