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650 F.2d 35

Docket No. 80-1735.

Horn v. Mullins

Fourth Circuit Court of Appeals

Argued April 6, 1981.

Decided May 27, 1981.

Fourth Circuit Court of Appeals · decided 1981-05-27

2 counsel of record

Key passage — most relied on by later courts

“), be eligible for a pension while so disabled. A Participant shall be considered to be totally disabled only if by reason of such accident he is subsequently determined to be eligible for Social Security Disability Insurance Benefits under Title II of the Social Security Act or successor. 10 1974 Pension Plan, Art. II, pt. C. A Social Security disability award thus conclusively establishes the medical disability of the pension applicant. The disabled applicant must further show that a mining accident was”

quoted by 3 later decisions, including Hanshaw v. Conners, Burton v. Connors

“[T]he determination of whether an individual is disabled necessarily involves vocational as well as medical considerations. A back injury which precludes an individual from performing his usual job would rarely prevent performance of light and sedentary activities. However, whether an individual with such an injury could meet the vocational demands of light or sedentary employment is an obviously different matter. The test for disability is a functional one, and a requirement that a mine accident injury alone preclude alternative work fails to take that fact into account. Given such a requirement, a plaintiff could establish that a mine accident injury is substantially responsible for preventing him from returning to his usual job, but, because other medical conditions or vocational factors preclude alternative work, it could be found that his total disability did not result from a mine accident. The only reasonable interpretation of the requirement that total disability be “the result of a mine accident,” therefore, is that it requires total disability to have been proximately caused by the mine accident. That is, if the plaintiff was injured in a mine accident and that injury, whether in combination with a previous or subsequent condition, is substantially responsible for plaintiffs inability to perform his job and for whatever medical and vocational reasons he is unable to perform an alternative job, then his total disability results from a mine accident.”

quoted by 1 later decision, including 761 F. Supp. 2d 1123 - Miller v. Monumental Life Insurance

Applies 29 U.S.C. § 1132 (§ 502 of the Employee Retirement Income Security Act of 1974) · 29 U.S.C. § 185 (§ 301 of the Labor Management Relations Act of 1947 (Taft-Hartley Act)) · 42 U.S.C. § 423 (§ 223 of the Social Security Act of 1935)

Relies on Danti v. Lewis · Seafarers Pension Plan v. Sturgis · 498 F. Supp. 1197 - Horn v. Mullins

Good law ✅— No negative treatment on recordhow we know

Opinion by Kenneth Keller Hall · Decided 1981-05-27

How this case has been cited

Cited by 57 later decisions — most recently March 2009 · most notably Berry v. Ciba-Geigy Corp. (1985), Wolfe v. Jc Penney Company Inc (1983)

28 federal appellate · 3 district · 1 state decisions

370198119902000decided

Later decisions citing this case, by decade. The current decade is in progress, and our corpus holds fewer opinions from the most recent years, so the latest bars are undercounted — not a real decline.

View the full empirical analysis of this case →

¶1*36E. Calvin Golumbic, Gen. Counsel, Washington, D. C. (William F. Hanrahan, Deputy Gen. Counsel, Jeanne K. Beck, Associate Counsel, Phillip T. Kimball, Associate Counsel, Washington, D. C., Stuart B. Campbell, Campbell, Young & Hodges, Wytheville, Va., on brief), for appellants.

¶2Matthew J. Cody, Jr., Lebanan, Va., for appellee.

¶3Before BRYAN, Senior Circuit Judge, and HALL and PHILLIPS, Circuit Judges.

¶4K. K. HALL, Circuit Judge:

¶5The trustees of the United Mine Workers Health and Retirement Funds (UMW Trust) appeal from a decision of the district court, 498 F.Supp. 1197, awarding a disability pension to Norman L. Horn. The court granted Horn’s motion for summary judgment, finding that he was disabled as a result of a mining accident and therefore entitled to the pension. We affirm.

¶6The UMW Trust provides that a miner with ten years of credited service who receives a social security award as a result of a mine accident is entitled to a disability pension.1 At issue in this appeal is the narrow question of whether Horn’s disability resulted from a mine accident.

¶7Horn injured his back on October 18, 1976, lifting a bag of cement while employed as a coal miner. Two days later his physician diagnosed the condition as lower back syndrome. One week later Horn was admitted to the hospital where he was examined by an orthopaedic surgeon and a neurosurgeon who subsequently operated to remove a ruptured disk from Horn’s back.

¶8Horn first applied for social security disability benefits in November, 1977. His original claim and subsequent motion to reconsider were denied. Before appealing, Horn visited three other medical specialists who examined him and reported that his numerous physical and mental problems rendered his chances for vocational rehabilitation doubtful. Horn presented this report as well as the testimony of a vocational expert in an appeals hearing held before a Social Security Administrative Law Judge (AU). Considering the entire record and the new evidence, the ALJ determined that Horn was totally disabled2 as of October *3720, 1976 as a result of his recurrent headaches, psychological trauma, stabbing chest pains, and back pains with numbness in the right leg.

¶9Horn then filed a claim with the UMW Trust for disability benefits, using his social security award as proof of disability. The trustees determined that Horn had the requisite ten years of mine service and a social security award, but they denied his application on the grounds that his disability did not result from a mine accident. Horn unsuccessfully appealed the decision to a hearing officer appointed by the UMW Trust.

¶10Horn filed suit in federal district court pursuant to § 301(a) of the Labor-Management Relations Act3 and § 502(f) of the Employee Retirement Income Security Act.4 The district court ruled the medical evidence sufficient to prove that the mining accident was in “substantial part” responsible for Horn’s inability to return to work and that no substantial evidence existed to prove Horn’s ability to perform alternative work. Based upon these rulings, the court granted Horn’s motion for summary judgment.

¶11The standard for reviewing a decision of the trustees is whether it is arbitrary or capricious. Seafarers Pension Plan v. Sturgis, 630 F.2d 218, 221 (4th Cir. 1980). To determine whether the action was arbitrary or capricious, we must first decide whether the trustees’ decision was supported by substantial evidence. Danti v. Lewis, 312 F.2d 345, 348-50 (D.C.Cir.1962). The trustees acknowledge that the social security award creates an “irrebuttable presumption” of disability and they do not challenge that determination. They do, however, attack the district court’s finding as to the causes of that disability. Based upon evidence from the social security proceedings, the trustees argue that Horn’s total disability resulted from a number of medical problems, at least two of which postdated and were unrelated to the mine accident.

¶12The district court dismissed the trustees’ arguments, holding that they failed to prove that the accident was not substantially related to the disability and that Horn was able to perform alternative work. While we agree with the result reached by the district court, we do so for other reasons.

¶13We think the critical factor in this case is the date of disability determined by the ALJ after careful consideration of the conflicting evidence. He found the date of total disability to be October 20, 1976, the first day Horn was treated for his back injury and within forty-eight hours of the mine accident. Clearly the total disability on October 20 occurred as a result of the mine accident on October 18.

¶14Accordingly, we find the trustees’ decision that Horn’s permanent disability did not result from his accident is not supported by substantial evidence. Therefore, the denial of benefits on that ground is arbitrary and capricious and the district court’s entry of summary judgment for Horn was correct.

¶15AFFIRMED.

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