Retirement – accidental disability – causation

Where (1) the plaintiff filed an application for accidental disability retirement benefits stating that the medical reason for the application was “depression resulting from a head injury” and (2) the Administrative Law Division Appeal Judge concluded that the plaintiff had shouldered the burden of proving that he was eligible for Accidental Disability Retirement Benefits The decision of the Social Retirement Appeals Board to overturn the DALA judge’s decision should be overturned because CRAB did not show any appropriate basis for rejecting a DALA judge’s finding of causation.

“This case involves two significant issues. First, we address the circumstances in which the CRAB may reverse the factual findings of a judge in the Division of Administrative Law Appeals (DALA) when CRAB reviews the decision made by that judge after a hearing and discussion of the credibility assessment Testimony of Living Witnesses Second, we turn to CRAB’s reading of Vest v. Resumption of Socialist Retirement Bd, 41 Mass app. ct. 191 (1996), which has been interpreted to mean that an employee may not receive disability retirement benefits unless the employee proves that he has been permanently unable to perform the essential duties of his position as of the last day on which the employee actually performed those duties. We conclude that this construct, which would negate disability retirement protection for countless workers who suffer sequelae or degenerative or progressive disease resulting from a work accident, is wrong. …

“This case involves an application for accidental disability retirement benefits, filed by Robert Holub based on the psychological consequences of a head injury sustained when he fell from the back of a garbage truck on 14 September 2004. The immediate application indicated that the medical reason for the application was” Depression due to a head injury.” A Provincial Medical Committee, defined by law as an “Independent Three-Member Medical Committee,” GLc 32, §1, consisting of three physicians, answered all three questions included in the Staff Retirement Management Committee The preprinted PERAC “Provincial Medical Commission” “certified” affirmatively, thus finding that Holub was “mentally or physically incapable of performing the essential duties of his or her job as described in the current job description,” and that “the said incapacity is (likely to be permanent),” and that “the said incapacitation (is) may be the natural and direct consequence of the continuing personal injury or risk to which he is exposed by reason of claiming retirement,” i.e. his fall from the garbage truck in which he was employed. …

“CRAB has articulated at length the reasons for rejecting the conclusion of the Regional Medical Commission and the DALA judge. This expression, required by our case law, allows us to examine CRAB’s decision to reject the judge’s findings. Ultimately, we conclude that CRAB did not provide a sufficient basis for rejecting these findings or a conclusion Judge that Holub’s depression was caused by an aggravation of his head injury “due to pre-existing ADHD and mood disorders”.

Ultimately, CRAB’s conclusion was that “Holub’s psychiatric conditions were continuous with his pre-existing psychiatric conditions and were not altered by the head injury”. Crucial to this conclusion were two sub-findings not supported by standard evidence. First, CRAB rejected the conclusion The Provincial Medical Commission found that Holub had not received psychiatric treatment prior to the head injury. …

“CRAB’s rejection of the Medical Commission’s statement was based on additional evidence, in particular citing a number of websites that were not in the administrative record, which it concluded, apparently contradicting the conclusion of the actual psychiatrists on the Regional Medical Commission that treatment of control problems Anger amounts to “psychotherapy,” so the doctors’ conclusion was wrong. …

“CRAB is not permitted to rely on such additional registry evidence, and … there is no basis in the registry for second guessing the supported judgment of the physicians of the RMC as to the nature of Holub’s previous treatment, which they were aware of.

The second critical basis for CRAB’s conclusion was to cite the reports of one physician, Dr. Michael Rutter, who met Holub on a brief occasion as the physician who evaluated him in connection with a workers’ compensation claim, and who concluded that Holub’s symptoms were caused by overuse of prescribed opioids. CRAB asserted that Dr. Rutter determined that Holub’s psychological state “was continuous with his pre-existing psychological state and was unaltered by the head injury.”

But a study of Dr. Rutter’s report shows that he didn’t address symptoms of depression at all. …

As an alternative basis for dismissing the DALA judge’s decision, CRAB alleged reliance on Jacket, 41 Mass app. ct. 191, which CRAB says it has ‘expanded’ in its previous decisions to mean ‘that the employee must demonstrate that he or she is permanently unable to perform the essential duties of his position as of the last day on which the employee actually performed those duties.’

“This is a serious application error Jacket. …

“…in fact, the rule explained by CRAB requiring permanent inability to perform essential duties “as of the last day on which the employee actually performed such duties” has no support in law. It would deny retirement benefits by reason of incapacity to a person He was injured on his last day on the job, and the injury caused him to have a disabling stroke the next day.It would negate disability retirement for employees who are exposed to something at work that eventually manifests in cancer.In fact, it would negate the Eligibility for Accidental Disability Retirement All employees who suffer an injury that leads to consequences or a progressive or degenerative condition that ultimately results in permanent disability.The Statute contains no such limitation, and Jacket not so suggest. …

“Since CRAB demonstrated no appropriate basis for rejecting the DALA judge’s finding with respect to causation or subsidiary findings discussed above, it should have affirmed that finding with respect to causation. Accordingly, the Supreme Court’s judgment was affirmed.”

Holub v. Worcester Retirement Board, et al. (Advocates Weekly #11-088-23) (14 pages) (Rubin, J.) The case was heard by Shannon Frison, J., on motions to rule on the pleadings. Michael Sacco, Worcester Retirement Board; David R. Marx to the Socialist Pension Appeals Board; Charles E. Berg for Plaintiff (Case No. 21-P-707) (August 25, 2023).

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