Administrative denial of firefighter’s claim for benefits upheld where firefighter changed story of how injury happened and administrative denial was supported by substantial evidence, under collective bargaining agreement and NY Admin. Proc. §306(1) (COA 4/5/2011)

Claimant firefighter changed his description of the cause of his back injury from his original version given to his supervisor in his initial report of injury ( which was a defective air suspension in his seat) to a different version (which was hitting a pothole that caused the air-suspension seat to elevate and then shoot downwards, which he claimed at the collective-bargaining-agreement hearing challenging the district’s denial of his claim for benefits for a work-related injury).  After the firefighter’s initial report, the district had had the seat inspected by the district’s mechanic and the manufacturer’s representative neither of whom found anything wrong.   In its denial, the district attributed the firefighter’s back complaints to his two prior back injuries.   Claimant’s neurosurgeon testified at the hearing that he would not causally related the injury to a work-related injury if the injury did not occur as the firefighter had claimed.  

The district’s denial of benefits was upheld because it was supported by “substantial evidence”.  “Substantial evidence” is such relevant proof as a reasonable mind may accept as adequate to support a conclusion or ultimate fact, and is less than a preponderance of the evidence.  Substantial evidence requires only that a given inference is reasonable and plausible, not necessarily the most probable.  The firefighter had the burden under the collective bargaining agreement and under NY Admin. Proc. Act §306(1) to prove that the denial was not supported by substantial evidence.  The hearing officer was required to give deference to the district’s determination.  The fact that there was also substantial evidence supporting the firefighter’s position was irrelevant so long as there was substantial evidence supporting the district’s denial. 

Matter of Ridge Road Fire District, v. Michael P. Schiano (Ct. App. April 5, 2011) (four to three decision).

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