Petitioner filed an application for accidental disability retirement [ADR] benefits based on psychological injuries she alleged she had sustained during an assault that occurred at her workplace. Petitioner's application for ADR was denied by the retirement system because Petitioner had not complied with the notice provisions of Retirement and Social Security Law §363(c).*
Ultimately a Hearing Officer sustained the denial of Petitioner's application for ADR benefits, finding, among other things, that Petitioner did not provide the Retirement System:
[1] Notice of the nature and extent of her injuries within 90 days of the incident; and
[2] The statutory exceptions with respect to such notice requirement did not apply in this instance.**
Upon administrative review, the New York State Comptroller [Respondent] sustained the Hearing Officer's decision and Petitioner commenced the instant CPLR Article 78 proceeding challenging the Respondent's determination.
Observing that Petitioner contends, and the Appellate Division said it agreed, that Petitioner's employer had actual notice of the incident at the time of its occurrence, the Appellate Division's decision noted that the statute "requires written notice" and to prevail absent such written notice Petitioner was required to demonstrate that an exception to the statutory notice requirement applied in her situation.
Addressing the specific exceptions cited by Petitioner, the Court's decision stated that Petitioner "did not file a claim for workers' compensation benefits, premised upon her alleged psychological injuries, until nearly 2½ years after the underlying incident occurred and well beyond the 30-day notice requirement set forth in Workers' Compensation Law §18." Further, the Appellate Division opined that "Even assuming that the Workers' Compensation Board elected to excuse this defect on the basis that [Petitioner's] employer had actual knowledge of the accident ... any decision in that regard would neither be binding upon [Respondent] nor preclude the denial of [Petitioner's ADR] application."
The Appellate Division then said that it was not persuaded that Petitioner may avail herself of "the good cause exception". While there was no question that an investigation was conducted almost immediately after the incident and numerous reports, summaries and statements were filed promptly thereafter, none of those documents filed, including Petitioner's own statements, described the nature of the assault as herein alleged, "nor do those contemporaneous records make mention of any injury".
Significantly the Court said there is "nothing irrational or unreasonable about [Respondent's] interpretation of the regulation as providing that the event that triggers the notice requirement is the occurrence that resulted in the disability, not the diagnosis of such disability".
Finding that the documentary evidence upon which Petitioner relied "failed to describe the nature of the accident and the resulting injuries alleged", the Appellate Division concluded that substantial evidence supported the Respondent's finding that Petitioner "cannot avail herself of the good cause exception" and sustained the Respondent's determination.
* Retirement and Social Security Law §363(c)(a) provides that "no application for accidental disability retirement benefits shall be approved unless the applicant has filed with respondent, within 90 days of the incident upon which the alleged disability is based, written notice of, among other things, the particulars of the incident and the nature and extent of the injuries sustained.
**Exceptions to the statutory notice requirement are provided for and include, as relevant here, where "notice of such accident [has been] filed in accordance with the provisions of the [W]orkers' [C]ompensation [L]aw" or "for good cause shown as provided by [the applicable] rules and regulations".
Click HERE to access the Appellate Division's decision posted on the Internet.