Case 1:19-cv-00597 Document 12-4 Filed 12/20/19 Page 1 of 2 PageID 179

UNSWORN DECLARATION OF ROGER WRISTON

In the matter of:
Grah_a1_n et al. v. Justice Energy. Inc.. et al.

I, Roger Wriston, of 676 Cranberry Road, Mount HOpe, WV 25880, pursuant to 28

U.S.C. 1476 do hereby solemnly declare the followingwas formerly employed by Bluestone Coal Corporation, with my last day of credited
service on or about June 22, 2012. On or about that date I retired.

During my years of service, Bluestone Coal Corporation was bound by a series of
collective bargaining agreements with the United Mine Workers of America. Those
collective bargaining agreements included promises by Bluestone Coal Corporation to
provide pension, healthcare, and prescription drug bene?ts to quali?ed retirees.

Under those collective bargaining agreements, and as a result of my credited service at
Bluestone Coal Corporation, I quali?ed for pension, healthcare, and prescription drug
bene?ts. My wife (Tammie Wriston) and I are entitled to those bene?ts during our
retirement.

Since in or about October 2017, Bluestone Coal Corporation has failed to provide the
level of healthcare and prescription drug bene?ts to which my wife and I are entitled.
Bluestone Coal Corporation has periodically cut off my medical and prescription drug
coverage without warning or explanation. Not knowing if or when I will have medical
and prescription drug coverage is a constant concern.

Bluestone Coal Corporation has failed to pay for medical and hOSpitalization bills. One

individual unpaid bill is in the amount of $12,367.76. I have received calls from

Case 1:19-cv-00597 Document 12-4 Filed 12/20/19 Page 2 of 2 PageID 180

collection agencies regarding these unpaid bills, which are distressing and embarrassing.
I do not have enough money to pay these bills.

7) Bluestone Coal Corporation?s insurance company has sent me Explanations of Bene?ts
regarding some of the medical bills which state that I owe Nonetheless, the bills are
not paid and I have received invoices for the full amount.

8) My wife and I have foregone medical treatment, because we know that our bills will not
be paid. For instance, my wife needs medical treatment for her back, which requires
injections. But we know the bills will not be paid, so she has not received those
injections. We know that avoiding medical treatment can do irreparable harm to our
health, but we cannot afford to pay the bills.

I declare under penalty of perjury that the foregoing is true and correct. Executed on:

$547

Date

as 49.2%:

RogerdNriston (Signature)