September 09, 2016

There is a presumption that an accident that occurred in the course of employment arose out of that employment

There is a presumption that an accident that occurred in the course of employment arose out of that employment
Oathout v Averill Park Cent. Sch., 2016 NY Slip Op 05892, Appellate Division, Third Department

The Workers' Compensation Board ruled that a claimant for workers’ compensation benefits employed as a custodial worker by the Averill Park Central School District sustained a compensable injury. The Board subsequently denied a request by the School District for reconsideration and/or full Board review.

The Averill Park Central School District, a self-insured employer and its third-party administrator [School District] had controverted the employee's claim for workers' compensation benefits. Following a hearing, the Workers' Compensation Administrative Law Judge found that the employee had sustained a work-related injury and awarded the claimant workers' compensation benefits.

The Appellate Division affirmed the Board’s decision, explaining that "Whether a compensable accident has occurred presents a question of fact for resolution of the Board and its decision will be upheld when supported by substantial evidence." Further, said the court, "absent substantial evidence to the contrary, a presumption exists that an accident that occurs in the course of employment arises out of that employment."

The claimant had testified that she had just finished cleaning the school gymnasium and was walking down a hallway with a coworker when she felt the sharp pain in her foot. This said the Appellate Division, gave rise to the statutory presumption.

Claimant’s treating physician had opined that the injury "maybe partially [due] to her metatarsus adductus"* while the School District’s medical expert who performed an independent examination on claimant, “was unable to draw a direct connection between the claimant's [medical] condition and the [claimant’s] injury.”

The School District argued that the statutory presumption was rebutted by proof that the claimant’s injury had not stemmed from an accident associated with her job duties but was an idiopathic condition, her congenital metatarsus adductus.

However, giving deference to the Board's resolution of any credibility issues involved in making its determination, the Appellate Division held that substantial evidence supported the Board’s determination that the injuries arose out of and in the course of claimant's employment and sustained its decision that the claimant had sustained a work-related injury.  

* Metatarsus adductus, also known as metatarsus varus, is a common foot deformity noted at birth that causes the front half of the foot, or forefoot, to turn inward.

The decision is posted on the Internet at: