RICKY MARTER v. BOARD OF TRUSTEES, ETC. (PUBLIC EMPLOYEES' RETIREMENT SYSTEM) ( 2022 )


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  •                                 NOT FOR PUBLICATION WITHOUT THE
    APPROVAL OF THE APPELLATE DIVISION
    This opinion shall not "constitute precedent or be binding upon any court ." Although it is posted on the
    internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3.
    SUPERIOR COURT OF NEW JERSEY
    APPELLATE DIVISION
    DOCKET NO. A-3024-19
    RICKY MARTER,
    Petitioner-Appellant,
    v.
    BOARD OF TRUSTEES,
    PUBLIC EMPLOYEES'
    RETIREMENT SYSTEM,
    Respondent-Respondent.
    __________________________
    Submitted January 24, 2022 – Decided January 31, 2022
    Before Judges Sabatino and Mayer.
    On Appeal from the Board of Trustees of the Public
    Employees' Retirement System, Department of
    Treasury, PERS No. x-xxx914.
    Gaylord Popp, LLC, attorneys for appellant (Samuel M.
    Gaylord, on the brief).
    Andrew J. Bruck, Acting Attorney General, attorney for
    respondent (Melissa H. Raksa, Assistant Attorney
    General, of counsel; Jeffrey D. Padgett, on the brief).
    PER CURIAM
    Ricky Marter, a former senior corrections officer at the Monmouth County
    juvenile facility, appeals from a February 20, 2020 final agency decision by the
    Board of Trustees of the Public Employees' Retirement System ("PERS")
    denying his claim for accidental disability retirement benefits under N.J.S.A.
    43:15A-43.
    The PERS Board's determination adopted the decision of an
    administrative law judge ("ALJ"), who had presided over fact-finding hearings.
    The ALJ concluded appellant had failed to prove his slip-and-fall accident at
    work in 2010 had caused him to sustain mental and cognitive deficits rendering
    him "permanently and totally disabled." Richardson v. Bd. Of Trs., Police and
    Firemen's Ret. Sys., 
    192 N.J. 189
    , 212-13 (2007).
    For the reasons that follow, we remand this matter to the agency for
    reconsideration and, if it deems appropriate, additional fact-finding. We do so
    because the ALJ's principal finding about medical causation, which attributes
    appellant's claimed mental and cognitive deficits to preexisting "degenerative"
    causes, does not correspond to the record.
    The factual record was developed over two days of hearings before the
    ALJ in May 2019 and August 2019. The ALJ heard testimony from appellant,
    A-3024-19
    2
    his treating psychologist, Dr. Theodore Batlas, and the Board's competing
    expert, Dr. Steven Lomazow, a neurologist.
    Appellant's disability claim arises out of an incident at work on January
    27, 2010, in which he slipped on a wet floor and struck his head. It is unclear
    whether he lost consciousness in the fall. Appellant was taken to a hospital and
    released.
    Appellant contends the head injury caused him to suffer memory loss and
    various cognitive deficits. He stopped working due to the alleged disability.
    Appellant was initially evaluated and treated in 2011 by a Dr. Alan
    Colicchio, a neurologist, who diagnosed him with a cerebral concussion. Also
    in 2011, appellant was evaluated in two Independent Medical Examinations
    ("IMEs") by Dr. Jeffrey Pollock, a neurologist, and Dr. Allan Burstein, a
    psychiatrist. Both Dr. Pollock and Dr. Burstein found that appellant was not
    permanently and totally disabled, perceiving appellant was exaggerating his
    symptoms.
    Appellant's claim for accidental permanent disability was denied by
    PERS, and he requested a contested-case hearing in the Office of Administrative
    Law ("OAL"). That hearing was delayed for many years because appellant
    moved, without opposition, to have the case placed on the OAL's inactive list,
    A-3024-19
    3
    pending a re-evaluation by an orthopedist. Evidently, appellant decided not to
    pursue an orthopedic basis for his disability claim and instead relied solely on a
    claim of neurological and cognitive deficits.
    According to appellant's testimony at the hearing and various statements
    he made to the examining doctors, he allegedly cannot perform mentally
    difficult tasks and generally stays home and is inactive. However, a surveillance
    video from 2011 showed appellant doing vigorous activities such as using a leaf
    blower, mowing the lawn, swinging an axe, using a power saw, and power-
    washing a deck. Appellant also admitted in his testimony that he continues to
    drive a motor vehicle.
    Dr. Batlas's office administered a series of neuropsychological tests in
    2019. Dr. Batlas concluded from those tests, and his own examination and
    records review, that appellant sustained a permanent disabling head injury in the
    2010 incident. These opinions are reflected in both Dr. Batlas's written reports
    admitted into evidence and his testimony at the administrative hearing.
    Dr. Lomazow, meanwhile, concluded from his one-session IME in 2019
    that appellant was not permanently disabled and that he was exaggerating his
    alleged deficits. Dr. Lomazow did not administer separate neuropsychological
    tests, but instead reviewed appellant's medical records, including the test results
    A-3024-19
    4
    from Dr. Batlas, and conducted his own less-elaborate "bedside" evaluation of
    appellant's cognitive and memory functions.       Dr. Lomazow also noted the
    various activities performed by appellant on the 2011 video surveillance. Dr.
    Lomazow's observations and opinions are set forth in his written report admitted
    into evidence and also his testimony at the hearing.
    In her written decision, the ALJ found both testifying experts were "highly
    qualified." She concluded that the Board's expert, Dr. Lomazow, was "more
    persuasive" than Dr. Batlas, both as to the contested issues of the presence of a
    permanent and total disability and causation.
    Notably, in her decision, the ALJ stated she "accepted Dr. Lomazow's
    opinion, based on objective findings, that any symptoms and possible diagnosis
    reported by petitioner, whether exaggerated or not, were due to preexisting
    longstanding and degenerative conditions and were unrelated to the closed head
    trauma, resulting from the incident." (Emphasis added).
    The Board adopted the ALJ's findings without further elaboration.
    On appeal, appellant argues the ALJ's decision is flawed because the ALJ
    should have given more weight to the opinion of Dr. Batlas as the treating
    doctor. Appellant further contends the Board's expert and the ALJ unduly
    focused on appellant's physical capacity, as shown in the 2011 video, rather than
    A-3024-19
    5
    his mental ability to respond spontaneously to situations at the juvenile detention
    facility.
    It is well settled that our standard of appellate review in administrative
    law cases of this nature is to afford substantial deference to the agency, unless
    its decision is arbitrary, capricious, or unreasonable, or lacking fair support in
    the record. Caminiti v. Bd. of Trs., Police and Firemen's Ret. Sys., 
    431 N.J. Super. 1
    , 14 (App. Div. 2013). In addition, we customarily will not set aside
    factual and credibility findings unless they are clearly mistaken or not supported
    by substantial credible evidence in the record. Cf. H.K. v. Dep't of Hum. Servs.,
    
    184 N.J. 367
    , 386 (2005). The pivotal question in this appeal is whether the
    record contains such "substantial credible evidence" to support the ALJ's
    findings as adopted by the Board.
    Having reviewed in depth the testimony and medical reports submitted
    into evidence, we cannot discern "substantial credible evidence" in the record to
    support the ALJ's finding that Dr. Lomazow presented expert proof that
    appellant's claimed mental and cognitive deficits "were due to preexisting
    longstanding and degenerative conditions." Nor does there appear to be such
    expert proof of pertinent degeneration elsewhere in the record.
    A-3024-19
    6
    Dr. Lomazow does note in his written report that an MRI of appellant's
    spine conducted in 2010 had revealed "longstanding . . . degenerative changes"
    at the C6-7 vertebrae. However, his report did not link those changes in the
    cervical spine to cognitive or mental problems. Further, Dr. Lomazow admitted
    on cross-examination at the hearing that he was not aware that appellant had
    "any pre-existing head injuries or concussions."
    The term "degenerative changes" often is used in litigation involving
    claims of personal injury to describe how changes over time in a claimant's
    spinal column can produce debilitating injuries, commonly orthopedic in nature.
    See, e.g., Johnson v. Scaccetti, 
    192 N.J. 256
    , 266 (2007) (quoting the defense's
    orthopedic expert's diagnosis that the plaintiff's back pain was caused by
    "preexisting degenerative changes that everyone of us gets along the way");
    Singletary v. Wawa, 
    406 N.J. Super. 558
    , 567 (App. Div. 2009) (discussing, in
    a case involving head, neck, arm, and shoulder pain, plaintiff's "degenerative
    changes at C4-5 and C6-7").
    "Degeneration" is a general medical term that signifies deterioration. It
    can refer to a "worsening of mental, physical, or moral qualities." Stedman's
    Medical Dictionary 503 (28th ed. 2006). In our cases, the term is almost
    A-3024-19
    7
    exclusively used to describe spinal injuries in which discs slowly wear down
    over time.
    We are mindful the term "degenerative" is less frequently used to describe
    cognitive impairments, but it can be. See, e.g., In re Clark, 
    210 N.J. Super. 548
    ,
    557 (Ch. Div. 1986) (adopting a neurologist's observation that a patient's
    "different levels of cognitive functioning from day to day" was "consistent with
    degenerative diseases" in finding the patient incompetent to make certain
    medical decisions). In another illustration, the Legislature has used the term
    "degenerative" when describing mental disease.          See N.J.S.A. 26:2M-16
    (describing Alzheimer's as a "progressive, degenerative, and irreversible
    neurological disease").
    The only degenerative condition Dr. Lomazow identified in appellant was
    a spinal injury. He described the spinal condition as one that was "longstanding
    and degenerative," which is the same phrase the ALJ used in explaining her
    finding of a lack of causation. As we have noted, the ALJ stated that Dr.
    Lomazow found appellant's symptoms "all unrelated to a closed head trauma,
    and found changes of this nature to be longstanding degenerative and diagnoses
    that are preexisting and unrelated to the incident." The record does not support
    that summary of Dr. Lomazow's diagnosis.
    A-3024-19
    8
    Because the record does not support the ALJ's finding on this principal
    element of the case, we remand the matter to the Board to reconsider its
    wholesale adoption of the ALJ's decision and denial of benefits. On remand, the
    Board may refer the matter back to the ALJ for reconsideration and clarification
    of her findings, with the discretion to reopen the record further with additional
    proofs if warranted. See In re Kallen, 
    92 N.J. 14
    , 23 (1983) (authorizing a
    remand to reopen administrative hearings in certain circumstances). If the ALJ
    issues such a new decision, it may then be presented to the Board for further
    consideration and a new final agency decision. We do not retain jurisdiction.
    Remanded.
    A-3024-19
    9
    

Document Info

Docket Number: A-3024-19

Filed Date: 1/31/2022

Precedential Status: Non-Precedential

Modified Date: 1/31/2022