Morris v. New York City Employees' Retirement Sys.
| Decision Date | 02 January 2001 |
| Docket Number | No. 00 CIV. 1060 DLC.,00 CIV. 1060 DLC. |
| Citation | 129 F.Supp.2d 599 |
| Parties | Thomas F. MORRIS, Plaintiff, v. NEW YORK CITY EMPLOYEES' RETIREMENT SYSTEM, Defendant. |
| Court | U.S. District Court — Southern District of New York |
Steven DeCastro, New York City, for Plaintiff.
Michael D. Hess, Carolyn A. Hafner, Corporation Counsel of the City of New York, New York City, for Defendant.
These competing summary judgment motions principally concern the amount of notice required for a person knowingly to waive his right to judicial review of an administrative decision denying his application for disability benefits. On February 19, 1999, the New York City Employees' Retirement System ("NYCERS") denied an application submitted by plaintiff Thomas F. Morris ("Morris") for disability benefits ("February 19 Denial"), and notified him of his right to have the denial reviewed by a Special Medical Review Committee on the condition that he sign a Final Medical Review Waiver ("Waiver") giving up his right to any other judicial or administrative review to which he might be entitled. Morris signed the Waiver and, following the Special Medical Review, was again denied disability benefits.
On February 14, 2000, Morris brought this action against NYCERS under 42 U.S.C. § 1983 ("Section 1983"). In his first cause of action, Morris asserts that NYCERS violated his due process rights because NYCERS did not notify Morris that, as an alternative to the Special Medical Review, he had the right to judicial review of the February 19 Denial under Civil Practice Law and Rules ("CPLR") §§ 7801 et seq. ("Article 78"), and was giving up that right by signing the Waiver. In his second and third causes of action, Morris asserts that the Special Medical Review Committee violated due process by failing to follow its own procedures, and that the Committee's procedures—even if properly followed—violate due process. The parties now bring cross motions for summary judgment. For the reasons stated below, each motion is granted in part.
The following facts are undisputed. NYCERS is a City administrative agency that manages retirement and disability benefits for City employees.1 City employees can choose whether to become members of NYCERS during the first six months of their employment.2 Once an employee becomes a member of NYCERS, he contributes a percentage of his salary to NYCERS, and NYCERS is required to pay the employee a "defined benefit" in return. Id. All NYCERS members are entitled to disability retirement benefits after they have worked for the City for 10 years. See Retirement and Social Security Law ("RSSL") § 605(b)(2). If an employee has worked for the City for less than 10 years, he is entitled to accidental disability benefits, but only if he was incapacitated as a result of an accident sustained during the performance of his duties. See RSSL § 605(b)(3). When a NYCERS member submits an application for accidental disability benefits, NYCERS' medical board assesses the member's eligibility based upon a medical examination and an investigation of statements and certifications made by him or on his behalf. See New York City Administrative Code ("NYCAC") § 13-168. The medical board then makes a recommendation to the Board of Trustees, which reviews and certifies the medical board's conclusions. See NYCAC § 13-168.
Morris is a former employee of the New York City Department of Transportation. Morris was hired by the City of New York ("City") in 1988, and worked as a debris remover, and then as an assistant Highway Repairer for the Department of Transportation. Morris alleges that he suffered an injury on the job on April 12, 1993. Based on that injury, Morris applied to NYCERS for accidental disability benefits in July of 1996. NYCERS denied Morris's application.3 Morris reapplied for benefits at least one more time and was again denied accidental disability benefits.
On February 19, 1999, Morris received a letter from the executive director of NYCERS, informing Morris that the medical board had recommended that Morris's most recent application for accidental disability benefits be denied and that the Board of Trustees had adopted that recommendation. The February 19 Denial advised Morris of his right to challenge the denial through an appeal to the Special Medical Review Committee, whose decision would be "final and conclusive." It read in pertinent part:
Should you wish to contest this recommendation, a request for medical review of the Medical Board's findings may be filed on your behalf by either your Bargaining Representative or by the Head of the Agency in which you are employed. The law gives you the opportunity to have your case reviewed by a Special Medical Review Committee which is made up of three independent doctors.
The request and attached completed waiver must be filed with the Executive Director of NYCERS within 15 days from your receipt of this notification.
Upon receipt of the request and signed waiver the Special Medical Review Administrator will provide you with the names of the three physicians for you to contact and schedule appointments to be examined.
Please be advised that the recommendations of the physicians serving on the Special Medical Committee shall supercede the recommendations of NYCERS' Medical Board and shall be final and conclusive, and no other disposition of the application by the Court or an Administrative Body or otherwise may be had.
(Emphasis in original.)
At the same time, Morris also received the Waiver. By executing the Waiver he both applied for review by the Special Medical Review Committee and agreed to waive "any and all rights ... to seek or obtain any other disposition ... by court, administrative proceedings or otherwise." It read in pertinent part:
To NYCERS' Board of Trustees:
I do hereby provide that the execution and filing of this waiver shall constitute an agreement by me that the application for Disability Retirement filed with the New York City Employees' Retirement System shall be disposed of by action of the Special Medical Committee pursuant to the Administrative Code of the City of New York, and that such action shall be final and conclusive.
Furthermore, by agreeing to the above, I waive any and all rights that I might otherwise have to seek or obtain any other disposition of such application for Disability Retirement by court, administrative proceedings or otherwise.
I understand that this waiver shall be effective and binding upon me in accordance with the terms stated herein.
(Emphasis added.)
On March 4, 1999, plaintiff signed and notarized the Waiver. On March 8, Morris's Union filed a request for a Special Medical Review on his behalf. Morris received a letter on March 26 ("March 26 Letter") from the Assistant Deputy Director of NYCERS that acknowledged receipt of the Union's March 8 request and described the next step in the Special Medical Review procedure:
Please be advised that you will be receiving, within the next few weeks, a letter, which will give you the names of the three (3) Special Medical Review Committee's doctors you must contact for a final medical review examination. .. You will be notified of the Special Medical Review Committee's decision approximately 30 days following your last appointment with the Special Medical Review Committee.
On April 7, 1999, Morris received a letter from NYCERS ("April 7 Letter"), with a list of the three doctors who would be his Special Medical Review Committee (Dr. Lester Lieberman, Dr. Robert Zartesky, and Dr. Shiela Horn) and instructing Morris to schedule appointments with each of them. The April 7 Letter contained the first notice to Morris regarding the Special Medical Review Committee's procedures, including notice that he could not provide the Special Medical Review Committee with additional evidence in support of his claim. It described the procedure to be followed by the Special Medical Review Committee as follows:
Each physician will have available for review all the information submitted to the NYCERS' Medical Board, the Medical Board's report and the NYCERS' minutes of any relevant Board of Trustees deliberations. You may not submit any additional evidence to the Special Medical Review Committee.
Upon receipt of this committee's reports, the consensus of the Review Committee will be transmitted to NYCERS, and you will be notified of the final disposition.
(Emphasis in original.)
In May, Morris was examined by the three Medical Review Committee doctors. Each doctor filled out a Review Committee Physician's Report of Findings and Disability ("Report"). The Report presented two questions:
I. REQUEST FOR ACCIDENTIAL [sic] DISABILITY RETIREMENT
Is the employee physically or mentally incapacitated for the performance of the duties of his/her job title?
II. FOR ACCIDENTAL DISABILITY ONLY
Is the employee's disability a natural and proximate result of an accident incurred in the performance of such duty?
Both questions had "Yes" and "No" boxes that could be checked off. The Report also included a third section for "Reports of Findings (e.g. Medical History, Exam Findings and Diagnosis)."
In their Reports, Dr. Lieberman checked "Yes" to Questions I and II; Dr. Zaretsky checked "Yes" to Question I and "No" to Question II; and Dr. Horn checked "No" to Question I and did not check a response to Question II. All three doctors attached additional findings to the Report. Although the three physicians disagreed in their assessment of Morris only one of the three concluded that Morris was "incapacitated for the performance of the duties of his job title" as the result of "an accident incurred in the performance of such duty." On September 1, 1999, Morris received a final letter from NYCERS ("September 1 Denial"), that stated:
This is to advise you that the Special Medical Review Committee agreed with findings of the NYCERS' Medical Board....
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