The Medical Board's recommendation that an application for performance of duty disability retirement benefits be denied is conclusive if it is supported by some credible evidence and is not arbitrary or capricious

Supreme Court annulled a determination by the Board of Trustees of the New York City Employees' Retirement System [Trustees] denying the application of a retired New York City correction officer, [Petitioner] for performance of duty disability retirement benefits based on its Medical Board's recommendation and directed that the Petitioner be granted performance of duty disability retirement benefits retroactive to March 11, 2016.

The Appellate Division reversed the Supreme Court's ruling, on the law, with costs, and confirmed the Trustees' determination and dismissed Petitioner's CPLR Article 78 proceeding on the merits.

The Appellate Division explained that the Trustees' Medical Board's determination is conclusive if it is supported by some credible evidence and is not arbitrary or capricious, citing Matter of Solomonoff v New York City Employees' Retirement Sys., 188 AD3d 700. Further, opined the court, in the event there is conflicting medical evidence involved in the proceeding, the "resolution of a conflict in the medical evidence is solely within the province of the Medical Board.

Noting the decision in Topkin v Board of Educ. of City School Dist. of N.Y., 121 AD2d at 531, the Appellate Division said:

1] "The board is privileged to accept the medical reports of its own expert over those of a claimant"

2. "A mere conflict in opinion among physicians is not a ground for disturbing a determination; and

[3] "Courts may not 'substitute [their] own judgment for that of the Medical Board,' citing Matter of Borenstein v New York City Employees' Retirement Sys., 88 NY2d at 761.

Click HERE to access the full text of the Appellate Division's decision in this appeal. 

 

Law practice management software

Nicole Black, a Rochester, New York attorney, has posted an item on her law blog, Sui Generis, providing a "round up" of law practice management software, litigation fact management software, ABA Techshow and more.

Click HERE to access her post.

 

Audits and reports issued by the New York State Comptroller during the week ending April 16, 2021

New York State Comptroller Thomas P. DiNapoli announced the following audits and reports were issued during the week ending April 16, 2021.

Click on the text highlighted in color to access the complete audit report.

MUNICIPAL AUDITS

Village of Shoreham – Board Oversight and Justice Court (Suffolk County)  Auditors found the board did not properly oversee the village’s financial operations and the Justice Court did not properly account for court funds. Auditors found 22 claims totaling $132,819 were paid without support, duplicate receipts were rarely issued and not all cash was deposited in a timely manner. The board also did not annually audit the clerk-treasurer's or court's records and reports. For the court, 70 tickets could not be accounted for, duplicate receipts were not always issued and bank reconciliations and accountability analyses were not complete or reconciled. In addition, receipts totaling $3,435 were collected and deposited but payments to the clerk-treasurer and reported to the Justice Court Fund only amounted to $3,360.

SCHOOL DISTRICT AUDITS

Hudson City School District – Information Technology (Columbia County) District officials did not adequately secure and protect its information technology (IT) systems against unauthorized use, access and loss. The board and district officials also did not adopt adequate IT policies or a disaster recovery plan. Auditors found questionable internet use on four of six computers tested. School officials also did not disable 123 of the 462 enabled network accounts auditors examined. These 123 user accounts were not needed and included generic and former employee accounts. In addition, sensitive IT control weaknesses were communicated confidentially to officials.

 

Royalton-Hartland Central School District – Information Technology Contingency Planning (Genesee County, Niagara County and Orleans County) The board and district officials have not developed and adopted a comprehensive written information technology (IT) contingency plan. The district pays $10,500 for central site infrastructure support, which includes a disaster recovery plan template, a key component of an IT contingency plan. Although the district paid for a template, officials did not obtain it. Without a comprehensive written IT contingency plan in place that is properly distributed to all responsible parties and periodically tested for efficacy, district officials have less assurance that employees will react quickly and effectively to maintain business continuity. As a result, important financial and other data could be lost, or suffer a disruption to operations.

Westhampton Beach Union Free School District – Extra-Classroom Activity Funds (Suffolk County) The extra-classroom activity clubs did not maintain adequate records. Therefore, auditors could not determine whether all funds received and disbursed were properly accounted for. Deposits were not always supported by school deposit forms or accurately completed bank deposit slips and activity logs.

 

Wyandanch Union Free School District – Budget Review (Suffolk County) Auditors found that the significant revenue and expenditure projections in the proposed budget are reasonable. District officials did implement the recommendations in Comptroller DiNapoli’s July 2020 budget review letter. The district's proposed budget complies with the tax levy limit because it includes a tax levy of $22,922,337, which is within the limits established by law.

 

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Find out how your government money is spent at Open Book New York. Track municipal spending, the state's 180,000 contracts, billions in state payments and public authority data. Visit the Reading Room for contract FOIL requests, bid protest decisions and commonly requested data.

 

Tolling the running of the statute of limitations to permit the reinstatement of an action

In this decision the Appellate Division addressed the application of the statute of limitations with respect to certain proceedings encountered in the course of a CPLR Article 78.

Typically the statute of limitations for filing a timely Article 78 petition is four months from the time that the determination to be reviewed becomes final. CPLR 205(a), however, provides, in pertinent part, that [i]f an action is timely commenced and is terminated in any other manner than by ... a dismissal of the complaint for neglect to prosecute the action, ... the plaintiff may commence a new action upon the same transaction or occurrence ... within six months after the termination ....

In contrast, the CPLR provides that in the event a dismissal is one for neglect to prosecute the action, "the judge shall set forth on the record the specific conduct constituting the neglect, which conduct shall demonstrate a general pattern of delay in proceeding with the litigation."

Further, explained the Appellate Division, "CPLR 205(a) is a tolling provision, which serves the salutary purpose of preventing a Statute of Limitations from barring recovery where the action, at first timely commenced, had been dismissed due to a technical defect which can be remedied in a new action". It is "designed to insure to the diligent suitor the right to a hearing in court until he or she reaches a judgment on the merits,"citing Wells Fargo Bank, N.A. v Eitani, 148 AD3d 193.

Thus, said the court, the "'neglect to prosecute' exception in CPLR 205(a) applies not only where the dismissal of the prior action is for '[w]ant of prosecution' pursuant to CPLR 3216, but whenever neglect to prosecute is in fact the basis for dismissal."

Accordingly, the court in this proceeding opined that "the tolling provision of CPLR 205(a) is inapplicable where, as here, over the course of nearly 14 months, a litigant fails to timely perfect a proceeding and fails to make any effort to obtain an extension of time to perfect, citing Andrea v Arnone, Hedin, Casker, Kennedy & Drake, Architects & Landscape Architects, P.C. [Habiterra Assoc.], 5 NY3d at 521.

Click Here to access the full text of the Appellate Divisions decision.

 

Middletown chiropractor sentenced to nine years for insurance fraud

On April 13, 2021, New York State Comptroller Thomas P. DiNapoli announced James “Jay” Spina was sentenced in federal court for running a large-scale healthcare insurance fraud scheme. Spina and three co-conspirators systematically double-billed insurers, charged for services never rendered, created shell companies and falsified records to hide their crimes.

In 2018, Spina and three others were charged with billing insurers for medically unnecessary services and procedures, submitting claims for services not rendered, double-billing for services, fabricating medical records and concealing the fraud by blocking audits. The submitted claims totaled more than $80 million. All four individuals who were charged have pleaded guilty.

Spina pled guilty to one count of conspiracy to commit healthcare fraud and was sentenced to serve 108 months (nine years) in federal prison, plus three years of probation and pay $9.7 million in restitution and forfeit $9.1 million. The co-conspirators are awaiting sentencing.

DiNapoli said “This type of fraud harms all New Yorkers and contributes to higher health care costs across the state and country." He thanked  U.S. Attorney Audrey Strauss, the FBI, the U.S. Department of Health and Human Services Inspector General and the Orange County Sheriff's Office for their aid and assistance in this matter.

U.S. Attorney Audrey Strauss said: “James Spina led a sophisticated, widespread, and callous scheme that put greed and profits ahead of patients and their well-being.  In doing so, he betrayed his professional obligations and bilked insurance companies and Medicare out of millions of dollars.  Thanks to the coordinated efforts of federal and state investigative agencies, Spina will now serve a lengthy sentence in federal prison.”

Since taking office in 2007, DiNapoli has committed to fighting public corruption and encourages the public to help fight fraud and abuse.

Reports of alleged of fraud involving taxpayer money may be made by calling the toll-free Fraud Hotline at 1-888-672-4555, by mailing a report to the Office of the State Comptroller, Division of Investigations, 14th Floor, 110 State St., Albany, NY 12236, or via Internet at https://www.osc.state.ny.us/investigations.

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Claimant who voluntarily retired became ineligible for workers' compensation benefits after the effective date of such retirement

An individual working for a public employer [Claimant] suffered an injury on the job and was classified as permanently partially disabled. Awarded benefits "for reduced earnings," Claimant continued to perform her duties with her employer "on a fairly consistent basis for many years."

When Claimant decided to retire, she opted for "regular service retirement" because she had reached the eligibility age and did not seek disability retirement benefits.  The Workers' Compensation Board found that Claimant's work-related injuries did not cause or contribute to her decision to retire and thus she was not entitled to an award of reduced earnings subsequent to the date of her retirement. Claimant appealed the Board's determination.

Although Claimant stated that she received medical advice from one physician to retire, the Appellate Division noted that the record did not contain any substantiating medical documentation supporting her having received such advice from a physician. 

The Appellate Division sustained the Board's determination that Claimant withdrew from the labor market voluntarily when she retired and thus she was not entitled to a Workers' Compensation award for "reduced earnings" subsequent to the effective date of her retirement.

Click HEREto access the Appellate Division's decision.

Determining workers' compensation benefits in situations where the employee suffered a disability that is not amenable to a schedule award

The Appellate Division affirmed a decision by the Workers' Compensation Board in which the Board ruled, among other things, that the claimant sustained a 32.5% loss of wage-earning capacity.

Citing Matter of Varrone v Coastal Envt. Group, 166 AD3d 1269, the court opined that "In situations where, as here, a claimant sustains a permanent partial disability that is not amenable to a schedule award, the Board must determine the claimant's loss of wage-earning capacity in order to fix the duration of benefits".

The court agreed with the Board's method for determining the loss of wage-earning capacity for a claimant with a non-schedule permanent partial disability, which involved the evaluation of three elements: 

1. The nature and degree of the medical impairment;

2. Functional ability/loss; and

3. Non-medical vocational factors such as education, skill, training, age and literacy.

Click HERE to access the Appellate Division's decision.

Government Technology webinar - update for the week of April 12, 2021

How Vallejo Boosted Economic Development in a Post-Pandemic Economy
Leaders from the city of Vallejo, Calif. explore the business challenges faced by the city and how a mission critical, cloud-platform solution was implemented to enable residents to do business with the city electronically, reduce call volumes and decrease processing backlogs, and boost economic development during a time of growing fiscal uncertainty. Watch Now

How King County Took a Hybrid Cloud Approach to Modernization
Most government leaders recognize the value cloud can bring to their organizations. However, they also realize that shutting down to undertake a wholesale cloud migration isn’t realistic. Instead, they must follow a hybrid approach — taking a series of incremental, bite-sized steps toward cloud migration while continuing to manage on-premises data centers, applications and other legacy systems. Watch Now

Using DevOps Metrics to Effectively Contain Costs
The current economic climate has severely impacted budgets. Reducing institutional costs and increasing efficiencies will be a top priority in 2021 and beyond. This webinar will take a deep dive into cost control strategies that can simultaneously help government organizations accelerate their digital modernization efforts. Watch Now

High-Velocity Service Management: Delivering Constituent Services Better, Faster and Cheaper
Constituents’ needs and expectations are constantly changing and evolving, which is why governments are working hard to deliver citizen services faster and more effectively than ever before. Automation helps agencies modernize constituent service management and streamline workflows. But most full-scale service desk solutions remain too costly for many governments, especially at a time of severe budget constraints. Watch Now

A MASTER CLASS: How to Create a Resilient Government of Tomorrow
The topic of resilience is especially important as governments emerge from the pandemic only to find their needs have grown while their resources have become more limited. As they move forward, how will governments lay the proper foundation for their resilience needs and design the right strategy to ensure resilience? How will they implement this strategy? These are important questions this masterclass will help answer in five modules. Start the Class Now

To view more on-demand and upcoming webinars, visit webinars.govtech.com.

For assistance with registration, contact:
Jeremy Smith, jsmith@erepublic.com (916) 932-1402 direct

 

Vaccine Passports: New York

How Excelsior Pass, the First U.S. Vaccine Passport, Works 

[Source: GOVTECH TODAY]

The idea of vaccine passports is drawing its share of controversy, but while some states are shutting the idea down, New York’s Excelsior Pass is off and running. GT’s Ben Millerbreaks down what the tool does and doesn’t do. And a contributed piece on GT this week considers whether blockchain technology has a role to play in the creation of secure vaccine passports. 

Click HERE to access the full text of the article posted by GOVTECH TODAY.

 

New York State Comptroller Releases Municipal and School District Audits

New York State Comptroller Thomas P. DiNapoli released the following audits of government entities during the week ending April 11, 2021.

Click on the text in COLOR to access the audit report.

Municipal Audits

• Albany Water Board
• City of Peekskill
• Grand Gorge Fire District
• Masonville Fire District
• Middletown No. 1 Fire District
• Town of Greenwich
• Town of New Hudson
• Village of Head of the Harbor

 

School District Audits

• Briarcliff Manor Union
• Broadalbin-Perth
• Cherry Valley-Springfield
• Hamilton
• Ravena-Coeymans-Selkirk

 

Judical review of rejections of Freedom of Information requests for public records

The petitioner [Plaintiff] in this first CPLR Article 78 of two Freedom of Information Law [FOIL] actions sought a court order to compel the agency to produce certain public records Plaintiff had demanded. Supreme dismissed the proceeding and Plaintiff appealed.

The Appellate Division vacated the dismissal of the action by Supreme Court in part and remanded the matter "to a different judge" for further proceedings "consistent with [the Appellant Division's] order".

Citing Matter of Lesher v Hynes, 19 NY3d 57, the court explained that the agency "failed to meet its burden of establishing that disclosure of any records responsive to [Plaintiff's] FOIL request would "interfere with law enforcement investigations or judicial proceedings," and, in any event, that the exemption no longer applies "after enforcement investigations and any ensuing judicial proceedings have run their course".

The Appellate Division also noted that it rejected the agency's "broad arguments for withholding all of the responsive records" as to honor such a contention "would amount to a blanket exemption that would seemingly apply to virtually any records of any investigation conducted by [the agency]".

In the words of the court, "blanket exemptions for particular types of documents are inimical to FOIL's policy of open government." Click HERE to access this decision by Appellate Division.

The Appellate Division, however, dismissed a second appeal of Article 78 action involving anther FOIL application brought by the same Plaintiff seeking certain other public records.

In this second case Plaintiff sought a court order to compel the agency to disclose records for "all requests for religious accommodations (such as, dress, shifts etc.) by employees and the result thereof ... includ[ing] ... the job title and date," during a specified three-year period.

The court opined that Plaintiff "failed to describe the documents sought with sufficient specificity as to permit [the agency] to identify and locate them," citing Matter of Lebron v Smith, 40 AD3d 515, leave to appeal denied, 9 NY3d 810.

In addition, the agency had submitted an affidavit executed by its Director of Human Resources explaining that "such information [was] not stored in any centralized manner, and that the only way to attempt a complete response to the [Plaintiff's] FOIL request would be to have the agency's thousands of employees search through their paper and electronic records." 

Thus, said the court, the agency had established "a valid basis for denying the [Plaintiff's] FOIL request" by showing that any responsive records "are not indexed in a manner that would enable the identification and location of documents" in the agency's possession. Click HERE to access this second ruling by the Appellate Division.

 

 

The New York State Budget for Fiscal 2021-2022

Click HERE to access Governor Andrew M. Cuomo's summary of the budget for the State's fiscal year 2021-2022 designed "to reimagine, rebuild and renew New York in the wake of the ongoing COVID-19 pandemic."

On April 7, 2021 State Comptroller Thomas p. Dinapoli issued the following statement addressing the Legislature and Governor agreement on a new state budget.

"More than a year into the pandemic, the number of cases remain high in New York but the accelerated pace of vaccinations and job growth in many sectors indicate an improving economic outlook. We are not out of the woods, and we must remain cautious as there is still uncertainty about the epidemic and the trajectory and equity of the recovery. 

“The budget includes significant new resources from federal aid and from tax increases. Higher personal income tax rates on high-income taxpayers will likely increase the volatility of personal income tax collections, and will make combined state and local rates for New York City high-income earners the highest in the nation. Effects on the recovery of New York City and on the state and city budgets must be monitored closely.

“New revenues will support investments in education and health care programs, provide benefits to the middle class, and importantly offer relief to New Yorkers and small businesses who need it, including workers who have been excluded from federal stimulus aid. Helping struggling New Yorkers is essential for an equitable recovery.

“While much of the new resources may be temporary and necessary to meet current needs, it is important that spending not grow to unsustainable levels. The state must plan for the end of emergency federal aid and use new tax resources to fund essential services, to once again begin contributing to rainy day funds and to reduce projected out-year gaps. Long-term alignment of recurring revenues with recurring spending is essential to putting New York’s fiscal house in order.

“My office’s full analysis of the enacted state budget will be released in the following weeks.”