Pereira v. State, 14770

• Decision Date: 15 February 1994
• Docket Number: No. 14770,14770
• Citation: 228 Conn. 535,637 A.2d 392
• Court: Connecticut Supreme Court
• Parties: Arlene PEREIRA v. STATE of Connecticut.

Page 392

637 A.2d 392

228 Conn. 535

Arlene PEREIRA v. STATE of Connecticut.

No. 14770.

Supreme Court of Connecticut.

Argued Nov. 30, 1993.

Decided Feb. 15, 1994.

Edward T. Dodd, Jr., Waterbury, for appellant (plaintiff).

Edward F. Osswalt, Asst. Atty. Gen., with whom, on the brief, were Richard Blumenthal, Atty. Gen., and William J. McCullough, Asst. Atty. Gen., for appellee (defendant).

Before PETERS, C.J., and BERDON, NORCOTT, KATZ and PALMER, JJ. NORCOTT, Associate Justice.

The principal issue in this workers' compensation case is whether the defendant's notice of intention to contest compensability was sufficiently specific to satisfy the requirements of General Statutes (Rev. to 1989) § 31-297(b), ¹ thus allowing the defendant to challenge the plaintiff's claim on the merits. On March 22, 1989, the plaintiff, Arlene Pereira, sent to her employer, the defendant, state of Connecticut, a written notice of claim for workers' compensation benefits pursuant to General Statutes (Rev. to 1989) § 31-294. ² In her notice of claim, the plaintiff alleged that she suffered from stress which had arisen out of and in the course of her employment with the defendant. ³ In response, the defendant timely filed a written notice of intention to contest the plaintiff's right to compensation (disclaimer) pursuant to § 31-297(b). Thereafter, the plaintiff filed with the compensation commissioner for the seventh district (commissioner) a motion to preclude the defendant from contesting compensability. The plaintiff asserted in her motion that the defendant's disclaimer was a general denial that did not sufficiently set forth the grounds on which liability was contested. After a formal hearing, the commissioner denied the plaintiff's motion because: (1) the plaintiff's notice of claim did not fully state the defendant's name and therefore was "not sufficient to serve as a basis for a motion to preclude"; and (2) the defendant's disclaimer "set forth grounds specific enough to meet the requirements of" § 31-297(b). The plaintiff thereafter appealed to the compensation review division (review division) pursuant to General Statutes (Rev. to 1989) § 31-301(a). ⁴ The review division affirmed the commissioner's denial of the plaintiff's motion and the plaintiff filed an appeal with the Appellate Court that was dismissed for lack of a final judgment. After additional formal hearings at which the commissioner received testimonial and documentary evidence, the commissioner concluded that the plaintiff's stress had not been proximately caused by the conditions of her employment and dismissed her claim. The plaintiff appealed to the review division, which again affirmed the commissioner's decision. The plaintiff appealed to the Appellate Court pursuant to General Statutes (Rev. to 1989) § 31-301b ⁵ and we transferred the appeal to this court pursuant to Practice Book § 4023 and General Statutes § 51-199(c). We now affirm the decision of the review division.

The basic facts are undisputed. Since 1984, the plaintiff had been employed by the defendant as a social worker in its department of children and youth services. As a social worker, the plaintiff was responsible for the daily care of children who had been neglected or abused. Her responsibilities included removal of children from dangerous settings, reunification of families and arrangement of the adoption of children when the families' problems could not be resolved. The plaintiff described her caseload of between fifty and sixty cases as "enormous."

The plaintiff first began to feel anxious when she returned to work in August, 1988, after a six week leave during which she had had knee surgery. Although unable to articulate any specific reasons, she testified that she did not feel comfortable about returning to work. After her return to work, the plaintiff suffered from severe fatigue, palpitations, headaches, insomnia and stress. The plaintiff was treated by her family physician, Darrell Daniels, who prescribed Xanax and rest. In addition, Daniels recommended that she see a psychiatrist if her symptoms continued. During October, 1988, the plaintiff also experienced trouble breathing, for which she saw an allergist, Christopher Randolph. His diagnosis was that the plaintiff's symptoms resulted from anxiety rather than an organic trigger or an underlying reactive airway disease.

While driving to work on November 10, 1988, the plaintiff felt faint, steered her car to the side of the road and rested until she was able to proceed. The plaintiff again felt faint after arriving at work and was taken to Danbury Hospital. After a series of tests failed to reveal any physical malady, the plaintiff was diagnosed as suffering from a viral syndrome. An antibiotic was prescribed and the plaintiff was discharged. While at work on December 9, 1988, the plaintiff again had trouble breathing and developed a rash on her chest and back. She was taken to Danbury Hospital and was diagnosed as having a "hypertension episode."

Thereafter, on December 13, 1988, the plaintiff was treated by Richard Hart, an endocrinologist. At Hart's direction, a number of tests were performed on the plaintiff, the results of which ruled out any physical illness. Hart's resultant diagnosis was that the plaintiff's symptoms were "secondary to job related stress."

Subsequently, on Hart's recommendation, the plaintiff saw Ellen Fischbein, a psychiatrist, who, along with Susan Jacobson, a therapist and counselor who worked under Fischbein's supervision, treated the plaintiff from February 16, 1989, through the time of the commission's hearing. In the course of treatment, Fischbein diagnosed the plaintiff as suffering from panic attacks and agoraphobia. ⁶ Fischbein further opined that the plaintiff's condition was caused by stress at work. In reaching her opinion, Fischbein dismissed as possible causes: (1) the chronic illness of the plaintiff's father, with whom she lived, which, just prior to her attacks, had caused him to become paraplegic; (2) the plaintiff's loss in 1972 of her three month old child to crib death; (3) the plaintiff's overweight condition; (4) the attempted suicide, in August 1988, of the plaintiff's fifteen year old daughter; (5) problems with the plaintiff's eighteen year old learning disabled son who had dropped out of school; (6) the divorce, in 1988, and return to the family home of the plaintiff's brother, whose former wife had been a good friend of the plaintiff; (7) the long-term disability of the plaintiff's husband due to a serious back injury, which rendered him unable to work; and (8) the plaintiff's previous marriage to a very critical and demanding man, who had been emotionally abusive to her.

At the defendant's request, the plaintiff was examined by another psychiatrist, Walter Borden. After meeting with the plaintiff on May 1 and 16, 1989, Borden concluded that the plaintiff's symptoms were not the result of workplace stress, but of "a masked depression." Borden described the plaintiff's workload as an ordinary stressor that in his opinion was not sufficiently burdensome to trigger anxiety attacks by the plaintiff. According to Borden, the plaintiff's depression and resulting symptoms were caused by the combination of the stressors that had been dismissed as causes by Fischbein. ⁷

I

The plaintiff first claims that the commissioner improperly concluded that the defendant's disclaimer was sufficiently specific to apprise the plaintiff of the grounds on which the right to compensation was being contested as required by § 31-297(b). The plaintiff relies on Menzies v. Fisher, 165 Conn. 338, 347, 334 A.2d 452 (1973), in which we held "that the giving of notice by the employer as to specific grounds on which the right to compensation is contested is a condition precedent to the defense of the action." The plaintiff argues that the defendant's disclaimer is merely a general denial of liability that reveals no specific defense or reason why the claim is contested and that the defendant, therefore, is precluded from defending the action. We disagree.

In Menzies, we determined the scope and operation of the 1967 amendments to § 31-297(b); Public Acts 1967, No. 842, § 7; which specified that the employer's failure to file a notice of intention to contest compensability results in a conclusive presumption of the acceptance of liability. Menzies v. Fisher, supra, at 341, 334 A.2d 452. In light of the public act's legislative history, we concluded that § 31-297(b) "was amended to ensure (1) that employers would bear the burden of investigating a claim promptly and (2) that employees would be timely apprised of the specific reasons for the denial of their claim." Id., at 343, 334 A.2d 452. We also stated, however, that the notice need not be expressed with the technical precision of a pleading, but need only reveal the specific grounds on which compensability is contested. Id., at 347-48, 334 A.2d 452. A disclaimer is sufficient, therefore, if it reveals to the plaintiff specific substantive grounds on which compensability will be contested.

In order to qualify for workers' compensation benefits a claimant must prove five distinct elements. Tovish v. Gerber Electronics, 19 Conn.App. 273, 275, 562 A.2d 76, cert. denied, 212 Conn. 814, 565 A.2d 538 (1989). One of the elements of a prima facie claim is that the claimant has suffered a personal injury arising "out of and in the course of employment." Id., at 276, 562 A.2d 76; see also J. Asselin, Connecticut Workers' Compensation Practice Manual (1985) § 1. In the present case, the defendant's disclaimer stated: "Respondents do contend [the] plaintiff's stress did not arise out of or in the course of her employment." (Emphasis added.) This statement is not a general denial. Although the disclaimer was not artfully drafted, it clearly apprises the plaintiff of the defendant's intention to challenge an element of her claim, namely,...