AILSA CHANG, HOST:
There is only one doctor left in Kentucky who can officially diagnose miners with black lung disease so that they can get worker's compensation benefits. Kentucky Public Radio's Justin Hicks reports that that is partly due to a restrictive law passed by the state legislature six years ago. Some lawmakers are trying to change that.
JUSTIN HICKS, BYLINE: Brandon Crum's radiology clinic is in a former Walmart in Pikeville, Ky.
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HICKS: Each day, former coal miners come in gasping for air. He ushers them into an X-ray room to take a look.
BRANDON CRUM: That one X-ray that it takes maybe three minutes to do sums up an entire 20- or 30-year history of working in the mines.
HICKS: Many of Crum's patients are diagnosed with black lung. It's an incurable and fatal disease that's been directly linked to coal mining. Research has proven there's a surge of black lung now in Appalachia. Despite his detailed X-rays and patient histories, the state won't refer miners to Crum in order to determine if they should get worker's compensation benefits in Kentucky.
CRUM: I know of nowhere in the United States of America or the world except Kentucky where radiologists cannot read chest X-rays to diagnose a disease.
HICKS: It wasn't always this way. Kentucky used to let radiologists who specialized in coal dust do this work. But in 2018, Kentucky lawmakers changed things so that only pulmonologists can make the official black lung diagnosis. Crum says lawmakers did it to cover up a rise in the deadly disease among coal miners.
CRUM: Because I found too much black lung and complicated black lung. It's the truth.
HICKS: At the time, the coal industry testified that the law was to make diagnosis less subjective. Tyler White, who was president of the Kentucky Coal Association then, said the bill would combat their rising insurance premiums.
TYLER WHITE: These staggering increases deal a significant blow to employers and the overall cost of workers' compensation in Kentucky and now places the Kentucky coal industry at a material disadvantage to neighboring states.
HICKS: Just before the law went into effect, there were 10 doctors allowed to judge Kentucky black lung claims. Then, once fewer doctors were eligible, the rate of miners who were approved for benefits dropped drastically. Today, there's only one doctor who is screening black lung for workers' comp in the state. His name is Dr. Srinivas Ammisetty. He declined to be interviewed.
DOUG HOLLIDAY: He's a very nice person, an honest doctor, a fair doctor, but he's fallible just like anybody else.
HICKS: That's Doug Holliday. As a worker's comp attorney in Hazard, he's very familiar with Dr. Ammisetty, and he says the doctor has become the decisive voice for all of these cases.
HOLLIDAY: If a miner does not agree with the opinion that he has, he ought to have an opportunity to present evidence on the same footing that Dr. Ammisetty stands on.
HICKS: There's efforts to change this, though. Democratic State Representative Ashley Tackett Laferty says it's one of the reasons she ran for office.
ASHLEY TACKETT LAFERTY: There were quite a few bills that were harmful to our coal miners. So definitely, it was certainly a big motivation.
HICKS: Tackett Laferty is carrying a bill this year that would allow radiologists to give their medical opinions to the workers' comp board again, but even she wasn't aware there was only one doctor still participating.
LAFERTY: Well, I am glad to hear that this doctor is located in the vicinity of eastern Kentucky, but, yeah, that concerns me.
HICKS: The bill has been proposed before. But just like those other attempts, this year's version hasn't moved at all.
LAFERTY: We've really been working to try to bring it to the forefront, but, just, it seems like - that it's not working.
HICKS: Until then, coal miners seeking compensation from the mines they believe diseased them will continue to go to Dr. Ammisetty. Ammisetty says he plans to continue diagnosing black lung claims, although he closed his office in Pikeville at the start of the year.
For NPR News, I'm Justin Hicks in Pikeville, Ky.
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