S v Secretary of State for Work and Pensions

Dust reticulation within the statutory definition of pneumoconiosis is a pathological condition, not merely a radiological pattern. It means structural changes to lung tissue caused by dust accumulating in widely distributed foci throughout the lungs. It does not require nodules, a medical diagnosis of fibrosis, or scarring.

Radiographs and the International Labour Organisation classification are evidential tools. They do not themselves determine whether statutory pneumoconiosis exists. Decision-makers must assess all relevant evidence and must not treat radiological evidence as necessarily outweighing post-mortem evidence. For a deceased claimant, post-mortem evidence may establish dust reticulation.

The widow of a former coal miner made a posthumous claim for disablement benefit, contending that he had statutory pneumoconiosis when he died. The post-mortem report identified very mild pneumoconiotic macules and mild pneumoconiosis. Earlier radiographs and a CT scan had not identified pneumoconiosis.

The First-tier Tribunal, sitting at Leeds, dismissed the appeal on 11 February 2015. It considered that the absence of nodules, fibrosis and scarring meant that the statutory definition was not met. It also placed weight on the absence of radiological evidence.

The Upper Tribunal considered the meaning of dust reticulation in section 122(1) of the Social Security Contributions and Benefits Act 1992, and the proper assessment of post-mortem and radiological evidence.

1. Appeal allowed. The First-tier Tribunal made an error of law. Its decision was set aside and the appeal was remitted for a complete rehearing before a differently constituted tribunal.

2. Section 122(1) of the Social Security Contributions and Benefits Act 1992 includes within statutory pneumoconiosis the condition known as dust reticulation. The statutory language must be construed in light of its enactment history. The term reflected a pathological lung abnormality identified in a 1942 study, although the radiological appearance was inaccurately described as reticulate because of the limited X-ray equipment then used.

3. Dust reticulation means structural changes to lung tissue due to dust accumulating in widely distributed foci throughout the lungs. It is an early stage in the relevant spectrum of abnormalities. Nodules are unnecessary. Fibrosis, and therefore scarring, are also unnecessary. The First-tier Tribunal therefore erred by treating the absence of nodules or scarring as fatal to the claim.

4. Radiology is evidence, not the disease itself. The International Labour Organisation classification may assist assessment but cannot substitute for a clinical and legal assessment of all the evidence. For a deceased person, post-mortem material may establish dust reticulation. A tribunal must not assume that radiological evidence outweighs other evidence, nor treat a post-mortem diagnosis as conclusive without assessing it in the evidential context.

5. If dust macules otherwise establish dust reticulation, entitlement still depends on the disease being due to employment in a prescribed occupation. The rehearing tribunal was directed to apply the legal meaning stated at paragraph 96 and to consider all further evidence and submissions.

• Upper Tribunal (Administrative Appeals Chamber): allowed the appeal, set aside the First-tier Tribunal decision for error of law, and remitted the matter for rehearing.
• First-tier Tribunal: sitting at Leeds, dismissed the claimant's appeal on 11 February 2015 (tribunal ref: SC 007/14/00764).