Pokorny v. Getta's Garage, 14091

• Decision Date: 09 July 1991
• Docket Number: No. 14091,14091
• Citation: 219 Conn. 439,594 A.2d 446
• Court: Connecticut Supreme Court
• Parties: Joseph POKORNY v. GETTA'S GARAGE et al.

Page 446

594 A.2d 446

219 Conn. 439

Joseph POKORNY v. GETTA'S GARAGE et al.

No. 14091.

Supreme Court of Connecticut.

Argued March 28, 1991.

Decided July 9, 1991.

Thomas A. Mulligan, Fairfield, for appellants (defendants).

Lawrence J. Merly, with whom, on the brief, was Nicholas E. Wocl, Bridgeport, for appellee (plaintiff).

Douglas L. Drayton, Hartford, filed a brief for the Ins. Ass'n of Connecticut as amicus curiae.

Before SHEA, CALLAHAN, COVELLO, BORDEN and FRANCIS X. HENNESSY, JJ.

BORDEN, Associate Justice.

The certified issue in this appeal is whether an employer is required to pay a workers' compensation claimant the amount of his medical bills when such bills have been covered by a medical insurance carrier who has not filed a lien pursuant to General Statutes § 38-174n. ¹ We conclude that an employer is not so required.

The plaintiff, Joseph Pokorny, suffered severe personal injuries in an action that arose out of and in the course of his employment with the named defendant, Getta's Garage (Getta). Getta and its workers' compensation insurer, the defendant American Home Assurance Company (American), ² denied coverage for the injury, and the plaintiff's medical bills thereafter were paid by Getta's medical insurance carrier. The plaintiff filed a claim with the workers' compensation commission seeking, inter alia, to be paid the amount of his medical bills. The commissioner, and later the compensation review division (CRD), denied the plaintiff's claim because payment of that amount to the plaintiff would effect a double recovery. On appeal, the Appellate Court reversed the decision of the CRD. Pokorny v. Getta's Garage, 22 Conn.App. 539, 542, 579 A.2d 98 (1990). We now reverse the judgment of the Appellate Court.

The underlying facts are undisputed. On June 7, 1979, the plaintiff, who was employed by Getta ³ as a tow truck operator, went to the scene of an accident where a truck had spilled diesel fuel. While at the scene, the plaintiff inhaled diesel fumes, became dizzy, and was taken to Stamford Hospital where he suffered a brain stem stroke secondary to basilar artery occlusion. As a result of the stroke, the plaintiff is a quadriplegic, in addition to suffering facial paralysis and a permanent loss of voice. The defendants denied workers' compensation coverage, and the plaintiff's medical bills, totaling $175,521.43, were paid by Getta's medical insurance carrier.

In September, 1986, ⁴ after three days of hearings, the workers' compensation commissioner determined, inter alia, that the plaintiff's claim was compensable and ordered the defendants to "pay the claimant for all medical, surgical, [and] hospital ... services rendered to him in connection with the injury of June 7, 1979." The commissioner also stated, however, that "[i]f the parties are unable to agree on the same, such issues may be made the subject of further hearing(s) at the request of either party." The defendants did not appeal from that decision. After the parties failed to reach an agreement concerning the medical bills, a subsequent hearing was held and a supplemental finding and order entered in March, 1988. The commissioner determined that "[t]he private medical insurance carrier which has paid medical and hospital expenses totaling $175,521.43 on behalf of the [plaintiff] has not filed herein a lien or claim for repayment of all or any part thereof, and the [plaintiff's] claim for payment to him of said sum is hereby DENIED." The plaintiff filed a motion to correct the decision, ⁵ which the commissioner denied.

The plaintiff appealed to the CRD. In June, 1990, the CRD concluded that the commissioner properly had denied the plaintiff's claim for payment of the amount of the medical bills because, even though the medical insurance carrier had not filed a lien pursuant to § 38-174n, such an award would amount to an impermissible double recovery or windfall for the plaintiff. ⁶

The plaintiff appealed the decision of the CRD to the Appellate Court. The Appellate Court, Lavery and Foti, Js., reversed the decision of the commissioner, with O'Connell, J., dissenting. We granted certification limited to the above stated issue, and this appeal followed.

The defendants claim that the Appellate Court improperly interpreted our Workers' Compensation Act in determining that they were required to pay the plaintiff the amount of his medical bills although the medical insurance carrier had paid the bills and the plaintiff is not responsible for reimbursing that carrier. Specifically, the defendants argue that General Statutes § 31-284 ⁷ limits the plaintiff's recovery to the rights and claims provided by the Workers' Compensation Act, which abolished all traditional tort remedies. The defendants then argue that, although there is no specific statutory provision addressing the issue, a review of the relevant statutes and the workers' compensation administrative regulations demonstrates that "the issue ... is simply one between the employer and the [medical insurance] carrier and the [plaintiff] has neither rights nor obligations concerning [the liens statutorily allowed to medical insurance carriers]." We agree with the defendants.

The Appellate Court, in reversing the decision of the CRD, based its decision on three grounds propounded by the plaintiff. The first ground was that "the injury took place on June 7, 1979, and the law giving the private health insurance carrier a lien was not effective until October 1, 1981, and operated prospectively, not retrospectively." Pokorny v. Getta's Garage, supra, 22 Conn.App. at 545, 579 A.2d 98. The Appellate Court agreed with the plaintiff that this time sequence rendered "[t]he defendants ... liable to the plaintiff for the payment of all his medical and rehabilitation bills and services prior to October 1, 1981." Id., at 546, 579 A.2d 98. The second ground was that "the defendants' obligation to pay the plaintiff's medical bills did not change in the absence of a lien. The lien is for the benefit of the private health insurance carrier and not the employer or his workers' compensation insurance carrier." Id., at 545, 579 A.2d 98. The Appellate Court agreed that, "absent a lien imposed by the health insurance carrier, the employer is still bound to pay the employee his medical expenses, regardless of any payments made by the health insurance carrier." Id., at 547, 579 A.2d 98. The third ground was that "since no appeal was effectuated on the issue of compensability from the September, 1986 finding and award, and since the issue was not reopened at the February 1, 1988 hearing, the judgment of the commissioner is final and the plaintiff is entitled to have his medical bills paid by the defendants." Id., at 545, 579 A.2d 98. The Appellate Court agreed that "[s]ince the issue of compensability and the amounts of the plaintiff's medical and hospital expenses were not appealed, the judgment of the commission is final as to those issues." Id., at 548, 579 A.2d 98.

I

We first turn to the conclusion of the Appellate Court that, because the defendant did not appeal from the September, 1986 order, the commissioner's decision ordering the defendants to pay the plaintiff the amount of the medical bills was final. Id. The defendants argue that, because the language of the commissioner's decision provided that additional hearings on the issue were contemplated, the decision did not preclude them from challenging the payment of the medical expenses in these proceedings. We agree.

In this respect, the Appellate Court stated only that "[s]ince the issue of compensability and the amounts of the plaintiff's medical and hospital expenses were not appealed, the judgment of the commission is final as to those issues. General Statutes § 31-300." ⁸ Id. "The construction of a judgment is a question of law for the court." Lashgari v. Lashgari, 197 Conn. 189, 196, 496 A.2d 491 (1985). "As a general rule, judgments are to be construed in the same fashion as other written instruments." Id. The same principles apply to an award of a workers' compensation commissioner. Therefore, the September, 1986 decision must be construed "as a whole, with all relevant provisions considered together." Beckenstein v. Potter & Carrier, Inc., 191 Conn. 120, 134, 464 A.2d 6 (1983).

It is true that the commissioner's decision provided that "[t]he respondents are further ordered to pay the claimant for all medical, surgical, [and] hospital ... services rendered to him in connection with the injury of June 7, 1979." It also provided, however, in the next sentence, that "[i]f the parties are unable to agree on the same, such issues may be made the subject of further hearing(s) at the request of either party." (Emphasis added.) Reading the decision in its entirety, we conclude that either party had the right to petition for additional hearings on the issue of the defendants' obligation to pay for the plaintiff's medical bills, and that the defendants were not limited to appealing the decision concerning payment of the medical bills within the statutory time limitation provided in § 31-300. We conclude, therefore, that the Appellate Court was incorrect, as a matter of law, in its construction of the decision of the commissioner.

II

We next consider together the Appellate Court's conclusion that the plaintiff was entitled to prevail because (1) his injury took place before the effective date of § 38-174n, and (2) the defendants' obligation to pay the plaintiff the amount of his medical bills did not change in the absence of a lien having been asserted by the medical insurance carrier. The defendants argue that the Appellate Court improperly construed the Workers' Compensation Act as requiring payment to the plaintiff of the amount of his medical expenses, previously paid by his medical insurance carrier, which he will never be required to repay. The defendants argue that the Workers' Compensation Act does not provide...