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Applying statutory presumptions in resolving a workers? compensation claim

By Harvey Randall, Esq.

Applying statutory presumptions in resolving a workers? compensation claim
Matter of Renee S. Thompson v Genesee County Sheriff?s Dept., 43 A.D.3d 1252, Appellate Division, Third Department

Section 21 of the Workers? Compensation Law sets out a number of statutory presumptions to be used in adjudicating a claim for workers? compensation benefits. The proper application of these presumptions was the critical issue in resolving the Thompson case.

The Workers? Compensation Board ruled that the death of a Genesee County correction officer was not causally related to his employment and denied his widow?s claim for workers? compensation death benefits.

According to the decision by the Appellate Division, Correction Officer Thompson had a history of heart problems and had been previously diagnosed with cardiac arrhythmia.

After fact finding, a Workers? Compensation Law Judge determined that a work-related ?? scheduling of firearms training was the last in a series of incidents placing [Deputy Thompson] in a dangerous and precarious position with respect to his heart.?

The Law Judge concluded that ?stress from [Thompson?s] job caused [his] fatal arrhythmia.? The Workers? Compensation Board reversed the Law Judge?s determination, finding that Deputy Thompson?s death not to have been causally related to his employment. Thompson?s widow, Renee S. Thompson, appealed.

The Appellate Division reversed the Workers? Compensation Board?s decision, ruling that:

Inasmuch as there is no dispute that decedent?s initial injury occurred while he was working at his place of employment, he was entitled to the [Section 21] statutory presumption that the injury arose out of and in the course of such employment, and, considering that the cause of decedent?s fatal arrhythmia remains unexplained, the statutory presumption should have been invoked.

Although, said the court, Workers? Compensation Law §21 ?[does] not completely relieve claimant from the burden of demonstrating that decedent?s death arose out of and in the course of [the decedent?s] employment, a showing that the injury directly resulting in decedent?s death occurred during the course of decedent?s employment and that the injury was unwitnessed or unexplained is sufficient to entitle a claimant to the application of the presumption.?

Accordingly, the Board was incorrect in requiring Renee Thompson to come forward with evidence of a causal relationship before applying the statutory presumption in this case. The Appellate Division then pointed out that:

Once a claimant has established his or her entitlement to the statutory presumption, the burden shifts to the workers? compensation carrier to present ?substantial evidence to the contrary which, as a matter of law, precludes the Board from crediting any explanation for the death except that offered by the employer.?

Thus, said the Appellate Division, considering ?the social policy underlying the Workers? Compensation Law, as embodied in the presumption of compensability set forth in Workers? Compensation Law §21(1) ? [the presumptions] should have been resolved in favor of claimant and her children, not against them.?

Once the statutory presumption is applied and the burdens are properly placed, it is clear, said the court, that the insurance carrier failed to meet its burden and reversal of the Board?s determination is required.

Full post as published by New York Public Personnel Law on April 25, 2008 (boomark / email).