Although accidents suffered outside work hours and in public areas away from the workplace are typically "not compensable" within the meaning of the Workers' Compensation Law, there are a number of exceptions to this general rule

Claimant [Employee] for Workers' Compensation Benefits sustained serious injuries when he was struck by two motorized bicycles while crossing a street enroute to a bus stop on his way home after having attended his Employer's invitation-only event for members of his Employer's team. 

The Employer and its workers' compensation carrier [Employer] controverted Employee's application for Workers' Compensation benefits contending, among other things, that Employee's injuries did not arise out of and in the course of his employment. In response, Employee contended that his injuries were compensable under either the special errand or dual-purpose doctrines. 

Following administrative hearings, a Workers' Compensation Law Judge [ALJ] agreed with Employer and disallowed the Employee claim. Employee applied for, and was granted, an administrative review of the ALJ's decision. The Workers' Compensation Board [WCB] vacated the ALJ's ruling, finding that "the employer exercised a degree of control sufficient to find a causal nexus at the time of the accident." In so doing, the WCB noted that "[Employee] was acting in furtherance of the employer's business" at the time of the accident and that the change in environment and corresponding search for the appropriate bus stop "caused a greater risk of injury during a trip that was necessary to carry out a function of [Employee's] employment." Employer appealed the WCB's decision.

The Appellate Division said "In order for an injury to be compensable under the Workers' Compensation Law, it must arise both out of and in the course of employment". Although accidents that occur outside of work hours and in public areas away from the workplace are typically "not compensable", there are a number of exceptions to this rule exist, including, as relevant Claimant situation, "where there is a causal nexus between the accident and the employment". The court noted that "The test for determining whether specific activities are within the scope of employment or purely personal is whether the activities are both reasonable and sufficiently work related under the circumstances".

Noting that relevant considerations include, among other things, "the nature of the claimant's off-premises travel, whether the employer derives a benefit therefrom, and "[t]he degree of control exercised by the employer at the time of the accident".

With respect to event giving rise to Employee's injury, Employee testified that attending the event, which had been placed on "everyone's calendar" by one of the Employer's managers, was not only encouraged but was "absolutely, [100%]" part of his job requirements as participating in such "sessions and events ... were an integral part" of his duties as an account executive, and building positive working relationships with the Employer's business partners was "the only way" he and his coworkers could "sell anything." 

The Appellate Division also noted the Employee testified his Employer track[ed] every dollar of revenue and the amount of time and effort he expended in building these relationships impacted the metrics utilized to evaluate his performance.

Although the Employer's representative testified that employees were not required to participate in events such as the one underlying the instant action, he acknowledged that attendance at business partner events was "encouraged", explaining that the purpose of such events was to develop and maintain business relationships between the Employer's sales team and its business partners, which, in turn, allowed the Employer and its partners to better understand the different strategies that they should pursue in order to make sales.

The Appellate Division said that considering "the foregoing", it was satisfied that the WCB's finding of a causal nexus between the accident and Employee's employment is supported by substantial evidence. Despite the informal nature of the event, the Appellate Division opined that "it is readily apparent that the employer derived a benefit from [Employee's] participation in the event ... developing and maintaining business relationships that, in turn, ultimately generated increased sales and revenues for the [Employer].

Further, said the court, the record supports the WCB's finding that Employee's attendance at this work-related event "altered the usual geographical or temporal scheme of travel, thereby altering the risks to which [he was] usually exposed".

Accordingly, the Appellate Division affirmed the WCB's decision, noting that Employer's remaining arguments, to the extent not specifically addressed in its opinion, "have been examined and found to be lacking in merit".

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

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On September 26, 2024, CNN reported that The New York Times was first to announce the news of the federal government's indictment of New York City's mayor, Eric Adams, observing that the indictment follows a "months long federal investigation into [allegations of] campaign fundraising violations and foreign influence". CNN also noted that the alleged charges Mayor Adams is facing are not publicly known at this time. Click Read More for additional information.

A CPLR Article 78 action contended that certain new regulations promulgated by the New York City Civilian Complaint Review Board were invalid dismissed

A CPLR Article 78 action was filed by the "Police Benevolent Association of the City of New York, et al", [Plaintiffs'], challenging the New York City Civilian Complaint Review Board's [CCRB] expansion the definition of "Abuse of Authority" in its regulations to include "improper use of body worn cameras" [BWC]. On September 24, 2024 the Appellate Division sustained a Supreme Court decision dismissing the complaint. 

CCRB had promulgated this amendment to its regulations after a "detailed study" of the use of BWCs found "that officers often turned on their BWCs too late, prematurely turned them off, or failed to use them at all". 

Sustaining the change initiated by CCRB, the Appellate Division opined the amendment "is not irrational, unreasonable or inconsistent with the governing statute and [CCRB's action] should be given deference."

Citing Matter of Pell v Board of Educ. 0f Union Free School Dist. No. 1 of Towns of Scarsdale and Mamaroneck, 34 NY2d at page 231 and other decisions, the Appellate Division held that "definition's expansion is rational and supported by the detailed study and that decisions in prior cases concerning other expansions of the "Abuse of Authority" definition "did not compel a different result".

The court also noted that CCRB's addition of a definition of "severe act of bias" was not done in excess of CCRB's jurisdiction nor was it promulgated in an arbitrary and capricious manner and the challenged regulation is not "inconsistent with the statutory text" as the City Counsel expressly delegated to CCRB the authority to define the phrase.

The Appellate Division further opined that "The new regulation delegating CCRB's authority to initiate complaints was also an appropriate exercise of jurisdiction", pointing out that the Petitioners did not challenge the breadth of the delegation but argue that CCRB is not authorized to delegate this authority at all. 

The court ruled that "A plain reading of the Charter shows that CCRB is empowered to initiate complaints on its own" and to "appoint such employees as are necessary to exercise its powers, including but not limited to the power to initiate complaints ... and fulfill its duties", citing §440[c][1], [5] of the New York City.

The court also held that the amendment renaming two disposition categories, [1]  from "unsubstantiated" to "unable to determine," and [2] from "exonerated" to "within NYPD guidelines" was not arbitrary and capricious", noting that there was evidence in the record to support CCRB's position that "the changes would promote understanding by the public, both from feedback it received and from public hearing testimony".

The Appellate Division also rejected Petitioners' arguments to the contrary, explaining they do not prove a lack of sound basis in reason or that "the changes were akin without regard to the facts and [these] changes may not be disturbed simply because petitioners question the 'wisdom' of the agency's approach as to the terminology used".

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

An administrative denial of a claim for Social Security Disability Insurance benefits must be supported by substantial evidence to survive judicial review

Plaintiff-Appellant [Plaintiff] filed a claim for Social Security Disability Insurance benefits on her medical condition of major depressive disorder. After a hearing, the administrative law judge [ALJ] denied Plaintiff’s claim for benefits because the ALJ  determined that Plaintiff was not disabled within the meaning of the Social Security Act, 42 U.S.C. §§401–434. 

Plaintiff having exhausted the administrative appeals process, challenged the final administrative decision of the Social Security Administration [SSA] in the United States District Court for the Southern District of New York. The district court affirmed SSA's decision. 

In her appeal Plaintiff contended that SSA’s determination that she was not disabled during the period covered by her claim was not based on substantial evidence. The United States Court of Appeals, Second Circuit, agreed and vacated the district court’s judgment. It then returned the matter to the district court "with instructions to remand [the matter] to the agency for further proceedings".

Explaining the under 42 U.S.C. §405(g), "federal courts are permitted to engage in only “limited review of final SSA disability benefit decisions”, on an appeal from the denial of disability benefits, the Second Circuit "will focus on the administrative ruling rather than the district court’s opinion ... because the same standard of review applies to the agency’s decision, both in the district court and before a court of appeals”. Citing Estrella v. Berryhill, 925 F.3d 90, the Circuit Court said will then conduct a "plenary review of the administrative record to determine if there is substantial evidence, considering the record as a whole, to support the Commissioner’s decision and if the correct legal standards have been applied.”

In determining whether there is evidentiary sufficiency under this standard, a court is “required to examine ... contradictory evidence and evidence from which conflicting inferences can be drawn.” Noting that in the event the evidence "is susceptible to more than one rational interpretation, the Commissioner’s conclusion must be upheld.” However, this presupposes that the ALJ has not disregarded or misconstrued relevant evidence and has not applied incorrect legal standards.

Here, said the court Plaintiff argued that the ALJ "committed a categorical error" by denying her application for benefits without a medical opinion to support that decision in that the record. The Circuit Court that noted that the only substantive medical opinions was that of one physician, who opined that Plaintiff met the criteria of Listed Impairment 12.04 and did not have the capacity to perform even low stress work on a consistent basis.* 

As the record contained on one medical opinion which had concluding that Plaintiff was not disabled, Plaintiff contended that the ALJ’s decision was not supported by substantial evidence. The Circuit Court agreed, stating that "In the absence of a medical opinion contradicting sole physician's  opinion "substantive medical opinion" that Plaintiff meets the listed criteria, we must carefully scrutinize the rest of the record evidence to determine whether it supports the ALJ’s decision to partially discount [the physician's] opinion and conclude that Plaintiff did not meet those criteria. 

Noting that the Second Circuit has held that “the absence of an express rationale does not prevent [it] from upholding the ALJ’s determination regarding [an] appellant’s claimed listed impairment[] [where] portions of the ALJ’s decision and the evidence before [her] indicate that [her] conclusion was supported by substantial evidence,” in this instance the other portions of the ALJ’s decision and the record evidence here "do not provide substantial support for the ALJ’s conclusion that Plaintiff could adapt to changes in her environment or demands not already part of her daily life". 

The Circuit Court's decision also included the observation that "the ALJ herself found that Plaintiff had not “engage[d] in substantial gainful activity” after losing her part-time retail job ... implicitly recognizing that her venture into self-employment was insubstantial." To the extent that the ALJ’s cited evidence might suggest that Plaintiff was not disabled during some of 2018, the Circuit Court said this "certainly does not support a finding that [Plaintiff] was not seriously impaired well within her coverage period.

Holding that the ALJ’s determination that Plaintiff did not meet the 12.04 listing criteria is not supported by substantial evidence, the court concluded that the ALJ erred in finding that Plaintiff failed to establish that she was disabled under the Social Security Act and entitled to benefits at step three of the sequential analysis.

Circuit Court, stating it was "Reluctant, however, to determine that Plaintiff was in fact disabled, given that the absence of additional medical evidence stems from her failure to appear for a consultative examination" due to miscommunication, concluded that the better course is to remand the case to the agency for further proceedings, including a fuller consideration of the existing evidence and the results of a consultative examination.

Accordingly, the Circuit Court vacated the judgment of the district court and the case to the district court "with instructions to remand the case to the Commissioner for further proceedings not inconsistent with this opinion".

* In addition, two state agency psychologists also examined the record at the initial and reconsideration levels of the administrative process. Both opined that there was insufficient evidence to adjudicate Plaintiff’s claim.

Click HERE to access the Second Circuit Court of Appeals' decision posted on the Internet.

Challenging a disciplinary arbitration award pursuant to Article 75 of New York State's Civil Practice Law and Rules

An employee of a New York State agency [Appellant] commenced a CPLR Article 75 proceeding seeking to vacate or modify an arbitration award denying her grievance challenging charges of misconduct and insubordination that had been filed against her.

An Arbitrator had found Appellant guilty of the disciplinary charges and that imposing the penalty of termination from her position was appropriate. 

Supreme Court denied Appellant's challenge to the arbitration award and penalty imposed and Appellant appealed the Supreme Court's decision.

The Appellate Division, noting that "Judicial review of arbitration awards is extremely limited,* explained that "Where, as here, an arbitration award was rendered after a consensual arbitration process pursuant to the terms of a collective bargaining agreement, the award may not be vacated on the ground that the arbitrator exceeded his or her power unless it violates a strong public policy, is irrational, or clearly exceeds a specifically enumerated limitation of the arbitrator's power".

In this instance, said the court, Appellant failed to demonstrate that the arbitration award:

[1] Violated a strong public policy;

[2] Was irrational; or

[3] Clearly exceeded a specifically enumerated limitation of the arbitrator's power.

The court also noted that, contrary to Appellant's contention, the Arbitrator properly considered the Appellant's "entire record of employment in determining a penalty", and that the penalty of termination was not so disproportionate to the offenses charged as to be shocking to one's sense of fairness**.

Further, said the Appellate Division, Appellant "waived her contention that the Arbitrator was not impartial by failing to raise this contention upon becoming aware of the basis for the alleged bias or partiality" and, citing  Matter of Piller v Schwimmer, 135 AD3d 766 and Matter of Atlantic Purch., Inc. v Airport Props. II, LLC, 77 AD3d 824, "continued to participate in the [arbitration] proceeding."

* See Matter of Barella v State of New York Off. of Mental Health, 175 AD3d 495, citing Wien & Malkin LLP v Helmsley-Spear, Inc., 6 NY3d 471.

** See Pell v Board of Education, 34 NY2d 222.

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

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