Matter of the Claim of Frank McGann v Suffolk County Water Authority et al.
Attorneys and Parties
Brief Summary
Workers' compensation—occupational disease (bilateral carpal tunnel syndrome) and the Board’s ability to reject uncontroverted medical causation opinions.
The Workers' Compensation Board found insufficient credible medical evidence of an occupational disease causally related to claimant’s work and denied the claim.
The Board’s May 17, 2024 decision denying the occupational disease claim.
The Board misread or failed to consider uncontroverted medical addendums that accounted for claimant’s job duties and recreational pickleball activity and impermissibly fashioned its own medical opinion; its decision lacked substantial evidence.
Background
Claimant worked 32 years as a senior meter reader and developed progressive bilateral hand/wrist tingling and pain during the last two years before retiring in May 2021. He was diagnosed with bilateral carpal tunnel syndrome. Treating physician Harold Avella and the self-insured employer’s (SIE) orthopedic consultant Steven Goodman each opined the condition was causally related to repetitive work duties (tool use involving gripping, twisting, squeezing; valve operations; data entry; and collections). At hearing, the SIE raised Workers' Compensation Law § 114-a [authorizes disqualification/penalties where a claimant makes a material false statement or representation to obtain benefits], arguing claimant failed to disclose post-retirement pickleball. The Workers' Compensation Law Judge (WCLJ) directed medical addendums addressing the hearing testimony about job duties and pickleball. Avella and Goodman submitted addendums reaffirming causation after considering those details. The WCLJ established the claim for occupational disease; on administrative appeal, the Board reversed, and later denied reconsideration; claimant appealed.
Lower Court Decision
The Workers' Compensation Board rejected both doctors’ opinions as not credible or complete, citing inconsistencies in onset reporting, frequency of offending duties, limited detail provided to Goodman, and claimant’s failure to inform the doctors about pickleball. It concluded there was insufficient credible medical evidence of a causal relationship and denied the occupational disease claim.
Appellate Division Reversal
Reversed, with costs, and remitted. The court held the Board may not totally reject uncontroverted medical causation testimony and create its own medical opinion. The record showed both physicians submitted post-hearing addendums expressly considering claimant’s job duties and pickleball and still opined work-related causation. The Board misread or ignored these addendums; its determination lacked substantial evidence.
Legal Significance
Reaffirms that the Board’s power to weigh medical evidence does not permit it to disregard uncontroverted medical causation opinions or misread the record to fashion its own medical theory. Where physicians address credibility concerns (e.g., recreational activities) in addendums and remain consistent, the Board must engage with that evidence and apply the substantial evidence standard.
When all credited medical opinions—updated to reflect full job-duty and recreational-activity facts—support occupational causation, the Board cannot deny benefits by ignoring those addendums or substituting its own medical view; such a decision will be reversed for lack of substantial evidence.