November 04, 2019

Considering applications for accidental disability retirement benefits


A state trooper [Petitioner] filed for accidental disability retirement and State Police disability retirement benefits alleging that he was permanently incapacitated as a result of injuries sustained to his back, neck and right shoulder in when, in the course of investigating a motor vehicle accident, another vehicle rear-ended the parked patrol vehicle in which he was sitting and propelled his vehicle into a concrete barrier.
  
The New York Stateand Local Police and Fire Retirement System denied both applications, Petitioner sought a hearing and redetermination. The Hearing Officer upheld the denial of Petitioner's applications and he filed an appeal to the State Comptroller. The Comptroller ultimately remanded the applications for further action to a different Hearing Officer, finding that the first Hearing Officer had failed to make findings on an issue of fact central to the question of whether Petitioner's injuries rendered him permanently incapacitated.

Following a second hearing, during which all evidence and testimony presented at the first hearing was admitted into evidence* and ultimately the new Hearing Officer concluded that Petitioner had failed to establish that he was permanently incapacitated as a result of his injuries and, consequently, denied both of applications for benefits submitted by Petitioner.

The Comptroller accepted the second Hearing Officer's findings and conclusions and Petitioner commenced a CPLR Article 78 proceeding challenging the Comptroller's determination. Finding that the petition raised the issue of whether substantial evidence supported the determination, Supreme Court transferred the proceeding to the Appellate Division pursuant to CPLR §7804[g].

The Appellate Division affirmed the Comptroller's determination explaining that the applicant for accidental or State Police disability retirement benefits bears the burden of establishing, among other things, "that he or she is permanently incapacitated from performing his or her regular job duties." Further, noted the court, the Comptroller is vested with "the authority to resolve conflicts in medical evidence and to credit the opinion of one expert over that of another, so long as the credited expert provides an 'articulated, rational and fact-based opinion, founded upon a physical examination and review of relevant medical reports and records'" and where the Comptroller's determination is supported by substantial evidence, it will be sustained.

In this instance the Comptroller credited the expert opinions of the Retirement Systems expert, a board-certified orthopedic surgeon who reviewed petitioner's medical records and conducted physical examinations of Petitioner and opined that petitioner was not permanently incapacitated because there were reasonably safe treatment options available** and later following a second physical examination of Petitioner, found that Petitioner's conditions "had resolved or were stable."

In contrast to what the Appellate Division described as the Retirement System's expert "articulated, rational and fact-based opinions," Petitioner's experts opined that Petitioner was permanently incapacitated. The Comptroller discounted Petitioner's experts opinions for various reasons and rejected Petitioner's citing determinations made by the Workers' Compensation Board and the Social Security Administration, explaining that the opinions of those entities "are not binding upon the Comptroller."

Deferring to the Comptroller's credibility assessments, the Appellate Division found that substantial evidence supports the determination that Petitioner failed to prove that his injuries rendered him permanently incapacitated and confirm the Comptroller's determination.

* The decision notes that at the second hearing Petitioner had consented to the admission of evidence from the first hearing and thus rejected Petitioner's contention that the Comptroller could not rely on certain reports in the record.

** See Matter of Mondello v Beekman, 56 NY2d 513, affirmed on opinion below at 78 AD2d 824. In this instance the individual's application for line of duty disability retirement was dismissed because the individual had failed to accept proper corrective medical treatment, including surgery..

The decision is posted on the Internet at:
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