Wednesday, March 09, 2016

Resolving conflicting medical evidence submitted connection with a Workers’ Compensation Law claim is within the exclusive province of the Workers’ Compensation Board


Resolving conflicting medical evidence submitted in connection with a Workers’ Compensation Law claim is within the exclusive province of the Workers’ Compensation Board
Granville v Town of Hamburg; 2016 NY Slip Op 01373, Appellate Division, Third Department

The Town of Hamburg had employed Patrick Granville as a laborer and light equipment operator from 2003 to 2012. In May 2013, Granville filed for workers' compensation benefits claiming that he had sustained an occupational hearing loss due to exposure to loud occupational noise as a result of his operating such equipment such as heavy-duty sit-down lawn mowers, weed whackers, heavy-equipment tractors, backhoes, zambonis and air jacks.

The Town, a self-insured employer for the purposes of Workers’ Compensation, and its third-party administrator [collectively “the Town”] controverted the claim for benefits filed by Granville. The Workers' Compensation Law Judge [WCLJ] who conducted the hearing concluded that Granville had suffered a causally-related binaural loss of hearing. The Workers' Compensation Board affirmed the WCLJ’s findings.

The Town, conceding that Granville had suffered a hearing loss, appealed the Board’s decision, contending that the record as a whole:

[1] did not establish that Granville was exposed to injurious noise during the course of his employment by the Town; and 

[2] did not establish that Granville’s hearing loss was causally related to his employment.

The Appellate Division rejected the Town’s argument, explaining that Granville had satisfied his burden of establishing, by competent medical evidence, that a causal connection existed between his hearing loss and his employment.

At the workers’ compensation hearing Granville had testified that he had operated heavy and light machinery "at least ninety percent of the time" during a typical workweek, that he had no loud hobbies or activities outside of work and that, prior to his work with the employer, he had worked in the banking industry. He also testified that he was required to undergo a hearing test in 2004, shortly after commencing employment with the Town, and that the results of this test revealed that he had "no effects of hearing loss.* In addition, Granville submitted a report and medical opinion of his treating otolaryngologist, Dr. Sayeed Nabi, who found that Granville's hearing loss was causally related to his employment.**

In contrast, the otolaryngologist who examined Granville on behalf of the Town opined that Granville's hearing loss was neither consistent with injurious noise exposure nor causally related to his employment’

Sustaining the Board’s decision in favor of Granville, the Appellate Division said “The Board found the opinion of [Dr.] Nabi to be more credible and, according appropriate deference to that assessment, substantial evidence supports the determination that [Granville] suffered a causally-related binaural loss of hearing,” explaining that the resolution of conflicting medical opinions, particularly with regard to the issue of causation, is within the exclusive province of the Workers’ Compensation Board.

* The Appellate Division noted that the Town “failed to produce the records of this hearing test.”

** The court said that "[W]here medical proof is relied upon to demonstrate the existence of a causal relationship, it must signify a probability of the underlying cause that is supported by a rational basis and not be based upon a general expression of possibility"

The decision is posted on the Internet at:
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