Employer’s rejection of an individual’s claim for GML §207-c disability benefits does not necessarily bar his or her becoming eligible for such benefits at a later date
Zembiec v County of Monroe, 2013 NY Slip Op 01736, Appellate Division, Fourth Department
A Monroe County Sheriff's Department (MCSD) employee challenged the Department’s decision that he was not entitled to General Municipal Law §207-c benefits available to law enforcement personnel injured in the line of duty.
Supreme Court concluded that the MCSD’s determination was arbitrary and capricious and granted awarding the individual disability benefits retroactive to December 4, 2009, the date of the employee's request for those benefits. The Appellate Division affirmed the Supreme Court’s ruling.
The court took note of an earlier action involving the same parties [see Zembiec v County of Monroe [Appeal No. 2], 87 AD3d 1358] in which the employee sought disability benefits for the period August 12, 2008 through June 15, 2009 as well as his regular pay from June 15, 2009 through March 25, 2010. The Appellate Division denied that part of the employee’s petition seeking an award of regular pay from June 15, 2009 through March 25, 2010, explaining that the employee was required to report to a modified duty assignment on June 15, 2009, but did not do so
Among the arguments advanced by MCSD was that the employee’s claim in this proceeding was precluded by the doctrine of res judicata.* The Appellate Division rejected this claim, stating that the employees current claim for benefits was based on a December 2, 2009 status report prepared by an MCSD physician, in which the physician determined that he was not fit to return to work. The court explained that the employee’s introduction of this status report in the prior proceeding did not establish the claims being asserted in this proceeding and in the prior proceeding arose out of the same transaction or series of transactions.
Although the proceedings both involve claims concerning the employee's entitlement to disability benefits and are arguably related in time inasmuch as certain events relevant to this appeal, i.e., the issuance of the status report and petitioner's second request for disability benefits, occurred while the prior proceeding was pending, the proceedings are based upon two different transactions — MCSD’s June 15, 2009 decision denying the §207-c benefits and its July 19, 2010 decision denying the §207-c benefits being sought by the employee.
In the prior proceeding the court was concerned only with the issue whether MCSD’s June 15, 2009 determination was "arbitrary and capricious" and the court's "review of [the] administrative determination [in the prior proceeding was] limited to the facts and record adduced before the agency.'" Thus the court could not rely on post-determination submissions, such as the December 2, 2009 status report, in evaluating MCSD’s determination.
The Appellate also rejected MCSD’s alternative argument that the Doctrine of Collateral Estoppel** bared the employee’s instant claim, concluding that the issues concerning employee's ability to return to work and his eligibility for disability benefits in December 2009 had not been decided in the prior proceeding. The court explained that although it determined that Supreme Court erred in awarding the employee regular pay from June 15, 2009 through March 25, 2010, in the earlier proceeding, that determination had not foreclosed the possibility that employee might, at some point after June 15, 2009, again become eligible for disability benefits
* Res Judicata: Latin for a matter already decided or judged by a tribunal.
** The Doctrine of Collateral Estoppel bars issues that have been litigated from being litigated again by the same parties.
The instant decision is posted on the Internet at:http://www.nycourts.gov/reporter/3dseries/2013/2013_01736.htm
General Municipal Law§§ 207-a and 207-c- a 1098 page e-book focusing on administering General Municipal Law Sections 207-a/207-c and providing benefits thereunder and other disability retirement issues is available from the Public Employment Law Press. Click on http://section207.blogspot.com/ for additional information about this electronic reference manual.