On certification to the Superior Court, Appellate Division.
The opinion of the Court was delivered by O'hern, J. Chief Justice Wilentz and Justices Handler, Pollock, Garibaldi, Stein, and Coleman join in Justice O'Hern's opinion.
The opinion of the court was delivered by: O'hern
(This syllabus is not part of the opinion of the Court. It has been prepared by the Office of the Clerk for the convenience of the reader. It has been neither reviewed nor approved by the Supreme Court. Please note that, in the interests of brevity, portions of any opinion may not have been summarized).
IN THE MATTER OF IRENE MUSICK, DEPARTMENT OF CORRECTIONS (A-27-95)
Argued October 11, 1995 -- Decided February 1, 1996
O'HERN, J., writing for a unanimous Court.
Sick-leave injury (SLI) benefits for State employees who sustain work-related injuries are benefits that are supplementary to otherwise collectible workers' compensation benefits. The issue on appeal is the validity of an agency interpretation of a regulation that would limit SLI benefits to a one-year period following the first date of disability from work.
Irene Musick contracted carpal tunnel syndrome in connection with her employment as a clerk-bookkeeper in the New Jersey Department of Corrections (DOC). Carpal tunnel syndrome (CTS) is a disease of the musculoskeletal system most often associated with the stress arising from the repetitive movement of the hands, in this case, across a computer keyboard. The symptoms of CTS are pain, numbness in the hands, and sometimes pain radiating to the back. The effects of this disease are painful and can be disabling.
On August 14, 1989, Musick was referred by her employer to a DOC physician because of pain and numbness in the fingers of her left hand and pain in her left arm and shoulder. The DOC physician examined her and then referred her to West New Jersey Occupational Health Services (WJO). Doctors at WJO diagnosed CTS of the left hand and told Musick to stay out of work. However, the DOC personnel office ordered her to return to work on August 28, 1989, in disregard of the doctor's order. Because of extreme pain, Musick was referred by her doctor to an orthopedic surgeon who operated on Musick's left hand on September 21, 1989. She was cleared to return to work on November 27, 1989.
Musick's employer denied her claim for SLI benefits for the period between August 14 and November 27, 1989. The employer contended that Musick had failed to establish that her condition was work-related. Musick appealed this denial of benefits to the Merit System Board (the Board). Musick relied on the opinion of her doctor that the left-hand CTS was work-related. Initially, the Board denied Musick any SLI benefits for her left-hand CTS. Musick appealed to the Appellate Division. That court remanded the matter to await the outcome of other matters pending in the Appellate Division.
Shortly after the remand, Musick began suffering from pain in her right hand, which was diagnosed as work-related CTS. Musick underwent surgery on the right hand on September 3, 1991. On September 16, 1991, Musick was again diagnosed with CTS of her left hand and had a second surgery on October 15, 1991.
On January 6, 1992, the Board issued its final decision in respect of Musick's CTS-related SLI claims. The Board found that she was disabled from work from August 14, 1989, until November 27, 1989, due to left-hand CTS, and was disabled from August 6, 1991, until October 9, 1991, as a result of right-hand CTS. The Board further found that Musick was disabled from October 9, 1991, until December 2, 1991, as a result of recurrence of CTS in her left hand. The Board granted Musick SLI benefits for the period of August 14 through November 27, 1989, for left-hand CTS and from August 6 through October 9, 1991, for right-hand CTS. The Board denied SLI benefits for left-hand CTS from October 9 through December 2, 1991, finding that this was just a continuation of Musick's disability from the 1989 claim. Relying on N.J.A.C. 4A:6-1.6(b)3, the Board concluded that SLI benefits are limited and are not compensable for disabilities that continue for more than a one-year period.
On appeal, the Appellate Division reversed and remanded the case for an award of SLI benefits reflecting the 1991 recurrence in Musick's left hand. The Appellate Division found that the disability was related to her work and that there was no reasonable basis to penalize Musick for the hiatus in her disability of that hand. The Appellate Division reasoned that there was nothing in the enabling statute, N.J.S.A. 11A:6-8, to indicate that the Legislature had any contrary intent. Therefore, the court invalidated N.J.A.C. 4A:6-1.6(b)3 to the extent that it would cap the benefits at one year from the date of injury.
The Supreme Court granted the Board's petition for certification.
HELD: Given the Merit System Board's balanced approach to recognition of repetitive stress injuries and its overall need to allocate available resources among all State employees, the Board's policy determination to limit SLI benefits to one year from the first date of the disability is within the agency's statutory mandate, and application of that policy to Irene Musick does not constitute such a clear abuse of discretion as to warrant judicial intervention.
1. Prior to October 1991, claims for SLI benefits for CTS were routinely denied. By late 1991, the Board recognized that that policy needed to be changed and, accordingly, began to award SLI benefits for CTS claims. By October 1992, the Board eliminated the need to establish a one-time occurring accident or traumatic event in order to get SLI benefits. In January 1993, the Appellate Division dealt with the application of the one-year limitation on benefits in In re Naomi Dykas, where it was held that it was on the date the disability began and not the date when the injury or illness became manifest that the one-year time limitation begins to accrue. The Dykas court in dicta dealt with the hiatus issue by finding that the employee should not be penalized by the hiatus in disability. (pp. 5-10)
2. The Board's policy is clear that provable claims of CTS will be recognized but SLI benefits will be limited to one year from the first date of disability from work. In response to Dykas, the Board amended N.J.A.C. 4A:1.6(b)3. In that amendment, the Board rejected the hiatus exception. (pp. 10-11)
3. Courts have only a limited role in reviewing the actions of other branches of government. Courts can intervene in the administrative actions of governmental agencies only in those rare circumstances in which an agency action is clearly inconsistent with its statutory mission or other state policy. In setting aside an agency decision, the Court must determine whether: 1) the agency followed the law; 2) the record contains substantial evidence to support the findings on which the agency bases its action; and 3) 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 relevant factors. In this case, the Court addresses the first and third prongs of that test. (pp. 12-14)
4. The Legislature has given a very broad mandate to the Board to adopt the necessary rules and regulations to implement the SLI benefits program. It is not an irrational choice of policies to establish a fringe benefit for State employees that differentiates between an employee whose injury and treatment require an immediate and protracted absence from work, and an employee whose treatment and absences from work may fall beyond one year from the date of the initial injury. Such a classification is not suspect. Although the issues are debatable, the debate regarding the choice of competing policies should be reserved for the agency itself unless the Legislature's intent is clear. (pp.14-17)
Judgment of the Appellate Division is REVERSED and the decision of the Merit System Board is REINSTATED.
CHIEF JUSTICE WILENTZ and JUSTICES HANDLER, POLLOCK, GARIBALDI, STEIN and COLEMAN join in JUSTICE O'HERN'S opinion.
The opinion of the Court was delivered by O'HERN, J.
This appeal concerns sick-leave injury (SLI) benefits for State employees who suffer work-related injuries. These benefits are supplementary to otherwise collectible workers' compensation benefits. The issue in this case is the validity of an agency interpretation of a regulation that would limit SLI benefits to a one-year period following the first date of disability from work. We find that to place such a cap on benefits is within the statutory ...