Lisbon v. Contributory Retirement Appeal Bd.

• Decision Date: 04 September 1996
• Docket Number: No. 94-P-1983,94-P-1983
• Citation: 41 Mass.App.Ct. 246,670 N.E.2d 392
• Parties: Gilbert M. LISBON v. CONTRIBUTORY RETIREMENT APPEAL BOARD & another. 1
• Court: Appeals Court of Massachusetts

Page 392

670 N.E.2d 392

41 Mass.App.Ct. 246

Gilbert M. LISBON v. CONTRIBUTORY RETIREMENT APPEAL BOARD & another. ¹

No. 94-P-1983.

Appeals Court of Massachusetts Bristol.

Argued Jan. 4, 1996.

Decided Sept. 4, 1996.

Thomas A. Hickey, III, Boston, for Bristol County Retirement Board.

Paul J. Santos, New Bedford, for plaintiff.

Before ARMSTRONG, PERRETTA and LAURENCE, JJ.

LAURENCE, Justice.

The plaintiff, Gilbert M. Lisbon, had been a steward at the Bristol County house of correction for ten years when he suffered an incapacitating heart attack on March 30, 1989, while working at the facility's cook house. ² Relying on the 1991 medical opinion of his personal physician and the certificate of a regional medical panel, Lisbon claimed accidental disability benefits, pursuant to G.L. c. 32, § 7(1), on the ground that his attack was precipitated by a prison riot and a confrontation with prisoners on March 30, 1989.

Citing Lisbon's many health problems that predated his jail employment (which included coronary artery disease, three prior heart attacks, high blood pressure, diabetes, obesity, unhealthy eating habits, and a long-term smoking habit that lasted until 1988) as the more likely cause of his incapacity, the Bristol County Retirement Board (the board) rejected Lisbon's claim. On Lisbon's appeal to the Contributory Retirement Appeal Board (CRAB), an administrative magistrate recommended approval of his benefit application on the strength of his medical evidence. CRAB, however, concluded that Lisbon had failed to establish that his disabling heart attack was the result of an incident or a series of incidents occurring while in the performance of his duties rather than the product of the natural progression of his coronary artery disease and associated long-term illnesses.

Lisbon sought judicial review under G.L. c. 30A, § 14(7). A judge in the Superior Court found the magistrate's analysis persuasive and ruled that CRAB had wrongly denied Lisbon accidental disability benefits. On the board's appeal, we conclude that CRAB did not err in determining that Lisbon had failed to demonstrate his entitlement to those benefits and, accordingly, reverse the judgment of the Superior Court.

Background. The relevant factual background of this case is undisputed. ³ Lisbon had, as noted above, a long history of medical problems, including "athrosclerotic coronary heart disease." During the time he was employed as a cook at the Bristol correctional facility, he had experienced an "inferior wall myocardial infarction" in 1983 and "coronary episodes" in 1986 and 1987. All of these "heart attacks" required hospitalization but were not (on this record) job related. On March 30, 1989, while Lisbon was working at the cook house, a prison riot broke out elsewhere at the facility. Lisbon could see some of the riot from his cook house window, including inmates setting fires in the prison yard. At one point, "several" inmates entered the cook house, but left without incident when Lisbon ordered them out. There is no indication that the inmates said or did anything to menace or threaten Lisbon. He nonetheless locked the cook house. Correction officials shut down the jail and ordered all personnel, including Lisbon, to remain at their stations.

Soon thereafter, Lisbon began to have chest pain and was taken to the rear gate where emergency equipment and riot police were located. Lisbon was there examined by emergency medical technicians and then taken to St. Luke's Hospital. He was diagnosed as having "coronary artery disease" and remained hospitalized for two and one-half weeks. His personal physician noted in a January, 1991, report to Lisbon's attorney that Lisbon's chest pain was "clearly related" to emotional and physical stress experienced at the jail during the riot and that Lisbon had suffered a "myocardial infarction" at work. Lisbon has not worked since March 30, 1989.

Lisbon applied for accidental disability retirement in July, 1990. On his application, Lisbon cited his March 30, 1989, "heart attack" as the "personal injury or hazard undergone by reason of which [he] claimed to be incapacitated." His claim was confirmed, as noted above, by the written opinion of his personal physician, who also concluded that Lisbon was permanently disabled by reason of the job-related injury. Following a July 17, 1991, examination, a regional medical panel certified that Lisbon was permanently disabled and that his disability was "such as might be the natural and proximate result of personal injury sustained or hazard undergone on account of which retirement is claimed." ⁴

Because the medical panel suggested that it had, to some extent, relied on the "heart law," G.L. c. 32 § 94, ⁵ in reaching its decision, despite Lisbon's ineligibility under that law, the board sought clarification from the medical panel. In October, 1991, the chairman of the panel responded, stating that "[d]espite our statement to the contrary, Mr. Lisbon's application for disability retirement was not considered under the 'Heart Law' but rather under Accidental Disability." The panel also declined to amend its conclusions. The chairman further stated: "A detailed history regarding the confrontation [at the jail on March 30, 1989] was obtained and this convinced the Panel that it was highly stressful and productive of symptoms leading to his hospitalization.... The Panel finds there is a causal link to work in this case, despite the cited risk factors."

On November 20, 1991, the board denied Lisbon's application. Lisbon filed an administrative appeal to CRAB. An administrative magistrate of the Division of Administrative Law Appeals heard the case on March 4, 1993. The only testifying witness was Lisbon; all medical evidence was documentary. On May 15, 1993, the magistrate recommended that the board award Lisbon accidental disability retirement benefits, concluding as follows:

"The Appellant is an employee of the Bristol County House of Correction. He is not an employee of the Department of Correction and therefore is not entitled to the presumption under G.L. c. 32 sec. 94. While his duties may be the same as an employee within the Department of Correction, the statute is specific as to who is included and entitled to the "heart law" presumption.

"The medical panel has found that the riot of March 30, 1989, with regard to the Appellant, was highly stressful and productive of symptoms leading to his hospitalization and a heart attack. It was their opinion, originally and upon request for clarification, that the riot was the causal link leading to Mr. Lisbon's disability. The panel was aware of the Appellant's past medical history and the risk factor[s] he had with regard to heart disease before they made their decision. No evidence was introduced to rebut the findings of the panel or to show that the panel employed an erroneous standard.

"Based on the above, I find that the Appellant has established that the riot of March 30, 1989, was the cause of his disability. This matter is remanded to the Respondent for the awarding of accidental disability benefits."

The board objected to the magistrate's decision and requested that CRAB deny Lisbon's application for disability retirement. On October 23, 1993, CRAB adopted the magistrate's factual findings, but denied Lisbon disability benefits on the following analysis:

"A condition precedent to the allowance of accidental retirement benefits is the affirmative certification by a majority of the Medical Panel that the applicant is substantially unable to perform his duties, that such disability is likely to be permanent, and that there is a medical possibility of a causal relationship between the disability and a personal injury or hazard undergone while in the performance of his duties.

"In this case, the members of the Medical Panel certified that in their opinion [Lisbon] is permanently disabled from performing the duties of a steward at the Bristol County House of Correction and further indicated that there is a medical possibility of a causal relationship between the Appellant's disability and a personal injury or hazard undergone while he was in the performance of his duties. Nonetheless, G.L. c. 32, § 7, 'gives to the local board [and subsequently on appeal to this Board], the determination whether, on the relevant evidence, the causal relationship exists.' Noone v. Contributory Retirement Appeal Board, 34 Mass.App.Ct. 756 (1993).

"Here the facts indicate that the Appellant was working in the cook house when a riot broke out on March 30, 1989. He viewed the disturbance out a window and, when several inmates entered the cook house, he ordered them out. Later he experienced chest pain. The facts also indicate that the Appellant has a past history of hypertension, coronary problems, exogenous obesity and diabetes mellitus.

"The burden is on the Appellant to prove the causal nexus between his disability and an incident or series of incidents occurring while in the performance of his duties which resulted in that disability. The Appellee, consistent with its responsibilities, held that the Appellant failed to sustain that burden. Based upon the facts as found and the evidence presented herein, this Board concurs with that finding.

"The decision of the Appellee denying the Appellant's application for accidental retirement benefits is, therefore, affirmed."

On November 12, 1993, Lisbon filed this action for review of CRAB's adverse decision. After a hearing, a Superior Court judge characterized CRAB's determination that Lisbon had failed to sustain his burden of proving work-related causation as "conclusory ... [and] against the clear weight of the evidence ⁶.... [It] reverses, without reason, the Administrative Law Judge's [ALJ] well founded conclusion that [Lisbon] is entitled to benefits. The record overwhelmingly indicates that [Lisbon's] exposure to the rioting prisoners caused him to...