5 N.Y.2d 259 | NY | 1959
Lead Opinion
Ralph Croshier had for many years been a Forest Ranger for the State Conservation Department. As such, he was engaged in the fighting and suppression of fires, frequently in thickly wooded, rough and hilly terrain, and, on occasion, for long periods of time. In October of 1953, when he was 57 years old, he had a mild cardiac insufficiency and then, several months later, suffered a myocardial infarction which hospitalized him for several weeks. When he returned to his duties in March of 1954, although advised by his doctor to take things easy and restrict himself to supervisory work, he continued to perform the very strenuous, albeit usual, activities expected of Forest Rangers. Then, about a year later, on April 11, 1955, he participated in extinguishing what was described as an “ average, nasty * * * little ” forest fire on a steep hill and, shortly after he had ceased his efforts, he collapsed and died from a heart attack.
Croshier had been a member of the New York State Employees’ Retirement System, and his widow, claiming that his
Section 61 of the Retirement and Social Security Law provides that an “ accidental death benefit ” shall be payable upon the death of a member if the Comptroller shall determine that he died before the effective date of his retirement 1 ‘ as the natural and proximate result of an accident sustained in the performance of duty ” (subd. a) and section 74 declares, that the Comptroller shall have “ exclusive authority ” to determine all applications for such a benefit (subd. b). The question thus presented is whether, despite this broad grant of authority to the Comptroller, the courts are required to annul his determination that a heart attack, precipitated by physical exertion on the part of the victim in the performance of his usual and customary work, voluntarily undertaken, is not an accident.
No all-inclusive definition of “ accident ” is possible, nor any formulation of a test applicable in every case, for the word has been employed in a number of senses and given varying meanings depending upon the relevant context. In this State, the question of whether one has suffered an accident has been considered in at least three different areas—in the field of accident insurance,
Although no great reliance may here be placed upon the accident insurance cases — reflecting an interpretation least favorable to the claimant — since their outcome turns on the particular language of the policy, it might well be thought that the same phrase found in two statutes dealing with related subject matter should receive identical interpretation and application. In point of fact, that was the position taken by this court in 1937, when it explicitly held that a decision of the Industrial Board (under the Workmen’s Compensation Law) that an injury was accidental was “ binding” upon the medical board of the Retirement System. (Matter of Nash v. Broohs, 276 N. Y. 75, 82; see Matter of Slattery v. Board of Estimate & Apportionment, 271 N. Y. 346, 353.) The Legislature, however, changed the law in 1938 to provide that the Comptroller was to have ‘ ‘ exclusive authority ’ ’ to determine all applications for any form of benefit under the retirement provisions (Civil Service Law, former § 54, subd. 5; L. 1938, ch. 577; now contained in Retirement and Social Security Law, § 74, subd. b; § 61, subd. a) and that “ No decision ” by the Workmen’s Compensation Board “ shall be binding” on the Comptroller in the matter of determining a claimant’s eligibility for an accidental disability or death benefit (Civil Service Law, former § 67, as amd. by L. 1938, ch. 407) and it added a provision in 1945 reciting that a “ final determination ” of the Board that “ benefits are payable pursuant to the workmen’s compensation law by reason of accidental disability or death of a member of the retirement system shall not in any respect, be or constitute, a determination that an accidental disability retirement allowance or death benefit is payable pursuant to the provisions of this article by reason of the accidental disability or death of such member ” (former § 67, subd. 3; L. 1945, ch. 714; now contained in Retirement and Social Security Law, § 64, subd. b).
Having in mind these significant amendments, the variant purposes sought to be achieved by workmen’s compensation and retirement system benefits and the very marked difference in the size of the respective payments, it “ seems reasonably clear ”, as
In Matter of McCadden v. Moore (276 App. Div. 490, affd. 301 N. Y. 760, supra), for instance, a police officer became disabled following a heart attack brought on by overexertion shoveling snow in the performance of his duty. His application for accidental disability benefits as a member of the Retirement System was denied by the Comptroller who found — contrary to the finding actually made thereafter by the Workmen’s Compensation Board — that the employee had not sustained an accident. The Appellate Division confirmed that determination and, in the course of its opinion, wrote that, although “ numerous cases could be cited in which awards have been affirmed by the appellate courts for a heart condition brought on by over exertion ”, the amendments to the Civil Service Law, to which we above referred, made it manifest that “ the duty of determining the question of fact as to whether or not an employee has sustained
To be educed from the McCadden case and those that followed is the principle that it is for the Comptroller to determine whether or not the employee had sustained an accidental injury and that, in making this finding, he is not bound by the accident concept adopted by the Workmen’s Compensation Board or by the test laid down in Matter of Masse v. Robinson (301 N. Y. 34) for compensation cases.
That the medical and physiological facts are not seriously in dispute does not convert the ultimate issue of whether the death was “ the natural and proximate result of an accident ” into a pure question of law on which this court has the final word. The inferences to be drawn from the testimony partake sufficiently
It is noteworthy that in the cases decided under the Workmen’s Compensation Law this court did nothing more than accept the Board’s finding, of accident or no accident, solely upon the ground that there was evidence to support it. Recognizing the rule which accords conclusiveness to administrative determinations, we never indicated that the Board’s finding that the employee had sustained an accident was compelled as a matter of law. The Comptroller stands as a trier of fact in the same position as the Board, and we will not announce a different rule for the findings which that official makes in carrying out the provisions of the Retirement Law.
The Appellate Division, in reaching a contrary conclusion, was of the opinion that this court had, in Matter of Owens v. McGovern (309 N. Y. 455, supra), indicated a narrower scope for the Comptroller’s determination. In that case, upon somewhat similar facts, we reversed a determination by the Comptroller, remitting the proceeding to him, because he had declined to admit the medical testimony offered on behalf of the claimant, but nothing we there decided or said was intended to change the law, firmly established long before Matter of Owens. Although, in the light of the arguments now advanced, the concurring opinion in Owens — the only one to which a majority of the court adhered—might have been clearer on the point, it does not suggest that the Comptroller, or the courts in reviewing his determination, would have to find that the employee sustained an accident if he overtaxed himself in doing his work. Indeed, as we actually wrote, if the findings and conclusions are supported by the record, then, “ the courts have no alternative but to accept them * * * even though such a course might * * * lead to a result at odds with that reached by the Workmen’s Compensation Board ” (309 N. Y., at p. 458). This is such a case.
The order of the AppeHate Division should be reversed, without costs, and the Comptroller’s determination confirmed.
. See Schecter v. Equitable Life Assur. Soc. of U. S., 275 App. Div. 958, motion for leave to appeal denied 300 N. Y. 763; Wilcox v. Mutual Life Ins. Co., 265 N. Y. 665; see, also, Burr v. Commercial Travelers Mut. Acc. Assn., 295 N. Y. 294, 305; Silverstein v. Metropolitan Life Ins. Co., 254 N. Y. 81, 85.
. See Matter of Masse v. Robinson, 301 N. Y. 34; Matter of Kehoe v. London Guar, & Acc. Ins. Co., 303 N. Y. 973.
. See Matter of McCadden v. Moore, 276 App. Div. 490, affd. 301 N. Y. 760, and other cases cited, infra, p. 264.
. Under the Retirement and Social Security Law, the fact that an employee sustained an accident bears not on coverage, but solely on the quantum of benefits to be paid; when an employee dies, his beneficiary will receive benefits even though death was not caused by an accident. Under the Workmen’s Compensation Law, however, there is no coverage whatsoever for the death of an employee (excluding eases of occupational disease) unless it was accidentally occasioned. The desire to give an employee the benefit of the statute’s coverage undoubtedly prompted the Board to utilize the more easily satisfied test of accident applied in the Masse case.
Dissenting Opinion
On this appeal we review a determination of the State Comptroller, made after a hearing before a
This decisional paradox is about to be resolved on the theory that the Legislature has endowed the Comptroller, acting through his deputy, with a unique type of juridical discretion whenever called upon to determine claims for benefits arising under the Retirement System and this, because the Legislature has said that a prior final determination by the Industrial Board “ shall not in any respect, be or constitute, a determination that an accidental disability retirement allowance or death benefit is payable pursuant to the provisions of this article by reason of the accidental disability or death of such member.” (Civil Service Law, former § 67, subd. 3.) While the Legislature thus excused the Comptroller from being bound by a prior determination of the Industrial Board attributable to the same accident, they did not thereby say that, in making a determination, he was no longer bound to follow accepted rules governing the making of decisions. On the contrary, when the Legislature gave the Comptroller “ exclusive authority to determine all applications for any form of retirement or benefit provided ” under the retirement statutes (Retirement and Social Security Law, § 74, subd. b), which includes a claim such as this, it was not a carte blanche permission to do as he pleased. To make sure such freedom would not be abused, the Legislature also specifically provided that the Comptroller was to make his determination “ on the basis of the evidence ” (Retirement and Social Security Law, § 61, subd. a). They thus embedded in the statute a rule of law which is fundamental to an orderly settlement of any controversy, whether tried in a court, by an administrator or other designated authority. In deciding as he did, the Deputy Comptroller has ignored this fundamental statutory precept to draw a conclusion of law contrary, not only to all the evidence on the issue, but contrary as well, to his own findings of fact.
On the day in question, April 11, 1955, during the forenoon he responded to a number of permit fires and false alarms. In the afternoon he responded to a fire alarm in a hilly region near Dean Boad, Putnam County. The fire was in a steep, woody and very rough terrain. To reach the area of the fire, the decedent had to cross a brook and climb through boulders and thick underbrush to “ a steep hill approximately 400 feet high ”. The decedent fought the fire for approximately two hours, during which time he carried on his back an Indian tank with hose weighing about 40 pounds, a long rake weighing 8 or 9 pounds and a hook. The fire was a bad one, requiring the services of the decedent and about 20 to 25 volunteer firemen to extinguish. As was his custom, the decedent stayed behind to make certain that the fire would not break out anew. He asked one of the volunteers to stay with him, saying: “ I am not feeling so good.” At that moment he collapsed and died before aid could reach him. It was this extraordinary physical exertion that ‘ ‘ precipitated the attack of coronary occlusion resulting in his death ”, a fact which the Deputy Comptroller has found. It was not
Here, the forest fire leading to the decedent’s untimely death was wholly unforeseen. It was sudden, unexpected and without foreseeable cause. It was catastrophic; as the hearing officer himself described it, “ nasty ” and “ mean ”; it was an emergency and required unusual physical effort to control. The decedent was restricted to light duty because of a pre-existing heart condition, which his employer well knew. In responding
As has been said, the Deputy Comptroller, backed by all the testimony, both eyewitness and medical, has found causal relation to the death. In such posture, the question whether there was an accident within the statute became a question of law. The findings of the Comptroller made “ on the basis of the evidence ” require him to answer, as matter of law, that the member died “ as the natural and proximate result of an accident sustained in the performance of duty in the service upon which his membership was based ” (§ 61, subd. a). He was not free to say that, because the decedent had a pre-existing heart condition, extraordinary physical exertion in excess of his strength performed in an unforeseen sudden and unexpected emergency arising in the course of his duties resulting in death was not accident. To so determine was error as matter of law under both the statute and decisions. When the Legislature made provision for payment of accidental death benefits to a widow of a deceased employee, it contemplated that such claims would be dealt with in accordance with the evidence. It did not intend that the Comptroller or his deputy should cancel it out by making a determination contrary to the evidence and the facts as actually found. The Legislature intended that the Comptroller and his deputy—like any other trier of the fact — should make a decision on “ the basis of the evidence ” (§ 61, subd. a).
For these reasons, I vote to affirm the order appealed from, with costs.
Dissenting Opinion
I concur for affirmance with the Chief Judge and Judge Dye.
All the proof before the Comptroller’s hearing officer was that the fatal heart attack was caused by unusual work effort in
This is not a ease where a quasi-judicial tribunal exercised its statutory power in making its own choice between the available findings on disputed proof. No one disputes that power. But here the tribunal settled no dispute, resolved no conflict. It just simply refused to make an award in accord with the evidence and in accord with its own fact findings.
The only explanation for this extraordinary result is that the officer had made a general policy decision to refuse awards in all cardiac cases, regardless of proof or findings. Such an attitude or policy was of course not open to him. The idea that there is a difference in “ social philosophy ” between the Workmen’s Compensation Law and the Retirement and Social Security Law has never been announced by the Legislature or accepted by this court. Whatever that vague and spacious term may mean, it can hardly justify the assumption by an executive of the State of power to reject claims according to his special ad hoc views of whether the Retirement Fund should from time to time be invaded or conserved. If such power resides in the Comptroller’s deputy, the Legislature has as to this matter left without protection the more than 200,000 members of the State Retirement System.
Dissenting Opinion
I agree with Judges Dye and Desmond for affirmance.
It seems to me that this case was decided by the Deputy Comptroller before he came to the decision-rendering stage. What the decision had to be was conclusively determined by his own finding. He found as a fact that the activities of the deceased immediately prior to his cardiac affliction, all of which took place in the performance of duty,
The Deputy Comptroller tells us that the activities of the deceased “ precipitated ” the attack, and few if any words could he have chosen for a more decisive indication of cause and effect. Webster’s New Collegiate Dictionary (1953) defines the verb ‘ ‘ precipitate ’ ’ thus:. “ 1. To throw or dash headlong; cast or hurl down, as from a precipice. 2. To move very rapidly; to urge or press on with haste or violence; to cause to happen suddenly, unexpectedly, or too soon * *
I will not assume that the Deputy Comptroller had insufficient vocabulary to express his findings. He found that the deceased’s heart attack was urged on with haste or pressed on with violence or caused suddenly or unexpectedly by duties he was performing as a most integral part of his job. If we need not now hold that the deceased died “ as the natural and proximate result of an accident sustained in the performance of duty”, then we can never in any case hold that a man who breathes his last breath because of a heart attack leaves anything by way of right against his employer for it, because it could not be held to be an occurrence in the course of his employment. That of course is contra numerous of our cases, which have had sufficient citation in the opinions of Judges Dye and Fulb to obviate repetition here. Were this a question of evidence, I would not disturb the conclusion; but the evidence invited a finding that the deceased’s activities did cause the occlusion, and the Deputy Comptroller could not and did not resist such finding. The statute does not admit, immediately thereafter, of the conclusion that deceased ‘ ‘ did not sustain an accident. ’ ’ The statute does not license the hearing officer to rewrite the dictionary.
The fire and deceased’s activities during it were as much a cause of his death as had a tree fallen on him or the flames taken hold of him. It would be no answer to say that a younger and faster man could have eluded the falling tree or reached water in time. So it is no answer to say that this man would have survived had his heart been a bit stronger. Had the State any physical requirements to impose upon those fighting forest fires, it should have insured that all such employees fulfilled them.
I find it difficult to appreciate the majority’s accentuation of the fact that this was deceased’s “ usual customary work, voluntarily undertaken ”. (Italics supplied.) By that it is not to be understood that he was a “ volunteer fireman” with the choice of going to the fire or not, as his whim dictated. It was deceased’s assigned task to be at those fires. On the day in question he had just begun his afternoon meal when his special radio — and he had one in his home and one in his truck with the latter in operation “ all times ” — called him to attend the fire in question. The call came from an observer whose duty it was to make such calls. Had deceased refused to attend the fire he might have jeopardized his position. There was nothing ‘ ‘ voluntary ’ ’ about his being there.
If ‘
Some occupations are sedentary; others involve physical labors. The health of a given individual may be below par, but nonetheless quite adequate to keep him at his job. The State’s own expert testified that it is not at all rare to advise a man who has had cardiac difficulties to return to his “ previous occupation ” and that heavy exertion is not uniformly prohibited;
The advice that the deceased received and his own judgment in appraising it obviously impelled him to gauge the possibilities and to conclude that the job was not too much for him. No one can avoid the inference that the deceased felt himself able to continue his usual duties; to draw a contrary inference is to say that he went back to work with the intention of overtaxing his heart. Certainly this man was at work voluntarily; so was every man whose survivor has received accidental death benefits. Death is always brought about by the failure of some indispensable part of the being’s anatomy; the question always is: what brought on the failure? This man was not at home in bed, concluding an inactive day, when his heart gave out; he was in the very process of executing his duties. His end was brought about in the performance of those duties, a performance compelled by an accident of circumstance: “ a nasty, mean, forest fire”. That is the finding, and the conclusion of law thereafter constructs itself. The scheme of the statute, upon such finding, leaves no room thereafter for discretion; hence the reversal proposed by the majority does not amount to mere approval of a discretion lodged by statute. It amounts to the judicial delegation of legislative power to an agency. Our function is not so comprehensive, In my judgment we have no course but to affirm.
Judges Froessel, Van Voorhis and Burke concur with Judge Fuld; Chief Judge Conway and Judges Desmond and Dye dissent in separate opinions in which each concurs.
Order reversed, etc.
