1. Introduction
This decision addresses how a workers’ compensation claim may proceed when the injured employee dies before adjudication and cannot testify or undergo an independent medical examination. It also examines whether an accident involving a worker with preexisting heart disease arose out of employment, and whether accident-related injuries contributed sufficiently to death to support death benefits.
Walter E. Greek worked as a school bus driver for the self-insured Dansville Central School District. Although he had premature ventricular contractions and cardiomyopathy, his conditions had been treated, and he had been assessed as presenting no imminent risk of symptoms that would interfere with safely operating a commercial vehicle.
On April 5, 2022, while driving an empty bus into the employer’s garage parking lot, he lost control and struck another bus. He was found unresponsive and in ventricular fibrillation. Efforts to restore his normal heart rhythm took approximately an hour. He sustained neurological injury from prolonged inadequate circulation, together with kidney, lung and rib injuries, and remained comatose until his death five days later.
Two proceedings followed: a claim for benefits attributable to injuries sustained during his lifetime and a separate death benefits claim. After his surviving spouse also died, Michelle L. Greek prosecuted both proceedings as executor of his estate. The employer challenged the continuation of the lifetime claim, the handling of a missed prehearing conference and the causal connection between employment, injury and death.
The court affirmed the Workers’ Compensation Board’s operative amended decisions. Its significance lies principally in applying established doctrines together: death does not automatically terminate an unresolved claim; procedural objections may be waived through delay; an unexplained workplace accident may receive the statutory presumption of work connection; and a compensable injury need only contribute to death, rather than be its sole or predominant cause.
3. Analysis: Legal Reasoning
A. Mandatory procedural language does not eliminate waiver
The employer relied on 12 NYCRR 300.38(g)(16), which directs that a represented claimant’s case be marked “no further action” when the claimant fails to appear or is otherwise unprepared at a prehearing conference. The opinion also referenced the corresponding provision for unrepresented claimants, 12 NYCRR 300.33(f)(9).
The court did not resolve the issue by announcing an automatic exception for deceased claimants. Instead, it focused on the employer’s conduct. Although the regulations did not expressly authorize waiver, the employer could waive a procedural objection by failing to raise it at the proper time. Its objection came long after the May 2022 conference and after substantial additional proceedings.
The distinction matters: the decision does not make the attendance requirement optional. It establishes that an employer cannot necessarily preserve a procedural objection indefinitely merely because the underlying regulation uses mandatory language.
B. Death does not automatically extinguish an unresolved compensation claim
The Board has discretion to continue proceedings after an injured employee dies, resolve outstanding disputes and make an appropriate award. That discretion is constrained by the practical ability to adjudicate the claim fairly.
Abatement may be warranted when the record is undeveloped and death prevents the employer from meaningfully investigating contested matters through cross-examination or an independent medical examination. The relevant question is therefore not simply whether those opportunities have been lost, but whether their loss leaves the employer unable to develop and contest the material issues.
Here, surveillance footage documented the accident, and hospital records documented its aftermath. The employer also retained a physician to review the medical records and address causation. Those sources allowed the parties to litigate the central dispute without the employee’s testimony or a physical examination.
The court accordingly found substantial evidence supporting the Board’s assessment of the available record and no abuse of discretion in allowing the claim to continue. This is a record-specific ruling, not a declaration that every deceased employee’s claim must survive.
C. Occurrence at work and causal connection to work are distinct requirements
A compensable injury must occur both in the course of employment and arise out of employment. The first requirement concerns the circumstances in which the employee was working. The second concerns the connection between employment and the accident or injury.
The accident indisputably occurred while Greek was performing his work. Workers’ Compensation Law § 21(1) therefore supplied a rebuttable presumption that the accident also arose out of employment, absent substantial evidence to the contrary.
The employer argued that an unrelated episode of ventricular fibrillation caused Greek to lose consciousness before the collision. On that account, the initial medical emergency was personal rather than occupational, and the rib and lung injuries resulted from resuscitation following that unrelated event.
The Board was not required to accept that sequence. Greek’s treating cardiologist testified that he had been doing well and that a premature ventricular contraction unexpectedly progressing to the fatal rhythm would have been surprising given his history. Both treating cardiologists acknowledged that chest trauma could produce the arrhythmia. The employer’s reviewing physician, meanwhile, admitted that he was assuming a cardiac event had caused unconsciousness before the collision.
The medical uncertainty therefore did not compel a finding against compensability. The Board credited evidence undermining the employer’s proposed sequence and found that the medical proof did not establish an unrelated cardiac event preceding the accident. The court deferred to that permissible assessment.
Importantly, the decision does not establish that work definitively caused the initial arrhythmia. It upholds the Board’s finding that the employer’s competing explanation did not defeat compensability on this record.
D. Injuries from necessary treatment remained within the compensable chain
The employer’s argument concerning resuscitation injuries depended on treating the cardiac emergency as unrelated to work. Once the Board rejected that premise, it could find the ensuing injuries compensable whether they resulted directly from the collision or from necessary treatment for the injuries sustained.
The reasoning recognizes that the consequences of a compensable accident can extend beyond the immediate impact. It does not hold that injuries sustained during every workplace medical intervention are automatically compensable; the connection to the compensable event remains essential.
E. A work-related injury need only contribute to death
The death benefits claim required its own causal analysis. Claimant did not have to prove that the compensable condition was the sole or most direct cause of death. A contributing causal role was sufficient.
The death certificate identified complications of probable cardiac arrhythmia due to nonischemic cardiomyopathy as the immediate cause, but also identified multiple blunt force injuries as significant contributing factors. The medical examiner explained that, more likely than not, the traumatic injuries imposed additional stress on Greek’s already vulnerable heart and contributed to his death.
The post-accident treating cardiologist could not exclude a contribution from the trauma and had no reason to dispute the medical examiner’s assessment. The affirmative foundation was thus not merely a physician’s inability to rule out causation: it included the medical examiner’s positive opinion and the death certificate.
The court upheld the Board’s decision to credit that evidence. Underlying heart disease and compensable trauma were not mutually exclusive causes; both could contribute to the fatal outcome.
F. Appellate review respected the Board’s fact-finding role
The court repeatedly acknowledged that evidence could support a different result. That did not authorize it to choose a different medical explanation or reassess witness credibility. Its task was to determine whether substantial evidence supported the Board’s findings and whether the Board properly exercised its discretion.
This distinction explains the result: affirmance did not require the employer’s account to be medically impossible, only that the Board’s contrary findings had adequate evidentiary support.
5. Potential Impact and Limits
Evidence preservation becomes especially important when the worker cannot participate. Surveillance footage, contemporaneous treatment records and expert records review may preserve the ability to adjudicate a claim despite death. Their value lies in addressing the actual disputed issues, not merely in increasing the volume of documentation.
Employers must raise procedural objections promptly. A mandatory-sounding regulation does not necessarily protect a party that permits proceedings to continue without timely objection.
Preexisting disease does not settle accident causation. The existence of a cardiac condition did not establish that a personal medical event preceded and caused the collision. Future cases will still depend on the evidence concerning sequence, mechanism and the statutory presumption.
Death benefits can coexist with a dominant nonoccupational disease. A work-related injury may contribute to death by imposing additional stress on an already compromised organ. The decision nevertheless requires supporting causal evidence; it does not equate temporal proximity with causation.
The opinion is best understood as a coordinated application of existing doctrine rather than a wholesale new rule. It does not make all posthumous claims viable, all accidents at work compensable, or all deaths following a workplace injury work-related. Nor does it decide general questions about entitlement to or distribution of benefits after the deaths of an employee and surviving spouse.