March 21, 2019

Disregarding unrebutted medical evidence in the record supporting an application for accidental disability retirement benefits fatal to the Medical Board and the Board of Trustees rejecting the application


Petitioner's application for accident disability retirement (ADR) benefits was rejected by both the Medical Board and the Board of Trustees. The Appellate Division unanimously annulled these decisions, on the law, and the matter remanded for further proceedings.

Petitioner, said the Appellate Division, had met his burden in establishing that he was entitled to ADR benefits by presenting:

 [1] the reports of his treating physicians, including the surgeon who performed his spinal surgery;

[2] the line-of-duty (LOD) accident reports indicating neck and back injuries;

[3] the contemporaneous emergency room reports also documenting neck and back pain; and

[4] MRIs from 2010 and 2011 revealing disc herniation, disc degeneration, and stenosis.

The medical evidence in the record, said the court, showed that Petitioner suffered from chronic back pain as a result of LOD injuries, in particular those sustained during a LOD accident that occurred in 2008.

The Board of Trustees' finding that Petitioner's 2008 accident was not causally related to his disability was based on a two-year gap in Petitioner's treatment, during which time he had returned to full duty. The Appellate Division found that this decision by the Board of Trustees "was conclusory" in light of the medical evidence in the record and  "[b]oth the Medical Board and the Board of Trustees failed to refute the opinion of Petitioner's surgeon that Petitioner's condition, which necessitated surgical intervention, was the result of his LOD injuries."

While the Medical Board was free to come to any conclusion supported by medical evidence before it, the court ruled that the board could not disregard the only competent evidence on the issue before it and its failure to refute the opinion of Petitioner's surgeon that Petitioner's condition was the result of his LOD injuries required that the Board's determination be vacated.

The decision is posted on the Internet at: