Christine McQuilken v. Board of Trustees of the Teachers' Pension and Annuity Fund ( 2024 )


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  •                                 NOT FOR PUBLICATION WITHOUT THE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-1414-22
    CHRISTINE MCQUILKEN,
    Petitioner-Appellant,
    v.
    BOARD OF TRUSTEES,
    TEACHERS' PENSION
    AND ANNUITY FUND,
    Respondent-Respondent.
    ___________________________
    Argued March 4, 2024 – Decided April 4, 2024
    Before Judges Mawla and Vinci.
    On appeal from the Board of Trustees of the Teachers'
    Pension and Annuity Fund, Department of the
    Treasury, Agency Docket No. TPAF No. 646009.
    Jason Earl Sokolowski argued the cause for appellant
    (Zazzali, Fagella, Nowak, Kleinbaum & Friedman, PC,
    attorneys; Jason Earl Sokolowski, of counsel and on the
    briefs).
    Yi Zhu, Deputy Attorney General, argued the cause for
    respondent (Matthew J. Platkin, Attorney General,
    attorney; Sara M. Gregory, Assistant Attorney General,
    of counsel; Yi Zhu, on the brief).
    PER CURIAM
    Petitioner Christine McQuilken appeals from the December 1, 2022 final
    agency decision of the Board of Trustees, Teachers' Pension and Annuity Fund
    (the "Board") denying her application for ordinary disability retirement benefits.
    Based on our review of the record and the applicable principles of law, we
    affirm.
    McQuilken was employed by the Hunterdon Central Regional High
    School District (the "District") as a special education teacher from 2001 until
    she terminated her employment effective July 1, 2019. On December 3, 2018,
    she applied for ordinary disability retirement benefits alleging she was unable
    to perform her job duties due to chronic low back pain, central and lateral
    stenosis, progressive degenerative spine issues, and severe osteoarthritis of the
    spine and left hip.
    On April 30, 2019, the Board arranged for McQuilken to be evaluated by
    an orthopedic surgeon. On July 11, 2019, the Board considered and denied her
    application for ordinary disability benefits because it determined she was not
    totally and permanently disabled from performing her regular and assigned
    duties. McQuilken requested an administrative hearing to appeal the Board's
    A-1414-22
    2
    decision and the matter was transferred to the Office of Administrative Law. An
    Administrative Law Judge ("ALJ") conducted a two-day hearing at which
    McQuilken, her orthopedics expert, and the Board's orthopedics expert testified.
    McQuilken testified that a typical day for her during her last year of work
    consisted of four classes and a tutorial from 7:20 a.m. to 3:00 p.m. The essential
    performance responsibilities enumerated in the job description for a special
    education teacher included developing lesson plans and classroom learning
    activities,   identifying   pupil   needs,   providing   appropriate   instruction,
    communicating with parents, and cooperating with other staff in assessing and
    resolving learning problems.
    Her job description also contained an "ADA [Americans with Disabilities
    Act] compliance" section that described certain physical demands "that must be
    met . . . to successfully perform the essential responsibilities and functions of
    the job . . . [u]nless reasonable accommodations can be made . . . ."          The
    demands included lifting items needed to perform the functions of the job,
    remaining stationary for required periods of time, moving from place to place,
    participating in emergency drills, and frequent reaching, bending, twisting,
    climbing, squatting, balancing, stooping, pushing, and pulling.           The job
    description stated "[r]easonable accommodation may be made to enable
    A-1414-22
    3
    individuals with disabilities to perform the essential responsibilities and
    functions of the job."
    According to McQuilken, for several years before she stopped working,
    she "was having knee issues" and, after she underwent right hip replacement
    surgery in 2011, she "had back issues," and then her left hip "started to go"
    which resulted in pain in her knees, lower back, and left hip. She testified her
    back pain would "[w]ax and wane" depending on how active she was. She
    experienced pain in both knees, but not at the same time. She described the knee
    pain as a burning sensation that would come and go. During her last year of
    work, she experienced constant pain in her left hip. She received injections in
    her back, knees, and left hip that provided some relief.
    McQuilken submitted her application for ordinary disability retirement
    benefits in December 2018 because she believed she was not "doing [her] job
    the way . . . [she did her] job." Specifically, she was late to class and meetings
    and could no longer perform hall duty because of the pain in her knees, left hip
    and back. She experienced pain in those areas since 2012, but in 2018 she began
    to experience pain in two or three locations at once and could no longer manage
    the pain with medication and physical therapy.
    The pain made it increasingly difficult for McQuilken to perform certain
    A-1414-22
    4
    physical aspects of her job, such as walking up and down stairs, moving around
    the classroom, realigning and lifting desks, moving between the upper and lower
    campuses of the school, and standing for long periods of time. McQuilken
    explained that because of the individual attention necessary for her special
    education students, she needed to move around the classroom to each student
    during class. She also needed to carry her laptop from class to class which
    caused "a heaviness" in her lower back. Her job required repetitive bending,
    and squatting to put materials up on walls, pull down maps, pick things up from
    the ground, and assist students at their desks.
    McQuilken requested that the District schedule her classes in one building
    and furnish her with an elevator key, which it did. She also requested to be
    excused from additional duties associated with standardized testing, which the
    District accommodated. Despite those accommodations, McQuilken testified
    she still needed to use the stairs daily because the elevator was at the end of the
    hallway, and it was difficult for her to navigate through students in the hallway.
    In addition, she needed to go to the library and attend assemblies in another
    building. She was also required to take part in fire drills and other safety drills
    that required her to clear the hallways, lock the classroom door, cover the
    windows, and sometimes escort students from one campus to the other. She did
    A-1414-22
    5
    not request any additional accommodations because she did not want to "feel
    like [she was] causing a problem . . . ."
    McQuilken continued to work from December 2018 until July 1, 2019,
    because she was not emotionally or financially ready "to go out." During that
    period, she tried to "push through" work, but would sometimes need to take half-
    days, sick days, or other leave. She did not provide any evidence of the number
    of days she missed or was late. McQuilken had a walking cane but only used it
    on "really bad days" at work because she was trying to be discreet about her
    medical condition and was embarrassed.
    McQuilken testified that her treating orthopedist, Dr. Aleya Salam,
    advised her to stop working before December 2018. In a medical note dated
    November 8, 2018, however, Dr. Salam indicated McQuilken was "[w]orking
    on full duty," had "[n]o active problems," was "not disabled permanently," and
    was "functioning well with activities of daily living." On November 19, 2018,
    Dr. Salam prepared a medical certification in which she opined McQuilken was
    totally and permanently disabled and no longer able to perform her assigned job
    duties, noting there can be "no limited duty in teaching." On September 25,
    2018, McQuilken's primary care physician, Dr. Pamela Donetz, also prepared a
    medical certification in which she opined McQuilken was totally and
    A-1414-22
    6
    permanently disabled and unable to perform her assigned job duties, noting her
    "job duties require extensive walking often on a time schedule which she is
    unable to do."
    McQuilken's orthopedics expert conducted an independent medical
    examination on June 10, 2020, nearly eighteen months after McQuilken filed for
    disability retirement benefits and one year after she stopped working. He
    diagnosed McQuilken with cumulative and repetitive trauma and occupational
    low back syndrome, a herniated disc at L5-S1, bulging discs in the lumbar spine,
    lumbar facet joint arthropathy, lumbar spine degenerative disc disease, chronic
    patellofemoral syndrome and degenerative joint disease in both knees, and
    osteoarthritis and bursitis in her left hip.
    Based on his review of McQuilken's medical history, subjective
    complaints, treating physicians' reports, job description, and his own physical
    examination, the expert concluded she was totally and permanently disabled
    from performing her essential job duties.        He opined that McQuilken's
    progressive spinal issues would result in her inability to do the standing,
    bending, and reaching over that is required of her job. The expert also opined
    that she would probably need a total left knee replacement and would be unable
    to do the kneeling, squatting, climbing, and stooping required. He did not
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    address her ability to perform the essential performance responsibilities of her
    job, such as developing lesson plans and instructing students.
    McQuilken's expert conceded his opinion was limited to whether
    McQuilken could do her job as of the date of his examination, June 10, 2020.
    He testified: "I could [m]ake a[n] assumption and say based upon the exam and
    the medical records . . . that in [2018] when she applied for her pension, she was
    disabled. . . . [B]ut we never do a retro[active] opin[ion]." He continued, "I
    do[]n[o]t know if that[ i]s my call. I really think . . . that[ i]s the [ALJ's] call to
    make . . . ."
    The ALJ questioned McQuilken's expert to clarify his testimony, as
    follows:
    [ALJ]: Okay. All right, [d]octor. I just have one
    question. When you had testified about that you don't
    do a retroactive determination about disability.
    [McQuilken's Expert]: Yes.
    [ALJ]: So I just . . . want to be clear when you
    said — . . . .
    [McQuilken's Expert]: On ordinaries, there[ i]s a little
    retro[active] here so I mean, I do know she was on the
    Class II Opioid . . . . She[ i]s taking it every six hours
    for her pain. We know that she[ ha]s had multiple MRI
    films. We know that there[ i]s a progression on the
    degenerative joint disease in both knees as well as in
    this hip[,] so we know that there[ i]s progression. But
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    8
    I would feel more comfortable if you make the call as
    to when you feel this came to a head.
    [ALJ]: All right. Well, so I understand what you[ a]re
    saying about your comfort level but I[ a]m just trying
    to get an understanding of your opinion so you are
    testifying to a reasonable degree of medical certainty
    that in June of 2020 that she[ i]s disabled and you[ a]re
    saying that that is your theory as to 2018 . . . .
    [McQuilken's Expert]: Right. It would be my theory
    that [be]cause I did[]n[o]t examine her in 2018 and . . .
    I do[]n[o]t like to give that opinion . . . and so if you
    put me up against the wall and say, "well, in [2018] do
    you think she could work?" Well, we already know she
    had the herniated disc, she had the spinal stenosis, she
    had the hip problem, she had the knee tri-
    compartmentalized arthritis. She[ i]s on the Class II
    Opioids. It would be easy for me to say "yeah, you
    know what [a] [special] ed[ucation] teacher
    could[]n[o]t do the job anymore."
    [(Emphasis added).]
    The Board's orthopedics expert conducted an independent medical
    examination of McQuilken on April 30, 2019, four months after she filed her
    application for benefits and two months before she stopped working. Based on
    his review of McQuilken's medical records and his own examination, the Board's
    expert diagnosed McQuilken with pain in both knees, arthritis in her hip, and
    low back pain.    His examination of her back revealed tenderness, but no
    evidence of muscle spasm or nerve compression. He noted that a 2012 MRI
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    9
    showed lumbar spondylosis and hypotrophy, a degenerative change which could
    cause lower back pain, and the records indicated McQuilken underwent epidural
    and facet injections in her lumbar spine for pain relief.
    His examination also revealed arthritis with limited range of motion of her
    left hip, which could cause pain. The Board's expert concluded McQuilken had
    good range of motion of her knees, and the records indicated she had steroid and
    other injections to relieve pain and slow the progression of the arthritis in her
    knees. Based on his review of MRI reports from 2012, 2015, and 2019, he
    opined McQuilken had degenerative changes in her lumbar spine, but the reports
    appeared to be similar and indicated she had the same degenerative conditions
    in her lumbar spine for several years. The MRI reports did not reveal a disc
    herniation and his physical examination did not indicate McQuilken had either
    a motor sensory or reflex deficit consistent with a disc herniation.
    The Board's expert concluded McQuilken was not totally and permanently
    disabled largely because she was still working when he examined her. On
    February 1, 2021, after reviewing additional medical records, the Board's expert
    authored an addendum report in which he stated, "the conclusions in my prior
    report remain unchanged. At the time I examined her, she was working. There
    is nothing in the records stating that she was permanently disabled from her job.
    A-1414-22
    10
    If there is a concern about this, then the individual should be re-evaluated."
    The Board's expert noted incorrectly in his report that McQuilken
    previously underwent right knee replacement surgery and had a related scar. At
    the hearing, he testified that notation was an error because McQuilken had a
    right hip replacement, not a knee replacement.
    Following the hearing, the ALJ issued a twenty-three-page initial decision
    affirming the Board's denial of McQuilken's application. The ALJ concluded
    McQuilken failed to demonstrate by a preponderance of the credible evidence
    she was unable to perform her regular and assigned duties at the time of her
    application or at the time she terminated her employment.
    The ALJ did not "accept [the] testimony and opinion" of McQuilken's
    expert as "fully reasonable or reliable." She reasoned because he was only able
    to offer "assumptions" as to whether McQuilken was disabled when she applied
    for benefits, his opinion did not "rise to the requisite reasonable degree of
    medical certainty." In addition, the expert did not address her ability to perform
    the essential responsibilities of her job.
    The ALJ did not accept the testimony and opinion of the Board's expert
    because he "made several mistakes in his report" including noting incorrectly
    that McQuilken had knee replacement surgery and a related scar. The ALJ also
    A-1414-22
    11
    rejected his testimony because "the main reason he found [McQuilken] not to be
    disabled was the fact that she was working at the time of his evaluation" and
    concluded she was "precluded from being deemed disabled." As a result, the
    ALJ was "unable to give greater weight to the testimony of either expert."
    The ALJ found McQuilken's testimony credible and determined she "had
    difficulty in meeting the physical demands of her job and . . . had pain in her
    back, knees, and hip." The ALJ noted there was no evidence to establish "the
    number of days or frequency . . . [McQuilken] took off from work or otherwise
    used leave time due to her medical condition."
    The ALJ found, "neither [McQuilken], nor her treating physicians, nor her
    expert, addressed her ability to perform the essential responsibilities of her
    job . . . ." She found "[w]hile [McQuilken] believed she was not performing her
    job duties as she wanted or as she believed she should, there [was] no
    competen[t] evidence in the record that she was unable to perform the essential
    responsibilities of a special education teacher."        The ALJ determined
    McQuilken:
    failed to demonstrate an inability to perform the
    essential    teaching    and/or     teaching    related
    responsibilities of her job as a special education
    teacher. Although the job of special education teacher
    certainly has physical demands, it involves much more
    than its physical demands.           Moreover, while
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    [McQuilken] requested the use of the elevator and that
    her classes be scheduled in one building, there is no
    evidence in the record of her seeking any additional
    accommodations to the physical demands of the job that
    would have enabled her to continue performing the
    essential performance responsibilities.         Indeed,
    [McQuilken] acknowledged that she tried to be
    discre[et] at work regarding her condition and that she
    rarely used a cane.
    The ALJ concluded McQuilken failed to demonstrate she: (1) was
    physically incapacitated for the performance of the duties of a special education
    teacher; (2) was unable to perform her regular and assigned duties due to a
    permanently-disabling medical condition at the time of her application for
    benefits; and (3) was physically incapacitated for the performance of duty at the
    time she terminated her employment.
    After considering McQuilken's exceptions to the ALJ's initial decision,
    the Board adopted the ALJ's decision. On appeal, McQuilken argues the Board's
    decision was arbitrary, capricious, and unreasonable because the ALJ
    erroneously concluded she did not demonstrate by a preponderance of the
    credible evidence that she is totally and permanently disabled. McQuilken also
    contends the ALJ erred by not accepting her expert's testimony and affording it
    greater weight than the testimony and opinion of the Board's expert. Finally,
    she argues the Board violated its own regulations in processing her application.
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    13
    "Our review of a pension board's decision in the fact sensitive matter of
    disability retirement benefits is limited." Rooth v. Bd. of Trs., Pub. Emps.' Ret.
    Sys., 
    472 N.J. Super. 357
    , 364 (App. Div. 2022) (citing Allstars Auto Grp., Inc.
    v. N.J. Motor Vehicle Comm'n, 
    234 N.J. 150
    , 157 (2018)). An agency's action
    on the merits will be sustained unless that action is arbitrary, capricious, or
    unreasonable.     In re State & Sch. Emps.' Health Benefits Comm'ns'
    Implementation of Yucht, 
    233 N.J. 267
    , 279 (2018).
    Our role in reviewing decisions of an administrative agency is generally
    limited to: (1) whether the agency's action violates legislative policies; (2)
    whether the record contains substantial evidence to support the agency's
    findings; and (3) whether "the agency clearly erred in reaching a conclusion that
    could not reasonably have been made on a showing of the relevant factors."
    Allstars Auto Grp., 234 N.J. at 157 (quoting In re Stallworth, 
    208 N.J. 182
    , 194
    (2011)). If the "evidence and the inferences to be drawn therefrom support the
    agency . . . decision" we must affirm even if we might have decided differently.
    Campbell v. N.J. Racing Comm'n, 
    169 N.J. 579
    , 587 (2001) (quoting Clowes v.
    Terminix Int'l, Inc., 
    109 N.J. 575
    , 588 (1988)).
    "It is settled that '[a]n administrative agency's interpretation of statutes
    and regulations within its implementing and enforcing responsibility is
    A-1414-22
    14
    ordinarily entitled to our deference.'" Wnuck v. N.J. Div. of Motor Vehicles,
    
    337 N.J. Super. 52
    , 56 (App. Div. 2001) (alteration in original) (quoting In re
    Appeal by Progressive Cas. Ins. Co., 
    307 N.J. Super. 93
    , 102 (App. Div. 1997)).
    However, we are not bound by an agency's interpretation of a statute, or its
    determination of a strictly legal issue. Allstars Auto Grp., 234 N.J. at 158.
    Pursuant to N.J.S.A. 18A:66-39(b), a teacher "shall . . . be retired for
    ordinary disability" if a physician designated by the Board examines the teacher
    and certifies the teacher is "physically or mentally incapacitated for the
    performance of duty and should be retired." 1 The burden lies with the applicant
    to prove such incapacitation by a preponderance of the credible evidence. Bueno
    v. Bd. of Trs., Tchrs.' Pension & Annuity Fund, 
    404 N.J. Super. 119
    , 126 (App.
    Div. 2008). An applicant must "at a minimum prove an 'incapacity to perform
    duties in the general area of [their] ordinary employment . . . .'" 
    Id. at 131
    (quoting Skulski v. Nolan, 
    68 N.J. 179
    , 205-06 (1975)). An applicant cannot
    "merely show[] inability to perform the specific job for which [the applicant]
    was hired." Skulski, 
    68 N.J. at 205-06
    .
    1
    An ordinary disability is a "[p]ermanent and total disability resulting from a
    cardiovascular, pulmonary or musculo-skeletal condition which was not a direct
    result of a traumatic event occurring in the performance of duty." N.J.S.A.
    43:15A-43(a).
    A-1414-22
    15
    Applying Skulski and Bueno in light of our limited scope of review, we
    are satisfied the Board's decision was not arbitrary, capricious, or unreasonable.
    The ALJ found that although McQuilken had difficulty with the physical
    demands of her job and subjectively believed she was not doing the job the way
    she would have preferred, there was no competent evidence in the record to show
    she was unable to perform her essential responsibilities. The ALJ noted there
    was no evidence in the record to establish the number of days McQuilken missed
    or was late to work, nor was there any objective evidence to support her claim
    of total and permanent disability. In addition, the ALJ found McQuilken did not
    seek "additional accommodations to the physical demands of her job that would
    have enabled her to continue" performing her essential responsibilities. The
    Board's decision is supported by sufficient credible evidence in the record and
    was not arbitrary, capricious, or unreasonable.
    McQuilken's contention that the ALJ improperly failed to give greater
    weight to her expert's testimony is not persuasive. The ALJ, as the finder of
    fact, had to assess the credibility of the experts to determine the weight accorded
    to each witness's testimony. Angel v. Rand Express Lines, Inc., 
    66 N.J. Super. 77
    , 85-86 (App. Div. 1961). We are not required to defer to the ALJ on the
    credibility of expert witnesses. ZRB, LLC v. N.J. Dep't of Env't Prot., 403 N.J.
    A-1414-22
    16
    Super. 531, 561 (App Div. 2008). However, the ALJ's findings regarding the
    reasonableness and reliability of their testimony are entitled to deference
    because the ALJ heard the testimony and was in the best position to assess their
    credibility. See S.D. v. Div. of Med. Assistance & Health Servs., 
    349 N.J. Super. 480
    , 484 (App. Div. 2002).
    Here, McQuilken's expert did not examine her until June 10, 2020, nearly
    one year after she retired, and declined to offer an opinion based on a reasonable
    degree of medical certainty that she was disabled before that date. Rather, he
    limited his testimony to "assumptions" he "could [m]ake" and refused to offer a
    retroactive opinion. The ALJ's finding that the expert's testimony was not "fully
    reasonable or reliable" on the question of whether McQuilken was disabled prior
    to June 2020 was amply supported by the testimony. We discern no basis to
    disregard the ALJ's determination as to the weight accorded to the expert's
    testimony.
    McQuilken's contention that the Board violated its own regulations lacks
    merit. Specifically, she argues the Board processed her application before she
    terminated her employment in violation of N.J.A.C. 17:1-6.4(a) and (c), and was
    required to have its expert reexamine her to determine whether she was disabled
    at the time she stopped working. N.J.A.C. 17:1-6.4(a) states: "Each disability
    A-1414-22
    17
    retirement applicant must prove that his or her retirement is due to a total and
    permanent disability that renders the applicant physically or mentally
    incapacitated from performing normal or assigned job duties at the time the
    member left employment . . . ."2 N.J.A.C. 17:1-6.4(c) provides: "The [Division
    of Pension and Benefits] will review all disability retirement applications
    submitted after a member has terminated service to determine whether the
    member's application is eligible for processing . . . ."
    In this case, the ALJ determined McQuilken failed to prove she was
    disabled at the time she applied for disability benefits or when she terminated
    service on July 1, 2019.      The Board considered and denied McQuilken's
    application on July 11, 2019, and issued its final decision adopting the ALJ's
    decision on July 15, 2019, after McQuilken terminated service. The Board did
    not violate N.J.A.C. 17:1-6.4(a) or (c).
    Finally, McQuilken's contention that the Board should have required its
    expert to reexamine her is not convincing. The ALJ did not accept the testimony
    and opinion of the Board's expert as reasonable or reliable and did not consider
    it in her determination that McQuilken was not physically incapacitated for the
    2
    The ALJ incorrectly cited N.J.A.C. 17:3-6.7(a), which concerns accidental
    rather than ordinary disability retirement benefits. Substantively, there is no
    difference.
    A-1414-22
    18
    performance of duty. There is no basis to conclude a reexamination by the
    Board's expert after McQuilken stopped working would have led to a different
    result.   Further, it was McQuilken's burden to prove she was totally and
    permanently disabled at the time she stopped working, which she failed to do.
    The Board's decision is supported by sufficient credible evidence in the
    record. R. 2:11-3(e)(1)(D). To the extent we have not addressed McQuilken's
    other arguments, they are without sufficient merit to warrant discussion in a
    written opinion. R. 2:11-3(e)(1)(E).
    Affirmed.
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Document Info

Docket Number: A-1414-22

Filed Date: 4/4/2024

Precedential Status: Non-Precedential

Modified Date: 4/4/2024