ARTIFICIAL INTELLIGENCE [AI] IS NOT USED, IN WHOLE OR IN PART, IN PREPARING NYPPL SUMMARIES OF JUDICIAL AND QUASI-JUDICIAL DECISIONS

October 21, 2022

Denial of an application for disability retirement benefits must be supported by substantial evidence

In Matter of Kelly v DiNapoli, 30 NY3d 674, the Court of Appeals held that "For the purpose of Retirement and Social Security Law, the applicant bears the burden of establishing that the disability was the result of an accident, which is defined as "a sudden, fortuitous mischance, unexpected, out of the ordinary, and injurious in impact". This standard requires an applicant for accidental disability retirement benefits to "demonstrate that [the] injuries were caused by a precipitating event that was sudden, unexpected and not a risk inherent in [the individual's] ordinary job duties"

Petitioner in this Article 78 action, an administrative law judge [ALJ] for the Department of Corrections and Community Supervision, sustained injuries when she was leaving a hearing room and was hit on her left leg by a very heavy, self-closing, security door.

Following a hearing on the ALJ's application for accidental disability retirement benefits, the Hearing Officer denied the application, finding that the ALJ did not meet her burden of establishing that the incident constituted an accident within the meaning of Retirement and Social Security Law § 605. The Comptroller sustained the hearing officer's findings and decision and the ALJ appealed.

The Appellate Division disagreed. In its view, the incident as described by the ALJ constituted an accident. The court said that "Although [the ALJ] was aware of the hazard posed by the heavy, self-closing door, she reasonably expected that the supervisor, who was holding the door open, would continue to do so as [the ALJ] walked through."

Thus, said the Appellate Division, the ALJ demonstrated that her injuries were caused by a "sudden [and] unexpected" precipitating event — the supervisor letting go of the heavy, self-closing door while the ALJ walked through it — which was not a risk inherent in her job duties.

The court distinguished the facts in this case from a situation in which it determined that strong wind blowing shut a heavy, self-closing door and injuring the applicant for accidental disability retirement benefits did not constitute an accident, citing Matter of Rizzo v DiNapoli, 201 AD3d at 1100.* The Appellate Division opined that "a distinction must be drawn between a naturally occurring event such as wind" and the instant case in which the ALJ had a reasonable expectation that the supervisor would not release the door until she was safely through.

Accordingly, the Appellate Division concluded that the Comptroller's determination is not supported by substantial evidence.

Click HEREto access the text of the Appellate Division's decision.

* Matter of Rizzo v DiNapoli, 2022 NY Slip Op 06027, posted on the Internet at https://www.nycourts.gov/reporter/3dseries/2022/2022_06027.htm, in which the Court of Appeals held "Substantial evidence supports the determination that the precipitating cause of petitioner's injuries was not an accident." 

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NYPPL Blogger Harvey Randall served as Principal Attorney, New York State Department of Civil Service; Director of Personnel, SUNY Central Administration; Director of Research, Governor’s Office of Employee Relations; and Staff Judge Advocate General, New York Guard. Consistent with the Declaration of Principles jointly adopted by a Committee of the American Bar Association and a Committee of Publishers and Associations, the material posted to this blog is presented with the understanding that neither the publisher nor NYPPL and, or, its staff and contributors are providing legal advice to the reader and in the event legal or other expert assistance is needed, the reader is urged to seek such advice from a knowledgeable professional.
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