December 21, 2010

Burden of proof in disability claims

Burden of proof in disability claims
Musa v Nassau County Police Dept., 276 AD2d 851

The Musa decision demonstrates the burden place on an applicant seeking workers’ compensation death benefits.

Musa, a Nassau County police officer, committed suicide while at home. His widow, Nancy Musa, filed an application for workers’ compensation benefits death benefits.

The basis for her claim: her husband committing suicide because of work-related stress caused by the Nassau Police Department’s use of improper practices to reprimand him and to prevent his promotion.

The Workers’ Compensation Board, reversing a Workers’ Compensation Law Judge’s ruling, concluded that Musa’s death did not arise out of and in the course of his employment and rejected Mrs. Musa’s application for workers’ compensation death benefits. The Board concluded that Musa’s suicide was precipitated by an underlying depressive condition unrelated to any stress experienced by decedent at work.

Mrs. Musa appealed, arguing that the Board’s determination was not supported by substantial evidence because it was based, in part, on a report by a medical expert who failed to appear at the hearing. While the Appellate Division agreed with Mrs. Musa that the Board incorrectly relied upon this expert’s medical report in making its determination, it nevertheless affirmed the Board’s decision to reject her claim for benefits.

The reason for this, said the court, was that workers’ compensation death benefits may be awarded in cases of suicide only where the suicide results from insanity, brain derangement or a pattern of mental deterioration caused by a work-related injury. While Musa’s husband’s depressive condition might qualify as a brain derangement permitting an award of death benefits, Mrs. Musa failed to meet her burden of establishing by competent medical proof that a causal relationship existed between her husband’s employment and his depression and the suicide.

According to the decision, the only medical evidence offered by Mrs. Musa concerning causation was the testimony of her husband’s treating psychologist. While the psychologist testified that Musa’s suicide was causally related to employment stress, the Board rejected this opinion, finding that it was based upon information provided by Mrs. Musa and her attorney following the decedent’s suicide rather than the psychologist’s independent recollection of treating Musa’s husband five years earlier.

Affirming the Board’s decision, the Appellate Division commented that because the Board found that the psychologist’s opinion lacked evidentiary support in the record, the opinion had no probative value on the issue of causal relationship and the Board correctly declined to consider it.