by pneumoconiosis, as the case may be. (B) For purposes of subparagraph (A), complicated pneumoconiosis or progressive massive fibrosis can be established by any of the following: (i) A chest radiograph, which yields one or more large opacities whose greatest diameter exceeds 1 centimeter and would be classified in Category A, B, or C in the International Classification of Radiographs of Pneumoconioses by the International Labour Organization, in the absence of more probative evidence sufficient to establish that the etiology of the large opacity is not pneumoconiosis. (ii) A chest CT scan, which yields one or more large opacities whose greatest diameter exceeds 1 centimeter, in the absence of more probative evidence sufficient to establish that the etiology of the large opacity is not pneumoconiosis. (iii) A lung biopsy or autopsy, which would yield a lesion at least 1 centimeter in its long axis diameter if measured at the time of gross dissection. (iv) A diagnosis by other means that would reasonably be expected to yield results described in clause (i), (ii), or (iii). . 103. Development of medical evidence by the Secretary Part C of the Black Lung Benefits Act ( 30 U.S.C. 931 et seq. ) is amended by adding at the end the following: 435. Development of medical evidence by the Secretary (a) Complete pulmonary evaluation Upon request by a claimant for benefits under this title, the Secretary shall provide the claimant an opportunity to substantiate the claim through a complete pulmonary evaluation of the miner that shall include— (1) an initial report, conducted by a qualified physician on the list provided under subsection (e), and in accordance with subsection (e)(5) and sections 402(f)(1)(D) and 413(b)