Claimant for Workers' Compensation benefits injured in the course of his work filed a claim for Workers' Compensation Benefits and subsequently filed a claim of alleged he he had also suffered psychiatric injuries as a result of the accident and requested a hearing on that issue.
Claimant's self-insured employer and its third-party administrator [Employer] conceded that Claimant had sustained head, neck, right shoulder and right leg injuries in the accident but contended that Claimant's death prevented an adequate development of the record on the disputed psychiatric conditions and thus required the abatement of that portion of the claim.
A Workers' Compensation Administrative Law Judge determined that the Claimant had presented prima facie medical evidence of posttraumatic concussion, headaches and amnesia, as well as adjustment disorder with mixed anxiety and insomnia, and continued the case for further proceedings.
The Workers' Compensation Board [Board], after considering the Employer's administrative appeal of the hearing officer's determination, disagreed, ruling that the psychiatric claim "abated" upon Claimant's death" and modified the claim for Workers' Compensation benefits to reflect such abatement of the claim with regard to Claimant's alleged psychiatric conditions. Claimant's representative appealed the Board's decision.
The Appellate Division confirmed the Board's ruling, explaining that in the event "an injured employee dies before his or her workers' compensation claim can be adjudicated, the Board has discretion to continue the proceeding, resolve any controversies and, if appropriate, make an award of workers' compensation benefits",
The Appellate Division's decision also noted that the Board has recognized that "due process concerns may be implicated in those cases if the claimant's death deprives a party of "the essential elements of a fair trial in resolving those controversies unless waived, including the opportunity to cross- examine witnesses, to inspect documents and to offer evidence in explanation or rebuttal".
Noting that the Board is vested with discretion to "decline[ ] to allow such a claim to proceed where the record is undeveloped and the employer or carrier is unable to cross-examine the deceased claimant regarding his or her allegation of a work-related injury or subject him or her to an independent medical examination on controverted issues such as causation and any alleged disability", the Appellate Division affirmed the Board's decision.
Click HERE to access the Appellate Division's decision posted on the Internet.