‘Do you have to be dead?’: US coalminers plead for benefits as black-lung disease cases surge

For 38 years, Josh Armes worked as a coal miner in West Virginia and Virginia.After retirement, Armes, 74, of Grundy, Virginia, was diagnosed with black lung disease, medically known as coal workers’ pneumoconiosis (CWP), caused by breathing in coal dust over long periods, which irreversibly damages the lungs.Armes has required an oxygen tank to breathe for the pastfour years or so, along with regular doctor visits and an albuterol inhaler to help when he has trouble breathing. Even with the supplemental oxygen, he’s severely limited in what he can physically do.In 2014, Armes received notice that the federal black lung benefits he had been receiving for more than three years were being appealed against by a coal operator. For the last 12 years, he and his family have been in an appeals process limbo, trying to regain their benefits while Armes’s condition progresses.The federal black lung program was created in 1969 to provide coal miners disabled by black lung with monetary compensation and medical benefits. But the Armes family is just one of many who have struggled with appeals and long delays in obtaining federal black lung benefits.Graph of black lung diseaseThose delays come as the Trump administration moves to boost the coal industry and as cases of black lung are surging – reaching a nearly 50-year high, according to data published in the American Journal of Respiratory and Critical Care Medicine last month.According to a May report by the government accountability office (GAO), 7,709 miner beneficiaries were receiving black lung benefits in 2024. The report was requested in 2023 by Democratic senators Mark Warner, John Hickenlooper, Tim Kaine, and John Fetterman, who have also introduced legislation to improve the black-lung benefits system.In the fiscal year 2025, about 22,500 beneficiaries, including dependents, survivors, and miners, were receiving black lung benefits.Between 2013 to 2024, 40% of approved claims by the Department of Labor were disputed, generally by coal operators.The May report said miners have expressed problems with obtaining black-lung benefits. It said miners have been forced to wait several years for their claims to be approved, and raised issues with coal operators filing appeals.“I can’t figure out one thing. They sent me a paper that said I got first- and second-stage black lung. That ought to be enough, or do you have to be dead?” Armes said.Lisa Emery, director of the Breathing Center and Black Lung Clinic at New River Health in Oak Hill, West Virginia, shows an X-ray of the lungs of a miner suffering from black lung disease. Photograph: Pierre Hardy/AFP/Getty ImagesHis daughter, Crystal Armes, said obtaining the black lung benefits is an arduous process, involving paying out of pocket for medical tests and finding a lawyer to take on the case. She also argued that the law should change so that coal companies shouldn’t be able to appeal after benefits are awarded.“The burden of proof lies on the coalminer to prove that he has black lung,” she said. “We have appealed it and appealed it and appealed it. Still appealing it. He [Josh] does have black lung. Hopefully, soon we will be awarded the black lung benefits again. But I’m not holding my breath on that one.”The GAO report said: “Miners in all six groups expressed their belief that mine operators were either ‘waiting for them to die’ or ‘waiting for them to give up’ so they could avoid paying benefit.” It noted between January 2013 to mid-August 2024, 390 beneficiaries whose claims were initially approved had their claims denied after appeal, leaving them responsible for paying back the benefits.According to the report, the median length of an appealed claim was three years or more.Among 53,000 closed claims between January 2013 and August 2024, 11 claims took longer than 10 years to close. The report did not state how many open cases have surpassed 10 years.George Russ, 84, a retired miner with black lung disease at a UMWA meeting in Summersville, West Virginia in August. Photograph: Robert Nickelsberg/Getty ImagesThe Armes family are still waiting for their black lungs benefits appeals process to complete, while not receiving benefits.“When you’re awarded it, they can appeal it, get a different judge, and it’s stripped away from you, which I find absolutely insane,” added Crystal Armes. “They fight you at every single step of the way. They’ll send you from one doctor to another doctor to go do another test and another test. You got to go to this doctor. You got to travel over here, and it’s very costly. And some people don’t have the means to be able to do that. I don’t feel like the process should be this difficult.”According to data published in August in the American Journal of Respiratory and Critical Care Medicine, researchers at the National Institute for Safety and Occupational Health (Niosh) found 32.5% of veteran underground coalminers in central Appalachia are suffering from black lung disease, a rate unseen since 1978.Between 2020 and 2023, more than 1,700 coal miners in the US died from black lung disease.The rise in cases has been attributed to silica dust that is more common in the coal seams being mined today.In April, E&E Greenwire reported that the Trump administration’s Mine Safety and Health Administration (MSHA) would “indefinitely delay” a federal silica dust rule, “pending judicial review” – but any judicial review is on pause due to the agency requesting an abeyance on court action.Rebecca Shelton, Director of Policy for Appalachian Citizens’ Law Center, in a statement on the agency’s freeze on enforcing the rule, said: “If the Trump administration actually cared about protecting coal miners from black lung, we’d have a strong silica rule in place right now. Instead, they are hiding behind a ridiculous legal process to delay action while miners get sick and die.”The United Mine Workers of America has pushed to unfreeze the federal silica dust rule, which would mandate engineering and ventilation controls to protect miners on the job. It was passed in April 2024, but funding for the rule was blocked by Republicans in Congress in June 2024, and the MSHA under the Trump administration indicated to the union it has no plans to enforce the rule.“Every day [that] federal regulators drag their feet and sit on this rule, another working father, mother, husband, wife, sister or brother contracts an incurable, fatal disease,” Brian Sanson, president of UMWA International, in a statement. “Someone’s life is forever changed. A company’s profit margin cannot take precedence over a miner’s right to draw a breath.”Meanwhile, miners already dealing with black lung disease are still facing difficulties in trying to obtain federal benefits.“These people, like my dad, he gave his life to mining to support his family, and now you know we’ve been fighting this fight for over 10 plus years now. Everyone should be outraged by this,” added Crystal Armes. “We’re hardworking, everyday Americans who go to work every day, pay our taxes, try to do the right thing, and then, we can’t get what was promised us.”The White House deferred comment to the Department of Labor.Niosh did not respond to multiple requests for comment.A spokesperson for the MSHA at the Department of Labor said in an email: “Until pending litigation and limited rulemaking on respirable crystalline silica are resolved, MSHA continues to vigorously enforce the permissible exposure limit of 100 micrograms per cubic meter.”