CASE NO. 5270 CRB-3-07-9
COMPENSATION REVIEW BOARD
WORKERS’ COMPENSATION COMMISSION
AUGUST 22, 2008
EDITH R. PUE
GALLAGHER BASSETT SERVICES
The claimant was represented by Christopher DePalma, Esq., Kennedy, Johnson, D’Elia & Gillooly, 555 Long Wharf Drive, 13th Floor, New Haven, CT 06511.
The respondents were represented by Mark Oberlatz, Esq., Law Offices of Jonathan M. Zajac, P.O. Box 699, Avon, CT 06001.
This Petition for Review from the August 20, 2007 Finding and Award of the Commissioner acting for the Third District was heard April 25, 2008 before a Compensation Review Board panel consisting of the Commission Chairman John A. Mastropietro and Commissioners Ernie R. Walker and Charles F. Senich.
JOHN A. MASTROPIETRO, CHAIRMAN. This appeal results from the August 20, 2007 Finding and Award of the Commissioner acting for the Third District. In that Finding and Award the trial commissioner concluded, inter alia, that the respondents were liable for various diagnostic and medical treatment rendered for suspected cardiac issues. The pertinent facts are as follows.
The claimant was injured on or about March 1, 2005. The claimant suffered compensable injuries to her left shoulder, breast bone and rib cage. On March 17, 2005 the claimant went to St. Raphael’s Hospital with complaints of pain in her chest, rib cage and radiating down her arm and to part of her mouth. The emergency room staff referred the claimant to the hospital’s cardiology center. A series of diagnostic tests were run and the claimant was admitted overnight for observation. The following day the claimant was released and given a diagnosis of myofascial strain and costochondritis. It was determined the claimant did not suffer a heart attack. The claimant sought medical treatment from her primary care physicians. Ultimately, Dr. Michael A. Luchini, an orthopedic surgeon, became the claimant’s treating physician. Dr. Luchini saw the claimant on August 18, 2005 and diagnosed the claimant as suffering from “costochondritis and scapulothoracic strain.” Physical therapy and medication was prescribed. The claimant continued to treat with Dr. Luchini who in his September 25, 2006 report opined that the claimant should undergo an arthroscopic procedure to relieve her left shoulder pain.
Thereafter there were a number of Emergency Room visits by the claimant all related to pain resulting from her March 2005 work injury. We note the respondents accepted compensability of the March 1, 2005 injury. The only issue presented for review is whether the diagnostic and medical care provided to the claimant for a possible cardiac condition was the financial liability of the respondents. The trial commissioner concluded it was and we affirm.
Whether certain medical care and related testing constitutes reasonable and necessary medical treatment as that term has been construed pursuant to § 31-294d(a)(1) is a question of fact. Vannoy-Joseph v. State, 5164 CRB-8-06-11 (January 29, 2008). See also, Anderson v. R & K Spero Co., 107 Conn. App. 608 (2008). As such the trial commissioner’s determination will not be disturbed unless it is without evidentiary support, contrary to law or based on unreasonable or impermissible factual inferences. Fair v. Peoples Savings Bank, 207 Conn. 535 (1988).
The respondents argue that in order for liability to be assessed against them for the cardiac work-up, there must be a finding that the cardiac condition is causally connected to the claimant’s employment. We disagree. Sec. 31-294d(a)(1) provides in pertinent part, “The employer, as soon as the employer has knowledge of an injury, shall provide a competent physician or surgeon to attend the injured employee and, in addition, shall furnish any medical and surgical aid or hospital and nursing service as the physician or surgeon deems reasonable or necessary.”
Clearly, the fact that the medical personnel at St. Raphael’s referred the claimant for a cardiac diagnostic work-up supports an inference that the referral was reasonable medical treatment. Such action was consistent with accepted medical procedures in instances where a patient complains of chest and left arm pain and should satisfy the statute’s requirements as to what constitutes reasonable and necessary medical treatment. That inference is further buttressed by the opinion of the respondents’ examiner, Dr. Edward Staub, indicating that when a patient complains of chest pain the proper medical protocol is to rule out a heart condition. See Findings, ¶¶ 33, 34, and X, Y, FF, GG. The claimant’s complaint of pain in her chest and related body parts was the causal impetus for the claimant’s visit to the ER. Those complaints were ultimately diagnosed as a medical condition causally related to her March 1, 2005 injury. It therefore logically follows that diagnostic testing consistent with established medical procedures to determine what was the source of claimant’s pain constitutes reasonable and necessary medical care.
We therefore affirm the August 20, 2007 Finding and Award of the Commissioner acting for the Third District.
Commissioners Ernie R. Walker and Charles F. Senich concur.