January 7, 2021

Evaluating an individual's application for accidental disability retirement where a statutory presumption of causation is a factor

A New York City police officer [Plaintiff] filed an application for accidental disability retirement [ADR] benefits based on a heart condition. The Medical Board [Board] concluded that Plaintiff was disabled as a result of various heart ailments but recommended ordinary disability retirement [ODR]* because there was no evidence that Plaintiff had hypertension or any other stress-related heart problems. The Retirement System adopted the Board's recommendation.

Plaintiff filed a petition pursuant to CPLR Article 78 seeking a court order [1] vacating the Retirement System's determination denying Plaintiff 's application for ADR and [2] directing that he be granted retirement with accidental disability benefits. Supreme Court granted Plaintiff's petition and the Retirement System appealed.

The Appellate Division affirmed the Supreme Court's ruling, explaining that the lower court had properly granted the petition based on the presumption of causation set out in General Municipal Law §207-k.**

Conceding that there was some evidence that Plaintiff was diagnosed with "essential hypertension" prior to his retirement, the Appellate Division noted that most of the evidence related to hypertension post-dated his retirement.

Further, said the court, the Board did not express an opinion as to whether Plaintiff's other heart ailments, including his need for a dual chamber pacemaker were causally related to stress or other occupational factors and failed "to address Plaintiff's numerous heart problems and focused only on the absence of hypertension."

The Appellate Division then opined that the Retirement System "cannot deny ADR benefits in a case governed by General Municipal Law §207-k by relying solely on the absence of evidence tying the disability to work-related stress," citing Bitchatchi v Board of Trustees of N.Y. City Police Dept. Pension Fund, Art. II, 20 NY3d 268.

* Ordinary Disability Retirement benefits are typically less generous than Accidental Disability Retirement benefits.

** General Municipal Law §207-k sets out a rebuttable presumption that a  disability resulting from any condition of impairment of health caused by diseases of the heart suffered by an applicant for accidental disability retirement benefits was incurred in the performance and discharge of official duty unless the contrary is proven by competent evidence.

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