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August 24, 2020

Evaluation of conflicting medical evidence by an appointing authority

A deputy sheriff [Deputy] was injured in a work-related accident and was receiving benefits pursuant to §207-c of the General Municipal Law.* Following the receipt of a report from an orthopedic surgeon indicating that Deputy was capable of returning to work if assigned to work a "light duty position, Deputy was notified by the Sheriff's Department [Department] that [1] his §207-c benefits would be discontinued and [2] he would be place in a light-duty assignment with the Department. Deputy declined the light duty assignment and, as provided for in the relevant collective bargaining agreement, requested a hearing concerning the Department's decision.** 

A hearing was held and the Hearing Officer determined that Deputy's benefits [1] had been improperly terminated and [2] recommended that Deputy's benefits be reinstated retroactively.

The Department rejected the Hearing Officer's determination and recommendation without providing any explanation for its decision and Deputy commenced an Article 78 CPLR proceeding seeking, among other things, a court order annulling the Department's determination.

Citing Matter of Alverson v Albany County, 173 AD3d 1415, the Appellate Division said  that the Department failure to make any findings or otherwise specify any basis for its determinations "deprived the court of the ability to conduct meaningful judicial review." According, the court annulled the Department's determination and remitted the matter to it "to address the procedural issues and develop appropriate factual findings."

Upon remittal, the Department considered the conflicting medical evidence in the record concerning whether Deputy was capable or incapable of performing light-duty work.

Deputy's primary care physician had testified that Deputy's work-related injuries "rendered him wholly incapable of returning to work in any capacity" while a physician assistant working under the primary care physician supervision testified that Deputy would be capable of performing the specific tasks that he would be assigned as part of his light-duty assignment only if he was permitted "to take his prescribed pain medications."

In contrast, the testimony and independent medical examination report of the Department's medical expert supported the conclusion that Deputy was capable of returning to work in a modified or light-duty capacity.

The Department, after evaluating the testimony of the medical experts, found that Deputy was capable of performing light-duty work and that his §207-c benefits had been properly terminated in accordance with the terms and conditions of collective bargaining agreement. In so doing the Department credited a "work abilities checklist" completed by an orthopedic surgeon and the medical opinion given by its medical expert over the medical evidence presented by Deputy's medical experts.

Based upon that credibility determination, Department found that Deputy was capable of returning to work in a light-duty capacity and Deputy next filed the instant CPLR Article 78 petition challenging the Department's ultimate decision.

The Appellate Division dismissed Deputy's petition, concluding that [1] the Department's resolution of the conflicting medical evidence was rational, fact-based and  supported by the record, and [2] substantial evidence supported the Department's determination to terminate Deputy's §207-c benefits "notwithstanding the existence of evidence that could support a contrary conclusion."

The court, Judge Colangelo, dissenting,*** explained that a "Judicial review of an administrative determination made after a hearing at which evidence is taken pursuant to direction of law is limited to a consideration of whether that determination was supported by substantial evidence upon the whole record," noting that "Substantial evidence consists of 'such relevant proof as a reasonable mind may accept as adequate to support a conclusion or ultimate fact.'"

In the words of the Appellate Division, "[W]here the medical evidence [is] in conflict, it [is] for the administrative agency to choose between the conflicting opinions, and the courts are not free to reject the choice made by the administrative agency where room for choice exists."

* General Municipal Law §207-c provides for the payment of salary, wages, medical and hospital expenses of law enforcement personnel having injuries or illness incurred in the performance of duty.

** The "stipulated issue" to be addressed at the hearing was whether Deputy's §207-c benefits had been properly terminated.

*** Justice Colangelo opined that "As the majority notes, [Deputy] adduced credible medical evidence — namely, the testimony of his primary care physician and a registered physician assistant — in support of his contention that he was incapable of even light-duty work at the time that [the Department] terminated his General Municipal Law §207-c benefits" and in Judge Colangelo's view the Department's determination was not supported by substantial evidence and he would annul it.

The decision is posted on the Internet at:

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