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Jul 26, 2021

Surviving Spouse Fails to Show Causal Connection Between NY Injury and Decedent’s Subsequent Death

A New York appellate court affirmed a determination by the state’s Workers’ Compensation Board that the surviving spouse of a deceased worker failed to establish—by competent medical evidence—that his wife’s death was causally connected to her employment [Matter of Herris v. United Parcel Serv., 2021 N.Y. App. Div. LEXIS 4634 (3d Dept. July 22, 2021)]. Acknowledging that the decedent had developed substance abuse issues arising out of her earlier compensable injuries, and that she died following a night of heavy drinking and a possible narcotics overdose, the appellate court stressed that there had been no autopsy to determine the actual cause of death. Moreover, the expert medical evidence offered by the decedent’s husband was too speculative to support an award.

Background

Claimant’s wife—the decedent—had coronary artery disease that led to a heart attack in 2002. Her failure to heal properly from the ensuing coronary bypass surgery required additional surgeries to repair her sternum and chest wall. In 2006, she sustained work-related injuries when she reinsured her chest while lifting a package at work. The decedent underwent a series of surgeries to address that injury and problems involving her shoulder, knee and back that related back to it in varying ways, developed consequential depression, and was eventually classified with a permanent partial disability.

In July 2014, the decedent collapsed at home and died, after which claimant sought workers’ compensation death benefits. The WCLJ disallowed the claim, determining that the decedent’s death was not causally related to her employment. The Board affirmed, and claimant appealed.

Appellate Court: Burden Was on Claimant

Acknowledging that the claimant was not required to show that decedent’s work-related illness was the sole or most direct cause of her death, the court stressed that he did nevertheless bear the burden of establishing—by competent medical evidence—that a causal connection existed between decedent’s death and her employment.

Night of Heavy Drinking, Possible Narcotic Overdose

The claimant indicated that the decedent died after a night of heavy drinking and that a narcotics overdose was suspected, but no autopsy was performed, and her death certificate did not list a cause of death. The claimant instead relied upon the report of a physician who, after reviewing decedent’s medical records and speaking to claimant about decedent’s lifestyle, opined that decedent’s compensable injuries had led to pain and “significant emotional trauma” that, in turn, caused substance abuse issues that contributed to her death.

The appellate court noted, however, that the Board had rejected that opinion as unsupported and speculative. The physician had not treated the decedent; his opinion relied upon a description of decedent’s pain and substance abuse issues from claimant that the appellate court noted “was far from thorough.”

IME Physician Cast Doubt on Causal Connection

The court also noted that the Board had credited the report and testimony of a physician who conducted an independent medical examination at the behest of the employer and its workers’ compensation carrier. This physician concluded that, although decedent’s death might have been connected to substance abuse issues arising out of her compensable injuries, it could have also been “solely related to [her] underlying coronary artery disease.” The IME physician opined that the medical evidence simply did not permit a finding one way or the other.

The appellate court accorded deference to the Board’s assessment of credibility, finding that substantial evidence supported the Board’s determination that claimant did not establish the requisite causal link between the decedent’s work-related injuries and her death.