Workers' Compensation Board rejected a claimant's application for review of a Workers' Compensation Law Judge's decision because it was not filled out completely

The Workers' Compensation Board ruled that a Claimant failed to comply with the requirements of 12 NYCRR 300.13 (b) and denied review of a decision by the Workers' Compensation Law Judge. The Board found that the application for Board review was defective because it was not filled out completely and, as a result, denied Claimant's application.

Claimant appealed, contending that the Board abused its discretion in denying her application for Board review based upon her failure to comply with the rules governing the content of such applications that require the application to be filled out completely. The Appellate Division disagreed and sustained the Board's determination.

The court noting that "the Board 'may adopt reasonable rules consistent with and supplemental to the provisions of [the Workers' Compensation Law],' and the Chair of the Board 'may make reasonable regulations consistent with the provisions of [the Workers' Compensation Law],''' explained that where, as here, the Board's regulations provide that "an application to the Board for administrative review of a decision by a [WCLJ] shall be in the format as prescribed by the Chair [of the Board]" and "must be filled out completely."

Here Claimant was represented by counsel and filed her Form RB-89 application for Board review. Although question number 13 on that application requested that claimant provide the "[h]earing dates, [t]ranscripts, [d]ocuments, [e]xhibits, and other evidence" that she would rely upon in her administrative appeal and advised to "see [the] instructions for details," it is not disputed that Claimant's application failed to provide the requested information by leaving the box for question number 13 blank.

As the Board explains in its guidance document on this issue, the "RB-89 [form] is the application for review itself, and [it] is not merely a coversheet." By requiring an applicant to completely fill out the application for Board review, "the 'completeness doctrine' assists the responding party in identifying the exact issues, grounds and evidence used in support of the application in determining the issues and crafting a timely and effective rebuttal. Having a complete application . . . also assists the Board in providing timely and effective review of the application . . . as it eliminates confusion over which evidence is involved in the application and which issues are preserved for appeal."

Completion of an application for Board review, opined the Appellate Division, means that "each section or item of [the application or rebuttal] is completed in its entirety pursuant to the instructions for each form" and that a form is not filled out completely "when a party responds to sections or items on the form merely by referring to the attached legal brief or other documentation without further explanation." Accordingly, said the Appellate Division citing 12 NYCRR 300.13 [b] [4] [i], the Board may deny an application for review where the party seeking review, other than a claimant who is not represented by counsel, fails to fill out completely the application or otherwise fails to "comply with prescribed formatting, completion and service submission requirements" [Emphasis supplied].

The Appellate Division said that in its view, "the Board's format requirements for applications for Board review submitted by represented claimants are reasonable given the reasons identified by the Board and were promulgated pursuant to its statutory authority and "broad regulatory powers" and sustained the Board's decision that Claimant's application was defective because it was not filled out completely.

The decision is posted on the Internet at:

http://www.nycourts.gov/reporter/3dseries/2019/2019_05365.htm

Appointing authority rejects hearing officer's recommendation to continue benefits being provided police officer pursuant to General Municipal Law §207-c after the police officer suffered a job-related injury

The petitioner [Police Officer] in this CPLR Article 78 action suffered a job-related injury and was granted benefits pursuant to General Municipal Law §207-c* by the appointing authority Subsequently Police Officer  returned to work on a light-duty assignment and later was examined by a physician on behalf of the appointing authority. The physician reported that Police Officer was capable of returning to work on full duty as a police officer without restrictions.

The appointing authority terminated the Police Officer's §207-c benefits and directed that "he return to full duty, without restrictions." In accordance with the relevant provisions set out in a collective bargaining agreement [CBA], the Police Office requested a hearing and ultimately the designated hearing officer recommended that Police Officer continue to be provided with GML §207-c benefits. Notwithstanding the hearing officer's recommendation, the appointing authority issued a final determination denying the Police Officer's application for §207-c benefits finding that "based on the entire record" Police Officer was capable of performing his full duties as a police officer. Upon being notified that his light-duty assignment was terminated and being directed to return to work full time, without restrictions, Police Officer commenced this CPLR Article 78 proceeding, which Supreme Court transferred to the Appellate Division for its consideration.

The Appellate Division, citing Matter of Campo v City of Mount Vernon, 156 AD3d 694, explained that "[j]udicial review of an administrative determination made after a hearing at which evidence is taken pursuant to direction of law is limited to a consideration of whether that determination was supported by substantial evidence upon the whole record." Here, said the court, the hearing procedures were negotiated by the appointing authority and the Police Officer's union and memorialized in a CBA. The CBA provided that hearing officer was to issue findings of fact and make a recommendation on the questions certified to him. The appointing authority, however, retained full power and authority to render the final determination on the questions.

Noting that the hearing officer's findings are entitled to considerable weight, the Appellate Division explained that such findings "are not conclusive and may be overruled by the administrative authority, provided that the final determination is supported by substantial evidence."

Here, said the court, there was conflicting medical evidence and "it was for the administrative agency to choose between the conflicting opinions, and the courts are not free to reject the choice made by the administrative agency where room for choice exists." In words of the Appellate Division, [t]he testimony and opinion of the physician who examined the [Police Officer] on behalf of the [appointing authority] was rational and fact-based and, since a reasonable mind could accept that testimony and opinion, the determination of the [appointing authority] is supported by substantial evidence."  

The Appellate Division confirmed the appointing authority's determination terminating Police Officer's  light-duty assignment and directing him to return to work full time and dismissed the Police Officer's petition "on the merits, with costs."

* GML 207-c provides for the payment  of the salary, wages, medical and hospital expenses of   law enforcement personnel suffering injuries or illness incurred in the performance  of their law enforcement  duties. GML 207-a provides similar benefits to firefighting personnel suffering injuries of illness incurred in the performance of their firefighting duties.

The decision is posted on the Internet at:

http://www.nycourts.gov/reporter/3dseries/2019/2019_05670.htm

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Relying on the continuing wrong doctrine to determine if an Article 78 petition was timely filed

CPLR Article 78 requires that a challenge to an administrative determination be commenced within four months of the time the determination becoming "final and binding upon the petitioner." An administrative determination becomes final and binding for the purpose of trigging the running of the statute of limitations when the determination "has its impact" on the petitioner.

In this instance the petitioner [Plaintiff] commenced her CPLR Article 78 action seeking judicial review an administrative determination by her employer [Town] that classified her as an employee hired after December 31, 2014. This determination made her subject to a 15% health insurance premium contribution requirement set out in the controlling Taylor Law collective bargaining agreement.

Town moved to dismiss Plaintiff's petition as untimely, well as for other reasons. The court concurred with the Town's argument that as its administrative decision was made, in effect, on December 31, 2014, Plaintiff's Article 78 action  commenced more than two years later was untimely and dismissed her petition. Plaintiff appealed the court's ruling.

The Appellate Division opined that an administrative determination regarding payment of salary or pay adjustments is final and binding, and a challenge thereto accrues, when the employee receives a check or salary payment reflecting the administrative determination, noting that the new, now required 15% health insurance premium contribution was reflected in Plaintiff's first paycheck issued in April 2015, more than two years prior to the commencement of this Article 78 action.*

Addressing Plaintiff's argument that her Article 78 was timely under the "continuous wrong doctrine," the Appellate Division, citing Selkirk v State of New York, 249 AD2d 818, indicated that the continuing wrong doctrine "may only be predicated on continuing unlawful acts and not on the continuing effects of earlier unlawful conduct." In other words, courts distinguish between a single wrong that has continuing effects or impacts and [2] "a series of independent, distinct wrongs" in order to determine if the continuing wrong doctrine is viable under the facts alleged in this action.

As the Town had decided that Plaintiff was an employee hired after December 31, 2014, triggering her being required to pay a 15% health insurance premium contribution, Plaintiff first felt the impact of this administrative determination upon receiving her first paycheck issued to her in April 2015, more than two years before Plaintiff filed her Article 78 petition, the Appellate Division opined that "[e]ach subsequent paycheck deduction 'represent[ed] the consequences of [that allegedly] wrongful act in the form of continuing damages,' and was not an independent wrong in itself."

Accordingly, the court ruled that the doctrine "does not apply here to toll the statute of limitation and  sustained the Supreme Court's determination dismissing Plaintiff's petition as untimely.

* The Appellate Division also noted that Plaintiff's untimely filing of a grievance did not toll the running of the statute of limitations which, for the purposes of perfecting her Article 78 action, commenced when, at the latest, Plaintiff received her first paycheck issued in April 2015.

The decision is posted on the Internet at:

http://www.nycourts.gov/reporter/3dseries/2019/2019_05671.htm