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Eidam v. Emps' Ret. Sys. of R.I.

Superior Court of Rhode Island, Kent
Feb 21, 2024
No. KC-2022-0659 (R.I. Super. Feb. 21, 2024)

Opinion

KC-2022-0659

02-21-2024

DAWN EIDAM Plaintiff, v. EMPLOYEES' RETIREMENT SYSTEM OF RHODE ISLAND Defendant.

For Plaintiff: Harry J. Hoopis, Esq. For Defendant: Michael P. Robinson, Esq. Larissa Delisi, Esq.


For Plaintiff: Harry J. Hoopis, Esq.

For Defendant: Michael P. Robinson, Esq. Larissa Delisi, Esq.

DECISION

VAN COUYGHEN, J.

The matter before this Court is Dawn Eidam's (Plaintiff or Ms. Eidam) appeal of the Employees' Retirement System of the State of Rhode Island's (ERSRI) decision granting her Application for Accidental Disability Retirement with a retirement benefit allowance of 50 percent of her compensation at the time of retirement. Ms. Eidam contends that she is entitled to a total disability pension with payment in the maximum amount allowed by statute. For the reasons contained herein, Plaintiff's appeal is denied, and ERSRI's decision is affirmed. Jurisdiction is pursuant to G.L. 1956 § 42-35-15.

I

Facts and Travel

Ms. Eidam submitted her Application for Accidental Disability Retirement (Application) to ERSRI on September 18, 2020. See Designation of Administrative Record (Admin. R.) 0022-0030. In her Application, Ms. Eidam states that she was employed by Rhode Island Community Living and Supports (RICLAS) as a Community Living Aid. See id. at 0024. She asserts that she was "[a]ssaulted by [a] client, thrown into [a] table, then thrown onto the floor" while at work on October 24, 2018, resulting in "[d]isk [h]erniations [and] foot drop[.]" See id. at 0023-0024. She states that this caused her to "[lose] feeling from [her right] knee down" and chronic pain in her lower back and left hip. Id. at 0023. The facts involving the incident in question and her initial injuries are not in dispute.

The procedure whereby the applicant can file for accidental disability retirement is set forth in 120 RICR 00-00-1.9. Individuals seeking disability retirement begin the application process by submitting a three-part form to ERSRI. See id. at 0022-0030, 0033-0035, 0096-0098. The first part is completed by the applicant, the second by her employer, and the third by the applicant's doctor. See id. In addition to the information related to the applicant's disability requested in the form, ERSRI also requires that the applicant's employer and medical providers submit employment and medical records to the agency. See id. at 0028-0030, 0035.

Disability retirement applications are initially submitted to ERSRI's Retirement Board (Retirement Board or Board), which is responsible for the general administration of the state employees' retirement system, including making the final determination as to whether or not to grant an application for disability retirement. G.L. 1956 § 36-8-3. Applications for ordinary and accidental disability retirement are then referred to the Retirement Board's Disability Subcommittee (Disability Subcommittee or Subcommittee) for a preliminary review. 120 RICR 00-00-1.9(E). After the Subcommittee receives a complete application, it refers the applicant to three physicians for an examination. Id. at (C)(6). Each physician provides the Disability Subcommittee with a report which includes his or her opinion regarding the extent that the applicant's disability limits his or her ability to pursue employment. (Admin. R. 0073-0094.) In addition to the application materials and medical examinations, the Subcommittee may require the applicant to appear before it to answer questions regarding the application. 120 RICR 00-00-1.9(E)(4). The Subcommittee makes a recommendation to the Retirement Board on whether to grant an application based on its review of the application materials and the reports submitted by the three physicians engaged by the agency. G.L. 1956 §§ 36-10-14 and 36-10-15 (citing G.L. 1956 § 28-33-17(b)); 120 RICR 00-00-1.9(D). The Retirement Board then votes on whether to accept the Subcommittee's recommendation. 120 RICR 00-00-1.9(E)(2).

An applicant aggrieved by the Board's decision may request a reconsideration hearing before the Disability Subcommittee, at which point he or she is given the opportunity to make remarks and submit any new evidence in support of his or her application. Id. at (F), (H). This reconsideration hearing is the only stage in the application process in which an applicant is expressly provided the right to speak before members of the Board or Subcommittee, pursuant to 120 RICR 00-00-1.9. The Subcommittee then makes a second recommendation to the Board as to whether or not to grant disability retirement in light of the information presented at the reconsideration hearing. Id. at (I). The Retirement Board then votes on whether to accept the Subcommittee's new recommendation. Id. This second vote by the Retirement Board constitutes a final decision from ERSRI, at which point the applicant is entitled to judicial review of the agency's decision by the Superior Court. Id. at (I)(2); § 42-35-15(a).

The record reflects that, as part of Ms. Eidam's Application, her employer submitted an Injury Report, an Employer's Disability Statement, and a description of her responsibilities as a Community Living Aid. (Admin. R. 0031-0072.) Her treating physician, Alan Daniels, M.D., (Dr. Daniels) also submitted a Physician's Statement to the Committee. Id. at 0096-0133.

The Injury Report was completed and signed by her supervisor on the day of the injury, October 24, 2018. Id. at 0032. It states that Ms. Eidam was injured at 7:30 that morning when a client attacked her, causing pain in her left elbow, left rib cage, left hip, and lower back, as well as bruising and swelling to her left shin. Id. The Employer's Disability Statement was completed by Maria Coleman, Human Resources Analyst I, on September 11, 2020, and states that "[a]ccording to [Ms. Eidam]'s treating provider she is unable to perform all of her job duties." Id. at 0034-0035. The Physician's Statement, completed by her treating physician, Dr. Daniels, states that "Ms. Eidam . . . remains temporarily [and] totally disabled now as of 08/18/2020," and "cannot perform a job as she cannot do any lifting, she cannot have any risk of altercations, needs to be able to alternate between sitting and standing, [and] cannot work a full day due to endurance issues. At this moment [on August 18, 2020,] she cannot work at all, but this will change at the next visit when she will be released to modified return to work. She is not yet at maximum medical improvement but will be at the next visit." Id. at 0099.

Ms. Eidam was examined by three physicians in connection with her application in June and July of 2021. See id. at 0073-0095. Each physician performed a physical exam and reviewed her medical history. See id. at 0075-0076, 0083-0086, 0092.

Following his physical examination of Ms. Eidam and a review of her medical records, Kenneth Catallozzi, M.D. (Dr. Catallozzi) found that Ms. Eidam's injuries were probably caused by her accident at work. Id. at 0074, 0076-0077. He stated that he does not believe Ms. Eidam "would be able to perform her regular work duties in a group home environment" and that "working in that . . . environment is potentially injurious to her health." Id. at 0077. He added that he "believe[s] at the present time [July 16, 2021] [Ms. Eidam] has reached maximum medical improvement from her occupational injury . . . ." Id. Dr. Catallozzi also stated that he "believe[s] [Ms. Eidam] is not permanently and totally disabled from any employment[,]" and that she would be able to work in a "more sedentary environment that would allow for frequent changes in position and did not require any lifting greater than 10 pounds or repetitive bending, stooping or lifting activities." Id.

Following his physical examination of Ms. Eidam and a review of her medical history, John Golberg, M.D. (Dr. Goldberg) also believed that she was "unable to perform the essential duties" of her previous job as a Community Living Aid, but that she was "not permanently or totally disabled" from any employment. Id. at 0087-0088. He believed that she "achieved maximal medical improvement [in] her recovery from spinal surgery[,]" adding that "[s]he is left with some degree of chronic lumbago and mild residual radicular symptoms on the left and some persisting weakness of dorsiflexion of the left ankle." Id. He ultimately concluded that she "may function in other capacities that do not require direct patient contact. At least she could function as a personal care attendant under different circumstances that did not require heavy lifting." Id. at 0088.

Similarly, David Mayer, M.D. (Dr. Mayer) found that Ms. Eidam is unable to perform her job as a Community Living Aid due to her injuries from the workplace accident on October 24, 2018. Id. at 0093. Dr. Mayer reviewed Ms. Eidam's medical history, interviewed her over the phone, and conducted a physical examination. Id. at 0092. He stated that "[h]er job requires physical strength to restrain behavioral outbursts. It involves extensive housekeeping labors. In her present condition [on or about July 23, 2021,] she is unable to do this, and she is very vulnerable to further injury should she be assaulted." Id. at 0093. Furthermore, he had "no expectation [her condition would] improve further in regards to the back pain and sciatica and mild foot drop." Id. at 0094. However, he also stated that she is able to perform a sedentary job that does not require "lifting over 15 pounds, . . . bending, squatting, . . . [or climbing] more than 1 flight of stairs[,]" and allows her to "change position at will[.]" Id. at 0093. He also reported that Ms. Eidam "state[d] that she would like to try a receptionist type of job with the freedom to . . . sit and stand at will if uncomfortable." Id. at 0094. In accordance with those findings, Dr. Mayer determined that Ms. Eidam was "not permanently disabled from any employment[.]" Id.

On October 1, 2021, following its review of the reports submitted by the physicians engaged by the agency and other materials submitted by Ms. Eidam, her employer, and her treating physician, the Disability Subcommittee voted to recommend that the Board grant her Application for Accidental Disability Retirement, but with a benefit allowance of 50 percent of her compensation at the time of retirement. Id. at 0004, 0019-0020. The Subcommittee made its recommendation based on its finding that Ms. Eidam was permanently and totally disabled from her job as a Community Living Aid, but not totally and permanently disabled from any employment. Id. at 0019. The Subcommittee's findings and recommendation to the Retirement Board were based on the papers submitted in connection with Ms. Eidam's Application. See id. at 0019-0020; 120 RICR-00-00-1.9(E).

On October 8, 2021, the Retirement Board voted to accept the Disability Subcommittee's recommendation. Id. at 0004.

Ms. Eidam requested a reconsideration hearing pursuant to 120 RICR 00-00-1.9(F). See id. at 0017-0018. Ms. Eidam appeared pro se before the Disability Subcommittee for her reconsideration hearing on May 6, 2022. See generally id. at 0010-0013 (Hr'g Tr.). The hearing was primarily focused on the Subcommittee's reconsideration of whether she was "permanently and totally disabled from any employment as opposed to just the duties of [her] job." (Hr'g Tr. 7:2-6.) The record does not indicate that the Subcommittee requested Ms. Eidam to appear to answer questions in connection with her Application before it made its first recommendation to the Retirement Board, thus this reconsideration hearing was her only opportunity to speak with members of the Board or Subcommittee. See 120 RICR 00-00-1.9. In her remarks, she explained that she started working at RICLAS at twenty-two years old and did not "have [the] skills to go out and get a . . . decent paying job." (Hr'g Tr. 7:23-24.) She added that, because of the "limitations [caused by the accident], [she] couldn't even qualify to get a job at Dunkin' Donuts or Walmart, because [she] can't stand . . . for long periods of time[,]" cannot "walk for long distances[,]" and wears a brace every day. Id. at 7:25-8:4. In response to Subcommittee members' questions, Ms. Eidam stated that she was still able to drive for about forty-five minutes to an hour before needing to stop and stretch, able to stand for only ten minutes "at the most," and can only walk for the distance of about two blocks because of her chronic pain. Id. at 8:19-9:18. Ms. Eidam added that she underwent an MRI and CAT Scan as part of her treatment and that she was waiting for the results of those tests. Id. at 9:20-22, 10:18-19. Furthermore, she stated that she was recently notified that she would receive disability benefits from the Social Security Administration. Id. at 9:22-23, 9:25-10:1. Subcommittee members also asked about her education and skills. Id. at 12:2-19. She stated that she had a high school education and that she "[did not] know how to work . . . an office computer[,]" but that she can use Google. Id. at 12:4, 12:12-19.

After the hearing, the Disability Subcommittee recommended to reaffirm its initial recommendation to approve Ms. Eidam's Application at 50 percent of her annual compensation. (Admin. R. 0007-0008.) It reached this decision, in part, based on the medical records submitted to ERSRI, in which all three doctors engaged by the Retirement Board believed Ms. Eidam was unable to perform her job as a Community Living Aid, but that she was not permanently and totally disabled from any employment. Id. at 0007. It also relied on the statement submitted by Ms. Eidam's treating physician, Dr. Daniels, who also found that she could not perform her current job, but that she was not permanently and totally disabled from any employment. Id. at 0007, 0097. The Subcommittee also relied on Ms. Eidam's own statements, both from the hearing and the statements she made to one of the doctors who evaluated her, stating that she was able to take care of everyday activities and could perform sedentary work. Id. at 0007. The Subcommittee found that Ms. Eidam "presented as bright, articulate and engaging. She testified that she is capable of utilizing the internet, and given her testimony as to her capabilities, as well as her evident personable and intelligent presentation, the [Subcommittee] believe[d] she is capable of becoming proficient in computer usage for purposes of engaging in sedentary employment." Id. For those reasons, the Subcommittee reaffirmed its recommendation, pursuant to the criteria established in § 36-10-15(b) and forwarded it to the Board. Id. at 0007-0008.

On May 18, 2022, ERSRI's Retirement Board accepted the Subcommittee's recommendation. Id. at 0004. ERSRI notified Ms. Eidam of its decision by mail in a letter dated July 26, 2022. Id. at 0001. Ms. Eidam, now represented by counsel, filed her Complaint on August 23, 2022 to appeal the agency's decision to the Superior Court. (Compl.)

II

Standard of Review

Section 42-35-15(g) of the Administrative Procedures Act (APA) establishes this Court's appellate jurisdiction to review final decisions issued by state administrative agencies. See McAninch v. State of R.I. Department of Labor & Training, 64 A.3d 84, 87 (R.I. 2013). Pursuant to § 42-35-15(g):

The court shall not substitute its judgment for that of the agency as to the weight of the evidence on questions of fact. The court may affirm the decision of the agency or remand the case for further proceedings, or it may reverse or modify the decision if substantial rights of the appellant have been prejudiced because the administrative findings, inferences, conclusions, or decisions are:
(1) In violation of constitutional or statutory provisions;
(2) In excess of the statutory authority of the agency;
(3) Made upon unlawful procedure;
(4) Affected by other error of law;
(5) Clearly erroneous in view of the reliable, probative, and substantial evidence on the whole record; or
(6) Arbitrary or capricious or characterized by abuse of discretion or clearly unwarranted exercise of discretion.

In reviewing an administrative agency's decision, "[q]uestions of law determined by the administrative agency are not binding upon [the court] and may be freely reviewed to determine the relevant law and its applicability to the facts presented in the record." Department of Environmental Management v. State Labor Relations Board, 799 A.2d 274, 277 (R.I. 2002) (citing Carmody v. R.I. Conflict of Interest Commission, 509 A.2d 453, 458 (R.I. 1986)). Notwithstanding this Court's authority to afford great deference to an administrative agency's factual findings, "'questions of law-including statutory interpretation-are reviewed de novo."' McAninch, 64 A.3d at 86 (quoting Heritage Healthcare Services, Inc. v. Marques, 14 A.3d 932, 936 (R.I. 2011)). This Court may vacate an administrative decision based on errors of law. R.I. Temps, Inc. v. Department of Labor & Training, Board of Review, 749 A.2d 1121, 1125 (R.I. 2000) (citing Environmental Scientific Corp. v. Durfee, 621 A.2d 200, 208 (R.I. 1993)). Furthermore, when a question of law involves an issue of statutory interpretation, the Court's "'ultimate goal is to give effect to the purpose of the act as intended by the Legislature."' McAninch, 64 A.3d at 86 (quoting Labor Ready Northeast, Inc. v. McConaghy, 849 A.2d 340, 344 (R.I. 2004)).

Conversely, when considering questions of fact, the Court "may not substitute its judgment for that of the agency and must affirm the decision of the agency unless its findings are clearly erroneous." Guarino v. Department of Social Welfare, 122 R.I. 583, 588, 410 A.2d 425, 428 (1980) (citing § 42-35-15(g)(5)). Further, the Court may not "weigh the evidence [or] pass upon the credibility of witnesses [or] substitute its findings of fact for those made at the administrative level." E. Grossman & Sons, Inc. v. Rocha, 118 R.I. 276, 285, 373 A.2d 496, 501 (1977). Rather, § 42-35-15(g) limits the Court to an examination of the record in order to ascertain whether the agency's decision is supported legally by competent and substantial evidence. See Center for Behavioral Health, Rhode Island, Inc. v. Barros, 710 A.2d 680, 684 (R.I. 1998). Legally competent evidence is "relevant evidence that a reasonable mind might accept as adequate to support a conclusion [and] means an amount more than a scintilla but less than a preponderance." Town of Burrillville v. R.I. State Labor Relations Board, 921 A.2d 113, 118 (R.I. 2007) (internal quotation omitted).

III

Analysis

The criteria for granting accidental disability retirement benefits to state employees are set forth in § 36-10-14, which provides in part:

(a) Medical examination of an active member for accidental disability and investigation of all statements and certificates by him or her or in his or her behalf in connection therewith shall be made upon the application of the head of the department in which the member is employed or upon application of the member, or of a person acting in his or her behalf, stating that the member is physically or mentally incapacitated for the performance of service as a natural and proximate result of an accident while in the performance of duty, and certify the definite time, place, and conditions of the duty performed by the member resulting in the alleged disability, and that the alleged disability is not the result of willful negligence or misconduct on the part of the member, and is not the result of age or length of service, and that the member should, therefore, be retired.
(b) The application shall be made within five (5) years of the alleged accident from which the injury has resulted in the members present disability and shall be accompanied by an accident report and a physicians report certifying to the disability . . . . The application may also state the member is permanently and totally disabled from any employment.
(c) If a medical examination conducted by three (3) physicians engaged by the retirement board and such investigation as the retirement board may desire to make shall show that the member is physically or mentally incapacitated for the performance of service as a natural and proximate result of an accident, while in the performance of duty, and that the disability is not the result of willful negligence or misconduct on the part of the member, and is not the result of age or length of service, and that the member has not
attained the age of sixty-five (65), and that the member should be retired, the physicians who conducted the examination shall so certify to the retirement board stating the time, place, and conditions of service performed by the member resulting in the disability and the retirement board may grant the member an accidental disability benefit.

The amount an applicant receives in accidental disability retirement benefits depends on the extent that his or her disability limits the applicant's ability to work. See § 36-10-15. Applicants who are "found [by the Board] to be permanently and totally disabled from service but . . . not . . . permanently and totally disabled from any employment as a result of his/her accidental disability . . . shall receive a retirement allowance equal to fifty percent (50%) of the rate of the member's compensation at the date of the member's retirement[.]" Id. at (b). In contrast, an applicant "found by the [B]oard to be permanently and totally disable[d] from any employment . . . shall receive a retirement allowance equal to sixty-six and two-thirds percent (66 ⅔ %)" of his or her compensation at time of retirement. Id. at (c).

The Retirement Board is required to apply the terms of § 28-33-17(b) in deciding whether an applicant is permanently and totally disabled from service in their current role or disabled from any kind of employment. See § 36-10-15(c). Section 28-33-17 provides in pertinent part:
(b)(1) In the following cases, it shall, for the purpose of this section, be that the injury resulted in permanent total disability:
(i) The total and irrecoverable loss of sight in both eyes or the reduction to one-tenth (⅒) or less of normal vision with glasses;
(ii) The loss of both feet at or above the ankle;
(iii) The loss of both hands at or above the wrist;
(iv) The loss of one hand and one foot;
(v) An injury to the spine resulting in permanent and complete paralysis of the legs or arms; and
(vi) An injury to the skull resulting in incurable imbecility or insanity.
(2) In all other cases, total disability shall be determined only if, as a result of the injury, the employee is physically unable to earn any wages in any employment; provided, that in cases where manifest injustice would otherwise result, total disability shall be determined
when an employee proves, taking into account the employee's age, education, background, abilities, and training, that he or she is unable, on account of his or her compensable injury, to perform his or her regular job and is unable to perform any alternative employment. The court may deny total disability under this subsection without requiring the employer to identify particular alternative employment.

On appeal, Ms. Eidam argues that the Retirement Board's decision is contrary to the rules and regulations governing accidental disability retirement and clearly erroneous in view of the reliable, probative, and substantial evidence on the record. (Mem. of Law in Supp. of Pl.'s Compl. (Pl.'s Mem.) 5.) Specifically, Plaintiff asserts that the Disability Subcommittee should have "continue[d] the hearing to a date subsequent to [her] schedule[d] MRI and C[AT] Scan," and that ERSRI failed to consider Plaintiff's testimony "that she was receiving Social Security Disability benefits and that the Social Security Administration determined that she was totally and permanently disabled from any employment." Id. at 2.

The only information on the record pertaining to an award from the Social Security Administration is Ms. Eidam's statement at the reconsideration hearing that she "just received disability, Social Security. . . . I just got my notice of award for that[.]" (Hr'g Tr. 9:22-23, 9:25-10:1.) Plaintiff did not state that the Social Security Administration "determined that she was totally and permanently disabled" during the hearing and has not provided any evidence to support that assertion. See Pl.'s Mem. 2. Recipients of Social Security Disability Insurance are not necessarily required to establish that they are permanently or totally incapacitated from employment (discussed infra). See 20 C.F.R. § 404.1505.

In response, ERSRI argues the Retirement Board's decision was supported by legally competent evidence and was well-grounded in statutory and decisional law. (Def.'s Mem. of Law in Supp. of its Decision of May 18, 2022 (Def.'s Memo) 2.) ERSRI argues its finding that Ms. Eidam is not totally and permanently disabled from any employment is supported by legally competent evidence on the record. Id. at 14-17. It also argues that the Disability Subcommittee did not err in failing to continue the reconsideration hearing because Ms. Eidam did not request a continuance. Id. at 18. Third, ERSRI asserts that it did not err by failing to reference Ms. Eidam's alleged receipt of federal disability benefits from the Social Security Administration in its written decision because ERSRI is not bound by determinations of the Social Security Administration and because the standards for receiving each set of benefits are different. Id. at 20-21.

Here, the Retirement Board's decision to grant Ms. Eidam's Application with a benefit allowance of 50 percent of her compensation at the time of retirement was properly determined and in accordance with §§ 36-10-14 and 36-10-15. See generally Admin. R. Furthermore, its finding that Ms. Eidam is permanently and totally disabled from service as a Community Living Aid but not "permanently and totally disabled from any employment" is clearly supported by competent and substantial evidence on the record. See id. at 0007.

Pursuant to the requirements set forth in § 36-10-14, Ms. Eidam submitted her Application to the Retirement Board on September 18, 2020, stating that she was physically incapacitated for the performance of service as a Community Living Aid. See id. at 0023-0025. Her Application was made within less than five years from the workplace accident that caused her disability, which occurred on October 24, 2018. See id. at 0023-0024; § 36-10-14(b). Ms. Eidam was also examined by three physicians engaged by the Retirement Board; all three doctors believed her disability prevented her from performing her job as a Community Living Aid, but that she was not disabled from any employment because she could work in a sedentary environment. Admin. R. 0077, 0087-0088, 0093; see § 36-10-14(c).

The Retirement Board relied on the evidence provided in Ms. Eidam's Application and her remarks from the reconsideration hearing before the Disability Subcommittee to determine that her disability prevents her from performing the essential duties of a Community Living Aid, but that the Board was still "unable to conclude that [Ms.] Eidam is incapable of any employment." Id. at 0007.

The Disability Subcommittee focused on the reports from all three independent medical examiners and Ms. Eidam's treating physician's statement in making its recommendation to the Retirement Board. Id. The Subcommittee found that all three independent examiners reached the conclusion that she "is not permanently and totally disabled from any employment[,]" based on the reports submitted by Dr. Catallozzi, Dr. Goldberg, and Dr. Mayer. Id. It also relied on the Physician's Statement completed by her treating physician, Dr. Daniels, in which he "checked a box indicating that she is not permanently and totally disabled from any employment, and stated: . . . '[s]he may return to work with permanent restrictions . . . .'" Id. The Subcommittee found that, based on Ms. Eidam's testimony at the reconsideration hearing, she is able to "drive, garden, run errands, cook meals, and take care of routine activities of daily living." Id. Specifically, it relied on her statement that "[she] can do everything. It just, you know, takes a little longer and-But I can, you know, take care of myself." Id. It also found that "[s]he testified that she is capable of utilizing the internet, and given her testimony as to her capabilities, as well as her evident personable and intelligent presentation, . . . [Ms. Eidam] is capable of becoming proficient in computer usage for purposes of engaging in sedentary employment." Id.

The Subcommittee specifically included Dr. Catallozzi's statement that "[he] believe[d] [Ms. Eidam] is not permanently and totally disabled from any employment[;]" Dr. Goldberg's statement that Ms. Eidam "is not permanently or totally disabled[;]" and Dr. Mayer's statement that "[Ms. Eidam] state[d] that she would like to try a receptionist type of job with the freedom to sit and stand at will if uncomfortable." (Admin. R. 0007.)

In reviewing an administrative agency's decision, this Court may not "weigh the evidence [or] pass upon the credibility of witnesses [or] substitute its findings of fact for those made at the administrative level" or "substitute its judgment for that of the agency and must affirm the decision of the agency unless its findings are clearly erroneous." E. Grossman & Sons, Inc., 118 R.I. at 285, 373 A.2d at 501; Guarino, 122 R.I. at 588, 410 A.2d at 428 (citing § 42-35-15(g)(5)). In the instant matter, it is clear that Ms. Eidam suffered substantial permanent injuries. However, it is also clear that the Retirement Board relied upon competent medical evidence in its determination that Ms. Eidam is not permanently and totally disabled from any employment as a result of her disability following her accident at work on October 24, 2018. Although Plaintiff has presented medical records and testimony to ERSRI indicating that she cannot perform her job as a Community Living Aid, she has not provided any evidence that she is unable to perform a sedentary job. See generally Admin. R. The medical records from each independent examiner and the statement from her treating physician clearly support the Retirement Board's finding that Ms. Eidam is not permanently and totally disabled from all employment. See id. at 0073-0133. Every doctor who evaluated her believed that she was not totally and permanently disabled from all employment. Id. at 0077, 0087-0088, 0093, 0097. In fact, Ms. Eidam stated to Dr. Mayer that "she would like to try a receptionist type of job with the freedom to . . . sit and stand at will if uncomfortable." Id. at 0094.

Additionally, her testimony at the reconsideration hearing demonstrates that she can perform everyday tasks, take care of her raised-bed garden, drive a car for trips of about forty-five minutes to an hour, and walk short distances. See Hr'g Tr. 8:19-9:18, 11:15-16. Although Ms. Eidam stated that her disability would preclude employment at places such as Dunkin' Donuts or Walmart because she cannot stand for extended periods of time or walk far distances, she did not provide any evidence or explanation for why she is unable to perform a sedentary job that permits her to sit or stand throughout the day. See id. at 7:21-8:4. Even on appeal, Plaintiff does not explain how the Subcommittee's finding that she is not permanently and totally disabled from any employment is erroneous in light of ample evidence it relied on to make its recommendation. See Pl.'s Mem.

Therefore, because the Retirement Board relied upon competent evidence from medical exams performed by doctors engaged by the Retirement Board, a statement submitted by Ms. Eidam's treating physician, and Ms. Eidam's own statements regarding her physical limitations, this Court finds that ERSRI's decision to grant Ms. Eidam's Application with a retirement benefit allowance of 50 percent of her compensation at the time of retirement was founded on competent evidence on the record and thus properly decided. See Guarino, 122 R.I. at 588, 410 A.2d at 428 (citing § 42-35-15(g)).

This Court also finds that ERSRI did not err in failing to continue the reconsideration hearing to a later date. See Pl.'s Mem. 2. It is within the Disability Subcommittee's discretion to postpone its decision on an application for accidental disability retirement to allow time for an applicant to present additional information to the Subcommittee. 120-RICR-00-00-1.9(E)(3). In the instant matter, Ms. Eidam did not request that the Subcommittee postpone its decision so that it would be able to consider the results from her MRI and CAT Scan, thus Ms. Eidam waived consideration of those reports. See generally Hr'g Tr. The Subcommittee had sufficient information necessary to make its recommendation on her Application pursuant to §§ 36-10-14 and 36-10-15. See Admin. R. 0003-0008. In addition, although Plaintiff argues that the Disability Subcommittee should have waited to consider the test results before making its determination, she does not provide any additional medical records on appeal or explain how the test results could have impacted the Disability Subcommittee's finding that she is not permanently and totally disabled from any employment. See generally Pl.'s Mem. Accordingly, this Court finds that it was proper for the Subcommittee to make its recommendation based on the information before it on the day of the reconsideration hearing, May 6, 2022. See §§ 36-10-14 and 36-10-15; Hr'g. Tr.; Admin. R. 0003-0008.

In addition, the Retirement Board acted within its authority in finding that Ms. Eidam was not permanently and totally disabled from any employment notwithstanding testimony that she received Social Security disability benefits. Administrative agencies are granted discretion to weigh the evidence before them when addressing questions of fact. See § 42-35-15(g). This Court must defer to the agency "as to the weight of the evidence on questions of fact" unless its findings were "[c]learly erroneous," or "[a]rbitrary[.]" See §§ 42-35-15(g)(5) and 42-35-15(g)(6). Plaintiff does not explain how the Retirement Board's findings were clearly erroneous or arbitrary on appeal. See generally Pl.'s Mem. The Board acted within its discretion by placing more weight and credibility to the professional opinions of four medical doctors, among other highly credibly evidence, over Plaintiff's testimony regarding notice of a future award from a different government agency. See § 42-35-15(g). Because the Retirement Board's finding is clearly supported by legally competent evidence (discussed supra), this Court disagrees with Plaintiff's contention that the Retirement Board did not place enough weight on her testimony regarding Social Security disability benefits.

Furthermore, Plaintiff asserts that the Retirement Board failed to consider that "the Social Security Administration determined that she was totally and permanently disabled from any employment." (Pl.'s Mem. 2.) Plaintiff has not provided evidence to support that assertion. While Ms. Eidam stated that she would receive Social Security disability benefits, she did not state that the Social Security Administration found her to be totally and permanently disabled. See Hr'g Tr. 9:22-10:1. Further, the criteria that the Social Security Administration considers when determining whether to award disability benefits is different than the criteria ERSRI considers in determining whether to grant accidental disability retirement. Compare 20 C.F.R. § 404.1505 with §§ 36-10-14 and 36-10-15 (citing § 28-33-17(b)); see also Matter of McCaffrey v. Town of East Fishkill, 42 A.D.3d 22, 25 (N.Y.App.Div. 2007) ("The essential attributes of [state-run accidental disability retirement] plans are that they provide enhanced retirement benefits . . . . SSDI [Social Security Disability Insurance] benefits are different. [T]he SSDI program is not a pension program, it is an insurance program.") (citing 42 USC § 423; Sanchez v Schweiker, 656 F.2d 966, 968 (5th Cir. 1981); Matter of Scheuring v. New York State Comptroller, 32 A.D.3d 1127 (N.Y.App.Div. 2006)). Furthermore, the two programs serve significantly different purposes. See id. Social Security disability benefits are a form of insurance awarded to individuals who cannot "do any substantial gainful activity" because of any physical impairment expected to last at least twelve months. 20 C.F.R. § 404.1505(a). By contrast, the form of disability retirement sought by Plaintiff functions as a retirement plan that is awarded to individuals who are totally and permanently disabled from any employment. Sections 36-10-14 and 36-10-15 (citing § 28-33-17(b)). The standard to award Social Security disability benefits is lower than to grant accidental disability retirement. See Rossi v. Employees' Retirement System, 895 A.2d 106, 112 (R.I. 2006). ("[W]orkers' compensation [i.e., a monetary award granted to individuals disabled from work, but not necessarily permanently incapacitated, like Social Security disability] is not intended as a substitute for retirement, and therefore the standards for receiving benefits are less demanding than the requirements for accidental disability [retirement]." (citing Tavares v. Aramark Corp., 841 A.2d 1124, 1128 (R.I. 2004) and Mullaney v. Gilbane Building Co., 520 A.2d 141, 143-44 (R.I. 1987)). Even if this Court was permitted to reassess the weight and credibility given to the evidence in Ms. Eidam's Application, an award of Social Security disability benefits is immaterial to ERSRI's decision whether to grant Ms. Eidam disability retirement because the benefits from both agencies are awarded based on significantly different criteria.

The Court is sympathetic to the injury that Ms. Eidam suffered as a result of the accident at work and the restrictions imposed by her disability; however, the evidence presented on appeal does not support a finding that she is disabled from any employment.

IV

Conclusion

In conclusion, the Retirement Board properly relied upon competent evidence in making its determination that Plaintiff is not totally and permanently disabled from any employment. Accordingly, the decision of the Retirement Board is hereby affirmed, and Plaintiff's appeal is denied. Council shall confer and submit the appropriate order and judgment for entry by the Court.


Summaries of

Eidam v. Emps' Ret. Sys. of R.I.

Superior Court of Rhode Island, Kent
Feb 21, 2024
No. KC-2022-0659 (R.I. Super. Feb. 21, 2024)
Case details for

Eidam v. Emps' Ret. Sys. of R.I.

Case Details

Full title:DAWN EIDAM Plaintiff, v. EMPLOYEES' RETIREMENT SYSTEM OF RHODE ISLAND…

Court:Superior Court of Rhode Island, Kent

Date published: Feb 21, 2024

Citations

No. KC-2022-0659 (R.I. Super. Feb. 21, 2024)