NIOSH and the Department of Labor Join Forces to Establish a B Reader Quality Assurance Program

September 29, 2015
NIOSH Update:

Contact: Stephanie Stevens (202) 245-0641

The National Institute for Occupational Safety and Health (NIOSH) and the Department of Labor’s Office of Workers’ Compensation Programs (OWCP) have signed a memorandum of understanding (MOU) to create a quality assurance program to help ensure accurate and objective evaluations of chest x-rays for federal black lung benefits claims.

The B Reader quality assurance program established by the MOU will provide a process to monitor and assess the accuracy with which NIOSH-certified physicians called B Readers identify shadows on chest x-rays known as large opacities. The presence or absence of large opacities plays an important role in determining a coal miner’s right to black lung benefits.

“NIOSH has had a longstanding commitment to ensuring professionalism, proficiency, and objectivity among the physicians it certifies as B Readers,” said David Weissman, MD, director of NIOSH’s Respiratory Health Division. “By formalizing this agreement with OWCP, together we will establish a new mechanism to help ensure that chest x-ray readings used in black lung benefits proceedings meet the highest standards.”

NIOSH began the B Reader Program in 1974 to ensure competency in “classifying” chest x-rays for the presence and severity of changes associated with dust-induced lung diseases. This is done using a classification system developed by the International Labour Office (ILO). The ILO system is used for reporting lung abnormalities in black lung benefit proceedings. To become B Readers, physicians must pass the B Reader examination and retest every four years to maintain their status.

OWCP has the primary responsibility to administer claims for benefits under the Black Lung Benefits Act. NIOSH has long-served as OWCP’s scientific advisor to assist in their mission to fulfill the congressional mandate of awarding benefits to miners totally disabled by black lung disease resulting from their work in coal mines.

“Over the past two years, the Department of Labor has implemented several initiatives to improve the quality and timeliness of decisions on black lung claims,” OWCP Director Leonard J. Howie III, said. “This interagency agreement will provide a process to monitor and assess the quality of x-ray readings submitted to the Department of Labor as part of the adjudication process.”

NIOSH is the federal agency that conducts research and makes recommendations for preventing work-related injuries, illnesses, and deaths. For more information about NIOSH visit For more information on NIOSH’s B Reader Program, visit

Page last reviewed: September 29, 2015