State of Connecticut Workers' Compensation Commission, John A. Mastropietro, Chairman
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Scott v. City of Bridgeport

CASE NO. 4637 CRB-4-03-2

COMPENSATION REVIEW BOARD

WORKERS’ COMPENSATION COMMISSION

FEBRUARY 24, 2004

WEBSTER SCOTT

CLAIMANT-APPELLANT

v.

CITY OF BRIDGEPORT

EMPLOYER

and

BERKLEY ADMINISTRATORS

INSURER

RESPONDENTS-APPELLEES

APPEARANCES:

The claimant was represented by Mark S. Carron, Esq., Carron & Fink, 1698A Post Road East, Peppermill Office Building, Westport, CT 06880.

The respondents were represented by Michael Buonopane, Esq., Montstream & May, L.L.P., Salmon Brook Corporate Park, 655 Winding Brook Drive, P.O. Box 1087, Glastonbury, CT 06033.

This Petition for Review from the February 7, 2003 Finding and Award of the Commissioner acting for the Fourth District was heard September 26, 2003 before a Compensation Review Board panel consisting of the Commission Chairman John A. Mastropietro and Commissioners James J. Metro and Stephen B. Delaney.

OPINION

JOHN A. MASTROPIETRO, CHAIRMAN. The claimant, Webster Scott, has appealed from the February 7, 2003 Finding and Award of the Commissioner acting for the Fourth District. We remand the case to the trial commissioner for further proceedings consistent with this opinion.

The pertinent facts are as follows. The claimant sustained a compensable injury to his left leg when he fell off a ladder on January 19, 2000. The parties agree Mr. Scott was terminated for cause under a union contract for failure to contact his employer regarding absences from work. The claimant alleges he failed to contact his employer due to a head injury which he also sustained as a result of the same fall on January 19, 2000. He contends this head injury and related loss of memory prevented him from being able to remember to contact the respondent. The respondents maintain the claimant did not sustain a head injury on January 19, 2000. They further allege there are no clear medical opinions to substantiate a memory loss which would have hindered the claimant’s ability to contact his employer. The respondent employer terminated the claimant’s health insurance and gave the appropriate COBRA notice. The claimant alleges he could not afford to purchase the COBRA insurance and he was thereafter left uninsured.

On June 11, 2001 Dr. David Brown referred the claimant to a neurologist for consultation of complaints of emotional instability and memory loss. There was no prior medical evidence submitted regarding a claim of a head injury relating to the January 19, 2000 fall.

The parties agree the claimant was entitled to a 15% permanent loss of use to his left lower extremity and the claimant reached maximum medical improvement on January 28, 2002. The respondents had not provided health insurance pursuant to § 31-284b C.G.S. because they claimed they had no duty to reinstate health insurance or any other fringe benefits because the payment of permanency benefits took place subsequent to the scheduled expiration of those benefits. The claimant sought reinstatement of his health insurance for some period of time on a prospective basis based on the respondents’ termination of the insurance for a period he should have retained such under § 31-284b.

The trial commissioner dismissed the claimant’s claim for a head/traumatic brain injury pursuant to § 31-294c C.G.S., finding the claimant did not establish sufficient evidence necessary to satisfy the exemption for notice pursuant to § 31-294c. The trial commissioner found the claimant was entitled to permanent partial disability benefits from January 28, 2002 to June 8, 2002 pursuant to the parties’ stipulation of facts. Therefore the claimant was entitled to permanent partial benefits for those 18.75 weeks and was entitled to health insurance benefits for that period pursuant to § 31-284b. The trial commissioner ordered the respondents to pay any out of pocket medical expenses the claimant incurred for the period of time from January 28, 2002 to June 8, 2002.

There are two issues on appeal. The first issue is whether the trial commissioner improperly dismissed the claimant’s claim for a head/traumatic brain injury as untimely pursuant to § 31-294c. An additional issue is whether the trial commissioner’s order regarding paying out of pocket medical expenses for the period the claimant should have been provided medical insurance under § 31-284b was inadequate.

The claimant sustained a compensable leg injury when he fell off a ladder on January 19, 2000. There is no allegation the respondents were not placed on timely notice of that claim. Not until April 27, 2001 did the claimant file a notice of claim for a head/traumatic brain injury. The claimant alleges this injury was also the result of the same January 19, 2000 fall. “Once the compensability of an incident is established, disability related to later injuries that arise from the same incident may be compensated without the filing of an additional notice of claim.” Jones v. New Haven Child Development, 4316 CRB-3-00-11 (October 29, 2001) citing Roman v. Eyelets for Industry, Inc., 3040 CRB-5-95-4 (Feb. 14, 1997), aff’d, 48 Conn. App. 357 (1998); Landrette v. Bristol, 11 Conn. Workers’ Comp. Rev. Op. 149, 1279 CRD-6-91-8 (Aug. 19, 1993). In this case it was established that the January 19, 2000 left leg injury was compensable. Therefore, the head/traumatic brain injury claim which the claimant alleges arose from the same fall on the same day can go forward without the need for an additional notice of claim. The claim should not be dismissed as untimely. The claimant should have the opportunity to demonstrate the causal link between a compensable accident and the head/traumatic brain injury. The fact the claimant later filed a notice of claim specifically for the head/traumatic brain injury is of no consequence as the prior notice of claim was already timely filed. We remand the case to the trial commissioner in order for the claimant to have the opportunity to present evidence that the January 19, 2000 fall was the cause of his head/traumatic brain injury.

Pursuant to § 31-284b a state or municipal employee is entitled to health insurance coverage for the period he receives compensation under chapter 568. The trial commissioner found the respondents terminated the claimant’s insurance coverage while he was still receiving benefits. The claimant has asked for some period of health insurance coverage on a prospective basis as a remedy. The trial commissioner found the claimant was entitled to health insurance benefits pursuant to § 31-284b from January 28, 2002 to June 8, 2002 and ordered respondents to pay the claimant any out-of-pocket medical expenses he incurred for that period of time.

The claimant alleges the trial commissioner’s award of medical expense reimbursement is inadequate. He alleges he did not incur any out of pocket medical expenses during that period because he was without insurance and did not have the funds to pay for medical care. The purpose of the Workers’ Compensation Act is remedial in nature and should be construed to accomplish its humanitarian purpose. Dubois v. General Dynamics Corp., 222 Conn. 62, 67 (1992); Syphers v. Dedicated Logistic Services, 3711 CRB-1-97-10 (November 16, 1998). The claimant was entitled to insurance coverage under § 31-284b which the respondent terminated. A remedy which grants the claimant reimbursement of expenses he did not have the opportunity to incur does not seem to accomplish the remedial purpose of the act. There was no testimony on this issue. The findings in the case were based on a stipulation of facts which does not specifically address the issue. The case is further remanded in order for the claimant to have the opportunity to present evidence regarding his request for an order granting a period of health insurance under § 31-284b.

Commissioners James J. Metro and Stephen B. Delaney concur.

Workers’ Compensation Commission

Page last revised: March 1, 2004

Page URL: http://wcc.state.ct.us/crb/2004/4637crb.htm

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