Coal Miners Fight for Health Benefits as Lung Disease Cases Rise

For 38 years, Josh Armes worked as a coal miner in West Virginia and Virginia. Today, at 74 years old, he lives with a serious health condition known as black lung disease. Medically called coal workers’ pneumoconiosis, this illness is caused by breathing in coal dust over long periods, which causes permanent damage to the lungs. For the past four years, Mr. Armes has needed an oxygen tank to breathe and must use an inhaler to help when he struggles to get enough air. Even with this help, his daily life is very limited.

Mr. Armes is not alone in his struggle. According to data published in the American Journal of Respiratory and Critical Care Medicine, cases of black lung disease are rising, reaching a nearly 50-year high. The federal black lung program was created in 1969 to provide miners who are disabled by the disease with money and medical benefits. However, many families are finding that getting this support is becoming increasingly difficult.

In 2014, Mr. Armes received notice that the federal benefits he had been receiving for more than three years were being challenged by a coal company. For the last 12 years, he and his family have been caught in a long legal process, trying to get their benefits back while his health continues to get worse. His daughter, Crystal Armes, says the process is very hard. She explains that families often have to pay for expensive medical tests themselves and must find a lawyer to help them fight the coal companies in court.

According to a report from the Government Accountability Office (GAO) released in May, the system is failing many miners. The report was requested by Democratic senators who want to see changes to the law. The data shows that between 2013 and 2024, 40% of approved claims were disputed, usually by the coal companies themselves. The report noted that the average length of an appealed claim is three years or more. During this time, many miners feel that the companies are simply waiting for them to give up or die so they do not have to pay.

Some miners have even been forced to pay back money they already received. The GAO report found that between January 2013 and mid-August 2024, 390 people who were initially approved for benefits had their claims denied after an appeal. This left them responsible for paying back the money they had already spent on medical care. Crystal Armes believes the law should be changed so that companies cannot appeal after benefits have been awarded. She argues that the current system puts too much pressure on the sick miner to prove they are ill, even after doctors have confirmed the diagnosis.

“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?” Josh Armes said. His frustration is shared by many others in the industry. The GAO report highlights that miners believe the companies are using these long delays as a way to avoid their responsibilities. While the Trump administration has moved to support the coal industry, the human cost of the work remains a major issue for those who spent their lives in the mines.

As of the 2025 fiscal year, about 22,500 people—including miners, their survivors, and their dependents—were receiving benefits. Despite this, the process remains a source of great stress for families like the Armes family. They continue to wait for a final decision, hoping that their long fight will eventually lead to the support they were promised. For now, the future of the federal black lung program remains a topic of debate, with lawmakers looking for ways to make the system fairer and faster for the people who need it most.