A New York appellate court has ruled in favor of a worker's right to receive diagnostic testing for hearing loss under workers' compensation laws. The decision, made on May 28, 2026, affects George Clement, who has been seeking further medical evaluation for his occupational hearing condition. This ruling is significant as it clarifies the responsibilities of employers and insurance carriers regarding medical treatments for employees with established injuries.
The case, known as Matter of Clement v. Colwell Bros., was filed under docket number CV-24-1878. The Appellate Division of the Supreme Court of the State of New York upheld a previous decision by the Workers' Compensation Board, which had authorized the diagnostic testing that Clement requested. This ruling emphasizes the importance of providing necessary medical care to workers who have suffered occupational diseases.
George Clement, the claimant, established a workers' compensation claim in 1989 for binaural hearing loss, receiving a 23% schedule loss of use award. In 2022, the liability for his claim was transferred to the Special Funds, which are responsible for covering certain medical treatments and care needs under the Workers' Compensation Law. In 2023, audiologist Sarah Sugden submitted a request for diagnostic testing, including tympanometry and audiometry evaluations, based on Clement's severe hearing loss documented in prior tests.
The request for diagnostic testing was initially denied by Special Funds during both Level 1 and Level 2 reviews. Following this, Sugden sought a Level 3 adjudication review, leading to a hearing where a Workers' Compensation Law Judge authorized the testing. The judge found that the evidence presented showed that the tests were causally related to Clement's existing condition and were medically necessary.
The Workers' Compensation Board affirmed this decision on October 15, 2024, leading to the appeal by Colwell Brothers and the insurance carrier. The court ruled that employers and carriers have a duty to provide medical treatment for established injuries under Workers' Compensation Law § 13(a). The ruling stated, "Whether a particular medical treatment is appropriate...is a factual issue for the Board to resolve, and its determination in this regard will be upheld if supported by substantial evidence."
The court's decision highlighted that the request for diagnostic testing was not simply based on the timing of the evaluations but on substantial medical evidence. The court noted that Sugden's request included test results indicating severe hearing loss and a recommendation for re-evaluation. The ruling emphasized that the Board is free to accept or reject medical evidence and determine its weight, ensuring that each case is assessed on its own facts.
As a result of this ruling, workers like George Clement can expect continued support for necessary medical evaluations related to their occupational injuries. This decision reinforces the need for employers and insurance carriers to carefully consider the medical documentation provided by healthcare professionals when evaluating claims for diagnostic testing and treatment.
The implications of this ruling extend beyond just Clement's case. It sets a precedent that may influence how future workers' compensation claims are handled, particularly those involving occupational diseases and the medical evaluations required for ongoing treatment. Employers and insurance companies will need to ensure they are compliant with the court's interpretation of their responsibilities under the law.
Going forward, the decision may encourage more workers to seek necessary medical evaluations without fear of denial based on procedural grounds. It also underscores the importance of thorough medical documentation in supporting claims for diagnostic testing and treatment.
Details were not available in the court filing regarding whether the decision can be appealed further. However, the carrier's subsequent application for reconsideration and/or full Board review was denied, indicating that the ruling stands as is for now. There are no related cases mentioned in the opinion that may impact this decision.