Black Lung Disease Hits 50-Year High, Report Says, as Claims Payments Climb Steadily

As black lung disease hits a 50-year high among Central Appalachian coal miners, protections and compensation from the federal government are not keeping pace, says a recent report from Reimagine Appalachia and the Appalachian Citizens’ Law Center. The groups found that the federal government, under the direction of President Donald Trump, has advanced more than $1 billion in investments to support the domestic coal industry even as the government cut miner safety and health initiatives. The report, which tracked major milestones in mine safety and health from January 2025 to August 2026, found that over those 500 days, the Trump administration’s approach to coal miner safety and health has been characterized by disinvestment and regulatory rollbacks on initiatives aimed at curbing the black lung epidemic. These actions include a failure to enforce protections from toxic silica dust, removing staff who screen for black lung, cutting the number of mine inspectors, and failing to adequately compensate mining families impacted by black lung. These actions stand in contrast to the Trump administration’s sizable investments and outspoken advocacy for bolstering the coal industry more broadly, the researchers contend. “We are watching a complete breakdown in the federal safety net meant to keep coal miners alive. When federal regulators fall asleep at the wheel, coal operators step in and put production goals ahead of human safety,” said Brian Sanson, International President, United Mine Workers of America (UMWA), in a September 2026 statement. The rise in illness may be showing up in more workers’ compensation claims. Nationwide, the number of claims has grown steadily in recent years. In Kentucky, one of the top coal-mining states, Kentucky Employers Mutual Insurance declined to provide the number of claims the company has seen in recent years. But the U.S. Department of Labor’s data show that federal black lung claims rose steadily in Kentucky, from 3,956 in 2013 to 4,776 in 2024, then dipped slightly to 4,734 last year. Benefits paid also grew steadily, topping $46 million last year. Trump on Coal The Trump administration campaigned on bringing back the nation’s coal industry as a way to bolster domestic energy production. Now, it has become a key piece of the promise to keep up with increasing energy demands caused in part by the data center building boom. In April 2025, Trump notably signed four executive orders aimed at boosting the coal industry, using his emergency authority to allow some older coal-fired power plants set for retirement to keep producing electricity and signed a proclamation offering coal-fired power plants a two-year exemption from federal requirements to reduce emissions of toxic chemicals such as mercury, arsenic and benzene. Trump also lifted barriers to coal mining and prioritized coal leasing on U.S. lands. According to Associated Press reports, Trump’s orders also directed Interior Secretary Doug Burgum to end an Obama-era moratorium that paused coal leasing on federal lands and require federal agencies to rescind policies transitioning the nation away from coal production. The administration has also stated its intent to promote coal technology development and exports. Increasing Risks Rates of black lung are the highest they have been since 1978, when cases in long-tenured Central Appalachian miners reached 34%. In August 2026, NIOSH released findings that showed that 32% of veteran underground coal miners in Central Appalachia have coal workers’ pneumoconiosis—black lung disease, up 12% since 2018. Coal workers’ pneumoconiosis (commonly referred to as CWP or black lung) is caused by inhaling coal mine dust, a dangerous mixture of particles and minerals that include coal and respirable crystalline silica. When severe, the disease can lead to lung impairment, disability, and premature death, according to the U.S. Centers for Disease Control and Prevention. Because Central Appalachian coal reserves are heavily depleted, miners have to mine a lot more rock to reach each ton of coal, said Sam Petsonk, a labor, employment and black lung lawyer at Petsonk PLLC. “And yet, we are continuing to produce large amounts of coal … at the same time we are willfully refusing to afford the appropriate measure of protection from silica dust,” Petsonk said. The increase in production and disease comes even as coal production has declined. As of September 2026, there were about 37,900 miners employed in the coal industry in the U.S., according to the Federal Reserve Bank of St. Louis. That number is part of an overall downward trend since December 2011, which saw the number peak at 89,600. The number of producing coal mines decreased from 560 to 524 mines, according to the U.S. Energy Information Administration’s (EIA) Annual Coal Report. In 2024, U.S. coal production decreased 11.3%, year over year, to 512.5 million short tons (MMst), with U.S. consumption at 410.9 MMst. Coal production peaked at 1,717.81 MMst in 2008, most of which was consumed in the U.S. In the 1970s, the black lung crisis at the time spurred the federal government to increase mine safety regulations and health-research initiatives. The policies dropped cases to only 7% by 1999, said Meredith Perkins, a black lung historian and Master of Public Affairs–Master of International Affairs student at Indiana University-Bloomington. The country is not seeing similar alarm or action today, she said. “Instead of strengthening and reforming black lung programs like we did in the 1970s, the federal government today is divesting funds, cutting staff, and unraveling regulations,” Bloomington said. “These measures don’t cut costs; they undercut prevention efforts and shift costs downstream, causing miners and taxpayers to bear higher burdens.” The Reimagine Appalachia/ACLC study’s findings include: A lack of enforcement and rollback of a 2024 rule regulating miners’ exposure to respirable crystalline silica The rollback and lack of enforcement of a 2024 rule regulating the authorization of coal operators that self-insure their black lung liability Mass layoffs at the National Institute for Occupational Safety and Health (NIOSH) Staff reductions at the Federal Mine Safety and Health Review Commission Understaffing and funding cuts at the Mine Safety and Health Administration (MSHA) Bills like the Black Lung Benefits Improvement Act, Relief for Survivors of Miners Act, and Support Our Miners Act have initiated attempts at reform, but have lacked bipartisan support. Severe staff cutbacks and political removals at the Federal Mine Safety and Health Review Commission have also crippled independent judicial oversight, allowing companies to delay safety penalties, UMWA President Sanson said in his statement. The costs of implementing protections and improvements are comparatively small when up against the federal investments being made in supporting the industry. For example, the Black Lung Benefits Improvement Act would cost just $7.4 million annually, and the coal industry’s implementation costs for the 2024 silica rule were projected as just $8.2 million annually. “We know what is causing this epidemic, and we know how to stop it—and yet we not only see a complete lack of action, we see a regression from the little progress we have made for coal miners,” said Dana Kuhnline, Program Director at Reimagine Appalachia. Coal Miner Disease Compensation The comments come as bill H.R. 9556 from U.S. Rep. Summer Lee, D-Pa., has been stuck in Congress since June 30. The bill would amend the Black Lung Benefits Act to “provide adequate benefits for miners suffering from black lung disease.” The Black Lung Benefits Act “provides monthly payments and medical benefits to coal miners totally disabled from pneumoconiosis (black lung disease) arising from their employment in or around the nation’s coal mines,” according to the Office of Workers’ Compensation Programs in the U.S. Department of Labor. Topics Trends Claims