LEXINGTON, Va. -- Charles Cooper spent all his working life in the West Virginia coal mines, breathing in coal dust and staying underground years after he was diagnosed with black lung disease.

"I had a high-school education. I wasn't qualified to do anything else," said Cooper, a Beckley, W.Va., resident who started mining in 1946. "As long as I could do the work, I had to make a living."

But he increasingly labored to breathe, and decided to retire in 1985 when the Westmoreland Coal Co. mine he worked in closed. That same year, he sought federal black lung benefits, which provide a monthly sum and medical treatments for fully disabled miners, but was turned down.

Cooper's local black lung association told him about Washington & Lee University School of Law's black lung legal clinic, which took his case in 1998, six years after he was diagnosed with complicated coal worker's pneumoconiosis, an advanced case of the disease.

Professor Mary Natkin and a succession of students at the Lexington, Va., school handled his second claim for benefits, hiring medical experts, taking depositions, arguing before federal administrative law judges, and answering Westmoreland's appeals. This spring, he finally won nearly $51,500 in back pay and a $574 monthly stipend from the company -- 21 years after he started trying to collect benefits.

Cooper, 78, is one of about
200 clients the pro bono legal clinic has helped since its inception in 1996. Under Natkin's guidance, a team of second- and third-year law students handle all aspects of miners' claims, from deciding whether to accept a case to arguing before the 4th U.S. Circuit Court of Appeals in Richmond. Attorney's fees collected in successful claims are used for other black lung cases, Natkin said.

It's the only law school clinic handling black lung claims and Natkin said its clients have had a success rate between 50 percent and 60 percent, compared with roughly 11 percent overall. Total disability is tough to prove and coal companies challenge most cases, factors which many miners and their survivors say have discouraged them from pursuing claims.

"We do, in a sense, have the luxury of being able to take just enough cases so that the students can do a very credible job on them," Natkin said. And because the university funds the clinic's costs, "we can afford to treat our clients like million-dollar clients," she said. "That is useful and that shows results."

Laura B. Gardy, a 2001 graduate who works as an attorney at the U.S. Commodity Futures Trading Commission, said working closely with former miners "opened my eyes to this whole other part of the world that I would have never, ever run into." Because of her experience, she was deeply affected by recent mining disasters, such as the Sago explosion that killed
12 workers.

Learning that her first client -- a former miner named Jimmy Lucas -- ultimately won his case years after she left law school "is more meaningful to me than a lot of the things I've done since," she said.

Douglas Smoot, who defends mining companies against black lung claims, said the students do an excellent job.

"I never thought I was dealing with lightweight people," Smoot said. "I've gone up to the 4th Circuit and gone up against students. That's the big time when you have to argue before three judges. They did well."

The clinic fills a great need among miners navigating the Department of Labor's intricate compensation regulations because most private attorneys can't afford to take such long-term cases, said Tim Cogan, a Wheeling, W.Va., lawyer who has represented miners on black lung claims.

Miners' lawyers must take cases on contingency, "meaning you can't get paid unless you win, and you can't get paid until the case is over," which can take several years, Cogan said.

Only about 20 attorneys across the U.S. regularly handle black lung claims, said Grant Crandall, general counsel of the United Mine Workers of America, which refers a handful of cases to the Washington & Lee clinic annually. Last fiscal year, miners and their survivors filed 4,489 claims, according to Department of Labor figures.

Charles Cooper still has a large dresser drawer full of appeals and other documents filed on his behalf. He regrets that his wife, who died in 2003, didn't get to see him win his case.

"She should have had some of that lump sum, too," he said. "It just ain't right to hold people off like that."

Conditions in the mines have improved since Cooper's working days, but Natkin and other advocates say the need for legal representation won't go away anytime soon. They say increasing demand for coal-powered electricity is opening up new jobs in the mines, potentially exposing more workers to unsafe conditions.

At a recent black lung health conference in Pipestem, W.Va., United Mine Workers officials and doctors who treat miners said that they fear they'll see more pneumoconiosis cases, especially in workers in underground mines that don't properly monitor coal dust levels.

Dr. Bob Cohen, an occupational pulmonologist and medical director of Chicago's John J. Stroger Jr. Hospital, which houses one of the nation's most comprehensive black lung clinics, said pneumoconiosis is fully preventable if coal companies require workers to wear personal dust-monitoring systems and follow existing laws.

"This (disease) is something we should only read about in history books," said Cohen, a member of the federal Mine Safety and Health Research Advisory Committee and part of a group investigating the Sago explosion. "These meetings should not be action meetings; they should be nostalgia -- 'Remember when people got black lung?"'

At his home in Beckley, Cooper has a hard time pushing, pulling or lifting and loses his breath frequently. He must get regular chest x-rays to monitor his condition, which could worsen but will never improve. Though he had a hard time with his benefits claim, he thinks fondly of his former career and the camaraderie with other miners.

"I don't regret working in the mines," he said. "It was a good job and I liked it."