Chest Radiography: Quality Assurance Review of B Readers

Normal Chest Radiograph

The National Institute for Occupational Safety and Health (NIOSH) and the DOL Office of Workers’ Compensation Programs (OWCP) are working together to carry out a quality assurance (QA) activity focused on classifications of chest radiographs according to the International Labour Organization (ILO) classification system that are submitted to the Black Lung Benefits Program operated by OWCP.  The QA activity focuses on how the presence or absence of large opacities are classified by B Readers submitting the classifications, because coal miners with large opacities are irrefutably presumed to be totally disabled, or to have died, from pneumoconiosis under 30 U.S.C. § 921(c)(3).  Thus, determinations of large opacities have an important impact on awarding benefits under the Black Lung Benefits Act.

The procedures by which NIOSH will conduct QA reviews of classifications referred by OWCP and determine corrective measures are described in the document “Quality Assurance Review of B Readers’ Classifications Submitted in the Department of Labor (DOL) Black Lung Benefits Program.”

Full background information, including the Memorandum of Understanding (MOU) between OWCP and NIOSH  that describes how OWCP will identify classifications for NIOSH QA review, public comments on draft QA review procedures, and NIOSH responses to public comments are available on the NIOSH Docket, and on