State of Connecticut Workers' Compensation Commission, John A. Mastropietro, Chairman
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Caprio v. Stop & Shop

CASE NO. 4028 CRB-03-99-04

COMPENSATION REVIEW BOARD

WORKERS’ COMPENSATION COMMISSION

JULY 26, 2000

JOSEPH CAPRIO

CLAIMANT-APPELLEE

v.

STOP & SHOP

EMPLOYER

SELF-INSURED

RESPONDENT-APPELLANT

APPEARANCES:

The claimant was represented by Kenneth G. Bartlett, Esq., 742 Chapel Street, New Haven, CT 06510.

The respondent was represented by Robert Bystrowski, Esq., Morrison, Mahoney & Miller, 100 Pearl Street, Hartford, CT 06103.

This Petition for Review from the March 31, 1999 Finding and Award of the Commissioner acting for the Third District was heard March 10, 2000 before a Compensation Review Board panel consisting of Commissioner Robin L. Wilson, Commissioner Leonard S. Paoletta and Commissioner Stephen B. Delaney.

OPINION

ROBIN L. WILSON, COMMISSIONER. The respondent has petitioned for review from the March 31, 1999 Finding and Award of the Commissioner acting for the Third District. In that decision, the trial commissioner found that the physical therapy, occupational therapy, and psychological treatment of the claimant’s pain, which was recommended by the Yale Pain Management Clinic, constituted reasonable and necessary medical treatment. In support of its appeal, the respondent contends that physical and occupational therapy was not necessary as the claimant had already successfully completed these therapies. The respondent further contends that a stipulation approved in 1996 settled any of the claimant’s psychological claims.

The trial commissioner found that on December 21, 1990, the claimant sustained a cervical spine injury while working for the respondent. As a result of this injury, the claimant had a two-level fusion performed by Dr. Pravda. The claimant sustained a twenty percent permanent partial impairment of his cervical spine. Subsequently, in 1992 the claimant was involved in a non-work related automobile accident which caused an additional 7.5 percent impairment of the cervical spine, and a second cervical fusion was performed. The claimant continued to suffer pain, and in 1993, Dr. Pravda referred the claimant to Dr. Wang for pain management treatment. In April 1994, Dr. Wang referred the claimant to Dr. Berv for treatment of depression and psychiatric problems. Dr. Berv diagnosed major depression caused by the compensable injury.

On July 3, 1996, the claimant entered into a Stipulation to Date for $30,000.00, which closed out all future claims arising out of the December 21, 1990 injury except for claims for future medical treatment regarding the cervical spine injury. In 1997 and 1998, Dr. Pravda recommended that the claimant be treated at the Yale Pain Management Clinic. The respondent authorized eight physical therapy and seven occupational therapy sessions at Gaylord Hospital from January 31, 1998 through February 20, 1998. Subsequently, the claimant was evaluated at the Yale Pain Management Clinic, and an October 8, 1998 report issued by the clinic indicated that the claimant suffered from post-cervical laminectomy syndrome, myofascial pain syndrome, sleep disturbance, opoid tolerance, and decreased range of motion movement of the cervical spine. The clinic thus recommended physical therapy, occupational therapy, referral for pain psychology treatment, and placement of a Medtronics infusion pump. The claimant sought authorization of said recommended treatment, and the trial commissioner found the physical and occupational therapy and the psychological treatment to be “reasonable and necessary and related to the compensable spine injury.” (Finding ¶ H).

In support of its appeal, the respondent disputes the authorization of physical and occupational therapy, contending that said treatment had been successfully completed at Gaylord Hospital from January 31, 1998 through February 20, 1998. The “determination of whether medical care is reasonable and necessary, including whether the medical care is palliative care or a curative remedy, is a factual issue to be decided by the trial commissioner.” Cummings v. Twin Tool Manufacturing, 13 Conn. Workers’ Comp. Rev. Op. 225, 228, 2008 CRB-1-94-4 (April 12, 1995) (citing Burgos v. United Technologies, 12 Conn. Workers’ Comp. Rev. Op. 204, 1441 CRB-4-92-6 (March 15, 1994)); see also Bowen v. Stanadyne, Inc., 2 Conn. Workers’ Comp. Rev. Op. 60, 232 CRD-1-83 (1984). When reviewing a trial commissioner’s decision, it is well established that this board “is obligated to hear the appeal on the record and not retry the facts….” O’Reilly v. General Dynamics Corp., 52 Conn. App. 813, 816 (1999) (quotations omitted).

Moreover, “(i)n reviewing the factual determinations of the commissioner, the review [board’s] scope of review is limited. The review [board] may not disturb the conclusions that the commissioner draws from the facts found unless they result from an incorrect application of the law to the subordinate facts or from an inference illegally or unreasonably drawn from them.” Ferrara v. Hospital of St. Raphael, 54 Conn. App. 345, 351 (1999) (citations omitted). “Once the commissioner makes a factual finding, [we are] bound by that finding if there is evidence in the record to support it….” Id. at 349 (citations omitted).

In the instant case, the October 8, 1998 report issued by Dr. Levin of the Yale Pain Management Clinic discusses the claimant’s medical history and symptoms,1 and recommends physical therapy and occupational therapy. The report states in pertinent part:

2. We recommend further physical therapy to optimize and restore the patient’s functional capacity by reducing muscle spasm[,] strengthening muscles, and improving range of motion and conditioning. We would hope that it would help correct postural gait imbalances.
3. We are recommending occupational therapy in order to increase the level of functioning with regard to work, daily activities, and leisure.

We conclude that the record adequately supports the trial commissioner’s decision that the recommended physical and occupational therapy constitutes reasonable and necessary medical treatment.

Next, we turn to the respondent’s argument that the trial commissioner erred in authorizing psychological treatment of the claimant’s pain because the stipulation approved in 1996 specifically included the claimant’s “psychological/depression disorder.” (Respondent’s Exh. 2). Therefore, the respondent argues that “any and all ‘psychological injury’ to the claimant arising out of and in the course of his employment” was settled by the stipulation. (Respondent’s Brief at 8).

Generally, a “stipulation is intended to foreclose a claimant from making a future claim for any disability or medical bill that flows from the compensable injury.” Wrubleski v. Kimberly-Clark Corp., 3106 CRB-7-95-6 (Dec. 24, 1996) (citing Muldoon v. Homestead Insulation Co., 231 Conn. 469, 480-81 (1994)). However, a stipulation would not prevent a claimant from raising a claim that is not related to the settled injury. Id.

In the instant case, the trial commissioner found that the 1996 stipulation closed out all future claims arising out of the December 21, 1990 injury except for claims for future medical treatment regarding the cervical spine injury. (Finding ¶ 16; Respondent’s Exh. 2). The trial commissioner found that the treatment recommended by the Yale Pain Management Clinic is “related to the pain the Claimant suffers from his 1990 cervical spine injury.” (Finding ¶ G). Accordingly, because the trial commissioner found that the psychological treatment of the claimant’s pain constituted reasonable and necessary medical treatment of the claimant’s 1990 cervical spine injury, said treatment was not foreclosed by the 1996 stipulation.

The trial commissioner’s decision is affirmed.

Commissioners Leonard S. Paoletta and Stephen B. Delaney concur.

1 The report summarizes his pain symptoms as follows: “Mr. Caprio reports that his pain has remained the same with his most severe pain in the bilateral trapezius area and paracervical region and a constant frontal headache. He states that the pain occasionally radiates to the scapula from the base of the neck but the pain is a throbbing quality. He states that the pain is constant, worse in the morning….” BACK TO TEXT

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State of Connecticut Workers' Compensation Commission, John A. Mastropietro, Chairman
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