Full Opinion

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION This opinion shall not "constitute precedent or be binding upon any court ." Although it is posted on the internet, this opinion is binding only on the parties in the case and its use in other cases is limited . R. 1:36-3. SUPERIOR COURT OF NEW JERSEY APPELLATE DIVISION DOCKET NO. A-1427-24 KEITH A. YORK, Petitioner-Appellant, v. BOARD OF TRUSTEES, POLICE AND FIREMEN'S RETIREMENT SYSTEM, Respondent-Respondent. _________________________ Submitted September 28, 2026 – Decided October 26, 2026 Before Judges Sabatino and Perez Friscia. On appeal from the Board of Trustees of the Police and Firemen's Retirement System, Department of the Treasury, PFRS No. xx63245. Limsky Mitolo, attorneys for appellant (Marcia J. Mitolo, of counsel and on the briefs). Nels J. Lauritzen, Deputy Director of Legal Affairs, attorney for respondent (Kimberly A. Sked, Staff Attorney, on the brief). PER CURIAM Petitioner Keith A. York appeals from the Board of Trustees ("Board") of the Police and Firemen's Retirement System's December 10, 2025 final agency decision ("final decision"), which denied his application for accidental disability retirement benefits pursuant to N.J.S.A. 43:16A-7(a)(1). We affirm. I. The Incident We derive the following facts from the findings and evidence before the Administrative Law Judge ("ALJ") and the Board. York was employed as a corrections officer with the New Jersey Department of Corrections ("DOC") from June 2000 to January 2021. He worked as a Restorative Housing Unit ("unit") sergeant at the DOC's Garden State Correctional Facility, was responsible for monitoring the unit, and commanded over twenty officers. While York was working on January 26, 2021, inmates caused a unit disruption. As described by York, two inmates "took the tier hostage," "busted out cell windows, had weapons [and] shards of glass," and "other offenders" threw "soap" and "food items . . . on the floor" to create a hazard. An inmate flooded the first floor of the unit, resulting in water on the walkway areas. York slipped and fell due to the wet floor condition, hitting his left elbow and knee into the "concrete." He was taken to the facility's medical unit for A-1427-24 2 treatment and observed his left kneecap was abnormally positioned. He was later transported to a hospital. York recalled feeling pain on his "whole left side" and his leg was immobile. At the hospital, York turned his knee, heard "a pop," and felt it "relocate[]" "back into place." After the hospital performed x- rays, he was diagnosed with a dislocated left knee, provided a leg immobilizer, and discharged. York's x-rays showed "no acute findings in the left knee" and normal findings of the left elbow with "no acute fracture or dislocation," "joint effusion," or "foreign bodies." York's Injuries and Treatment Because he was experiencing left knee, left elbow, and neck pain, York went to "Occupational Health" the next day. York was diagnosed with knee and elbow contusions. He was referred to an orthopedist for his knee and thereafter started physical therapy sessions. On February 8, 2021, York met with Mark G. Schwartz, M.D., an orthopedist, regarding "pain," "weakness," and "numbness" in his arm, knee, and neck. Dr. Schwartz examined and treated York. After conducting additional x- rays of York's knee and elbow, Dr. Schwartz determined there were "[n]o acute bony abnormalities." Dr. Schwartz sent York for a knee magnetic resonance imaging scan ("MRI"), which showed there was "no ligament or meniscal A-1427-24 3 pathology," "no evidence of osteochondral injury," and "[m]ild degenerative chondromalacia of the patellofemoral compartment." Dr. Schwartz treated York's left elbow with an ulnar nerve injection in February 2021 and his left knee with an injection in March 2021. On March 24, 2021, Dr. Schwartz documented "concern[s] about some symptom magnification on the part of" York. In March 2021, Jeffrey F. Greenberg, M.D., a neurologist, evaluated York. Dr. Greenberg performed a physical examination and noted that "when [York] does a neck stretch to the right side and brings his arms down, he can recreate the paresthesias" sensation. Dr. Greenberg also conducted an Electromyographic Conduction Test ("EMG") that suggested York had "C6[- C]7 radiculopathy." Dr. Greenberg ordered an MRI of the cervical spine. Regarding York's left arm pain, Dr. Greenberg determined York had to see another orthopedist for a diagnosis, as the doctor could not find a "primary neurological issue" and "had no[] . . . treatment options." In April 2021, York had a cervical MRI and the radiologist's report1 indicated findings of: a C3-C4 "shallow disc herniation," C4-C5 "bulging of the 1 We note that York's medical records, including his x-rays and MRI reports, were admitted without objection at trial before the ALJ. A-1427-24 4 annulus," C5-C6 "spondylotic disc, somewhat asymmetric" and "impression upon the right . . . cervical cord similar to the previous examination," and C6- C7 "mild bulging of the annulus with perhaps a . . . shallow central protrusion." The MRI impression indicated York had at the C5-C6 vertebrae: "[d]egenerative disc disease"; a spondylotic disc causing stenosis and "cord compression similar to the previous study"; and "[b]ilateral foraminal encroachment . . . secondary to . . . joint hypertrophy." Additionally, the imaging revealed "disc protrusion at C3-[C]4 and possibly C6-[C]7." Dr. Schwartz reviewed the MRI and determined the images showed "C5[-C]6 spinal stenosis" and "C6-[C]7 radiculopathy" on the "left side." York had a previous cervical spine MRI performed in 2017 because he was experiencing neck pain along with numbness and tingling in his right arm. The 2017 MRI indicated that "[t]here [wa]s disc desiccation and intervertebral disc space narrowing at C5[-C]6" and "[m]ild disc desiccation [was] seen elsewhere in the upper cervical spine." The MRI report also showed "degenerative changes at the atlantodental joint . . . similar to the previous [2017] study." Dr. Greenberg noted there was no change seen at C5-C6 in the MRIs and that in the 2021 report, "encroachment was not commented upon" but York A-1427-24 5 could have had a nerve root "'tickled' and aggravated." Dr. Greenberg noted that "the lion's share of [York's] complaints . . . [were] non[-]neurological in nature." In April 2021, York met with Todd M. Lipschultz, M.D., an orthopedist, for a second opinion and received treatment until December 2021. Dr. Lipschultz evaluated York, noting York's pre-accident medical history included preexisting cervical pathology treated with injections. Regarding the prior cervical treatment, Dr. Lipschultz expressed that he wanted to review York's prior cervical treatment records. He noted York's April 2021 cervical MRI showed "degenerative disc disease predominantly [at] C5[-C]6." After evaluating York's knee in May 2021, Dr. Lipschultz opined that the MRI of York's left knee showed "mild degenerative chondromalacia of the patellofemoral joint" and "no evidence of ligamentous or meniscus pathology." On June 21, 2021, Dr. Lipschultz determined that York "did not sustain an injury to his neck" on the day he fell at the correctional facility and, "[t]herefore, [Dr. Lipschultz was] unable to relate the current diagnosis of a C6[- C]7 radiculopathy to the work incident." Regarding York's knee, Dr. Lipschultz related York's fall to the diagnosis of a "contusion to the patellofemoral joint[ and] an aggravation of [preexisting] degenerative patellofemoral arthritis." Regarding York's elbow, Dr. Lipschultz recommended the use of a brace and A-1427-24 6 another injection. Additionally, York was found "capable of working restricted duty" and was recommended to have further physical therapy. Dr. Lipschultz also ordered an MRI of York's left elbow. A June 30, 2021 left elbow MRI report indicated there was "no osseous, chondral, ligament[,] or tendon pathology" but found a "small amount of edema . . . without evidence of bursitis or discrete mass." In July 2021, Dr. Lipschultz noted York's left elbow MRI was "normal." He also observed the prior left knee MRI "revealed chondromalacia of the patella" that was "mild in nature" and the 2017 cervical MRI showed "small central dis[c] herniations" at C3-C4, C4-C5, C5-C6, C6-C7, and C7-T1. Dr. Lipschultz ordered a functional capacity evaluation, which occurred in August 2021 and revealed York was placed "at medium category work." In September 2021, Dr. Lipschultz examined York and noted the prior EMG had not shown any peripheral nerve entrapment, but York still complained of pain. After York had a cervical epidural injection at C7-T1 in October 2021, Dr. Lipschultz indicated York relayed "some improvement." Dr. Lipschultz documented that in December 2021 York was having cervical trigger point injections, but York had otherwise achieved maximum medical improvement for his injuries. A-1427-24 7 Matthew J. Lesneski,2 M.D., a pain management specialist, performed York's cervical epidural injection at C7-T1. Dr. Lesneski also referred York to see an orthopedic surgeon for his knee. In January 2022, Dr. Lesneski performed cervical trigger point injections on York. The same month, Dr. Lesneski opined York was disabled from work due to chronic pain and had reached maximum medical improvement. York's Retirement and Application for Benefits On February 11, 2022, York applied for accidental disability retirement benefits under N.J.S.A. 43:16A-7(a)(1) with the New Jersey Division of Pensions and Benefits. York asserted he was disabled from the work fall and could no longer work as a corrections officer based on "injuries to [his] left knee[,] . . . left elbow[,] and cervical spine." York retired on March 1, 2022. On June 23, 2022, Andrew M. Hutter, M.D., an orthopedist, conducted an independent medical evaluation ("IME") of York on behalf of the Board. Dr. Hutter reviewed York's medical records and conducted a physical examination. Dr. Hutter opined that York had cervical radiculopathy, a left elbow contusion, and left knee pain. Regarding the alleged 2 The record contains different spellings of Dr. Lesneski's last name. We use "Lesneski" in this opinion, which is the spelling used in his electronic signature on his office's billing sheets. A-1427-24 8 cervical spine injury, Dr. Hutter found that York's left extremity pain and radiculopathy did not "correlate with the findings on the MRI report or the EMG report." Dr. Hutter reported that York's "MRI report of the cervical spine note[d] there was no change compared to a prior study[,] which was done before the accident in question." In assessing York's left elbow, Dr. Hutter determined that York had "subjective complaints not corroborated by any objective findings." Dr. Hutter opined that York's knee was "not a permanent injury" and "there was no documentation" of "a dislocation of the patella" or of a "meniscal tear or ligament tear." Within a reasonable degree of medical probability, Dr. Hutter concluded York's alleged injuries were not related to the January 2021 work accident. On July 25, 2023, York had Munir Ahmed, M.D., an orthopedist, conduct an IME of his left elbow, left knee, and cervical spine. Dr. Ahmed opined within a reasonable degree of medical certainty that the injuries "had a direct impact on [York's] abilities to perform his job[-]related duties as a corrections officer." Regarding York's cervical spine, Dr. Ahmed noted an "[a]ggravation of [preexisting] quiescent age[-]related degenerative changes, cervical spine, with moderate central canal stenosis" at C5-C6. As to the 2017 cervical treatment, A-1427-24 9 Dr. Ahmed noted a "past history of cervical discomfort" and "an injection ," but he did not directly address the 2017 MRI findings. Dr. Ahmed further determined that York had "[p]ost[-]traumatic left elbow strain and sprain," "[p]ost[-]traumatic left knee strain and sprain"; and "[p]ost[-]traumatic patellofemoral chondromalacia of the left knee." He noted the x-ray of York's knee was "normal" and the MRI showed "mild degenerative chondromalacia of the patellofemoral compartment." Regarding York's elbow, Dr. Ahmed explained the MRI showed "a small amount of edema." Dr. Ahmed opined within a reasonable degree of medical certainty that York was "considered totally and permanently disabled as a corrections officer" as a "substantial direct result of the traumatic event of the work[-]related injury of January 26, 2021." In October 2023, after reviewing Dr. Ahmed's IME report, Dr. Hutter authored an addendum report stating his opinions "remain[ed] unchanged." Dr. Hutter's addendum opinions were "expressed within a reasonable degree of medical probability." The Board's Initial Denial On September 12, 2022, the Board denied York's accidental disability retirement benefits application, finding: "the medical documentation provided A-1427-24 10 indicate[d] that [York's] reported disability [was] the result of a [preexisting] disease alone or a [preexisting disease] that [was] aggravated or accelerated by the work effort."3 The Board noted York was previously approved for ordinary disability retirement based on a finding of his total and permanent disability from performing his regular work duties. The Office of Administrative Law Hearing and Testimony After York appealed the determination, the Board transferred the matter to the Office of Administrative Law as a contested case. The parties exchanged discovery. The ALJ presided over a three-day hearing at which York, Dr. Ahmed, and Dr. Hutter testified. Dr. Ahmed testified that after conducting the IME he diagnosed York with: "post-traumatic cervical sprain and strain;" "cervical radiculopathy;" "aggravation of [preexisting] quiescent age related degenerative cervical spine with moderate central canal stenosis per MRI 4/6/21;" "post interventional pain management with cervical epidural steroid injections"; "post-traumatic left elbow s[p]rain and strain"; "post-traumatic left knee sprain and strain"; "post- 3 We note that York's counsel, during trial, noted there was "no permanent disability in the knee" and as such the "IME only determined that his permanent disability resulted from a [preexisting] neck injury." Thus, York's cervical spine injury was the only claimed permanent injury. A-1427-24 11 traumatic patellofemoral chondromalacia of the left knee"; and "post injection of left knee and left elbow." Dr. Ahmed acknowledged York had prior cervical findings of degeneration, "arthritic changes," and "small central disc herniations [at] C3[-C]4" and "C4-[C]5." He believed York had a "possibl[e]" new finding of a disc protrusion at C6-C7, which was consistent with York's complaints on his left side. Dr. Ahmed explained that an MRI would not "show nerve root damage," and York's symptoms of "[p]ain radiating to the ring and little fingers of the left hand all the way down from the arm to the medial aspect or the inner aspect of the elbow to the hand" were consistent with C6-C7 radiculopathy. Dr. Ahmed opined that the C6-C7 radiculopathy was an aggravation of a preexisting injury "related to the disc herniation . . . s[een] by C6[-C]7." Regarding causation, Dr. Ahmed stated that "[t]he substantial cause [of the C6-C7 radiculopathy] was the work[-]related accident that occurred on January 26, 2021." Dr. Ahmed further opined that York's left knee injuries were permanent because "he suffered a[n] . . . injury to the undersurface of the kneecap" from the work accident. While Dr. Ahmed determined York reached maximum medical improvement based on the treatment he received, he conceded York had not participated in "other treatment courses that could be done for the knee." A-1427-24 12 On cross-examination, Dr. Ahmed admitted York's knee injury diagnosis was "speculative," but he believed the patella dislocation was highly likely. Dr. Ahmed also conceded York's elbow "MRI findings were unremarkable." Further, he acknowledged that York's 2017 cervical spine MRI showed "arthritis on top of the disc herniation at, . . . the C5[-C]6 level" and the 2021 MRI only indicated a "possible C6[-C]7" finding. While Dr. Ahmed's report indicated he did not review the 2017 MRI films, he stated he relied on the radiologists' report and opined that York "absolutely" had "an aggravation of [preexisting] arthritic changes." Dr. Ahmed acknowledged that York's cervical injection was at "the C7[-]T1 level" and not at C6[-C]7. York testified he sustained injuries from falling at work on January 26, 2021, resulting in pain on his whole left side. Regarding his knee, York believed it was dislocated from the fall, stated that it required constant bracing, explained that he received an unsuccessful injection, and testified that he has continued to experience knee pain with buckling. Regarding his elbow, he had received an injection that caused "severe pain." York described having continued neck pain and radiculopathy, requiring him to have trigger point injections. He was prescribed and taking Gabapentin, Meloxicam, and Flexeril, as well as other medications for his pain. A-1427-24 13 Dr. Hutter testified consistent with his report and explained that after conducting York's IME, which included reviewing York's medical records, he determined "that the limiting factor for [York] is his neck." Dr. Hutter determined York's "elbow examination . . . was relatively normal" and as to the "knee . . . patella dislocation," there was nothing observed except York's "subjective complaints." Dr. Hutter opined York was not totally and permanently disabled from either the knee or elbow injury. He did, however, opine that York was totally and permanently disabled based on his neck injury but found that the objective medical evidence demonstrated it was because of York's preexisting degenerative disc problems. Dr. Hutter disagreed with Dr. Ahmed's opinion regarding York's neck because York's 2017 MRI indicated "degenerative changes." Dr. Hutter testified that York's joint hypertrophy involved "little overgrowths where the area's narrowed so the nerve [was not] gliding freely." While he acknowledged York's fall aggravated his cervical condition, Dr. Hutter opined "the neck [consisted of] longstanding degenerative changes," was a "chronic condition" based on his "problems before," and that if York's "symptoms got worse in the future, it would be due to the longstanding degenerative changes and not the injury of 2021." A-1427-24 14 Addressing York's knee complaints, Dr. Hutter stated that he disagreed with Dr. Ahmed's opinion because Dr. Hutter had "treated chondromalacia patellae thousands of times in [his] career and it is not something that causes instability." Dr. Hutter described chondromalacia as a "softening of the cartilage underneath the kneecap," explaining it is "another word for . . . a type of arthritis, early arthritis," and results from "normal[] wear and tear." Further, he found no "pathology on the elbow." On cross-examination, Dr. Hutter admitted he did not read York's cervical diagnostic films but relied on the MRI reports. He maintained a "shallow protrusion" or bulge disc is not medically considered a problem without nerve root compression, which was not found on the 2021 MRI as to the C6-C7 disc. Dr. Hutter explained that the 2017 cervical MRI report's finding of cervical "asymmetric narrowing," "mean[t] more on one side than the other," but did not mean "it was only on one side" or the report "would say only one side." Dr. Hutter further stated that "if you dislocate [the patella], you tear the ligaments." The ALJ's Findings On October 10, 2024, the ALJ issued a written initial decision finding that York failed to meet his burden of demonstrating "by a preponderance of the credible evidence" that a permanent injury to York's cervical spine was caused A-1427-24 15 by the work fall. The ALJ considered the admitted medical records of York's treating physicians, hospital records, and experts' IME reports. It was acknowledged during the hearing that the issue before the ALJ was "whether the disability[,] which rendered the petitioner totally and permanently disabled[,] was a direct result of the January 26, 2021, incident." The ALJ recognized that York's "primary complaints related to his cervical spine, the left elbow[,] and the left knee." The ALJ noted Dr. Ahmed and Dr. Hutter "agree[d] that . . . [York] [wa]s totally and permanently disabled from the performance of his duties as a corrections officer." "However, they disagree[d] on the cause of the disability." In evaluating the doctors' testimony, the ALJ found Dr. Hutter's testimony more credible. The ALJ specifically determined York had "[in]sufficient credible evidence" demonstrating that he had a "total and permanent disability . . . related to the" work incident. Further, the ALJ stated, "the fact that the petitioner had been working following the injury to the cervical spine in 2017 . . . is not dispositive of the issue" because "the greater weight of the evidence demonstrates that the disability relating to the cervical spine was [preexisting]." Regarding Dr. Ahmed's testimony, the ALJ found he testified "sincere[ly], but he did not credibly demonstrate that [York's] total and permanent injury was A-1427-24 16 a direct result of the 2021 incident." The ALJ highlighted that Dr. Ahmed did not establish York's "disability was related to the knee as opposed to the [preexisting] cervical injury" and emphasized that Dr. Ahmed had critically conceded that "any conclusion about the knee injury was 'speculative' at best." In finding York failed to show a permanent injury caused by a circumstance external to the member, the ALJ stated that his "medical history included a [preexisting] injury to the cervical spine, which is the only total and permanent disability [that] has been established in this matter." The ALJ reiterated multiple times that Dr. Hutter was "more credible" in his conclusion that York's "injuries were the result of [preexisting] injury to the cervical spine in 2017." The Board's Final Decision In November 2024, York filed with the Board exceptions to the ALJ's initial decision. On December 9, 2024, after reviewing the parties' arguments and evidence, the Board issued its final decision adopting the ALJ's initial decision and denying York accidental disability retirement benefits. York's Arguments on Appeal On appeal, York argues the Board's final decision erroneously adopted the initial decision, denying him accidental disability retirement benefits, because the ALJ: improperly found Dr. Hutter's conclusions were consistent with the A-1427-24 17 medical documents admitted into evidence; failed to correctly analyze the case law regarding preexisting injuries; and erred in determining his knee injury was not a permanent injury. II. Our review of an agency determination is limited. Russo v. Bd. of Trs., PFRS, 206 N.J. 14, 27 (2011). An appellate court "may not substitute its own judgment for the agency's, even though the court might have reached a different result." Allstars Auto Grp., Inc. v. N.J. Motor Vehicle Comm'n, 234 N.J. 150, 158 (2018) (quoting In re Stallworth, 208 N.J. 182, 194 (2011)) (internal quotation marks omitted). "An agency's determination on the merits 'will be sustained unless there is a clear showing that it is arbitrary, capricious, or unreasonable, or that it lacks fair support in the record.'" Saccone v. Bd. of Trs., PFRS, 219 N.J. 369, 380 (2014) (quoting Russo, 206 N.J. at 27). "We are not, however, 'bound by an agency's interpretation of a statute or its determination of a strictly legal issue, particularly when that interpretation is inaccurate or contrary to legislative objectives.'" Mount v. Bd. of Trs., PFRS, 233 N.J. 402, 418-19 (2018) (quoting Russo, 206 N.J. at 27) (internal quotation marks omitted). We review de novo "an agency's interpretation of a statute or case A-1427-24 18 law." Russo, 206 N.J. at 27; see also Bowser v. Bd. of Trs., PFRS, 455 N.J. Super. 165, 170-71 (App. Div. 2018).4 N.J.S.A. 43:16A-7 establishes the permanent and total disability requirements a member must meet to receive accidental disability retirement benefits. To qualify for accidental disability retirement benefits, an employee must demonstrate that he or she "is permanently and totally disabled as a direct result of a traumatic event occurring during and as a result of the performance of his [or her] regular or assigned duties." Mount, 233 N.J. at 419 (quoting N.J.S.A. 43:16A-7(a)(1)); see also N.J.S.A. 43:15A-43(a). Accidental disability retirement benefits "entitle[] a member to receive a higher level of benefits than those provided under an ordinary disability retirement." Thompson v. Bd. of Trs., TPAF, 449 N.J. Super. 478, 484 (App. Div. 2017) (quoting Patterson v. Bd. of Trs., SPRS, 194 N.J. 29, 43 (2008)). 4 We note our Supreme Court stated in a recent opinion, although we have "not always been consistent about what standard of review applies to an agency's interpretation of a statute it is charged with enforcing," we "do not attempt to reconcile our conflicting case law, . . . [when] our decision . . . would be the same regardless of whether we deferred to [an agency's] interpretation of [a statute] or reviewed the statute de novo." In re P.T. Jibsail Fam. Ltd. P'ship Tidelands License No. 1515-06-0012.1 TDI 190001, 263 N.J. 208, 216-17 (2026). A-1427-24 19 "[A] traumatic event is . . . an unexpected external happening that directly causes injury and is not the result of [preexisting] disease alone or in combination with work effort." Richardson v. Bd. of Trs., PFRS, 192 N.J. 189, 212 (2007). To establish entitlement to accidental disability retirement benefits under N.J.S.A. 43:16A-7(a)(1), the Supreme Court has elucidated that a member must prove: 1. that he [or she] is permanently and totally disabled; 2. as a direct result of a traumatic event that is a. identifiable as to time and place, b. undesigned and unexpected, and c. caused by a circumstance external to the member (not the result of [preexisting] disease that is aggravated or accelerated by the work); 3. that the traumatic event occurred during and as a result of the member's regular or assigned duties; 4. that the disability was not the result of the member's willful negligence; and 5. that the member is mentally or physically incapacitated from performing his usual or any other duty. [Mount, 233 N.J. at 421 (quoting Richardson, 192 N.J. at 212-13).] A-1427-24 20 Our Supreme Court has concluded that the words "traumatic event" and "direct result" in N.J.S.A. 43:16A-7 reflect the Legislature's intent "to make the granting of an accidental disability pension more difficult." Kasper v. Bd. of Trs., TPAF, 164 N.J. 564, 576 (2000). Further, the Court has also defined regularly assigned duties as "all activities engaged in by the employee in connection with his or her work." Id. at 585-86. III. We first address York's argument that the Board erred in adopting the ALJ's finding that Dr. Hutter's opinions were supported by York's admitted medical records. York maintains that Dr. Hutter's IME opinion was "flawed" and "rubber stamped by the ALJ without any reference to the medical documents." York's assertions are belied by the evidence and ALJ's written initial decision. The ALJ credited Hutter's testimony as more consistent "with the . . . documentary evidence." In its initial decision, the ALJ related Dr. Hutter's testimony to specific medical records, including objective diagnostic evidence. Regarding York's cervical spine injury claim from the 2021 work fall, the ALJ found Dr. Hutter credibly opined that York had preexisting cervical spine injuries as demonstrated by York's 2021 "MRI of the cervical spine" that A-1427-24 21 "indicated degenerative disc disease primarily at C5-[C]6 as well as spondylotic disc causing stenosis at that level as well, which [was] consistent with the prior study following the 2017 injury." The ALJ emphasized her reliance on Dr. Hutter's testimony that York's "MRI demonstrated degenerative disc disease of the cervical spine" that showed "the condition was [preexisting] and . . . related to the prior injury." Regarding the knee injury, the ALJ cited to Dr. Hutter's testimony that the MRI demonstrated "no tear or fracture" and medical records indicated York was referred for potential "knee surgery," but it was not "done." York's arguments focus on Dr. Ahmed's contrary testimony based on his evaluation of York's subjective complaints and the medical records. However, we are unpersuaded as the ALJ made sufficient factual findings and references to Dr. Hutter's opinions, which the ALJ reasonably deemed more credible than Dr. Ahmed's. We defer to those comparative credibility findings by the fact- finder. N.J. Div. of Child Prot. & Permanency v. M.M., 459 N.J. Super. 246, 257 (App. Div. 2019). Relevantly, the ALJ found that York failed to demonstrate "sufficient credible evidence that . . . [his] total and permanent disability was related to the most recent incident." Thus, we discern no basis to disturb the Board's final A-1427-24 22 decision adopting the ALJ's finding that York did not establish a permanent neck, knee, or elbow injury causally related to the fall. We also reject York's contention that the ALJ incorrectly analyzed precedential case law regarding preexisting injuries. The ALJ found Dr. Hutter demonstrated within a reasonable medical certainty that York's injuries were the result of preexisting injury to the cervical spine in 2017. While the court noted the testimony that York's fall exacerbated his underlying conditions, the ALJ found York's cervical spine injury was preexisting and the knee injury "was not total and permanent." Again, the ALJ emphasized that York's 2021 cervical spine MRI "demonstrated degenerative disc disease of the cervical spine," the condition was preexisting, and York had the burden of establishing a permanent injury caused from his work fall. Moreover, notably absent from York's arguments is any material reference to objective credible medical evidence showing he sustained either a new permanent injury or a resulting permanent injury from an exacerbation of his preexisting cervical condition. Finally, for the reasons we have already stated, we are unpersuaded by York's argument that the ALJ erred in not finding his knee injury was a permanent injury. The ALJ credited Dr. Hutter's "expert medical opinion that [York's] knee injury was not the root of the finding of total and permanent A-1427-24 23 disability." Further, the ALJ highlighted that "Dr. Ahmed . . . conceded that any conclusion about the knee injury was 'speculative' at best." In sum, the Board's final decision adopting the ALJ's initial decision and denying York's application for accidental disability retirement benefits under N.J.S.A. 43:16A-7(a)(1) is supported by substantial credible evidence. To the extent that we have not addressed York's remaining contentions, it is because they lack sufficient merit to be discussed in a written opinion. R. 2:11- 3(e)(1)(D) and (E). Affirmed. A-1427-24 24