Dubrosky v. Boehringer Ingelheim Corp.

• Decision Date: 27 August 2013
• Docket Number: No. 35030.,35030.
• Citation: 145 Conn.App. 261,76 A.3d 657
• Parties: Thomas DUBROSKY v. BOEHRINGER INGELHEIM CORPORATION et al.
• Court: Connecticut Court of Appeals

145 Conn.App. 261

76 A.3d 657

Thomas DUBROSKY

v.BOEHRINGER INGELHEIM CORPORATION et al.

No. 35030.

Appellate Court of Connecticut.

Argued May 29, 2013.

Decided Aug. 27, 2013.

Colette S. Griffin, Hartford, with whom was Harrold St. Juste, for the appellants (defendants).

Lawrence Morizio, Stratford, for the appellee (plaintiff).

BEACH, BEAR and BORDEN, Js.

BORDEN, J.

The dispositive issue in this workers' compensation appeal is whether an employer is deemed conclusively precluded from contesting the extent of a disability under General Statutes § 31–294c (b)¹ when it was impossible to commence payment of compensation within the statutory time period. The defendant employer, Boehringer Ingelheim Corporation, ² appeals from the decision of the Workers' Compensation Review Board (board) affirming the decision of the Workers' Compensation Commissioner for the Fourth District (commissioner) granting the motion to preclude pursuant to § 31–294c (b) filed by the plaintiff, Thomas Dubrosky.³ We reverse the decision of the board.

The following facts, as found by the commissioner, and procedural history are relevant to our resolution of this appeal. The plaintiff has worked for the defendant since 1974 as a pharmaceutical salesman. On January 9, 2009, the plaintiff slipped and fell on ice in the driveway of the Stratford Community Health Clinic while carrying product samples back to his vehicle after a business call. On January 12, 2009, the plaintiff reported the incident to his supervisor by e-mail. The plaintiff did not immediately seek medical treatment and did not miss any time from work.⁴

The plaintiff filed a form 30C ⁵ on February 18, 2009, seeking compensation for an injury to his left knee sustained during the slip and fall. The plaintiff first sought medical attention from his orthopedist, David F. Bindelglass, as part of a follow-up visit regarding his already arthritic left knee on February 27, 2009. The plaintiff subsequently sought medical treatment from Dr. Bindelglass on March 27 and October 2, 2009. The defendant received a bill from Dr. Bindelglass on June 1, 2009, seeking payment for treatments rendered to the plaintiff on February 27 and March 27, 2009. The defendant paid the bill on June 18, 2009. The defendant later paid another medical bill related to the plaintiff's treatment by Dr. Bindelglass on October 2, 2009.

The defendant filed a form 43 ⁶ contesting the claim on October 20, 2009, less than one year from the claimed injury.⁷ A formal hearing was held before the commissioner on January 3 and 31, 2011. The issues before the commissioner related to compensability for and causation of the injury, whether the form 43 was timely filed, the defendant's contest of the plaintiff's claim, the plaintiff's motion to preclude, and the defendant's motion to dismiss. The defendant withdrew its motion to dismiss at the January 31, 2011 hearing and accepted that an incident had occurred, but it sought to maintain its ability to contest the extent of the plaintiff's disability. At the end of the hearing, the only issues remaining before the commissioner were whether to grant the plaintiff's motion to preclude and whether the defendant could contest the extent of the plaintiff's injury. The plaintiff, in his motion to preclude, argued that the defendant had failed to file a timely disclaimer to the plaintiff's form 30C, and, therefore, under § 31–294c (b), the defendant was conclusively presumed to have accepted the compensabilityof the injury and the extent of the alleged disability.

On September 6, 2011, the commissioner issued a finding and award granting the plaintiff's motion to preclude. The commissioner concluded that the plaintiff filed a timely form 30C and, although the defendant had verbally accepted the claim, no voluntary agreement had been issued by the close of the record. The commissioner further found that although the defendant could not have commenced payment within twenty-eight days of the plaintiff's filing a form 30C because no medical bills had been received from the plaintiff during that time, the defendant could have filed a form 43 within the twenty-eight day period under the statute. Consequently, the commissioner precluded the defendant from contesting the plaintiff's claim, including the extent of his disability. The commissioner found that Dr. Bindelglass, who testified for the plaintiff, causally related the plaintiff's medical condition and need for treatment to the January 9, 2009 injury, and ordered the defendant to pay for all reasonable and necessary medical treatments and indemnity benefits related to the plaintiff's claim.

The defendant subsequently filed a motion to correct, which the commissioner denied in its entirety. The defendant filed a petition for review with the board on September 19, 2011, arguing, inter alia, that the commissioner improperly granted the plaintiff's motion to preclude in view of his finding that the defendant could not have paid for medical treatment within twenty-eight days of receiving the plaintiff's written notice of claim. The board issued an opinion affirming the commissioner's granting of the plaintiff's motion to preclude. The board held that because the defendant did not take any material actions responsive to the plaintiff's form 30C within the statutorily mandated period of twenty-eight days, the commissioner was obligated to grant the motion to preclude. This appeal followed.

On appeal, the defendant claims that the board improperly upheld the commissioner's ruling granting the plaintiff's motion to preclude because of the defendant's failure to comply with § 31–294c (b) by filing a notice to contest liability or commencing payment of medical bills within twenty-eight days of receiving the plaintiff's notice of claim. Specifically, the defendant argues that it could not comply with § 31–294c (b) to contest its liability, and that it was not able to commence payment of medical bills within twenty-eight days because no medical bills were generated within the statutory time period. We conclude that, under the facts of this case, it was not reasonably practical for the board to require the defendant to have complied with § 31–294c (b), and, therefore, the board's decision to uphold the commissioner's granting of the motion to preclude was improper.⁸

We begin by setting forth our standard of review governing workers' compensation appeals. “The conclusions drawn by [the commissioner] from the facts found must stand unless they result from an incorrect application of the law to the subordinate facts or from an inference illegally or unreasonably drawn from them.... Neither the ... board nor this court has the power to retry facts. It is well established that [a]lthough not dispositive, we accord great weight to the construction given to the workers' compensationstatutes by the commissioner and [the] board.... The commissioner has the power and duty, as the trier of fact, to determine the facts.” (Internal quotation marks omitted.) Mehan v. Stamford, 127 Conn.App. 619, 625, 15 A.3d 1122, cert. denied, 301 Conn. 911, 19 A.3d 180 (2011). “Our scope of review of the actions of the board is similarly limited.... The role of this court is to determine whether the review [board's] decision results from an incorrect application of the law to the subordinate facts or from an inference illegally or unreasonably drawn from them.” (Internal quotation marks omitted.) Bugryn v. State, 97 Conn.App. 324, 327, 904 A.2d 269, cert. denied, 280 Conn. 929, 909 A.2d 523 (2006).

“In deciding a motion to preclude, the commissioner must engage [in] a two part inquiry. First, he must determine whether the employee's notice of claim is adequate on its face.⁹ See General Statutes § 31–294c (a). Second, he must decide whether the employer failed to comply with § 31–294c either by filing a notice to contest the claim or by commencing payment on that claim within twenty-eight days of the notice of claim. See General Statutes § 31–294c (b). If the notice of claim is adequate but the employer fails to comply with the statute, then the motion to preclude must be granted.” Callender v. Reflexite Corp., 137 Conn.App. 324, 338, 49 A.3d 211, cert. granted on other grounds, 307 Conn. 915, 54 A.3d 179 (2012).

Our Supreme Court has articulated the underlying purpose of § 31–294c (b) on several occasions. In Harpaz v. Laidlaw Transit, Inc., 286 Conn. 102, 110–11, 942 A.2d 396 (2008), our Supreme Court examined the preclusion scheme set forth in § 31–294c (b): “The first two sentences of § 31–294c (b) address the procedure that an employer must follow if it wants to contest liability to pay compensation.... The statute prescribes therein that, within twenty-eight days of receiving a notice of claim, the employer must file a notice stating that it contests the claimant's right to compensation and setting forth the specific ground on which compensation is contested. The third sentence: (1) provides that an employer who fails to file a timely notice contesting liability must commence payment of compensation for the alleged injury within that same twenty-eight day period; and (2) grants the employer who timely commences payment a one year period in which to ‘contest the employee's right to receive compensation on any grounds or the extent of his disability’; but (3) relieves the employer of the obligation to commence payment within the twenty-eight day period if the notice of claim does not, inter alia, include a warning that ‘the employer shall be conclusively presumed to have accepted the compensability of the alleged injury or death unless the employer either files a notice contesting liability on or before the twenty-eighth day after receiving a written notice of claim or commences payment for the alleged injury or death on or before such twenty-eighth day.’ ... General Statutes § 31–294c (b). The fourth sentence provides for reimbursement to an employer who...