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We report on a 73-year-old man, who developed chronical bronchitis after 15 years of working as a coal miner. About 3 decades later a manifest COPD, and additionally a silicosis, were diagnosed. The silicosis was rated as an accepted case for the hazard insurance, but not as a reason for pension. The reasoning for the declining of pension for the applicant is refuted by the literature which defines occupational diseases and is generally accepted by the legislation. In this case the insurance argued that in low- to medium-grade spread of silicosis functional deficits of the lung and/or the cardio-vascular system are not to be expected. Thus the recognition and recompensation of a BK 4101 (grinders' disease, silicosis) was proposed, in contrast to the social court which demanded an expert's opinion on causality.