A patrol officer [Claimant] employed by a self-insured Sheriff's Department, filed a claim for workers' compensation benefits stemming from injuries to his jaw and head that occurred when he was assaulted by an individual while on duty. After Claimant's case was established he requested that his claim for benefits be amended to include "a causally-related injury to his left shoulder" based upon, in part, proof that he had been granted General Municipal Law §207-c benefits for that injury.
The Workers' Compensation Board [Board] determined that Claimant did not sustain a causally-related injury to his left shoulder and denied benefits base on this claim. Claimant appealed the Board's ruling.
Citing Workers' Compensation Law §2[7], the Appellate Division affirmed the Board's decision, explaining an injury is compensable only where it "aris[es] out of and in the course of employment" and the Claimant seeking benefits, "bears the burden of establishing, by competent medical evidence, a causal relationship between an injury and his or her employment." Further, said the court, the "factual determination" is the Board's and such decision will not be disturbed if supported by substantial evidence.
The Appellate Division's decision notes that Claimant testified that he injured his left shoulder while attempting to place restraints on an uncooperative, disorderly individual during the underlying incident but he had not asserted left shoulder injury in his initial claim for benefits and he did not seek medical attention for the alleged shoulder injury until five months following the incident. Further, said the Appellate Division, Claimant's "emergency room medical reports from the day of the incident reveal no concerns or complaints regarding his shoulder."
Significantly, a physician who evaluated Claimant on behalf of the Sheriff's Department opined that, based upon his review of Claimant's medical records and a physical examination, "Claimant's left shoulder injury was not causally-related to the underlying incident."
Addressing Claimant's arguments that relied on his being provided with General Municipal Law §207-c benefits, the Appellate Division opined that "it has long been held that Workers' Compensation Law and General Municipal Law §207-c are discrete statutory schemes designed to fulfill different purposes" and "do not necessarily examine and determine the same issue, in the same way, and under the same protocols, procedures and conditions, " citing Matter of Balcerak v County of Nassau, 94 NY2d 253.
Concluding that "substantial evidence supports the Board's conclusion" that Claimant did not sustain a causally- related injury to his left shoulder, the Appellate Division held that the Board's conclusion "will not be disturbed."
Click HEREto access the Appellate Division's decision posted on the Internet.
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