Full Opinion

In the United States Court of Appeals For the Seventh Circuit ____________________ No. 24-2234 JEFFBOAT, INC. and AMERICAN LONGSHORE MUTUAL ASSOCIATION, LTD., Petitioners, v. DIRECTOR, OFFICE OF WORKERS’ COMPENSATION PROGRAMS, United States Department of Labor, and CALVIN F. CHAFFERS, Respondents. ____________________ Petition for Review of an Order of the Benefits Review Board. Nos. 23-0108, 23-0301 ____________________ ARGUED FEBRUARY 12, 2025 — DECIDED JUNE 23, 2026 ____________________ Before PRYOR, KOLAR, and MALDONADO, Circuit Judges. MALDONADO, Circuit Judge. Calvin Chaffers worked as a ship painter for Jeffboat, Inc. for twelve years. After he was laid off in 2017, Chaffers filed a claim for workers’ compensa- tion under the Longshore and Harbor Workers’ Compensa- tion Act. Chaffers claimed that he experienced breathing dif- ficulties after he was exposed to numerous lung irritants as 2 No. 24-2234 part of his work. Jeffboat and its insurance company, Ameri- can Longshore Mutual Association, Ltd. (“Jeffboat” collec- tively), disputed the claim, and a formal hearing was held be- fore a Department of Labor administrative law judge (“ALJ”). Considering Chaffers’ testimony, medical records, and duel- ing expert reports, the ALJ found Chaffers was entitled to par- tial disability benefits. The Office of the District Director later awarded attorneys’ fees and costs to Chaffers. The Benefits Review Board affirmed both decisions. Jeffboat now petitions for review of the benefits determi- nation and fee award. Under the deferential substantial evi- dence standard, we affirm. I From 2005 to 2017, Chaffers was employed as a painter, paint quality inspector, and paint supervisor in Jeffboat’s shipyard in Jeffersonville, Indiana. Chaffers worked long hours painting and inspecting the underwater hulls of ships, either in ventilated buildings or unventilated canvas paint tents. Chaffers testified that his duties—such as preparing and applying paint, cleaning paint equipment, and sandblast- ing—exposed him to various chemicals. Specifically, he was exposed to fumes and particles from toxic paints, paint thin- ner, anti-freeze, welding, gouging, sandblasting, and charcoal slag abrasive products. Chaffers wore different forms of per- sonal protective equipment depending on the task, though he said Jeffboat did not always require such equipment. In December 2017, Chaffers filed a claim with the Depart- ment of Labor Office of Workers’ Compensation Programs (“OWCP”) under the Longshore and Harbor Workers’ No. 24-2234 3 Compensation Act. The Act provides compensation for cer- tain injuries “arising out of and in the course of employment.” 33 U.S.C. §§ 902(2), 903(a), 904(a). After a claims examiner rec- ommended denying benefits at an informal conference, Chaf- fers requested a formal hearing before an ALJ, which was held on August 26, 2021. At the hearing, Chaffers was the sole live witness, and he testified extensively about his medical history and exposure to toxic lung irritants. Chaffers testified that he has several health conditions, including hepatitis, sinusitis, hypertension, obesity, asthma, sleep apnea, depression, anxiety, chronic neck and back pain, lupus, and human immunodeficiency vi- rus (“HIV”) infection. Chaffers admitted that he was a long- time smoker of approximately a half-pack a day, though he switched to vaping sometime in 2015. Since he was laid off in 2017, Chaffers has not worked; he started receiving Social Se- curity disability benefits in 2019 based on various medical conditions. Chaffers first noticed shortness of breath in 2015 when he started needing to take breaks to catch his breath after walk- ing across the shipyard. He sought treatment for shortness of breath from various providers between 2017 and 2020, includ- ing Dr. Azmi Draw, a lung and sleep specialist, from 2018 to 2020. Based on two pulmonary function tests and a CT scan of Chaffers’ lungs, Dr. Draw diagnosed Chaffers with chronic obstructive pulmonary disease (“COPD”), shortness of breath, cough, hypersomnia, nicotine dependence, localized enlarged lymph nodes, and emphysema. Dr. Draw’s records did not include any opinion on the cause of the conditions, though Dr. Draw noted Chaffers’ smoking in his medical his- tory. Chaffers also saw Dr. James Woodiel, who diagnosed 4 No. 24-2234 Chaffers with pulmonary fibrosis and systemic lupus erythe- matosus. In Chaffers’ records, Dr. Woodiel also listed a diag- nosis of “exposure to paint fumes.” Chaffers’ retained expert, Dr. Ankit Gupta, a licensed phy- sician board certified in pulmonary disease, critical care med- icine, and internal medicine, provided an expert report opin- ing on Chaffers’ pulmonary impairment and its cause. Dr. Gupta based his report on an interview with Chaffers and his medical records. Dr. Gupta opined that Chaffers’ pulmonary function tests and CT scan showed a moderate restrictive lung function without airway obstruction, emphysema, and COPD. Dr. Gupta also opined that Chaffers had a 14% mild impairment under the American Medical Association (“AMA”) Guides to the Evaluation of Permanent Impairment, 6th Edition, due to a reduced diffusing capacity for carbon mon- oxide and history of shortness of breath. As for the cause of Chaffers’ conditions, Dr. Gupta con- cluded that, “[t]o a reasonable degree of medical probability,” Chaffers’ “workplace exposures caused his emphysema and contributed to his resulting disability.” According to Dr. Gupta, “[c]ontinuous paint exposure, especially oil-based paints, over a long period of time can cause emphysema,” and exposure to sandblasting can cause lung scarring and disease. Dr. Gupta acknowledged Chaffers’ smoking history and med- ical conditions but noted that Chaffers reported a history of “significant exposure to his lungs” in his employment. In Dr. Gupta’s view, Chaffers’ restrictive lung disease “[wa]s typical for patients with occupational exposures to sandblast- ing, . . . charcoal slag, and paint fumes.” Jeffboat’s expert, Dr. William Frazier, a physician who is board certified in internal medicine, sleep disorders medicine, No. 24-2234 5 critical care, and pulmonary medicine, opined that Chaffers did not have COPD, restrictive pulmonary disease, or pulmo- nary fibrosis. Dr. Frazier acknowledged that Chaffers had symptoms of shortness of breath and cough yet stated that the symptoms “are not [a] disease. Rather, they are common symptoms with many potential causes.” Dr. Frazier noted that “[h]eart disease causing shortness of breath and cough is common in men such as Mr. Chaffers who are middle-aged former smokers with hypertension and HIV infection.” Dr. Frazier did not diagnose Chaffers with a cardiac condition, nor did any other doctor. Dr. Frazier also speculated that Chaffers’ symptoms could be attributed to pulmonary hyper- tension, which, while rare, is “much more common in people with HIV infection.” Dr. Frazier acknowledged that long-term unprotected ex- posure to certain types of paint and antifreeze, as well as sandblasting materials, can cause lung disease. But he did not explain why these exposures did not cause or contribute to Chaffers’ breathing issues. Instead, because he believed that Chaffers had no confirmed pulmonary disease, Dr. Frazier stated that he could not offer an opinion on disease causation. The ALJ issued a decision on December 20, 2022, finding Chaffers partially disabled and entitled to benefits. Evaluat- ing the evidence, the ALJ followed the Act’s burden-shifting framework. Under § 20(a) of the Act, 33 U.S.C. § 920(a), a claimant is entitled to a presumption that their injury was causally related to their employment if they establish that (1) they suffered a harm; and (2) “conditions at the workplace ex- isted that could have caused the harm.” Am. Grain Trimmers, Inc. v. OWCP, 181 F.3d 810, 813 (7th Cir. 1999) (en banc). An employer may rebut this presumption through “substantial 6 No. 24-2234 evidence to the contrary.” Marinette Marine Corp. v. OWCP, 431 F.3d 1032, 1034 (7th Cir. 2005) (quoting Am. Grain Trim- mers, 181 F.3d at 813–14). If the presumption is rebutted, the burden of persuasion shifts back to the claimant to show by a preponderance of the evidence (“on the record as a whole”) that the workplace incident caused or aggravated his injury. Id. (citing Am. Grain Trimmers, 181 F.3d at 819). The ALJ found that Chaffers made a preliminary prima fa- cie case by showing that he suffered a harm, and that his workplace conditions could have caused the harm. Chaffers presented credible evidence of his lung injury—both Dr. Gupta and Dr. Frazier acknowledged Chaffers’ coughing and shortness of breath. And Dr. Gupta opined that Chaffers’ lung conditions could be causally related to his workplace expo- sures to sandblasting and paint fumes. Thus, the ALJ con- cluded, Chaffers was entitled to the § 20(a) presumption. Turning to Jeffboat’s evidence, the ALJ determined that Jeffboat successfully rebutted this presumption with Dr. Fra- zier’s testimony. Dr. Frazier opined that Chaffers’ breathing difficulties were unrelated to his work for Jeffboat and likely caused by an undiagnosed cardiac condition. With the presumption dropped from the case, the ALJ con- sidered the record as a whole and found that Chaffers’ injury was causally related to his work at Jeffboat. The ALJ found Dr. Gupta’s opinion more persuasive because he supported it with more fulsome explanation and medical literature, while Dr. Frazier only selectively reviewed Chaffers’ pulmonary function tests. Further, although Dr. Frazier acknowledged that long-term unprotected exposure to paints, antifreeze, and sandblasting materials can cause lung disease, he did not No. 24-2234 7 explain why such exposures could not have caused or con- tributed to Chaffers’ lung impairment. The ALJ ultimately concluded that Chaffers was perma- nently partially disabled. The ALJ awarded Chaffers perma- nent partial disability benefits, based on Dr. Gupta’s impair- ment rating of 14%, which was “the best, and perhaps only, level of disability supported by the record.” The ALJ also awarded medical benefits, for expenses that are reasonably necessary to treat Chaffers’ pulmonary conditions. After his success before the ALJ, Chaffers’ counsel filed a fee petition with the OWCP’s Office of the District Director, seeking $7,358.25 in fees and costs. Jeffboat objected to the hourly rate and some billing entries in Chaffers’ petition, and the District Director awarded Chaffers’ counsel $4,695.50. The Benefits Review Board affirmed the ALJ’s decision, ex- plaining that the findings of fact and conclusions of law were rational, supported by substantial evidence, and in accord- ance with applicable law. The Board also affirmed the award of attorneys’ fees because Jeffboat did not show the District Director erred. II Although Jeffboat petitions for review of the order of the Benefits Review Board, we sit in direct review of the ALJ and District Director decisions. See Consolidation Coal Co. v. Dir., OWCP, 911 F.3d 824, 838 (7th Cir. 2018); Old Ben Coal Co. v. Dir., OWCP, 292 F.3d 533, 538 (7th Cir. 2002). We take each decision in turn. A We start with Jeffboat’s challenge to the ALJ’s benefits de- termination. Our review is deferential: “We affirm an ALJ’s 8 No. 24-2234 findings so long as they are rational, supported by substantial evidence and consistent with governing law.” Consolidation Coal Co. v. Dir., OWCP, 129 F.4th 409, 416 (7th Cir. 2025) (quo- tation omitted). “The substantial evidence standard is some- what of a misnomer, however, because ‘the threshold for such evidentiary sufficiency is not high.’” Id. at 416–17 (quoting Biestek v. Berryhill, 587 U.S. 97, 103 (2019)). In this context, “[s]ubstantial evidence means ‘more than a mere scintilla,’” that is, “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Id. at 417 (quot- ing Consol. Edison Co. v. NLRB, 305 U.S. 197, 217 (1938)). “We do not reweigh the evidence, resolve inconsistencies in the record, make credibility determinations, or substitute our in- ferences for those drawn below.” Roberts & Schaefer Co. v. Dir., OWCP, 400 F.3d 992, 996 (7th Cir. 2005) (quotation omitted). Instead, we ensure that the ALJ looked at all the relevant evi- dence and did not substitute their judgment for that of an ex- pert or disregard expert opinions absent evidence to the con- trary. Bunge Corp. v. Carlisle, 227 F.3d 934, 938 (7th Cir. 2000). Jeffboat’s challenges on appeal boil down to two argu- ments: (1) Chaffers was not entitled to the § 20(a) presump- tion because the evidence did not show that he suffered any harm arising from his work conditions; and (2) the evidence did not support the ALJ’s determination that Chaffers was en- titled to benefits. Neither is persuasive. First, Jeffboat argues that Chaffers failed to make the prima facie showing required to avail himself of § 20(a)’s pre- sumption that his claim was covered by the Act. As noted ear- lier, § 20(a) creates a presumption that the claimant’s injury was causally related to their employment if the claimant es- tablishes that they suffered a harm that could have been No. 24-2234 9 caused by conditions at the workplace. See Am. Grain Trim- mers, 181 F.3d at 813; 33 U.S.C. § 920(a). Jeffboat insists that Chaffers failed to make a prima facie showing that he suffered harm at all or that any harm he did suffer could have been causally connected to his workplace. But Chaffers presented evidence that two physicians—a treating physician (Dr. Draw) and an expert witness (Dr. Gupta)—diagnosed him with COPD and emphysema. And Dr. Gupta opined that, “[t]o a reasonable degree of medical probability . . . Chaffers’ workplace exposures caused his em- physema and contributed to his resulting disability.” Even Dr. Frazier, Jeffboat’s medical expert, testified that the chem- icals to which Chaffers was exposed could cause lung disease. That evidence was sufficient for purposes of the § 20(a) presumption. “[I]f a claimant produces some evidence to sup- port her prima facie case, she is entitled to the presumption that her injury is work-related and compensable.” Rose v. Vec- trus Sys. Corp., BRB No. 20-0279, 2023 WL 111367, at *10 (Ben. Rev. Bd. 2023) (en banc); see also Brown v. I.T.T./Continental Baking Co., 921 F.2d 289, 296 n.6 (D.C. Cir. 1990); Albina Engine & Mach. v. Dir., OWCP, 627 F.3d 1293, 1298 (9th Cir. 2010). Chaffers did not need to present more—“‘some evidence’ is a light burden.” See Rose, 2023 WL 111367, at *10. And Chaffers only needed to satisfy the burden of production, not persua- sion; the consideration of contradictory evidence and “[c]red- ibility does not come into play in addressing whether a claim- ant has established a prima facie case.” See id. Second, Jeffboat argues that after it successfully rebutted the § 20(a) presumption, Chaffers failed to show by a prepon- derance of the evidence that the workplace caused or aggra- vated his injury. Jeffboat says that the ALJ improperly 10 No. 24-2234 weighed the evidence in finding that Chaffers was injured, that his injury was related to his work at Jeffboat, and that his injury rendered him disabled. These challenges fail. As an initial matter, to the extent Jeffboat is arguing that the ALJ erred when he credited Dr. Gupta over Dr. Frazier, this is precisely the kind of “reweigh[ing of] the evidence” in which we cannot engage. See Consolidation Coal, 129 F.4th at 417 (quotation omitted); see also Summers v. Freeman United Coal Mining Co., 14 F.3d 1220, 1223 (7th Cir. 1994) (collecting cases) (“It is the sole province of the ALJ to weigh the evi- dence and resolve conflicts therein.”). The ALJ considered both opinions, weighed them against the entirety of the rec- ord, and concluded that Dr. Gupta had the more persuasive position. Our role is only to assess whether that conclusion “has substantial evidentiary support,” Consolidation Coal, 129 F.4th at 417—not to “substitute our own inferences, or those of [Jeffboat], for those made by the ALJ,” see Summers, 14 F.3d at 1225. In any event, we find the ALJ’s decision was grounded in substantial evidence. Jeffboat first asserts that Chaffers failed to prove he suf- fered any injury at all. According to Jeffboat, the medical rec- ord evidence did not support the ALJ’s adoption of Dr. Gupta’s findings and conclusion that Chaffers suffered from pulmonary conditions, including COPD and emphysema. In- stead, Jeffboat says, the evidence only supported Dr. Frazier’s contrary opinion that Chaffers did not have any lung condi- tion and that his breathing issues were more likely symptoms of other underlying health conditions, including a potentially undiagnosed cardiac condition. But substantial evidence supported the ALJ’s determina- tion that Chaffers has some sort of pulmonary impairment. No. 24-2234 11 Dr. Gupta opined that Chaffers has COPD and emphysema. That opinion was consistent with treating physician Dr. Draw’s diagnoses based on Chaffers’ CT scan. Further, Dr. Gupta’s opinion was thoroughly explained and supported with citations to a medical journal. In contrast, as the ALJ ex- plained, Dr. Frazier selectively reviewed Chaffers’ pulmonary function tests, citing only to normal results while ignoring ab- normal results that suggested decreased functionality. More- over, both Dr. Gupta and Dr. Frazier acknowledged Chaffers’ coughing and shortness of breath. Coughing and shortness of breath from restricted lung flow is certainly a physical harm, regardless of whether it is a diagnosed pulmonary condition. Jeffboat therefore “can’t realistically say that [Chaffers] didn’t suffer an injury.” See Marinette Marine, 431 F.3d at 1034. Jeffboat is also mistaken in its suggestion that Chaffers had to prove he had a specific condition. The Act requires Chaffers to show “disability . . . result[ing] from an injury.” See 33 U.S.C. § 903(a). Courts and the Benefits Review Board have long viewed the concept of “injury” under the Act as broadly referring to any physical harm. See Psalidas v. Core Lab’ys, BRB No. 02-0687, 2003 WL 26100032, at *2 (Ben. Rev. Bd. June 30, 2003) (“Claimant need not show that he has a specific illness or disease in order to establish that he has suffered an injury under the Act, but need only establish some physical harm, i.e., that something has gone wrong with the human frame.” (citing Wheatley v. Adler, 407 F.2d 307 (D.C. Cir. 1968); Craw- ford v. Dir., OWCP, 932 F.2d 152 (2d Cir. 1991); Romeike v. Kai- ser Shipyards, 22 BRBS 57 (Ben. Rev. Bd. 1989))). In other words, it is enough that Chaffers suffered some sort of prob- lems with his lungs, regardless of the label. 12 No. 24-2234 Jeffboat next argues at length that the medical records do not support Dr. Gupta’s opinion that Chaffers’ workplace conditions at Jeffboat caused or contributed to his pulmonary impairments. The opinion should not have been credited, Jeffboat says, because it was mere speculation. Dr. Frazier’s opinion, on the other hand, was not based on speculation, Jeffboat contends. But the ALJ decided to credit Dr. Gupta’s opinion as more persuasive because of discrepancies in Dr. Frazier’s opinion. Dr. Frazier admitted that exposure to certain types of chemi- cals and paint fumes could contribute to lung disease. It was thus undisputed that Chaffers was exposed to harmful lung irritants and that those irritants could contribute to lung dis- ease. Dr. Gupta took the next logical step and concluded, based on his expertise, that Chaffers’ workplace exposure to the irritants contributed to his injury. In contrast, Dr. Frazier never explained why, if exposure to lung irritants like those faced by Chaffers could contribute to lung disease, they did not have such an effect in this case. Faced with this gap in Dr. Frazier’s reasoning, it was not unreasonable for the ALJ to rely on Dr. Gupta’s opinion over Dr. Frazier’s. Jeffboat also disputes causation on the grounds that Chaf- fers’ smoking history and pre-existing health conditions are the likely culprits of his current symptoms. But even a claim- ant with a pre-existing condition may be eligible to receive benefits “if a workplace incident aggravates that condition.” Sea-Land Servs., Inc. v. Dir., OWCP, 949 F.3d 921, 924 (5th Cir. 2020) (citation omitted). “[T]he aggravation rule does not re- quire that a later injury fundamentally alter a prior condition. It is enough that it produces or contributes to a worsening of symptoms.” See Marinette Marine, 431 F.3d at 1034 (citations No. 24-2234 13 omitted). So whether Chaffers’ health conditions were pre-ex- isting is immaterial when Dr. Gupta opined that the exposure to irritants contributed to Chaffers’ lung injury. We see noth- ing wrong with the ALJ crediting Dr. Gupta’s conclusion, es- pecially when Dr. Frazier was silent on whether the exposure contributed to Chaffers’ symptoms. Finally, Jeffboat argues that the ALJ’s finding that Chaffers was “disabled” under the Act was not supported by substan- tial evidence because no physician ever stated Chaffers was unable to work due to his lung condition. But Chaffers did not need to demonstrate that he was unable to return to work be- cause of his lung impairment to be covered by the Act. The Act “provides coverage for . . . permanent partial disability.” Bunge, 227 F.3d at 939 (citing 33 U.S.C. § 908(a)–(d)). Because there was no evidence that his injury prevented him from re- turning to work, the ALJ correctly classified Chaffers’ disabil- ity as “partial in nature.” See id. at 939–40 (an employee is con- sidered “totally disabled” when he is unable to find any “suit- able alternative employment”). Following 33 U.S.C. § 908(c)(23), the ALJ then determined the extent of that partial disability by crediting Dr. Gupta’s impairment rating of 14% based on the AMA Guides. The ALJ also relied on substantial evidence in classifying the disability as permanent (i.e., “of lasting or indefinite duration”) rather than temporary—the records showed Chaffers’ symptoms had been ongoing for years. See Bunge, 227 F.3d at 940. Because the ALJ’s findings of fact and conclusions of law were rational, supported by substantial evidence, and in ac- cordance with applicable law, we affirm the benefits decision. See Consolidation Coal Co., 129 F.4th at 416. 14 No. 24-2234 B As to Jeffboat’s challenge to the District Director’s fee award, it is waived. Jeffboat argues that the District Director abused his discretion by using unreasonably high hourly rates and failing to discount costs and time entries for various reasons. But Jeffboat waived this challenge by failing to pro- vide the relevant record materials and develop an argument with legal citations. Even after an order to submit “all items cited or relied on” in its briefs, Jeffboat did not supplement the record with the underlying fee petition materials (includ- ing the actual time entries in dispute). It is thus impossible to review Jeffboat’s arguments. Jeffboat also failed to cite any case law in support of its arguments as required by Federal Rule of Appellate Proce- dure 28(a)(8)(A). As we have explained, “perfunctory and un- developed arguments, and arguments that are unsupported by pertinent authority, are waived.” Crespo v. Colvin, 824 F.3d 667, 674 (7th Cir. 2016) (quotation omitted). We therefore ad- dress Jeffboat’s challenge to the District Director’s grant of at- torneys’ fees and costs no further apart from one final obser- vation about this half-baked argument: The Director already utilized his discretion in discounting the fees and costs sought by Chaffers by over one-third. * * * Accordingly, we DENY the petition for review and AFFIRM the decision of the Benefits Review Board.