October 17, 2023

Determinations by certain other entities not binding on a retirement system's medical board if the medical board's decision is supported by substantial evidence

Supreme Court denied Plaintiff's petition to annul Medical Board's determination rejecting Petitioner's application for accidental disability retirement [ADR] benefits and dismissed the proceeding Petitioner brought pursuant to CPLR Article 78. The Appellate Division unanimously affirmed the lower court's ruling, without costs.

The Appellate Division opined "Petitioner has not shown that [the Medical Board's] determination to deny her application for ADR benefits was arbitrary and capricious or made in violation of lawful procedure", citing Matter of Meyer v Board of Trustees of N.Y. City Fire Dept., Art. 1-B Pension Fund, 90 NY2d 139.

The court explained the evidence submitted at the hearing included the Medical Board's physical examination of Petitioner and its exhaustive review of the conflicting medical evidence from examining physicians, as well as Petitioner's acknowledgment that she could, without assistance, "perform daily life activities such as bathing, dressing, and walking." The Appellate Division's decision also noted "the Medical Board concluded that [Petitioner] did not complain of pain in her back, neck, and extremities when she went to the emergency room immediately after the accident underlying her request for ADR benefits, and that her various orthopedic problems were part of a normal degenerative process in a middle-aged person."

The Appellate Division's opinion noted that the Medical Board's determination conflicted with the finding of the Social Security Administration that awarded Petitioner disability benefits and Petitioner acknowledged "the finding of the Social Security Administration is not binding on the Medical Board [see Matter of Fusco, 136 AD3d at 451]".

Similarly, public safety officers and firefighters who have been deemed as suffering an occupational injury or disease within the meaning of the Worker's Compensation Law are sometimes disappointed to find that decisions of the Workers' Compensation Board have no bearing on their eligibility for other benefits such as accidental retirement benefits or General Municipal Law §207-a or §207-c benefits. For example, in Balcerak v County of Nassau, 94 NY2d 253, the Court of Appeals ruled that entitlement to benefits under the Workers' Compensation Law and General Municipal Law §207-c are discrete and entirely independent of one another. 

Click HERE to access the Appellate Division's decision posted on the Internet.

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