309 N.Y. 449 | NY | 1956
Lead Opinion
The question of law is this: on the hearing of an application for accidental death benefits from the State Employees’ Retirement System under section 81 of the Civil Service Law based on an allegation that death was caused by a heart attack due to strain and exertion in State employment, and where there is proof of such strain and exertion and of a fatal heart attack, may the State Comptroller deny the application without permitting the applicant to introduce medical evidence of causation? Our answer is “ no ”.
Summarized, petitioner’s proof before the hearing officer was that her husband, forty-five years old, while working as a junior civil engineer for the New York State Department of Public Works, was required as a member of a survey party staking out a proposed right of way to climb up and down a steep slope at the time when the ground was icy and covered with snow, that during that work decedent complained of a chest pain and shortness of breath whereupon he was relieved of those particular duties, but that the next morning he suddenly died of an acute coronary thrombosis. The Comptroller rejected the widow’s claim, holding that her husband’s death was not caused by an “ accident ” within the meaning of section 81 of the Civil Service Law. The Appellate Division affirmed, stating that its reasons therefor were the same as stated by that court in Matter of Odell v. McGovern (283 App. Div. 585, affd. 308 N. Y. 678). The Comptroller, so the Appellate Division wrote,11 acted within the permissible range of his power in rejecting the claim”. In the Odell case (supra), the widow of a State-employed attorney who suffered a heart attack sought this same kind of death benefit from the State Employees’ Retirement System on the theory that the fatal attack was brought on by emotional stress and anxiety caused by his courtroom work in the employ of the State. In the Odell case, the applicant urged that the
But it is impossible for us on this appeal to give a complete answer to the question of law discussed in the briefs since, for some reason not completely clear, there is no medical testimony whatever in this record. In the workmen’s compensation heart cases, of which we have had so many, there is usually no question but that the deceased workman underwent strain and exertion in the course of his duties. Ordinarily, too, in such workmen’s compensation cases there is no dispute but that claimant suffered a heart attack while at work or soon after-wards. The question in those cases is usually as to whether the exertion and strain of the work caused the heart attack so as to permit a finding of industrial accident. It is obviously impossible, given the other facts, to make such a causality finding, or to refuse it, without medical opinion proof. As Larson says in his “ Workmen’s Compensation Law ” the basic prob
While a claim of an “ accident ” consisting of heart injury from work strain cannot be sustained without medical testimony it is, of course, possible, theoretically at least, that a finding of “no accident ” could be made without such testimony. If the only testimony as to the work done showed that there was no particular strain or exertion, then, regardless of medical testimony and with or without it, the trier of the facts could, we suppose, say that ordinary, uneventful, placid routine work could not result in an “ accidental ” injury to a worker’s heart within any of the statutes or cases (see 1 Larson on Workmen’s Compensation, §§ 38.64, 38.83). But there had been put into this record testimony of unusually strenuous working conditions and so there should have been an opportunity for claimant to demonstrate by opinion testimony, if she could, that this strain and exertion caused the heart injury.
Petitioner tells us that this is a test case brought to examine into the statement or remark of the Appellate Division in Matter of Odell v. McGovern (283 App. Div. 585, 587, supra) that “ a
This court held in Matter of Slattery v. Board of Estimate & Apportionment (271 N. Y. 346, 350, supra) that there is “no substantial difference ” between “ accidental injuries ” (Workmen’s Compensation Law, § 2) and injuries which are “ the natural and proximate result of an accident ” (Civil Service Law, § 81). True, the Legislature afterwards decreed that the Compensation Board’s holding of accident causation should not bind the Comptroller, but that statutory denial of res judicata left intact the holding that there is “ substantial identity of subject-matter ” (Slattery opinion, supra, p. 351) and that the issue as to accidental causation is the same under both statutes. Now, there can no longer be any doubt as to the applicable law of accidental causation in heart cases under the Workmen’s Compensation Law. Such fatal heart failures may be held “ accidental, if the employee, by a miscalculation of his own strength, inadvertently hastened his own death by exertion that caused the final breakdown ” (1 Larson on Workmen’s Compensation, § 38.83, p. 566). Whether exertion in employment followed by heart failure adds up to an accident under these rules is ordinarily a question of ultimate fact. To set up such a question we need proof of the work done and of the physical aftermath, but we then must look for another element: medical causation. When we have direct testimony of the first two observable facts, we seek causation in the opinion evidence of medical witnesses. When all that proof has been assembled, then ‘ ‘ Whether a particular event was an industrial accident is to be determined, not by any legal definition, but by the commonsense viewpoint of the average man ” (Matter of Masse v. Robinson Co., 301 N. Y. 34, 37). In applying those ideas to the present case, we are not forcing this claim into a workmen’s compensation mold, or stretching the coverage of a so-called “ Masse rule ”. That the word “ accident ” is incapable of complete definition but is to be tested as to meaning by common speech and common understanding has been recognized in our courts and other courts for a long time (Mutual Accident Assn. v. Barry, 131 U. S. 100, 121; Bird v. St. Paul Fire & Marine Ins. Co., 224 N. Y. 47, 51; Lewis v. Ocean Accident & Guar. Corp., 224
I should make it clear that I disagree with nothing in Judge Fuld’s concurring opinion.
The order appealed from should be reversed, with costs in this court and in the Appellate Division, and the matter remitted to the State Comptroller for further proceedings not inconsistent with this opinion.
Concurrence Opinion
(concurring). In the disposition of the appeal, on the exceedingly narrow ground that the assertedly proffered medical evidence should have been received by the Comptroller for its possible bearing on causality, I concur.
In so doing, however, I would not have my vote construed as agreement with the contention advanced by petitioner that the Workmen’s Compensation Board’s finding of accident is in any way binding or conclusive on the Comptroller in determining whether accidental death benefits should be paid to petitioner under the Civil Service Law. (See, e.g., Matter of McCadden v. Moore, 301 N. Y. 760.) In other words, the court’s remission of the present matter to the Comptroller does not mean that that official must find that petitioner’s husband sustained an ‘1 accident ’ ’ within the sense of section 81 of the Civil Service Law or that his death was the natural or proximate result of such an accident. If different inferences may reasonably be drawn from the evidence adduced before him, the Comptroller may find, for whatever bearing it may have on the ultimate issue, that there was or was not unusual extra exertion and strain sufficient to have caused the coronary thrombosis; that there was or was not an accident; and, if there was an accident, that it was or was not the cause of death.
The Comptroller may not, of course, make a finding or render a determination completely unsupported by evidence, but, on
Conway, Ch. J., concurs with Desmond, J.; Fuld, J., concurs for reversal in a separate opinion in which Fboessel, Van Voobhis and Bubke, JJ., concur; Dye, J., taking no part.
Order reversed, with costs in this court and in the Appellate Division, and matter remitted to the State Comptroller for further proceedings.