Rebutting the statutory presumption that an “on-the-job” injury or death was job-related shifts burden of showing job-relatedness to the claimant

Rebutting the statutory presumption that an “on-the-job” injury or death was job-related shifts burden of showing job-relatedness to the claimant
Petrocelli v Sewanhaka Cent. School Dist., 54 AD3d 1143

Section 21 of the Workers’ Compensation Law sets out “a presumptions of compensability when an unwitnessed or unexplained death occurs during the course of one's employment.” The presumptions “in the absence of substantial evidence to the contrary are:

1. That the claim comes within the provision of this chapter;

2. That sufficient notice thereof was given;

3. That the injury was not occasioned by the willful intention of the injured employee to bring about the injury or death of himself or of another;

4. That the injury did not result solely from the intoxication of the injured employee while on duty.

5. That the contents of medical and surgical reports introduced in evidence by claimants for compensation shall constitute prima facie evidence of fact as to the matter contained therein.

However, these are rebuttable presumptions and if there is substantial evidence to the contrary, the claimant has the burden of establishing that the injury or death is causally related to employment.

Denise Petrocelli’s husband died while coaching a high school basketball game. Mrs. Petrocelli filed a claim for workers' compensation death benefits.

The death certificate listed as Mrs. Petrocelli’s husband’s cause of death as “a spontaneous rupture of the splenic artery with hemoperitoneum, due to portal hypertension complicating cirrhosis of the liver and chemotherapy for treatment of a primitive neuroectodermal tumor of the right adrenal gland.” A Workers' Compensation Administrative Law Judge ruled that the Workers' Compensation Law §21 presumption of compensability had been rebutted by the statements of the cause of death set out in the death certificate. Mrs. Petrocelli was directed to produce evidence of causally related death. Once this was done, the employer would have an opportunity to produce a consultant's report on the same issue.

The Workers' Compensation Board affirmed the ALJ’s finding and Mrs. Petrocelli appealed.

The Appellate Division sustained the Board’s determination, ruling that “irrefutable proof excluding all . . . conclusions other than that offered by the employer that the accidental injury was not work related” is not required to rebut a Workers’ Compensation Law Section 21 presumption.

In this instance, said the court, evidence contained in the death certificate indicates that Mrs. Petrocelli’s husband’s death was directly caused by factors not related to his work. Accordingly, the court declined to disturb the Board's finding that the Section 21 presumption was overcome, requiring Mrs. Petrocelli to come forward with proof of a causally related death.

The decision is posted on the Internet at: