McManus v. Kentucky Retirement Systems, 2002-CA-000961-MR.
| Decision Date | 13 June 2003 |
| Docket Number | No. 2002-CA-000961-MR.,2002-CA-000961-MR. |
| Citation | 124 S.W.3d 454 |
| Parties | Bruce McMANUS, Appellant, v. KENTUCKY RETIREMENT SYSTEMS; and Kentucky Employees Retirement System, Appellees. |
| Court | Kentucky Court of Appeals |
James P. Benassi, Morgan, Madden, Brashear & Collins, London, KY, for Appellant.
James Dodrill, Frankfort, KY, for Appellee.
Before BUCKINGHAM, GUIDUGLI, and McANULTY, Judges.
Bruce McManus appeals from an opinion and order of the Franklin Circuit Court that affirmed the denial of his application for disability retirement benefits by the Board of Trustees of the Kentucky Retirement Systems. We affirm.
McManus, who was born in 1950, became employed as a Family Services Clinician with the Department for Families and Children in February 1995. His duties included preparation of reports, conducting interviews, inspecting homes, testifying in court, supervising visits of children, and transporting children. In the spring of 1996, McManus started experiencing severe chest pain and suffered three heart attacks. He was diagnosed with diffuse coronary artery disease. He subsequently underwent several procedures involving cardiac catheterization, angioplasty, and a coronary bypass. McManus had been diagnosed with juvenile onset diabetes mellitus as early as age 15 in 1976. He was treated with standard insulin therapy that allowed him to continue relatively normal activity, but he developed numerous complications such as retinopathy, neuropathy, nephropathy and renal failure. By January 1999, McManus was forced to spend extensive periods in the hospital and subsequently quit his job.
On October 29, 1998, McManus filed a notification of retirement with the Kentucky Retirement Systems seeking retirement disability benefits pursuant to Kentucky Revised Statues (KRS) 61.600. Upon review of his application and medical records, each of the three members of the Medical Review Board recommended denial of benefits based on McManus's pre-existing diabetic condition. On November 2, 1999, McManus filed a motion to disqualify the current medical examiners that had reviewed his application, which was denied. In February 2000, the parties took the deposition of Dr. David Hogancamp, a cardiologist and McManus's primary physician. In April 2000, the parties took McManus's deposition by telephone because of his deteriorating health condition.
In May 2000, Kentucky Retirement Systems filed a notice of submission listing as an exhibit three chapters from a textbook entitled, "Diabetes Mellitus," which consisted of technical medical articles discussing the relationship between diabetes, arthroscleroses, and hypertension. In November 2000, McManus filed an objection to submission of this document. On December 19, 2000, the hearing officer ordered the parties to submit any additional documentary evidence by January 26, 2001 and position papers by March 14, 2001. After the parties filed position statements, the record was closed, and the case was submitted for decision without a hearing.
On May 29, 2001, the hearing officer issued his report and recommended order. Kentucky Retirement Systems stipulated that McManus met all the requirements for retirement disability under KRS 61.600(1) and (2), except that his disabling condition pre-existed his membership in the Kentucky Retirement Systems. The medical records indicated that McManus underwent two cardiac catheterizations in September 1996, October 1997, and a balloon angioplasty and replacement of a stent in October 1997. He was diagnosed as having hypertension, chronic end-stage coronary artery disease, and diabetes mellitus with hyperlipidemia, renal insufficiency, diabetic neuropathy, diabetic nephropathy, and diabetic retinopathy as early as May 1996. He was admitted to the hospital numerous times with chest pain and was described as suffering unstable angina with severe, diffuse coronary artery disease. Dr. Hogancamp's description of McManus's condition included severe diffuse coronary disease, chronic kidney failure, and juvenile onset diabetes. Dr. Hogancamp's report on the April 1998 catheterization procedure listed his impression of McManus's condition as "left ventricular dysfunction with large area of anteroapical hypokinesis" and "severe two-vessel coronary artery disease with diffusely diseased diabetic vessels."
During his deposition, Dr. Hogancamp was questioned extensively on the possible causes for McManus's coronary artery disease. Although acknowledging that diabetes is a well-known major risk factor for heart disease, he refused to opine that McManus's arthesclerosis was caused by his diabetes. He asserted that at this time, medical science was incapable of identifying causation of heart disease at the genetic or molecular level, so he could not say that McManus's diabetes was either a direct or indirect cause of his coronary artery disease. He noted that diabetes is only one of several known risk factors including high blood pressure, high cholesterol, and family history. Dr. Hogancamp stated: Dr. Hogancamp also explained that his use of the term "diabetic vessels" in his April 1998 report did not mean he believed diabetes was the cause of McManus's coronary artery disease.
After summarizing McManus's extensive medical history since 1996, the hearing officer found that McManus's diabetes mellitus pre-existed his re-employment and was the direct or indirect cause for his disabling conditions based in part on a clear clinical association between diabetes and coronary artery disease. He recommended that McManus's application be denied because he failed to sustain his burden of proof of establishing the requirements to qualify for retirement disability. McManus filed exceptions to the hearing officer's report, but the record does not contain a ruling on the exceptions. On July 3, 2001, the Disability Appeals Committee of the Board of Trustees accepted and adopted the hearing officer's report and recommendation. The circuit court upheld the Board's decision denying McManus's application for disability retirement benefits finding the decision was supported by substantial evidence. This appeal followed.
McManus raises several procedural issues that also affect analysis of the substantive issues in this appeal. First, he alleges that the hearing officer improperly assigned him, rather than the Kentucky Retirement Systems, the burden of proof as to causation for his coronary artery disease. KRS 61.600 states in relevant part:
(2) Upon the examination of the objective medical evidence by licensed physicians pursuant to KRS 61.665, it shall be determined that:
(a) The person, since his last day of paid employment, has been mentally or physically incapacitated to perform the job, or jobs of like duties, from which he received his last paid employment....
(b) The incapacity is a result of bodily injury, mental illness, or disease....
(c) The incapacity is deemed to be permanent; and
(d) The incapacity does not result directly or indirectly from bodily injury, mental illness, disease, or condition which pre-existed membership in the system or reemployment, whichever is most recent....
(3) Paragraph (d) of subsection (2) shall not apply if:
(a) The incapacity is a result of bodily injury, mental illness, disease, or condition which has been substantially aggravated by an injury or accident arising out of or in the course of employment; or
(b) The person has at least sixteen (16) years' current or prior service for employment with employers participating in the retirement systems administered by the Kentucky Retirement Systems.
This statute does not explicitly allocate the legal burden of proof, but it should be construed in conjunction with other statutes and case law. For instance, KRS 13B.090, part of the Administrative Procedure Act, addresses burdens of proof in connection with administrative proceedings. Section (7) states:
In all administrative hearings, unless otherwise provided by statute or federal law, the party proposing the agency take action or grant a benefit has the burden to show the propriety of the agency action or entitlement to the benefit sought. The agency has the burden to show the propriety of a penalty imposed or the removal of a benefit previously granted. The party asserting an...
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