Worker’s Medical Evidence Carries Day on Questions about Fall from Ladder

Case File

Testimony of two doctors was enough for a New York court to find in a worker's favor on the question of whether the worker's injury arose out of and in the course of his employment. Simply Research subscribers have access to the full text of the decision.

Case

Balseca v. Hudson Concrete Inc., No. CV-24-1236 (N.Y. App. Div. 05/22/25)

What Happened

A worker filed a claim for workers' compensation benefits alleging that he sustained injuries to his neck, back, right arm, right shoulder, right elbow, right wrist, both hips, and both legs when he fell off a ladder while working.

Following a hearing and medical depositions, a workers' compensation law judge disallowed the claim, finding the workers' testimony regarding his accident to be incredible.

On appeal, the Workers' Compensation Board credited the worker's testimony and established the claim for injuries to the claimant's neck, back, right shoulder, right elbow, both knees, and both hips.

The employer's carrier appealed.

Rule of Law

New York cases have held that the board is the sole and final judge of witness credibility, and "it alone" can evaluate the factors relevant to determining whether the testimony of a party or witness is worthy of belief. See Arce v. Schear Constr., LLC, 222 N.Y. S. 3d 212 (N.Y. App. Div. 2024).

What Appellate Division Said

Appellate Division affirmed the board's decision and found that the board had substantial evidence to find that the worker's accident arose out of and in the course of his employment.

Appellate Division cited the following facts to support its ruling:

+ The worker testified that he fell about four feet to the floor after the ladder he was standing on moved, causing him to lose his balance.

+ According to the worker, the fall occurred approximately 15-30 minutes before the end of his shift, and he did not tell his supervisor about the fall that day because he was afraid that he would lose his job.

+ The worker further testified that when he awoke the day after his fall, he was in a lot of pain and asked a friend to drive him to the hospital, where he was diagnosed with acute back pain.

+ The next day, the worker informed the employer of his injury via certified letter.

+ A pain management specialist first examined claimant three days after his fall and testified that his examination was limited to claimant's neck, back and right shoulder. 

+ The specialist diagnosed the worker with a sprain or strain of the cervical and lumbar spine, lumbar radiculopathy, right shoulder arthropathy, and right shoulder contusion and opined that the worker's injuries were consistent with and causally related to his reported fall at work.

+ An orthopedic surgeon, examined the worker three weeks after his fall, testifying that he did not examine claimant's neck or back and diagnosed him with right shoulder sprain with rotator cuff and labral tearing, right elbow sprain with partial flexor tendon tearing, bilateral hip sprain and labral tearing, and bilateral knee sprain with cruciate ligament injuries and meniscal tearing, findings that he testified were confirmed by a subsequent MRI. 

+ According to this surgeon, the injuries were causally related to the worker's reported fall at work.

+ The carrier's surgeon found that the worker suffered a causally related lumbar strain/sprain and right hip contusion.

"Given that the Board is vested with the authority to weigh conflicting medical evidence and to credit the opinion of one medical expert over another, and may accept or reject portions of a medical expert's opinion, substantial evidence supports the Board's determination establishing the claim for injuries to claimant's neck, back, right shoulder, right elbow, both knees and both hips," Appellate Division wrote.

Takeaway

Appellate Division will disturb a question of fact resolved by the Workers' Compensation Board only when the board's decision is not supported by substantial evidence.

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