The opinion
NOT FOR PUBLICATION WITHOUT THE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-2441-23
CAROL TAYLOR,
Petitioner-Appellant,
v.
BOARD OF TRUSTEES,
TEACHERS' PENSION AND
ANNUITY FUND,
Respondent-Respondent.
__________________________
Argued March 31, 2025 – Decided June 4, 2025
Before Judges Berdote Byrne and Jablonski.
On appeal from the Board of Trustees of the Teachers'
Pension and Annuity Fund, Department of the
Treasury, Agency Docket No. TPAF xx6336.
Samuel M. Gaylord argued the cause for appellant
(Szaferman Lakind Blumstein & Blader, PC, attorneys;
Samuel M. Gaylord, on the brief).
Matthew C. Melton, Deputy Attorney General, argued
the cause for respondent (Matthew J. Platkin, Attorney
General, attorney; Sookie Bae-Park, Assistant Attorney
General, of counsel; Matthew C. Melton, on the brief).
PER CURIAM
Petitioner appeals from the Teachers' Pension and Annuity Fund Board's
(the "Board") denial of her request for accidental disability retirement benefits
("ADR benefits") under N.J.S.A. 18A:66-39(c). The Board confirmed the
Administrative Law Judge's ("ALJ's") decision that petitioner was permanently
and totally disabled. The Board also adopted the ALJ's conclusion that
petitioner's condition was caused by an exacerbation of a pre-existing condition
rather than from a specific accident rendering her ineligible for ADR benefits.
Deferring to the ALJ's factual conclusions and credibility assessments, we
affirm.
I.
Petitioner was a long-time employee of the Mercer County Special
Services School District as a physical therapist. As part of her job
responsibilities, she often had to lift, push, and pull as part of her daily contact
with the special needs students she assisted. During her twelve-year career, she
developed a history of lower back injury following accidents she suffered in
2008, 2018, and 2019.
In 2008, petitioner was diagnosed with radiculopathy and lower back pain
from herniated discs in her lower back that occurred when she attempted to lift
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a student out of a car. After she received steroid injections to the injury area
and other conservative treatment, she returned to work approximately one year
later.
Ten years later, in 2018, she suffered a lumbar strain and sprain and
additional disc herniations when she tried to lift another student. Her treatment
for this injury was more extensive. She was referred to an orthopedic surgeon
who diagnosed her with a host of maladies including left-side and left leg
sciatica, intervertebral disc degeneration in her lumbar region, acute bilateral
lower back pain without sciatica, disc herniations, axial back pain, and
degenerative disc disease. She received epidural injections and referrals to a
spine surgeon for her radiating pain. In mid-2019, another orthopedic surgeon
cleared petitioner to return to work and advised that she adhere to specific
physical conditions including weight-lifting restrictions and avoiding repetitive
bending. This physician also concluded that this accident may have been related
to her 2008 injury. Following later examination, petitioner was cleared to return
to work without any restrictions.
Petitioner returned to work in September 2019. Ten days later, she fell
onto a concrete floor and reinjured her back when she provided gait-training
therapy to a student. She was initially instructed to ice the injured area. Later,
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after her back was x-rayed, she was given muscle relaxers and prescribed
physical therapy. Additional diagnostic testing by a consulting physician
revealed a lumbar strain. That same physician concluded this injury aggravated
her previous injury from 2018 that had not completely healed. The doctor
ultimately concluded petitioner suffered muscle strains in her lower back and
radiculopathy in her back's lumbar region. The doctor also ordered a course of
physical therapy.
In November 2019, petitioner was cleared to return to work with similar
lifting, weight, and movement restrictions. She was also referred to a pain
management specialist who gave her two injections that temporarily relieved her
pain. Although petitioner was again cleared to return to work on light duty,
petitioner testified that she was ultimately unable to work because of the impact
the injury had on her inability to perform the activities of daily living.
In November 2020, petitioner applied for ADR benefits. The Board
considered the application, denied her request, and awarded ordinary disability
benefits at the maximum level instead. The Board concluded that although
petitioner suffered an accident as part of her assigned duties and the accident
was both undesigned and unexpected, her disability was not directly caused by
the September 2019 accident. Rather, the Board found it resulted from an
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aggravation of a pre-existing condition. Petitioner appealed this determination
and the Board approved petitioner's request for an evidentiary hearing before
the Office of Administrative Law.
At the hearing, the parties presented competing expert testimony as to the
extent and permanency of petitioner's disability. Both experts reviewed medical
records and took medical histories, and both conducted independent medical
examinations. Petitioner's expert concluded that petitioner was totally and
permanently disabled because of the September 2019 accident. The Board's
expert, however, concluded petitioner's total and permanent disability resulted
from an exacerbation of the 2018 injury. The ALJ considered both experts
credible.
In her decision, the ALJ noted that "[t]he outcome of this case turns on
the credibility of the medical experts and their assessments of [petitioner's ]
medical condition." Declining to accept petitioner's expert's conclusion and
agreeing instead with the Board's expert, the ALJ ultimately determined the
Board's expert's opinion was more reasonable because it was more consistent
with petitioner's medical history. The ALJ noted:
However, [petitioner's expert] stands alone in his
conclusion. [Petitioner's consulted physicians] agree
with [the Board's expert's] conclusion. Specifically,
[one treating physician] stated in his October 7, 2019,
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5
report that the petitioner had not fully healed from the
October 2018 injury to her lower back and there was no
additional diagnosis beyond lumbar strain from the
September 13, 2019, incident . . . . The radiculopathy
had already developed. Similarly, [another treating
physician] noted the petitioner's pre-existing injuries
with regard to her October 15, 2018, injuries.
In a comprehensive written opinion, the ALJ ultimately concluded that
petitioner had not satisfied her burden to prove that her disability was directly
caused by the 2019 incident and, therefore, she was not entitled to ADR benefits.
This appeal followed.
II.
A.
"Our review of administrative agency action is limited." Russo v. Bd. of
Trs., Police & Firemen's Ret. Sys., 206 N.J. 14, 27 (2011) (citing In re
Herrmann, 192 N.J. 19, 27 (2007)); see also McKnight v. Bd. of Rev., Dep't of
Lab., 476 N.J. Super. 154, 162 (App. Div. 2023). "An administrative agency's
final quasi-judicial decision will be sustained unless there is a clear showing that
it is arbitrary, capricious, or unreasonable, or that it lacks fair support in the
record." Russo, 206 N.J. at 27 (quoting Herrmann, 192 N.J. at 27-28). Our
review of an agency's decision considers:
(1) whether the agency's action violates express or
implied legislative policies, that is, did the agency
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follow the law; (2) whether the record contains
substantial evidence to support the findings on which
the agency based its action; and (3) whether in applying
the legislative policies to the facts, the agency clearly
erred in reaching a conclusion that could not reasonably
have been made on a showing of the relevant factors.
[In re Proposed Quest Acad. Charter Sch. of Montclair
Founders Grp., 216 N.J. 370, 385-86 (2013) (quoting
Mazza v. Bd. of Trs., Police & Firemen's Ret. Sys., 143
N.J. 22, 25 (1995)).]
We must affirm an agency's findings of fact if "supported by adequate,
substantial[,] and credible evidence." In re Taylor, 158 N.J. 644, 656-57 (1999)
(quoting Rova Farms Resort, Inc. v. Invs. Ins. Co. of Am., 65 N.J. 474, 484
(1974)). Moreover, if we are "satisfied after [our] review that the evidence and
the inferences to be drawn therefrom support the agency head's decision, then
[we] must affirm even if [we] feel[] that [we] would have reached a different
result . . . ." Clowes v. Terminix Int'l, Inc., 109 N.J. 575, 588 (1988). The
burden of demonstrating arbitrary, capricious, or unreasonable action rests upon
the party challenging it. McGowan v. N.J. State Parole Bd., 347 N.J. Super.
544, 563 (App. Div. 2002). We are not bound, however, by an agency's
"determination of a strictly legal issue . . . ." Russo, 206 N.J. at 27 (quoting
Mayflower Sec. Co., Inc. v. Bureau of Sec., 64 N.J. 85, 93 (1973)). We review
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its purely legal conclusions de novo. In re Ridgefield Park Bd. of Educ., 244
N.J. 1, 17 (2020).
B.
A Teachers' Pension and Annuity Fund (TPAF) member is eligible for
ADR benefits if the member is "permanently and totally disabled as a direct
result of a traumatic event occurring during and as a result of the performance
of [the member's] regular or assigned duties." N.J.S.A. 18A:66-39(c) (emphasis
added). A petitioner seeking ADR benefits "must prove a disabling permanent
. . . injury and, in so doing, must produce such expert evidence as is required to
sustain that burden." Patterson v. Bd. of Trs., State Police Ret. Sys., 194 N.J.
29, 50-51 (2008).
Our Supreme Court established a five-part test to determine when an
injury was a direct result of a traumatic event. The burden rests on the applicant
to prove, by a preponderance of the evidence:
1. that [petitioner] is permanently and totally disabled;
2. as a direct result of a traumatic event that is
a. identifiable as to time and place,
b. undesigned and unexpected, and
c. caused by a circumstance external to the
member (not the result of pre-existing
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disease that is aggravated or accelerated by
the work);
3. that the traumatic event occurred during and as a
result of the member's regular or assigned duties;
4. that the disability was not the result of the member's
willful negligence; and
5. that the member is mentally or physically
incapacitated from performing his usual or any other
duty.
[Richardson v. Bd. of Trs., Police & Firemen's Ret.
Sys., 192 N.J. 189, 212-13 (2007).]
In interpreting the "direct result" causation requirement, "the traumatic
event need not be the sole or exclusive cause of the disability." Gerba v. Bd. of
Trs. of Pub. Emps.' Ret. Sys., 83 N.J. 174, 187 (1980), overruled on other
grounds by Maynard v. Bd. of Trs. of Teachers' Pension & Annuity Fund, 113
N.J. 169 (1988). Causation is satisfied when "the traumatic event is . . . the
essential significant or substantial contributing cause of the disability . . . even
though it acts in combination with an underlying physical disease." Ibid.
However, if the traumatic event merely "contributed to the progression of [the]
[underlying] condition" by "aggravation," then it is not the "essential significant
or substantial contributing cause" of the disability. Id. at 189, 187.
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C.
Petitioner's sole argument on appeal is that she sustained her burden of
proof established that her permanent and total disability was substantially
caused by the September 2019 incident. She argues because she was able to
perform all of her job-related duties before the September 2019 accident, and
she was unable to do so after it, she has established her causation requirement
and her expert's conclusion is more reasonable than the Board's. We disagree.
"When error in factfinding of a judge or administrative agency is alleged,
the scope of appellate review is limited. We will decide whether the findings
made could reasonably have been reached on 'sufficient' or 'substantial' credible
evidence present in the record considering the proofs as a whole." Cannuscio v.
Claridge Hotel and Casino, 319 N.J. Super. 342, 347 (App. Div. 1999) (citing
Close v. Kordulak Bros., 44 N.J. 589, 599 (1965)). "Appellate review does not
consist of weighing evidence anew and making independent factual findings;
rather, our function is to determine whether there is adequate evidence to support
the judgment rendered at trial." Ibid. (citing State v. Johnson, 42 N.J. 146, 161
(1964)). On appeal, the court gives "due regard to the opportunity of the one
who heard the witnesses to judge . . . their credibility." Close, 44 N.J. at 599.
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As the ALJ noted, "the weight to which an expert opinion is entitled can
rise no higher than the facts and reasoning upon which that opinion is
predicated." State v. Jenewicz, 193 N.J. 440, 466 (2008) (quoting Johnson v.
Salem Corp., 97 N.J. 78, 91 (1984)). "This is particularly true when . . . the
factfinder is confronted with directly divergent opinions expressed by the
experts." State v. M.J.K., 369 N.J. Super. 532, 549 (App. Div. 2004). The
weight accorded to an expert's testimony may depend on several factors, such
as whether the expert is testifying regarding their specialty, if their conclusions
are largely based on the patient's subjective complaints or on a cursory
examination, and if their opinions are supported by objective evidence
corroborated or contradicted by other physicians. Angel v. Rand Express Lines,
Inc., 66 N.J. Super. 77, 86 (App. Div. 1961). The factfinder, rather than a
reviewing court, "is better positioned to evaluate the witness' credibility,
qualifications, and the weight to be accorded [his or] her testimony." In re
Guardianship of DMH, 161 N.J. 365, 382 (1999).
Here, the ALJ's credibility determinations that were ultimately adopted by
the Board were supported by ample evidence in the record. It is undisputed
between the testifying experts that petitioner had a history of back problems
beginning in 2008. She received substantial treatment for this pain from 2018
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until a few weeks before the September 2019 injury. After it, she experienced
identical issues including lower back pain and left leg pain with the addition of
right-sided sacroiliac joint pain and right leg pain.
Petitioner had a well-documented history of lumbar spine issues that,
according to the Board's expert, were "exacerbated" by the September 2019
injury. Petitioner's expert does not contest petitioner's age-related conditions in
her spine and pre-existing lumbar spine pathology were "aggravated." These
facts constitute substantial credible evidence to affirm the Board's denial of
ADR benefits.
Here, the ALJ provided detailed reasoning as to why she placed more
significant weight on the testimony provided by the Board's expert as opposed
to that of the petitioner. Given the deference accorded to such determinations,
we find no error.
Affirmed.
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