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

A coalmine in Wharton, West Virginia. The Trump administration is moving to boost the coal industry. Photograph: Ricky Carioti for The Washington Post via Getty ImagesView image in fullscreenA coalmine in Wharton, West Virginia. The Trump administration is moving to boost the coal industry. Photograph: Ricky Carioti for The Washington Post via Getty ImagesUS unions‘Do you have to be dead?’: US coalminers plead for benefits as black-lung disease cases surgeTrump says he digs coal – but pneumoconiosis cases are at a 50-year high, and sick miners are mired in benefit delays

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 past four 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.

Those 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.

View image in fullscreenLisa 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.