APPEAL from a decision and award of the Workmen's Compensation Board, filed June 12, 1952, for compensation under the Workmen's Compensation Law for reduced earning capacity.
Albert P. Thill for appellants.
John W. Sweeney for claimant-respondent.
Nathaniel L. Goldstein, Attorney-General (Harry Pastor and Roy Wiedersum of counsel), for Workmen's Compensation Board, respondent.
The issue of law here before us is to determine whether there is substantial evidence, when the medical record is considered as a whole, to support an award by the Workmen's Compensation Board. The law problem that thus arises on what is 'substantial' medical proof when the case is seen as an entity is in an area not easily defined.
Records which have not been regarded as providing substantial evidence in support of awards are of some help in casting the line, but each case brings with it its own need for evaluation of whether the proof, including the opinion evidence of the physicians, gives substantial support to the findings reviewed.
Two recent cases give perspective to this problem. In Matter of Kopec v. Buffalo Brake Beam-Acme Steel & Malleable Iron Works (304 N.Y. 65) there was medical opinion by a single physician that he believed that an accident aggravated claimant's tuberculosis; the other medical proof in the record was overwhelming the other way and was based on findings of numerous chest and lung specialists. The physician who expressed the opinion in support of accidental aggravation had previously stated the tuberculosis was caused by occupation; and his opinion that the accident aggravated it was thought by the court to have been inconsistent and variable (p. 69), and not to afford a substantial ground to support the decision of the board (p. 72).
In Matter of Peploe v. Burns Bros. (281 A.D. 134) the opinion of a physician was given in the record that the decedent's fall in the course of employment had caused a coronary infarction which arose from the breaking off of a thrombus already existing in the heart; but the demonstrated proof on autopsy was that the thrombus had closed off a blood vessel and had not broken off; that there was no evidence of internal or external trauma, and that in the opinion of the physician performing the autopsy death was due to natural causes. The determination of the board based on a finding of association between the fall and the death was reversed because it was not supported by substantial evidence.
The mere expression of medical opinion, even if given in unequivocal language and firm tones, may not always afford a substantial basis for a finding in support of a compensation award where in the context of the record it may be demonstrated to the court that the board in crediting it did not use a considered judgment and has rejected relevant evidence which a reasonable mind would accept as adequate. There is, on judicial review, "sufficient flexibility"' to authorize correction of "ascertainable
abuses"'. (See decision and authorities cited in Matter of Kopec v. Buffalo Brake Beam-Acme Steel & Malleable Iron Works, supra, p. 71.)
There is, of course, adhering to this problem the question that always adheres to it, as to what one judge or another, or one administrator or another, would mean by words like 'substantial' and 'considered judgment' and 'adequate' and 'ascertainable abuses'; but the process of decision involves reference to these terms and requires an adjudication guided by a professional tradition in which these ...