This study aimed to explore the psychosocial, occupational, financial, and physical impact of chronic obstructive pulmonary disease on underground workers in the minerals industry in Northeastern Ontario, describe their experiences with the Ontario workers’ compensation claim process. This study also aimed to communicate experiences of physicians and union workers with underground mineral workers diagnosed with COPD as an occupational illness and the Ontario workers’ compensation claim process experience. Data were collected via semi-structured telephone interviews with 16 underground mineral workers with occupational COPD, four union compensation representatives and four physicians (two primary care and two specialists). Interviews were transcribed verbatim, and a thematic analysis was completed. Examples of themes that arose from the findings of the underground mineral workers’ COPD group included:​ 1) COPD affects quality of life, 2) I smoked;​ I did not think I could get compensation, 3) the compensation process is a joke, 4) doctors do not know anything, and 5) working in the mine is a dirty job – we did not know any better. Themes from the union compensation representatives and physicians included:​ 1) additional support resources required, 2) smoking cessation is essential, 3) the compensation claim process is challenging, 4) occupational diseases are challenging to prove, and 5) occupational COPD is costly. These results suggested that advocacy is critical to ensuring underground workers receive the support they need to obtain approval of a compensation claim. The results also illustrated the need for further education about the ability to document and support an occupational illness for physicians and worker’s compensation caseworkers involved in caring for an underground mineral worker diagnosed with occupational COPD. Continued research about occupational diseases and the compensation claim process for those with COPD is required to address the barriers and challenges experienced.