ELDRIDGE HAWKINS, JR. VS. BOARD OF TRUSTEES (POLICE AND FIREMEN'S RETIREMENT SYSTEM) ( 2020 )


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  •                                  NOT FOR PUBLICATION WITHOUT THE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-1974-18T3
    ELDRIDGE HAWKINS, JR.,
    Petitioner,
    v.
    BOARD OF TRUSTEES,
    POLICE AND FIREMEN'S
    RETIREMENT SYSTEM,
    Respondent.
    ______________________________
    Submitted March 30, 2020 – Decided April 22, 2020
    Before Judges Fasciale and Mitterhoff.
    On appeal from the Board of Trustees of the Police and
    Fireman's Retirement System, Department of the
    Treasury, PRFS No. 3-10-47790.
    Eldridge T. Hawkins, Sr., attorney for appellant.
    Gurbir S. Grewal, Attorney General, attorney for
    respondent (Melissa H. Raksa, Assistant Attorney
    General, of counsel; Juliana C. DeAngelis, Deputy
    Attorney General, on the brief).
    PER CURIAM
    Eldridge Hawkins, II, appeals from a November 13, 2018 decision by the
    Board of Trustees (the Board) of the Police and Firemen's Retirement System
    (PFRS), concluding that Hawkins was ineligible for accidental disability
    retirement benefits because his disability was not the direct result of an October
    2009 incident (the 2009 incident), but rather pre-existed it.1 The Board issued a
    comprehensive eight-page written decision. We affirm.
    Hawkins applied for accidental disability in December 2010. The Board
    determined that he was totally and permanently disabled, but denied his
    application, relying on medical documentation demonstrating that his disability
    was due to a pre-existing disease and not the direct result of the 2009 incident.
    The Board, however, granted Hawkins ordinary disability retirement benefits
    retroactive to March 2011. In reaching its final decision, the Board determined
    that the Administrative Law Judge (ALJ) applied the wrong burden of proof,
    1
    Hawkins filed a related complaint against numerous parties, including Board
    members, alleging that Board members discriminated against him when they
    initially denied his application for accidental disability benefits. The Board
    transferred the matter to the Office of Administrative Law for a hearing. We
    affirmed an order dismissing that Law Division complaint, indicating that
    Hawkins could appeal the Board's final decision if it ruled against him. See
    Hawkins v. Hutter, No. A-1783-14 (App. Div. Oct. 7, 2016). The Board
    thereafter issued its final decision, which is the subject of this appeal.
    A-1974-18T3
    2
    and therefore the Board rejected the ALJ's conclusion that Hawkins was entitled
    to accidental disability benefits.
    The Board concluded the ALJ's findings were not supported by the
    credible evidence. The Board noted that the ALJ's findings were based on the
    report of Dr. Stephan Kosmorsky, who—in the Board's view—did not discuss
    how Hawkins's injury was the direct result of the 2009 incident. And the Board
    determined that the ALJ ignored Hawkins's lack of treatment after the 2009
    incident, specifically that Hawkins waited for almost a year and a half after the
    incident, and one year after seeing Dr. Lee, before getting treatment for his knee.
    According to the Board, Dr. Lakin, who concluded Hawkins's knee problems
    were not the direct result of the 2009 incident, offered the more reliable opinion
    as to causation.
    The Board further concluded that the ALJ misapplied Richardson v. Board
    of Trustees, Police & Firemen's Retirement System, 
    192 N.J. 189
     (2007), which
    the Board said requires the disabling incident to be the "essential significant or
    substantial contributing cause of the . . . disability." The ALJ, according to the
    Board, failed to explain how Hawkins hitting his knee on the dashboard caused
    a permanent injury. It is undisputed that Hawkins suffered a prior knee injury
    requiring reconstructive ACL surgery in 2006.
    A-1974-18T3
    3
    On appeal, Hawkins argues:
    POINT I
    THE . . . BOARD, IN ITS REJECTION OF THE ALJ
    TRIAL COURT DECISION DID NOT FOLLOW THE
    LAW BY IMPROPERLY ASSERTING THAT THE
    "ALJ APPLIED THE INCORRECT BURDEN OF
    PROOF" AND SHOULD BE REVERSED.
    POINT II
    THE [ALJ] DECISION WHICH WAS FAVORABLE
    TO [HAWKINS] RESTS ON THE ALJ CREDIBILITY
    FINDINGS OF WITNESSES WHICH THE . . .
    BOARD HAS IMPROPERLY DISTURBED IN
    VIOLATION OF LAW WITH ITS NOVEMBER 13,
    2018 DECISION AND SHOULD BE REVERSED AS
    A MATTER OF LAW.
    POINT III
    THE [BOARD], THROUGH MISAPPLICATION OF
    LAW,   IMPROPERLY     DENIED   HAWKINS'
    ACCIDENTAL     DISABILITY    RETIREMENT
    BENEFITS PRIOR TO GETTING REVERSED BY
    THE ALJ AND ITS SUBSEQUENT DENIAL WAS
    ARBITRARY[,] CAPRICIOUS, UNSUPPORTED BY
    THE RECORD AND SHOULD BE REVERSED.
    POINT IV
    HAWKINS'[S]    TOTAL   AND   PERMANENT
    DISABILITY IS THE DIRECT RESULT OF THE
    [2009 INCIDENT] AND NOT THE RESULT OF A
    PRE[-]EXISTING    DISEASE   AND    ANY
    SUGGESTION TO THE CONTRARY BY THE
    A-1974-18T3
    4
    BOARD BELIES THE FACTUAL FINDINGS OF
    THE ALJ AND IS PLAINLY UNREASONABLE.
    POINT V
    HAWKINS IS NOT REQUIRED TO PROVE THAT
    THE [2009 INCIDENT] WAS THE SOLE CAUSE OF
    HIS PERMANENT DISABILITY, ONLY THAT IT
    WAS THE SUBSTANTIAL CONTRIBUTING
    CAUSE OF HIS PERMANENT DISABILITY AND
    ANY LEGAL ARGUMENT OR DECISION BY THE
    BOARD TO THE CONTRARY IS WRONG AS A
    MATTER OF LAW AND SHOULD BE REVERSED.
    POINT VI
    ALL   SUBSEQUENT     WRITTEN     MEDICAL
    OPINIONS ISSUED BY DR. JEFFERY LAKIN, THE
    STATE INDEPENDENT MEDICAL EXAMINER,
    BEYOND THE INITIAL REPORT ISSUED BY HIM
    ON MARCH 30, 2011 WERE GENERATED WITH
    NEFARIOUS INTENT, ARE NET OPINIONS, NOT
    LEGALLY SOUND, DEEMED NOT CREDIBLE BY
    THE ALJ AND SHOULD BE DISREGARDED
    LEAVING THE BOARD WITH A PLAINLY
    UNREASONABLE      DECISION    WHICH     IS
    UNSUPPORTED BY THE RECORD.
    POINT VII
    [HAWKINS] NEVER HAD A DISEASE PRE[-
    ]EXISTING OR OTHERWISE AND THUSLY DOES
    NOT FALL WITHIN THE         RICHARDSON
    STANDARD EXCLUSION FOR PRE[-]EXISTING
    A-1974-18T3
    5
    DISEASES, THUS THE . . . BOARD SHOULD BE
    REVERSED AS A MATTER OF LAW[. 2]
    "Our review of [an] administrative agency action is limited." Russo v.
    Bd. of Trs., Police & Firemen's Ret. Sys., 
    206 N.J. 14
    , 27 (2011). Reviewing
    courts presume the validity of the "administrative agency's exercise of its
    statutorily delegated responsibilities." Lavezzi v. State, 
    219 N.J. 163
    , 171
    (2014). For those reasons, "an appellate court ordinarily should not disturb an
    administrative agency's determinations or findings unless there is a clear
    showing that (1) the agency did not follow the law; (2) the decision was
    arbitrary, capricious, or unreasonable; or (3) the decision was not supported by
    substantial evidence." In re Application of Virtua-West Jersey Hosp. Vorhees
    for a Certificate of Need, 
    194 N.J. 413
    , 422 (2008).           "The burden of
    demonstrating that the agency's action was arbitrary, capricious or unreasonable
    rests upon the [party] challenging the administrative action." In re Arenas, 
    385 N.J. Super. 440
    , 443-44 (App. Div. 2006).
    "'[T]he test is not whether an appellate court would come to the same
    conclusion if the original determination was its to make, but rather whether the
    factfinder could reasonably so conclude upon the proofs.'" Brady v. Bd. of
    2
    Hawkins also submitted a reply brief, dated December 16, 2019, which raises
    largely the same arguments encompassed by his merits brief.
    A-1974-18T3
    6
    Review, 
    152 N.J. 197
    , 210 (1997) (quoting Charatan v. Bd. of Review, 
    200 N.J. Super. 74
    , 79 (App. Div. 1985)). "Where . . . the determination is founded upon
    sufficient credible evidence seen from the totality of the record and on that
    record[,] findings have been made and conclusions reached involving agency
    expertise, the agency decision should be sustained." Gerba v. Bd. of Trs., Pub.
    Emps.' Ret. Sys., 
    83 N.J. 174
    , 189 (1980). That said, appellate courts review de
    novo an agency's interpretation of a statute or case law. Russo, 
    206 N.J. at 27
    .
    A PFRS member is entitled to accidental disability benefits under N.J.S.A.
    43:16A-7(a)(1). Under that provision, PFRS authorizes an award of accidental
    disability benefits to a member provided that:
    [T]he medical board, after a medical examination of
    such member, shall certify that the member is
    permanently and totally disabled as a direct result of a
    traumatic event occurring during and as a result of the
    performance of his regular or assigned duties and that
    such disability was not the result of the member's
    willful negligence and that such member is mentally or
    physically incapacitated for the performance of his
    usual duty and of any other available duty in the
    department which his employer is willing to assign to
    him.
    [N.J.S.A. 43:16A-7(a)(1).]
    A-1974-18T3
    7
    In Richardson, the Court clarified the meaning of the term "traumatic event,"
    and set forth a five-pronged standard mandating that a pension-system member
    seeking accidental disability benefits prove:
    1. [T]hat he is permanently and totally disabled;
    2. as a direct result of a traumatic event that is
    a. identifiable as to time and place,
    b. undesigned and unexpected, and
    c. caused by a circumstance external to the
    member (not the result of pre-existing disease
    that is aggravated or accelerated by the work);
    3. that the traumatic event occurred during and as a
    result of the member's regular or assigned duties;
    4. that the disability was not the result of the member's
    willful negligence; an[d]
    5. that the member is mentally or physically
    incapacitated from performing his usual or any other
    duty.
    [
    192 N.J. at 212-13
    .]
    The issue here is whether the Board's finding that Hawkins's injury/disability
    was not directly caused by the 2009 incident⸻but rather pre-existed it⸻is
    supported by the record.
    A-1974-18T3
    8
    At the outset, this was a contested case submitted to the ALJ.             In
    accordance with N.J.S.A. 52:14B-10(c), "[a]ll hearings of a State agency
    required to be conducted as a contested case under this act or any other law shall
    be conducted by an [ALJ]."       The ALJ then files a report and a decision
    containing the recommended findings of fact and conclusions of law with th e
    agency. 
    Ibid.
     Upon reviewing the record, the agency may either "adopt, reject
    or modify the recommended report and decision." 
    Ibid.
     Thus, the Board may
    modify or reject any findings of fact, conclusions of law, or interpretations of
    policy if the reasons for doing so are clearly stated. 
    Ibid.
     If the Board modifies
    or rejects the ALJ's findings of fact, it must state the reasons for rejecting the
    findings and make new or modified findings that are supported by sufficient,
    competent, and credible evidence in the record. 
    Ibid.
    The Board adopted the ALJ's findings of fact with several modifications.
    The Board emphasized that the ALJ incorrectly placed the burden of proof on
    the Board rather than Hawkins. See Richardson, 
    192 N.J. at 212
    . The Board
    further noted the ALJ ignored key facts in his credibility findings. While it is
    true that an agency cannot reject or modify credibility findings of lay witness
    testimony, this does not apply to the expert testimony at issue here. N.J.S.A.
    52:14B-10(c); see also ZRB, LLC v. N.J. Dep't of Envtl. Prot., 403 N.J. Super.
    A-1974-18T3
    9
    531, 561 (App. Div. 2008) (holding that lay testimony, but not expert testimony,
    is subject to the constraints of N.J.S.A. 52:14B-10(c)).
    The ALJ " did not discuss how . . . Hawkins's 2009 injury [was] a direct
    result of the 2009 incident – [Hawkins] simply stated, where asked about direct
    result, that he is permanently disabled as a result of the incident." The Board
    also faulted the ALJ for failing to address the lack of a treatment record for
    Hawkins's knee for almost a year and a half after the 2009 incident. The Board
    also explained that it found Dr. Lakin's testimony more reliable because he
    explained the implications that the ACL reconstruction surgery had on
    Hawkins's knee and the direct implications that an accident such as the 2009
    incident would have had on a person's knee.
    Because the Board found that the ALJ did not address key facts and
    questions as to the direct result of the 2009 incident, it rejected the ALJ's
    conclusions of law. The ALJ failed to address basic questions, such as how
    Hawkins hitting his knee on the dashboard would have caused a permanent knee
    injury. The Board analyzed the facts under prior case law and explained how it
    arrived at its decision.
    It is undisputed that the 2009 incident constitutes a traumatic event in
    accordance with the statute. But the Board denied Hawkins accidental benefits
    A-1974-18T3
    10
    because "there is no explanation of causation to establish that the 2009 incident
    directly resulted in . . . Hawkins's disability." Hawkins conceded that he had
    surgery on his knees after he was injured in a motorcycle accident in 2006.
    The Board found that the ALJ merely accepted Dr. Lee's testimony
    without seeking further explanation. Dr. Lee opined that the 2009 incident
    directly caused Hawkins's disability, but he never explained how hitting one's
    knee on the dashboard could cause instability and laxity. Dr. Lee based his
    opinion on Hawkins's subjective complaints, but Hawkins did not complain
    about his knee pain until more than a year after the 2009 incident, despite
    seeking treatment for his neck, shoulder and back just one month after the
    incident. Hawkins sought treatment from Dr. Schob less than a month after the
    2009 incident, and he did not complain about pain in his left knee at that time.
    Hawkins's argument essentially places the burden of proof on the Board.
    He claims that "because the Board has not and cannot contradict [Hawkins's]
    assertions . . . , the Board's denial is not supported by the record, is arbitrary,
    capricious, plainly unreasonable and should be reversed." As the Board noted,
    and established in Richardson, the petitioner seeking benefits bears the burden
    of proof. See 
    192 N.J. at 212
    .
    A-1974-18T3
    11
    The Board found Dr. Lakin reliable because, unlike Dr. Lee, he explained
    the basis of ACL laxity and knee instability. He explained that these injuries
    are caused by "non-contact injury, twisting or turning. So a dashboard, you
    wouldn't expect it." He further stated that his review of medical records revealed
    that Hawkins endured contusions on his left knee as a result of the 2009 incident,
    but contusions do not cause instability or laxity of the knee and usually take "[a]
    period of days to a couple weeks" to heal. Dr. Lakin opined that Hawkins's ACL
    reconstruction surgery left him with "structural weaknesses after the surgery."
    Ultimately, Dr. Lakin concluded that Hawkins's disability was "not a direct
    result of [the 2009 incident]."
    The Board's findings of fact and conclusions of law are clearly supported
    by the record. As noted, the Board was not required to accept the ALJ's findings
    of fact or conclusions of law. See N.J.S.A. 52:14B-10(c). The Board's decision
    to modify the ALJ's findings of law and its ultimate conclusions of law are
    adequately supported by the record. The Board found Dr. Lakin credible, as he
    more fully explained Hawkins's condition. In finding Dr. Lakin credible, in
    emphasizing the gaps in the ALJ's findings and conclusions, and in correctly
    placing the burden on Hawkins, the Board's findings and conclusions are
    supported by the record and are not arbitrary nor capricious.
    A-1974-18T3
    12
    Although Hawkins asserts that his permanent disability is a direct result
    of the 2009 incident, the Board correctly rejected the ALJ's findings of fact and
    conclusions of law. See N.J.S.A. 52:14B-10(c). The Board found Dr. Lakin
    more credible than Dr. Lee and used his opinions in arriving at its own
    conclusion of law. In its decision, the Board explained why it found Dr. Lakin
    credible, and how it used his conclusions to arrive at its decision. See ZRB, 403
    N.J. Super. at 561. Hawkins bore the burden of proof, and the Board could not
    rectify why Hawkins waited over a year before complaining about kne e pain,
    how hitting his knee caused permanent disability, and how the 2009 incident
    was the direct cause of the permanent disability.        Thus, Hawkins has not
    sufficiently established that his permanent disability was the direct result of the
    2009 incident.
    We reject Hawkins's argument that he does not need to prove that his
    permanent disability is the direct result of the 2009 incident. N.J.S.A. 43:16A-
    7 explicitly states that to qualify, a member must certify that he is "permanently
    and totally disabled as a direct result of a traumatic event occurring." The
    Richardson Court reaffirmed "that the disability be a 'direct result of a traumatic
    event.'" 
    192 N.J. at 195
     (quoting N.J.S.A. 43:16A-7); see also Gerba, 
    83 N.J. at 186
     (analyzing and upholding the direct result requirement); Patterson v. Bd. of
    A-1974-18T3
    13
    Trs., State Police Ret. Sys., 
    194 N.J. 29
    , 42, 50 (2008) (quoting N.J.S.A.
    43:16A-7(a)(1)) (imposing requirement that a member prove he or she is
    "'permanently and totally disabled as a direct result of a traumatic event'");
    Mount v. Bd. of Trs., Police & Firemen's Ret. Sys., 
    233 N.J. 402
    , 428 (2018)
    (remanding on the issue of whether petitioner's disability directly resulted from
    the incident). Hawkins must satisfy this burden of proof to qualify.
    Hawkins argues that Dr. Lakin's testimony and 2013 reports contain net
    opinions and were submitted with "nefarious intent." Under Rule 1:7-2, to
    properly preserve an issue for appeal, "a party, at the time the ruling or order is
    made or sought, shall make known to the court specifically the action which the
    party desires the court to take or the party's objection to the action taken and the
    grounds therefor." If a party failed to raise an issue below, relief is not warranted
    unless that party demonstrates plain error by showing that the error was "clearly
    capable of producing an unjust result." R. 2:10-2; see also Jacobs v. Jersey Cent.
    Power & Light Co., 
    452 N.J. Super. 494
    , 502 (App. Div. 2017). Hawkins failed
    to object to both Dr. Lakin's testimony and the introduction of his reports at the
    administrative hearing. In fact, the ALJ asked Hawkins whether he objected to
    the admission of Dr. Lakin's 2013 reports, to which he replied, "I have no
    objection."
    A-1974-18T3
    14
    Nevertheless, Dr. Lakin's testimony does not constitute a net opinion. The
    net opinion rule "'forbids the admission into evidence of an expert's conclusions
    that are not supported by factual evidence or other data.'" Townsend v. Pierre,
    
    221 N.J. 36
    , 53-54 (2015) (quoting Polzo v. County of Essex, 
    196 N.J. 569
    , 583
    (2008)).    A conclusion "'"based merely on unfounded speculation and
    unquantified possibilities"'" is inadmissible.      Id. at 55 (quoting Grzanka v.
    Pfeifer, 
    301 N.J. Super. 563
    , 580 (App. Div. 1997)). The expert must "'give the
    why and wherefore ' that supports the opinion, 'rather than a mere conclusion.'"
    Id. at 54 (quoting Borough of Saddle River v. 66 E. Allendale, LLC, 
    216 N.J. 115
    , 144 (2013)). However, the expert may not base their opinion solely on
    their own subjective standard. Pomerantz Paper Corp. v. New Cmty. Corp., 
    207 N.J. 344
    , 373 (2011) (stating that "if an expert cannot offer objective support for
    his or her opinions, but testifies only to a view about a standard that is 'personal,'
    it fails because it is a mere net opinion").
    The Board found Dr. Lakin's testimony more credible because he
    reliably explained how the knee is different structurally
    and mechanically after an ACL reconstruction,
    explained how there could be laxity in the knee shortly
    after the surgery, took into consideration that the
    records are inconsistent as to . . . Hawkins's knee
    problems, and explained that laxity and instability are
    caused by twisting or turning injuries, not by hitting a
    knee on a dashboard.
    A-1974-18T3
    15
    The Board relied on Dr. Lakin's testimony because he was able to adequately
    explain the lack of causal connection between the accident and Hawkins's
    injured knee. Cf. Buckelew v. Grossbard, 
    87 N.J. 512
    , 524 (1981) (finding an
    expert opinion to be a net opinion where there was a "failure of the expert to
    explain a causal connection between the act or incident complained of and the
    injury or damage allegedly resulting therefrom"). In fact, the Board explicitly
    rejected Dr. Lee's testimony and Dr. Kosmorsky's report because they failed to
    explain how Hawkins's injury could be the direct result of the 2009 incident.
    To the extent that we have not addressed Hawkins's remaining
    contentions, we conclude that they are without merit to warrant attention in a
    written decision. R. 2:11-3(e)(1)(E).
    Affirmed.
    A-1974-18T3
    16