“Given his age and poor health, undergoing a lung biopsy would likely be too risky,” Hamby writes of 66-year-old Steve Day, denied the benefits by his mining company. The key for them is finding incontrovertible medical evidence of their disease.

And yet, their Appalachian fortitude is such that they keep up the fight, even as death approaches. They argue their cases before administrative law judges, or are represented by low-budget attorneys who are overmatched in endless legal sparring with coal companies and their powerful lawyers. In “Soul Full of Coal Dust” we meet miners who have been fighting their employers 20 years or longer for those payments. Thanks to a federal law dating back to the 1960s, miners who contract the disease are due monthly disability checks (usually less than $700) and coverage of all their medical expenses - unless the company that hired them argues the miners aren’t really sick at all. X-rays show grainy masses in their chests, and they regularly spit up black phlegm, symptoms of pneumoconiosis, more commonly known as black lung disease. They get winded after walking up just a few stairs, and some can only breathe with oxygen tanks feeding their lungs, day and night. After decades working underground in the sooty air of coal mines, many are severely disabled. The ailing coal miners in Chris Hamby’s “Soul Full of Coal Dust” are a tough bunch of men, even though they may no longer look the part.

SOUL FULL OF COAL DUST A Fight for Breath and Justice in Appalachia By Chris Hamby

A soul full of coal dust