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Partner Post: Dr. Wheeler and Black Lung Diagnoses

Doctor Works Against Patients for Profit 

Written by James P. Nevin james.jpg 

When Dr. Paul Wheeler, of Johns Hopkins Hospital, gave his opinion the court listened. Until lately. Research has proved there is an unmistakable pattern in Wheeler's readings. There have been more than 1,500 cases decided since 2000 in which Wheeler read at least one X-ray. In all, he has interpreted more than 3,400 films during this time, and unfortunately his biased opinions give the defendants something to hang their case on. When a respected doctor gives his opinion on an x-ray, an opinion that goes against the diagnosis of black lung, that single opinion can be enough doubt to sink the miners case.

Thankfully the judges are finally seeing Wheeler for who he is, the doctor who works for the coal companies. Judge Parker wrote in a clear-cut conclusion : "Based on my findings in reviewing this case, and the classic nature of the medical imaging and history, I am deeply saddened and concerned to hear that any serious dispute is occurring regarding the interpretation of his classically abnormal medical imaging," Parker wrote. "If other physicians are reaching different conclusions about this case ... it gives me serious pause and concern about bias and the lack of scientific independence or credibility of these observers."

A review of thousands of cases suggests that since 2000, miners have lost more than 800 cases after at least one doctor found black lung on an X-ray but Dr. Wheeler read it as negative. This includes 160 cases in which other doctors saw the more complicated form of the disease. Dr. Wheeler backs up his opinions against diagnosing black lung though puffery, stating "I know my credentials, I'd like to make sure that the people proving me wrong ... have ... credentials as good as mine."

Unfortunately the game being played by the attorneys for the mines and by Dr. Wheeler hurt the individuals who are dying of black lung. The payouts are comparatively meager - the maximum monthly payment, for miners with three or more dependents, is about $1,250 - and few lawyers will take cases because the odds of winning and ultimate compensation are low. Settlements are not allowed, and miners have to prove total disability caused by black lung, not just show a minimally positive X-ray.

When a black lung sufferer does rarely win, the Benefits Review Board, the highest appeals court in the administrative system, often vacates the award of benefits at the coal company's lawyers' request. With competing medical evidence the judge often finds the evidence on film to be a wash. Dr.Wheeler successfully creates just enough doubt for the court, allowing the mining companies to continue to avoid what they have done, leaving dying men and women without compensation.

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 James Nevin on Google+

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