Harry Blackmun

“ Specifically, the claimants and the dissent assert that the HEW interim regulations plainly contain no provision, either in the invocation subsection or in the rebuttal subsection, that directs factual inquiry into the issue of disability causation or the existence of pneumoconiosis. Accordingly, under the claimants' reading of the regulations, there is no manner in which the DOL interim regulations can be seen to be "not . . . more restrictive than" the HEW regulations. ”

“ The Black Lung Benefits Act has produced a complex and highly technical regulatory program. The identification and classification of medical eligibility criteria necessarily require significant expertise, and entail the exercise of judgment grounded in policy concerns. In those circumstances, courts appropriately defer to the agency entrusted by Congress to make such policy determinations. ”

“ What he described as simple pneumoconiosis seldom produces significant ventilation impairment, but it may reduce the ability of the lung to transfer oxygen to the blood. Complicated pneumoconiosis is a more serious disease, for the patient "incurs progressive massive fibrosis as a complex reaction to dust and other factors." In its complicated stage, pneumoconiosis "usually produces marked pulmonary impairment and considerable respiratory disability." ”

“ The Manual, however, does not demonstrate that HEW understood its interim regulations to preclude rebuttal with facts similar to DOL's third and fourth rebuttal provisions. At best, this document is ambiguous with respect to the statutory elements susceptible of rebuttal. See Manual § IB6 (e) (stating that the presumption of entitlement to benefits "may be rebutted if . . . (3) Biopsy or autopsy findings clearly establish that no pneumoconiosis exists") . ”

“ Natural Resources Defense Council, Inc., 467 U.S. 837, 866, 104 S.Ct. 2778, 2793, 81 L.Ed.2d 694 (1984) (" [F] ederal judges-who have no constituency-have a duty to respect legitimate policy choices made by those who do") ”