WIOT, M.D., INC. University of Cincinnati Department of Radiology PO Box 670742 Cincinnati, Ohio 45267-0742 513-558-2489 August 17, 1994 Mary Sue Smalley Jackson, Kelly, Holt O'Farrell Attorneys at Law 1600 Laidley Tower P.O. BOX 553 Charleston, WV 25322 Re: Cline, Calvin Dear Ms. Smalley, I have reviewed a large series of chest x-rays of the above named patient. Films include: PA and lateral dated 02/05/85 from Flat Top Clinic, 06/23/87 from Cannell Clinic, a PA film dated 08/14/87 from Associated Radiologists, PA and lateral film dated 12/16/88 from Beaver Family Care, PA, lateral and'q" lordotic from Dr. George Zaldivar, PA and lateral dated 10/24/91 from Beaver, West Virginia, PA and lateral dated 01/04/92 from Beaver Family Care, PA and lateral dated 05/07/92 from Beaver Family Care, PA and both Jliques dated 01/05/94 from Appalachian Regional Health Care and PA and lateral dated 05/13/94 from Internal Medicine Associates. All films are appropriately identified with the patient's name and all films are of acceptable quality by ILO standards. There are size opacities within the upper two zones on the right and the upper zone on the left which would be classified as 1/1 by ILO standards. In addition, there are large opacities present within the right upper zone fid a less evident large opacity on the left. These would be classified as Although there is slight progression between 1985 and 1994 in the size of the large opacities they still are within the limits of by ILO standards. In association with this is stranding extending from the right upper lobe toward the right hilum-and.there is mild elevation.of,the minor: fissure." By ILO standards, the findings must be classified as consistent with complicated coal worker's pneumoconiosis. However, the findings could all be related to old pulmonary tuberculosis and therefore as stated in the ILO rule book, I have indicated the question, at the bottom of the classificationrform under other comments. Sincerely, Claimant's Exhibit 30. 20 F. WIOT, M.D., INC. University of Cincinnati Depanment of Radiology PO Box 670742 Cincinnati, Ohio 45267-0742 513-558-2469 August 23, 1994 Mary Sue Smalley Jackson, Kelly, Holt O'Farrell Attorneys at Law 1600 Laidley Tower P.O. BOX 553 Charleston, WV 25322 Re: Cline, Calvin Dear Ms. Smalley, I have reviewed a PA chest x--ray of the above named patient dated 09/08/93 from Beckley Hospital marked with the patient's name. The film is of acceptable quality by ILO standards. There are size opacities present within both upper lung fields and in the right upper zone with a degree of profusion of 1/1. In addition, there are large opacities present bilaterally, greater on the right than on the left which would be classified;as The chest is otherwise unremarkable. I have submitted a classification sheet indicating findings compatible with complicated coal worker's pneumoconiosis. "Th- Sincerely, .- ome F. Wiot, M.D rofessor of Radi JFW/kjl Encl. OGY Claimant's Exhibitfio, 21 JEROME F. WIOT, M.D., INC. University of Cincinnati Department of Radiology PO Box 670742 Cincinnati, Ohio 45267-0742 513-558-2489 August 23, 1994 Mary Sue Smalley Jackson, Kelly, Holt O'Farrell Attorneys at Law 1600 Laidley Tower P.O. BOX 553 Charleston, WV 25322 Re: Cline, Calvin Dear Ms. Smalley, I have reviewed a CT scan of the chest dated 05/13/94 from Wedgewood Imaging marked with the patient's name. Both lung and mediastinal windows are available. There are large opacities present within both upper lung fields, larger on the right than on the left with associated cicatrization and blood formation. In addition, there are nodules present in the same areas, all consistent with complicated coal worker's pneumoconiosis. There are no other significant findings. In summary, this patient's CT scan is consistent with complicated coal worker's pneumoconiosis. Je-omg F. Wiot, M. "rofessor of Radiology JFW/kjl Encl. Claimant's Exhibit No.22