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July 18, 2014

If a preexisting dormant disease is aggravated by an accident, resulting in a disability that did not previously exist, the accident is responsible for the ensuing disability


If a preexisting dormant disease is aggravated by an accident, resulting in a disability that did not previously exist, the accident is responsible for the ensuing disability
2014 NY Slip Op 05007, Appellate Division, Third Department

A lieutenant with the Port Authority of New York and New Jersey [Lieutenant], applied for performance of duty and accidental disability retirement benefits in 2009, claiming that he was permanently incapacitated due to injuries to his back and right shoulder sustained as the result of a 2009 accident.

As to Lieutenant’s medical condition, his neurologist concluded that he suffered from a progressive narrowing of the spinal canal and, due to the 2009 accident, disc herniation was causing nerve root compression. In contrast, the Retirement Systems orthopedic surgeon concluded that the disc herniation and shoulder injury were degenerative in nature and caused by the early injuries and surgeries, rather than the 2009 accident, which had caused only a temporary exacerbation of Lieutenant's underlying arthritic condition.

The Hearing Officer recommended that Lieutenant 's applications be denied on the ground that he did not prove that his conceded disability resulted from the 2009 accident. Adopting the hearing officer’s findings and recommendation, the Comptroller denied Lieutenant’s application and he appealed.

The Appellate Division annulled the Comptroller’s determination, explaining that it has repeatedly held that "'when a preexisting dormant disease is aggravated by an accident, thereby causing a disability that did not previously exist, the accident is responsible for the ensuing disability”

Although the Retirement System's expert speculated that Lieutenant had suffered a number of injuries prior to 2009, “It is undisputed that he returned to full duty” after those events and thereafter after he suffered an job-related injury in 2009.  As a result of the 2009 incident, in which Lieutenant suffered a torn rotator cuff in his right shoulder and pain in his right low back and right hip, he lost the ability to walk, and he never returned to work.

The Appellate Division noted that although Lieutenant’s previous injuries may have had resulted in some low level symptoms that he had learned to manage, there is no dispute that Lieutenant was not incapacitated prior to the 2009 incident. Although the System’s expert characterized the exacerbation of Lieutenant's underlying conditions after that point as temporary, he could not explain why Lieutenant's conceded disability had not resolved as of the date of the hearing, 3½ years after the accident.

Under these circumstances, said the court, the Comptroller's determination is not supported by substantial evidence and must be annulled.
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