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Oct 13, 2020

NY Widow's Death Benefits Claim Filed 12 Years After Work Cessation Not Supported By Medical Evidence

A New York appellate court affirmed a decision by the state's Workers' Compensation Board that denied death benefits to a widow whose husband, a former correction officer, died in 2016, approximately 12 years after he stopped working for the employer [Matter of Turner v. New York State Dept. of Corr. & Community Supervision, 2020 N.Y. App. Div. LEXIS 5676 (Oct. 8, 2020)]. The court rejected the widow's contention that the claim was compensable because of the presumption contained in N.Y. Workers' Comp. Law § 21(1). It acknowledged that the presumption of compensability arose when an unwitnessed or unexplained death occurred during the course of the employee's employment, but stressed those facts were not present in the case.

Background

The correction officer last worked for the employer in 2004 and was classified with a permanent partial disability in 2007. Decedent died in 2016, and claimant thereafter filed a claim for workers' compensation death benefits, contending that decedent's post-disablement, sedentary lifestyle, and resulting weight gain were factors contributing to his death. The WCLJ denied the claim, finding insufficient evidence of a causally-related death. The Board affirmed.

Appellate Court

As noted above, the court rejected the widow's contention that the presumption applied. The court observed that the decedent's death occurred years after his employment as a correction officer had ceased and was neither unwitnessed nor unexplained; decedent died in a local hospital after emergency medical personnel were called to his home for reports of a gastrointestinal bleed, and the death certificate listed the cause of death as hypertensive heart disease. Under those circumstances, the court said even if the presumption had been applicable, it would have been effectively rebutted by the death certificate and the records of decedent's primary care physician, the latter of which revealed that decedent, who was morbidly obese and a smoker, suffered from chronic hypertension.

Pain Specialist's Testimony Not Persuasive

The court acknowledged that the decedent's pain management specialist opined that it was more likely than not that decedent's pain, spasm and sleep interruption were causally related to his prior established work injuries and that such conditions, in turn, more than likely contributed to decedent's sedentary lifestyle with increased weight and unstable blood pressure, and the decedent's ultimate demise. It also observed, however, that the pain specialist admitted that he had not reviewed any of the medical records maintained by decedent's treating physician prior to rendering his opinion as to a causal relationship between decedent's death and his previous employment. The pain specialist also admitted that he had not reviewed decedent's hospital records and that he was unaware of the circumstances giving rise to decedent's transport to the hospital and admission into the facility. The court said the Board was within its discretion to conclude that the pain specialist's opinion was insufficient to support a finding of a causally-related death.