CRB Case Annotations re: Section 31-294d

Claimant was retired correctional nurse who asserted total disability andrgery was due to workplace injuries. After a hearing where video evidence was presented showing claimant supervising and working on home renovation project, commissioner denied m need for further spinal suajority of claimant’s bid for temporary total disability benefits. Commissioner also did not rule on whether latest surgery was compensable. On appeal, CRB affirmed findings on disability as backed by probative evidence. On issue of medical treatment, CRB noted parties had agreed at start of formal not to address issue and commissioner was not obligated to rule at this time, but matter could be considered at further proceedings citing Martinez-McCord v. Judicial Branch, 5055 CRB-7-06-2 (February 1, 2007). See also, Carey, § 31-301 Factual findings; § 31-307; §31-308 (a).

Claimant asserted head and neck injuries as the result of a workplace assault. Respondents produced video evidence suggesting incident did not cause injury. Trial commissioner found claimant not credible and found opinions of experts who viewed video and opined claimant did not sustain injury in incident credible. On appeal, CRB affirmed. This case turned solely on evaluating factual evidence which commissioner concluded favored the respondents. See also, Bernard, § 31-275 (1); § 31-301 Factual findings; § 31-307.

Claimant asserted her lumbar spine condition was the result of a fall down incident at work. Respondents noted she had sustained numerous prior back injuries, did not raise this injury at a medical examination the day of the incident and their expert witness opined the incident was not a significant factor in her current condition. Trial commissioner accepted this argument finding claimant not credible and her medical witnesses not persuasive, and found commissioner's examiner "vacillated." CRB affirmed decision on appeal; probative evidence the commissioner found reliable supported the result. Commissioner clearly explained in text of her decision her rationale for not crediting opinion of the commissioner's examiner and finding the respondents expert more persuasive, this determination must stand on appeal, as per Sanchez v. Edson Manufacturing, 5980 CRB-6-15-1 (October 6, 2015), aff'd, 175 Conn. App. 105 (2017). See also, Reveron, § 31-275 (1); § 31-301 Factual findings.

Claimant asserted that he was still temporarily totally disabled but medical reports issued after viewing surveillance videos opined that claimant had work capacity. Trial commissioner adopted opinion of commissioner’s examiner and respondent’s examiner to grant forms 36. On appeal, CRB affirmed decision, sufficient probative evidence was present to sustain finding. See also, Schreckengost, § 31-301 Factual findings; § 31-307.

Respondents appealed commissioner’s conclusion that claimant’s right knee condition and need for knee replacement surgery were caused by previously accepted work-related injury, contending that findings erroneously failed to reference claimant’s prior knee injuries or injury which prompted claimant to seek medical attention after three year gap in treatment. CRB affirmed, noting that reports and testimony offered by claimant’s treater provided more than adequate basis for commissioner’s conclusions. CRB also noted that although neither respondents’ nor commissioner’s examiners opined that triggering injury constituted substantial contributing factor, all medical experts agreed that incident aggravated claimant’s pre-existing degenerative knee condition. In addition, commissioner specifically found that her examiner’s opinion was inconsistent with claimant’s testimony, which she deemed credible, and medical records. CRB affirmed denial of respondents’ motion to correct, but remarked that “interests of accuracy would have been better served” had commissioner granted respondents’ proposed corrections relative to triggering injury and three-year gap in treatment. Respondents also appealed commissioner’s authorization for second opinion with physician of claimant’s choosing; CRB declined to reach this claim of error in light of claimant’s decision to proceed with surgery, but did note that provisions of General Statutes § 31-294d (c) afford commissioners considerable latitude in rendering decisions regarding access to medical care providers. See also, Secula, § 31-275 (1); § 31-301 Factual findings; § 31-301-4.

Orzech v. Giacco Oil Company, 6307 CRB-8-19-2 & 6308 CRB-8-19-2 (January 30, 2020), appeal pending, A.C. 43941 (February 14, 2020).

Original claimant sought approval for knee surgery after compensable fall down injury. Prior to decision on whether this surgery was approved he died after self-administered drug overdose. Spouse filed claim as a dependent arguing his death was due to despondency due to his disability, noting medical examiner deemed death a suicide. At hearing, commissioner credited claimant’s evidence from that he needed a knee replacement prior to his demise; Respondents appealed but CRB affirmed ruling, finding claimant submitted sufficient evidence to establish causation. See also, Orzech, § 31-275 (1); § 31-301 Factual findings; § 31-306.

Following order of preclusion, claimant presented evidence that his cardiac arrest occurred in the course of his employment, and was not merely contemporaneous with work hours. Commissioner relied on opinion letter from cardiologist to award benefits. On appeal, respondents challenged adequacy of claimant’s evidence, but CRB affirmed award as it comported with precedent such as Hart v. Federal Express Corporation, 5897 CRB-2-13-11 (November 12, 2014), aff’d, 321 Conn. 1 (2016); Hadden v. Capitol Region Education Council, 5843 CRB-1-13-5 (May 20, 2014), aff’d, 164 Conn. App. 41 (2016); and McDonough v. Connecticut Bank & Trust Co., 204 Conn. 104 (1987). See also, LeFevre, § 31-275 (1); § 31-298; § 31-301 Factual findings; § 31-307.

Claimant had accepted upper extremity injury and underwent various tests and physical therapy after he had subsequent discomfort he attributed to a cervical spine ailment. After reviewing tests such as MRI’s and EMG’s commissioner found cervical spine ailment not compensable, authorized payment for diagnostic tests and denied payment for physical therapy. Claimant appealed that physical therapy should be deemed diagnostic; CRB affirmed commissioner; matter was a discretionary decision on his part.

Claimant had sustained catastrophic injuries and had subsequently been prescribed medical marijuana for pain. After receiving reimbursement for such treatment respondent stopped, asserting such conduct violated the federal Controlled Substances Act (CSA) and potentially, the federal RICO statute, for “aiding and abetting” a drug transaction. Trial commissioner did not accept this argument and ordered respondents to continue to pay for this treatment. On appeal, respondents argued that case was directly on point with the Maine Supreme Court decision in Bourgoin v. Twin Rivers Paper Co. LLC, 187 A3rd 10 (Me. 2018) determining a state tribunal’s order to pay a claimant for medical marijuana violated the CSA. CRB majority, however, found that the dissenting opinion in Bourgoin more persuasive that reimbursing a claimant for prescribed marijuana did not violate the CSA. CRB majority also found the 9th Circuit Court had affirmed that the CSA did not preempt state medical marijuana programs and Congress and the DOJ had provided exemptions to prosecutions for such programs, thus affirming the trial commissioner’s decision to the extent it directed respondent to continue reimbursing the claimant. In event federal approach to medical marijuana changes and creates a more serious legal threat, respondents can move under § 31-315 to vacate order. Schoolcraft, dissenting. Majority opinion in Bourgoin was a sound decision based on current status of federal statutes and the Supremacy clause. Even reimbursement of expenses creates potential legal exposure under the CSA. While federal actors have failed to conduct medical marijuana prosecutions to date, until there is an amendment to statutes this continues to be a realistic threat, and respondents may not receive warning they are now at risk before facing charges. As the Workers’ Compensation Commission is an entity of limited jurisdiction, it should not order respondents to act in violation of federal statutes.

Claimant fell off ladder in store and later attributed torn knee meniscus to this work injury. Respondents expert opined this injury was degenerative, noting claimant had not mentioned knee problems to medical providers after the incident. Commissioner sided with respondents finding claimant not a credible witness. On appeal, CRB affirmed dismissal, as issues of witness credibility cannot be revisited on appeal and per Abbotts v. Pace Motor Lines, Inc., 4974 CRB-4-05-7 (July 28, 2006), aff’d, 106 Conn. App. 436 (2008), cert. denied, 287 Conn. 910 (2008), expert opinions reliant on a less than credible claimant may be discounted by the trial commissioner. See also, DeMattia, § 31-275 (1); § 31-301 Factual findings.

Claimant already adjudicated with compensable cardiac ailments sustained additional injuries including retinal migraine headaches. Trial commissioner found claimant temporarily totally disabled from cardiac ailments and that retinal migraines were compensable sequela of original injury. CRB affirmed, finding sufficient evidence from treating physicians on record to support award. See also, DeLorge, § 31-275 (1); § 31-301 Factual findings; § 31-307.

Claimant asserted shoulder injury was the result of repetitive trauma using a machine at work. The commissioner relied on opinion of respondents’ expert witness and testimony from claimant’s supervisor, who opined claimant’s injuries were not work related. Claimant appealed, arguing these witnesses had discrepancies in their testimony. CRB affirmed dismissal; the commissioner is the judge of the weight of medical opinions. See also, Hyde, § 31-301 Factual findings.

Claimant was job coach for developmentally disabled adults who was hit with a water bottle from an agitated client. She asserted her continued need for medical treatment and inability to work was the result of this incident. While claimant’s treaters supported her position; respondent’s expert noted contemporaneous objective tests after incident showed no serious injury and claimant had been previously treated for depression, and opined work incident not the proximate cause of claimant’s condition. Trial commissioner found respondent’s expert persuasive and dismissed claim; on appeal CRB affirmed. Unlike Hadden v. Capitol Region Education Council, 5843 CRB-1-13-5 (May 20, 2014), aff’d, 164 Conn. App. 41 (2016), trial commissioner was not persuaded by the opinion of the claimant’s treaters; hence a different result ensued. See also, Shelesky, § 31-275 (1); § 31-296; § 31-301 Factual findings.

Claimant had long term issues with opioid dependency. Trial commissioner found expert witness who recommended out-of-state inpatient detoxification more persuasive than claimant’s treater; who favored ketamine injections. On appeal CRB affirmed decision. Cervero v. Mory’s Association, Inc., 5357 CRB-3-08-6 (May 19, 2009), aff’d, 122 Conn. App. 82, cert. denied, 298 Conn. 908 (2010), stands for principle that trier of fact is ultimate judge of what is the most appropriate modality of treatment. See also, Greco, § 31-301 Factual finding.

CRB reversed denial of medical treatment, noting that commissioner misstated “reasonable or necessary” medical treatment standard, pursuant to § 31-294d, as “reasonable and necessary” and denied three-level fusion on basis that medical evidence demonstrated recommended surgery was reasonable but not necessary. CRB affirmed decision to allow RME after commencement of formal proceedings and denial of claimant’s second motion for extension of time to file motion to correct on basis that §§ 31-278 and 31-298 afford commissioners wide discretion relative to conduct of hearings and submission of evidence. CRB declined to reach claim of error alleging deprivation of due process arising from denial of opportunity for claimant to submit rebuttal evidence following RME. CRB affirmed denial of deduction from respondents’ moratorium certain medical expenses and costs associated with claimant’s bankruptcy filing, noting that claimant failed to establish that said expenses and costs constituted “reasonable and necessary expenditures” as contemplated by § 31-293 (a). CRB affirmed denial of motion to correct, noting that proposed corrections reiterated arguments made at trial which were ultimately unavailing. CRB denied respondents’ motion to dismiss given that motion was not filed until after expiration of ten-day deadline which began to run when claimant failed to timely file her reasons for appeal. CRB found respondents waived any alleged defect and failed to demonstrate that claimant’s late filing had prejudiced their ability to defend claim. See also, Lionetti, § 31-278, § 31-293, § 31-298, § 31-301 Factual findings, § 31-301-2, § 31-301-4.

Claimant asserted shoulder and thumb injuries were the result of repetitive trauma using a machine at work. The commissioner relied on opinion of respondents’ expert witness, who opined claimant’s injuries were not work related. Claimant appealed, arguing witness was offering opinions beyond his expertise and based on an inaccurate factual foundation. CRB affirmed dismissal; commissioner is the judge of the weight of medical opinions. See also, Collin, § 31-275(1); § 31-301 Factual findings.

Jackson v. Yale University, 6273 CRB-5-18-5 (April 4, 2019), appeal pending, A.C. 42871 (April 29, 2019).

Claimant asserted current medical condition was the result of a prior accepted work injury. Commissioner found opinions of respondent’s examiner and commissioner’s examiner persuasive that substantial factor in claimant’s current back condition was degenerative process. Claimant appealed, but CRB held commissioner had sufficient probative evidence to dismiss the claim. See also, Jackson, § 31-275 (1).

Claimant asserted that injury was due to work as landscaper. Commissioner credited testimony from supervisor that claimant had long complained about a soccer injury and noted corroborating medical records documenting prior injury. CRB affirmed dismissal of claim. See also, Dominguez-Sanchez, § 31-275 (1); § 31-298; § 31-301 Factual findings.

Claimant alleged the need for further treatment from a prior compensable injury. Commissioner found expert witnesses who opined further treatment unnecessary persuasive and denied claim. On appeal, CRB noted appeal was jurisdictionally untimely, but found decision was grounded in probative evidence and would be affirmed. See also, Swaggerty, § 31-301 Appeal procedure.

Claimant who had five previous spine surgeries from a compensable injury argued error from trial commissioner denial of sixth surgery. CRB noted that medical witness commissioner found credible and persuasive opined against further surgery and affirmed. See also, Ayna, § 31-301 Factual findings; § 31-307.

Claimant alleged that he had sustained both repetitive trauma injuries and a specific traumatic injury while at work. Trial commissioner found medical opinions to the contrary persuasive and dismissed claim. CRB determined that it lacked jurisdiction due to late appeal but that the trial commissioner had sufficient evidence to reach his conclusion. See also, Tomaszek, § 31-275 (1); § 31-301 Appeal procedure.

Paraprofessional sustained accepted knee injury due to restraining agitated special ed students, later sought benefits for injury to other knee. Trial commissioner found her medical evidence persuasive and awarded benefits. CRB affirmed on appeal. Case indistinguishable from Rosa v. State/DCF, 5475 CRB-8-09-7 (June 22, 2010). Trial commissioner applied Marandino v. Prometheus Pharmacy, 294 Conn. 564 (2010) standard to ascertain causation, and pursuant to Lopez v. Lowe’s Home Improvement Center, 4922 CRB-6-05-3 (March 29, 2006) could determine which opinion of an expert witness he deemed reliable. Respondents also challenged order for payment of future medical benefits, CRB affirmed as consistent with Hodio v. Staples, Inc., 5152 CRB-3-06-10 (October 3, 2007). See also, Fernandes, § 31-275(1); § 31-301 Factual findings.

Claimant challenged trial commissioner’s conclusion, pursuant to the provisions of General Statutes § 31-349, that respondents were entitled to eight percent credit for permanent partial disability benefits previously collected by claimant in association with motor vehicle accident. CRB affirmed, noting that although medical evidence was somewhat ambiguous, record was devoid of expert opinion suggesting that current rating of fifteen percent was in addition to eight percent previously received by claimant. Claimant also challenged commissioner’s conclusion that permanency potentially owed to claimant because of prior fusion surgery was “subsumed” into current doctors’ ratings; CRB struck this conclusion on basis that it went beyond scope of evidentiary record. CRB affirmed commissioner’s refusal to award interest for disputed portion of permanency benefits but remanded for additional evidentiary proceedings relative to commissioner’s denial of interest for alleged untimely initial permanency payment. CRB found erroneous trier’s denial of reimbursement for costs associated with claimant’s attendance at formal hearing in Connecticut after having relocated to Florida, noting that respondents’ proposed findings suggested that permanency credit should be taken against disability award of ten percent rather than fifteen percent, thereby implicating “extent of disability” as issue for formal hearing. CRB affirmed trier’s denial of reimbursement for costs associated with claimant’s June 2015 office visit with Connecticut doctor on basis that totality of evidentiary record supported trier’s conclusion that visit did not constitute reasonable or necessary medical care. See also, Melillo, § 31-288, § 31-301. Factual Findings, § 31-312, § 31-349.

Claimant asserted current medical condition was result of injuries sustained falling off running board of truck. Trial commissioner accepted opinion of respondents’ expert witness that injury was self-limiting and claimant’s condition result of preexisting injuries. CRB affirmed decision on appeal. See also, Spillane, § 31-296a; § 31-301 Factual findings; § 31-307.

Claimant sustained compensable right hip injury and later claimed left hip and back problems were sequalae of original injury. Trial commissioner denied this claim. Claimant appealed arguing that the trial commissioner erred by not crediting treating physicians who had opined in favor of his bid for benefits, citing Bode v. Connecticut Mason Contractors, The Learning Corridor, 130 Conn. App. 672 (2011) cert. denied, 302 Conn. 942 (2011). Claimant also argued commissioner was obligated to explain why she did not find his evidence persuasive. CRB affirmed decision. If trial commissioner did not find claimant’s narrative persuasive she was not obligated to find medical opinions reliant on this narrative persuasive. Commissioner also not obligated to provide a detailed explanation on this point, see Biehn v. Bridgeport, 5232 CRB-4-07-6 (September 11, 2008). See also, Cassella, § 31-275 (1); § 31-307.

Claimant asserted that his medical condition and need for treatment, including a spinal cord stimulator, was due to a compensable back injury. Trial commissioner found claimant’s experts persuasive and awarded benefits. CRB affirmed on appeal. See also, LaLuna, § 31-307; § 31-308(a).

Claimant had sustained compensable back injury and underwent disc surgery; some years later he argued that disc at adjacent level was injured and required surgery, and he argues it was a sequalae of original injury. Claimant’s expert opined injury was work related but respondent’s expert opined that this was a separate matter and claimant’s injury was degenerative disc disease. Trial commissioner found respondent’s expert more persuasive and dismissed claim. CRB affirmed the dismissal. See also, Keyes, § 31-301 Factual findings; § 31-301-4.

Claimant sustained severed finger while operating lawn mower and putative employer drove him to hospital and later retrieved severed digit. Claimant did not file timely notice of claim but argued that respondent “furnished medical care” and this satisfied notice exception. Trial commissioner agreed & CRB affirmed on appeal; case distinguished from Kulis v. Moll, 172 Conn. 104 (1976) as CRB found trial commissioner applied test in Spencer v. Manhattan Bagel Company, 5419 CRB-8-09-1 (January 22, 2010). See also, Wetmore, § 31-294c; § 31-301 Factual findings; § 31-355(b).

Claimant sustained compensable injury to low back in 2008, resulting in surgery at L4-5, and in 2014 sought authorization for additional surgery at L4-5 and L5-S1, which respondents denied. Claimant proceeded with surgery under his own insurance, and subsequently appealed trial commissioner’s decision denying compensability. CRB affirmed, rejecting claimant’s contentions that (1) commissioner had erroneously disregarded favorable medical opinion, and (2) respondents were obligated by prior Voluntary Agreement to accept compensability of claimant’s back problems at both disk levels absent an “override” of Voluntary Agreement pursuant to General Statutes § 31-315. CRB also determined that evidentiary record provided sufficient basis for commissioner’s conclusions that 2008 injury was not a substantial contributing factor to claimant’s need for second surgery, and second surgery did not constitute reasonable or necessary medical treatment pursuant to General Statutes § 31-294d. See also, Garthwait, § 31-275 (1), § 31-301. Factual Findings, § 31-301-3, § 31-315.

Treating physician for claimant submitted bills and reports in bulk form in often illegible manner. Respondents argued treater was obligated under Commission regulations and protocols to submit reports & bills for each treatment on HCFA forms; and sought to disallow payment for treatment. Trial commissioner granted this request. CRB vacated this order. Nonpayment for reasonable and necessary treatment was not an enumerated sanction under Chapter 568 and without finding of actual prejudice to the respondent there was no equitable ground to withhold payment. However, if treater is unwilling or unable to adhere to Commission billing and reporting requirements he should be removed as an authorized treater.

Trial commissioner granted a Form 36 and claimant argued that treating physician changed his opinion on maximum medical improvement, negating support for the motion. After formal hearing commissioner determined that medical witnesses he deemed credible supported granting Form 36. Claimant appealed to CRB, asserting result inconsistent with Risola v. Hoffman Fuel Company of Danbury, 5120 CRB-7-06-8 (July 20, 2007), dismissed for lack of final judgment, A.C. 29056 (October 18, 2007). CRB affirmed. Facts in case distinguishable from Risola. Commissioner could find treater’s amended opinion unpersuasive as it was reliant on another medical witness commissioner deemed unreliable. See also, Jelliffe, § 31-301 Factual findings.

Claimant had sustained a head injury in 2007 while at work. Prior finding in 2010 determined that this was self-limiting and claimant sustained no long term disability. Claimant then later asserted he was totally disabled and improved knowledge of post-concussive syndrome would link that disability to his 2007 injury. Trial commissioner rejected this claim; determining that he failed to show a change of circumstances since prior finding and noting impact of collateral estoppel. Claimant appealed and CRB affirmed decision. Evidence presented did not compel a finding of changed circumstances. Claimant also did not introduce any objective tests that application of current medical standards would find his condition was due to work injury. See also, Pitruzzello, § 31-301 Factual findings; § 31-315.

Claimant sustained thumb injury at her employer in 2003, went to work for subsequent employer, and then sought thumb surgery. Carriers for present and previous employers contested legal liability for the surgery. Trial commissioner concluded initial injury created need for surgery. On appeal, CRB affirmed, as expert opinion on the record supported this result. See also, Palacios, § 31-299b, § 31-301 Factual findings.

Claimant asserted that ergonomic problems from work caused back injuries and resultant disability. Trial commissioner noted claimant had sustained prior noncompensable motor vehicle accidents and did not find claimant’s medical witnesses persuasive; choosing to rely on respondent’s examiner who found no causal link between claimant’s employer and injury. Claimant appealed asserting that her medical evidence was uncontroverted and as per Bode v. Connecticut Mason Contractors, The Learning Corridor, 130 Conn. App. 672 (2011) should have been credited. CRB affirmed dismissal; claimant’s interpretation of the Bode precedent was rejected in Pupuri v. Benny’s Home Service, LLC, 5697 CRB-2-11-11 (November 5, 2012) and Olwell v. State/Dept. of Developmental Services, 5731 CRB-7-12-2 (February 14, 2013). CRB also found that trial commissioner could have found treater’s opinions equivocal and inconsistent with opinions of respondent’s examiner. See also, Diaz, § 31-301 Factual findings; § 31-301-9; § 31-307.

Claimant was longtime teacher’s aide who asserted her current medical condition and need for treatment was due to three injuries sustained at work. Respondents challenged claimant as poor historian and argued alleged discrepancies in her medical evidence rendered them unreliable, citing DiNuzzo v. Dan Perkins Chevrolet Geo, Inc., 294 Conn. 132 (2009) and Jones v. Connecticut Children’s Medical Center Faculty Practice Plan, 131 Conn. 415 (2011). Trial commissioner awarded benefits and respondents appealed. CRB affirmed decision. Trier of fact found claimant a credible witness. Totality of factors standard enunciated in Estate of Haburey v. Winchester, 150 Conn. App. 699 (2014), cert. denied, 312 Conn. 922 (2014) and Marandino v. Prometheus Pharmacy, 294 Conn. 564 (2010) met by the claimant. See also, Tedesco, § 31-275(1); § 31-301 Factual findings; § 31-308(b).

Claimant was injured when car rear ended bus he was driving and later claimed need for shoulder surgery was due to this incident. Respondent presented surveillance tape which was inconsistent with claimant’s depiction of this incident to a treating physician and denied that this injury was compensable. Trial commissioner found injury was compensable and respondent appealed. CRB affirmed trial commissioner. Commissioner responsible for resolving any discrepancies between the claimant’s statements and other evidence on the record. Claimant had told other treaters contemporaneous with incident he injured his shoulder. Fact respondent did not depose claimant’s witnesses distinguishes case from DiNuzzo v. Dan Perkins Chevrolet Geo, Inc., 294 Conn. 132 (2009) and Tarantino v. Sears Roebuck & Co., 5939 CRB-4-14-5 (April 13, 2015); trial commissioner could rely on written reports “as is’ and draw reasonable inferences from their opinions; see Berube v. Tim’s Painting, 5068 CRB 3-06-3 (March 13, 2007). See also, Allen, § 31-275(1); § 31-301 Factual findings; § 31-307.

Respondents appealed trial commissioner’s determination that claimant’s use of medical marijuana constituted “reasonable or necessary medical treatment” consistent with provisions of § 31-294d(a)(1) C.G.S. Respondents also challenged trier’s conclusion that claimant was properly certified into medical marijuana program because claimant did not have a “bona fide” relationship with prescribing physician or a qualifying medical condition. CRB, noting that program’s enabling legislation did not deprive Workers’ Compensation Commission of jurisdiction to hear appeal, affirmed, and held that evidentiary record adequately supported trier’s findings relative to claimant’s compliance with program’s requirements. CRB also affirmed trier’s conclusion that pain management relief afforded to claimant by his use of medical marijuana satisfied standard for curative care as articulated in Bowen v. Stanadyne, Inc., 2 Conn. Workers’ Comp. Rev. Op. 60, 232 CRD-1-83 (June 19, 1984) and therefore constituted “reasonable or necessary” medical treatment. CRB declined to address respondents’ public policy arguments but did point out that workplace safety concerns relative to use of medical marijuana could apply equally to use of prescription narcotics. Citing the board’s analysis in Vannoy Joseph v. State/DMHAS, 5164 CRB-8-06-11 (January 29, 2008), CRB rejected respondents’ contention that lack of FDA approval for medical marijuana compelled commissioner to conclude that claimant’s use of medical marijuana did not constitute reasonable or necessary medical treatment. Finally, CRB affirmed denial of respondents’ Motion to Correct. See also, Petrini, § 31-301 Factual findings.

Claimant appealed from an order of the trial commissioner that she should reimburse respondent for $133,000 of fentanyl prescriptions the respondents claimed were unauthorized. CRB reversed the order. At time claimant received this treatment respondents had failed or neglected to enforce their rights under a prior agreement with a trial commissioner to stop paying for fentanyl. Treatment had not been deemed unnecessary until after it had already been provided. Statute relied upon by the respondent to justify reimbursement applies to claims still under dispute where payments are advanced without prejudice, and this was an accepted claim.

Claimant argued her need for further medical treatment was due to workplace exacerbation of a pre-existing condition. Trial commissioner relied on medical evidence he found probative that need for treatment was unrelated to compensable injury. Claimant appealed, arguing precedent in Cashman v. McTernan School, Inc., 130 Conn. 401 (1943) makes medical treatment under these circumstances compensable, and trial commissioner did not properly credit evidence from commissioner’s examiner supportive of claimant. CRB affirmed decision and distinguished Cashman. Claimant must establish proximate cause between compensable injury and need for treatment. Totality of opinion of commissioner’s examiner supported result and commissioner did not have to rely on the opinion supportive of claimant’s position Gagliardi v. Eagle Group, Inc., 4496 CRB-2-02-2 (February 27, 2003), aff’d, 82 Conn. App. 905 (2004)(Per Curiam). CRB did limit one order in decision, as trial commissioner could not rule on potential future need for medical treatment at this time, see Attardo v. Temporaries of New England, Inc., 5858 CRB-2-13-7 (June 19, 2014).

Claimant who had sustained two prior shoulder injuries at MA employers sustained additional injury at CT employer. Trial commissioner relied on opinion of respondents’ examiner to determine additional medical treatment & possible surgery not caused by CT injury. On appeal, CRB affirmed this finding. See also, Sanchez, § 31-275(1); § 31-294f; § 31-298; § 31-301 Factual findings; § 31-308(b).

Claimant, who sustained an earlier compensable injury, sought approval for lumbar spine surgery. Trial commissioner found experts who opined against surgery more persuasive than claimant’s treater who opined in favor. On appeal, CRB affirmed trial commissioner. Claimant argued commissioner erred by not ordering a commissioner’s examination prior to ruling on request, but CRB found commissioner was not obligated to order a commissioner’s examination. See also, Jodlowski, § 31-294f; § 31-298; § 31-301 Appeal procedure; § 31-301-9.

Trial commissioner determined that claimant’s need for medical treatment for his finger was due to prior noncompensable injuries and not a compensable injury he had sustained. Claimant appealed and CRB affirmed decision. Trial commissioner could find respondent’s expert witness offered reliable testimony and find claimant’s evidence unpersuasive. See also, Zezima, § 31-301 Factual findings.

Claimant sought approval for new microprocessor based prosthetic foot. Trial commissioner denied approval as he found existing prosthetic worked properly and was not persuaded replacement would return claimant to work force. CRB affirmed decision. Cervero v. Mory’s Association, Inc., 5357 CRB-3-08-6 (May 19, 2009), aff’d, 122 Conn. App. 82 (2010), cert. denied, 298 Conn. 908 (2010) places great discretion in trial commissioner to determine “reasonable and necessary” medical care.

Claimant asserted various dental injuries were related to compensable injury. Trial commissioner found claimant’s evidence on issue unpersuasive. CRB affirmed on appeal. See also, Van Fleet, § 31-301 Appeal procedure; � 31-301 Factual findings; § 31-315.

Claimant argued that he was totally disabled as a result of work injury. Trial commissioner dismissed claim for disability benefits, finding claimant had work capacity and cited reliance on respondent’s examiner as stating claimant did not need additional medical treatment. Claimant move to correct this finding which was denied. On appeal, CRB remanded on the medical treatment issue. Review of witnesses’ testimony which commissioner found reliable was that the claimant still needed certain treatment modalities. See also, Vallier, § 31-301 Factual findings; § 31-301-4; § 31-307.

Claimant asserted she sustained two work related knee injuries. She also sought knee replacement surgery. Trial commissioner found claimant presented credible expert witnesses who found such surgery warranted and CRB affirmed decision on appeal. Trial commissioner has discretion to determine what modality of treatment constitutes reasonable and necessary treatment; see See Cervero v. Mory’s Association, Inc., 5357 CRB-3-08-6 (May 19, 2009), aff’d, 122 Conn. App. 82 (2010), cert. denied, 298 Conn. 908 (2010). See also, Osborn, § 31-275(1); § 31-301 Factual findings.

Claimant said he was injured while at work raising lawn mower to truck; and that this incident was a substantial factor in his need for back surgery. Trial commissioner found claimant credible and credited opinion of treating physicians. On appeal, respondents argued they were prejudiced by claim form which stated an inaccurate date of injury. CRB affirmed trial commissioner who determined respondents not prejudiced as claimant actively pursued claim and sought hearings within one year of injury. See also, Kingston, § 31-294c; § 31-275(1); § 31-301 Factual findings.

Claimant sustained two compensable injuries, one in 2010 and second in 2011. Evidence presented was that claimant was a surgical candidate prior to the second injury. Trial commissioner concluded that pursuant to Hatt v. Burlington Coat Factory, 263 Conn. 279 (2003) the insurance carrier on the risk at time of second injury responsible for all medical treatment. Carrier appealed and CRB affirmed Finding. Evidence on record could reasonably lead trial commissioner to conclude claimant’s condition made materially and permanently worse as a result of second injury; expert witnesses ascribed enough weight to second injury as cause for surgery to support “substantial contributing factor” test. See also, Wilson, § 31-301 Factual findings; § 31-308(a).

Claimant appealed decision of trial commissioner to suspend pain management treatment and to find certain treaters unauthorized. CRB affirmed decision. Authorized treating physician’s testimony could reasonably cause trial commissioner to find continued treatment palliative and not curative.

Claimant sustained three compensable injuries while employed by respondent. She sought continued pain management treatment. Respondents argued claimant was at maximum medical improvement and further treatment was palliative, as claimant was not seeking employment despite a light duty work capacity. Trial commissioner agreed with respondents. CRB affirmed decision. CRB provides great deference to trier of fact to determine when medical care is curative. See Palumbo v. Bridgeport, 4991 CRB-4-05-9 (September 7, 2006). See also, Aylward, § 31-301 Factual findings; § 31-307; § 31-308(b); § 31-310.

Claimant was awarded reimbursement of medical bills incurred as a result of compensable injury. Respondent’s insurer appealed order, stating evidence was that a group health insurer had paid much of the outstanding bills and there had been no liens asserted by providers or carriers. CRB remanded matter for further proceedings to establish proper grounds to pay medical expenses and correct amounts due. See also, Bombria, § 31-299a.

Claimant sought to continue medical treatment. Trial commissioner found further treatment unwarranted. CRB affirmed trial commissioner. See also, Putney, § 31-301 Appeal procedure; § 31-301 Factual findings; § 31-307.

Claimant injured at work. After many years, respondents challenged efficacy of continued pain management and challenged claimant’s bid for spinal cord stimulator. Treating physician opined that this would improve claimant’s functional capacity so that he could return to work in some capacity. Trial Commissioner found opinion persuasive. CRB affirmed on appeal; treatment was within scope of Bowen v. Stanadyne, Inc., 2 Conn. Workers’ Comp. Rev. Op. 60, 232 CRD-1-83 June 19, 1984 standard of “curative treatment”. See also, Bryant, § 31-296; § 31-301 Factual findings; § 31-307; § 31-349.

Claimant suffered serious work injuries which included near amputation of thumb. After injury, claimant said he could not use hand. Surveillance video showed claimant using injured hand at gas station, holding hands et al. Trial commissioner relied on expert opinions claimant had work capacity and granted Form 36’s. Claimant argued trial commissioner erred in not approving additional surgery. CRB upheld trial commissioner. Expert witnesses commissioner found credible and persuasive opined surgery was not warranted. Decision was consistent with precedent in Cervero v. Mory’s Association, Inc., 5357 CRB-3-08-6 (May 19, 2009), aff’d, 122 Conn. App. 82 (2010), cert. denied, 298 Conn. 908 (2010). See also, Montenegro, § 31-288(b); § 31-300; § 31-301 Factual findings; § 31-307.

In a wide-ranging appeal, claimant challenged trial commissioner’s failure to find respondents unduly delayed indemnity payments and denial of interest, penalties and attorney’s fees. Claimant appealed trier’s determination that hands-free telephone device, IPad and aquatic therapy did not constitute reasonable or necessary medical care such that claimant was entitled to reimbursement for out-of-pocket costs. CRB affirmed findings relative to indemnity payments and medical care, noting that record supported trier’s inferences regarding claimant’s credibility and trier reasonably relied upon evidence in support of respondents’ assertion that indemnity payments were timely. CRB also held that trier reasonably inferred that claimant did not meet burden of proof necessary to establish that medical treatment for which she sought reimbursement satisfied standard for curative care as articulated in Bowen v. Stanadyne, Inc., 2 Conn. Workers’ Comp. Rev. Op. 60, 232 CRD-1-83 (June 19, 1984). CRB remanded on issue of whether respondents unduly delayed mileage reimbursements as findings suggested trier may not have reviewed all of claimant’s exhibits in support of that claim of error. CRB denied claimant’s two motions to file additional evidence. See also, Gendron, § 31-288; § 31-300; § 31-301. Factual findings; § 31-301-4; § 31-301-9; § 31-308(a).

Claimant originally appealed trial commissioner’s decision she should undergo detoxification at out of state facility. At appeal hearing, parties announced claimant agreed to this treatment. CRB deemed issue moot and sustained trial commissioner. See also, Tedesco, § 31-301 Factual findings; § 31-301-4; § 31-308a.

Claimant fell in parking lot and filed timely Form 30C. Trial commissioner later granted Motion to Preclude and found respondents liable to pay for claimant’s knee replacement. Respondents appealed. CRB affirmed. Donahue v. Veridiem, Inc., 291 Conn. 537 (2009) mandates that when a respondent is precluded from contesting a claim trial commissioner may rely solely on claimant’s medical evidence to ascertain compensability. Treater in this case opined work injury substantial factor behind claimant’s need for surgery. Appellate Court reversed finding of preclusion, finding respondents established “impossibility” under facts in case; with preclusion overturned case remanded for new findings on compensability. See also, Dubrosky, § 31-294c.

Trier dismissed claim for medical treatment on grounds that medications sought were palliative rather than curative and did not constitute reasonable or necessary treatment. Claimant, a former firefighter, contended that contested medications allowed him to perform his daily activities and continue working part-time at neighborhood bar which he co-owned with three other partners. CRB affirmed, noting that medical records attributing claimant’s lumbar issues to degenerative disk disease and indicating that contested medications were not likely to be curative provided a reasonable basis for trier’s dismissal of claim. CRB also found that trier could have reasonably inferred that claimant’s limited workplace activities and discretionary employment schedule did not satisfy standard for curative treatment as articulated in Bowen v. Stanadyne, Inc., 2 Conn. Workers’ Comp. Rev. Op. 60, 232 CRD-1-83 (June 19, 1984). CRB affirmed trier’s denial of claimant’s Motion to Correct. See also, Briggs, § 31-301 Factual findings; § 31-301-4.

Claimant had sustained knee injury necessitating nearly full removal of meniscus prior to being hired by respondent. While employed by respondent claimant suffered knee bruise in conveyer belt accident. Claimant treated with primary care doctor and continued working despite pain, and left job for nonmedical reasons. Subsequent to leaving FedEx, claimant’s orthopedic doctor diagnosed need for knee surgery and performed surgery. Claimant’s treater opined work injury reason surgery was necessary, relying on claimant’s narrative. Respondent’s examiner opined nature of knee contusion and degenerative knee problem were unrelated and bone bruise not a substantial factor in need for surgery. Trial commissioner found respondent’s examiner persuasive and dismissed claim for surgery. Commissioner also found “it improbable that the claimant’s left knee was completely asymptomatic prior to” compensable injury. On appeal, CRB stated commissioner’s finding on the claimant’s knee being asymptomatic was unsupported by evidence. CRB affirmed the Finding as the respondent’s examiner offered independent probative evidence supporting the decision. See also, Morales, § 31-275(1); § 31-301 Factual findings.

Claimant suffered two prior noncompensable injuries prior to compensable motor vehicle accident. Respondents challenged causation and need for back surgery. Trial commissioner directed claimant to be examined by neurologist as to the need for additional surgery. CRB upheld decision on appeal. See also, Gonzalez, § 31-300; § 31-301 Appeal procedure; § 31-301 Factual findings; § 31-301-4.

Claimant suffered trauma at work but also had degenerative disc ailment to cervical spine. Based on evidence presented trial commissioner concluded that claimant’s need for surgery was not due to compensable injury. CRB upheld on appeal, commissioner’s examiner provided sufficient supportive testimony for this conclusion. See also, Turrell, § 31-298; § 31-301 Factual findings; § 31-301 Appeal procedure.

Claimant injured when tool box fell on him. Injury accepted as compensable, but parties disputed extent of injury and whether claimant’s various medical treatments related to incident. Trial commissioner found claimant’s hernia surgery and shoulder surgery compensable; found other injuries and psychiatric care not compensable. Both parties appealed. CRB affirmed trial commissioner. Claimant’s appeal essentially sought to retry the facts and the record supported the decision with probative supportive evidence. Respondents argued hernia surgery claim unsupported by necessary medical opinion as required in Murchison v. Skinner Precision Industries, Inc., 162 Conn. 142 (1972). CRB upheld decision; case indistinguishable from Sprague v. Lindon Tree Service, 80 Conn. App. 670 (2003) and Lee v. Standard Oil of Connecticut, Inc., 5284 CRB-7-07-10 (February 25, 2009); totality of evidence supported commissioner who made deliberate decision in case. See also, Jodlowski, § 31-301 Factual findings; § 31-301-9.

Claimant asserted numerous work-related injuries and sought additional treatment. Commissioner’s examiner opined claimant was at maximum medical improvement and no additional treatment warranted. Trial commissioner relied on this opinion and claimant appealed. CRB upheld decision. Trial commissioner normally provides deference to opinions of a commissioner’s examiner, Damon v. VNS of CT/Masonicare, 5413 CRB-4-08-12 (December 15, 2009). If claimant’s condition deteriorates she may make new request to trial commissioner to authorize treatment. Serluca v. Stone & Webster Engineering, 5118 CRB-8-06-8 (July 13, 2007). See also, McClaren, § 31-301 Factual findings.

Claimant sought continued pain management treatment and social worker therapy. Conflicting expert opinions as to efficacy presented at formal hearing, and trail commissioner decided that experts who opined treatment was palliative and not curative more persuasive. On appeal, CRB upheld decision. Precedent in Anderson v. R & K Spero Company, et al., 107 Conn. App. 608 (2008) makes determination here a factual matter for the trial commissioner whether treatment will return claimant to work force. Commissioner relied on experts who found claimant’s treatment was not going to return her to work. See also, Jodlowski, § 31-301 Factual findings; § 31-301 Appeal procedure.

Claimant injured at work and reported neck pain. MRI identified herniated disc. Treater sought authorization to refer claimant to spine specialist. Respondents did not authorize and contested claim. Claimant treated at general practitioners who prescribed heavy doses of narcotics and advised him not to work. IME doctor confirmed disc problem but asserted claimant had work capacity. Claimant sought temporary total disability benefits and sanctions. Trial commissioner granted relief, finding respondent’s conduct in denying treatment without cause egregious. Respondents appealed claiming due process violation and denying misconduct. CRB upheld trial commissioner. CRB has made clear failure to authorize necessary treatment creates liability back to date of incapacity. McInnis v. Shelter Workz, 5299 CRB-3-07-11 (June 11, 2009). See also, Lee, § 31-288, § 31-300, § 31-301 Appeal procedure, § 31-307.

Trial commissioner concluded claimant suffered two compensable injuries, but had not proven he was totally disabled from either injury. Commissioner also decided that percutaneous laser disc surgery and a spinal cord stimulator not necessary; noting differing expert opinions on efficacy of these treatments. CRB upheld decision. See also, Anderson, § 31-275(1), § 31-294f, § 31-301 Factual findings, § 31-307.

Claimant injured in 1996 and has been treating since for effects of hip injury. Claimant, who also suffers from cerebral palsy and intellectual disabilities, is treating at Allied Rehabilitation Center. Respondents argued that claimant’s treatment at Allied not “medical treatment” as defined by statute. Trial commissioner approved treatment and CRB upheld on appeal. Appellate precedent such as Anderson v. R & K Spero Company, 107 Conn. App. 608 (2008) makes it a factual determination whether a certain modality is “medical treatment” and whether it is curative or palliative. Opinions from treating physician and respondents’ expert support trial commissioner’s decision. See also, Covaleski, § 31-301 Factual findings.

Claimant asserted two elbow injuries; repetitive trauma injury in March 2007 and accidental injury in May 2007. Trial commissioner found claimant’s evidence insufficient for initial injury but that subsequent injury was compensable. Commissioner found claimant’s need for surgery tied to that event. Respondents appealed, noting April 2007 MRI showed ligament tear. CRB affirmed trial commissioner. Treating physician opined May 2007 event substantial factor in claimant’s present medical condition; treater had not recommended surgery until after that compensable injury. Aggravation of a pre-existing injury can be deemed compensable. See also, Feliu, § 31- 301 Factual findings.

Claimant suffered accepted back injury while on business trip in March 2003; but symptoms increased in November 2003. Claimant asserted need for surgery due to original accident, but respondents’ expert disagreed. Trial commissioner did not find claimant a reliable witness and relied on respondents’ expert; and dismissed claim. CRB upheld. Claimant has burden of proof to prove current condition due to compensable injury. Trial commissioner could properly rely on respondents’ expert. See also, Williams, § 31-301 Factual findings.

Mele v. Hartford/Board of Education, 5495 CRB-1-09-9 (September 13, 2010), aff’d and remanded for further proceeding, 129 Conn. App. 858 (2011), cert denied, 302 Conn. 925 (2011).

Claimant appealed trial commissioner’s dismissal of claim for wheelchair modifications on basis that modifications sought were neither reasonable nor necessary. Claimant submitted report from physical therapist recommending certain modifications as well as report from treating orthopedist concurring with physical therapist’s recommendations. CRB reversed, concluding evidentiary record supported inference that physical therapist was qualified to offer opinion as to medical necessity of modifications. CRB found no undue delay relative to respondents’ administration of claim for wheelchair modifications, noting that claimant declined opportunity for assessment at Gaylord Hospital which arguably might have expedited medical necessity determination. Claimant made several attempts to introduce additional documents which were denied insofar as submissions did not comport with Admin. Reg. § 31-301-9. CRB also granted respondents’ Motion to Strike claimant’s submission referencing respondents’ alleged negotiations with Attorney General’s office to replace wheelchair. See also, Mele, § 31-301, Factual findings, § 31-301-9.

CRB affirmed commissioner’s finding and dismissal that claimant’s prior compensable back injury was not a factor in claimant’s need for a second back surgery. The need for a second back surgery was solely the result of a non compensable car accident. Further, the commissioner’s reference to the doctrine of superseding cause did not constitute reversible error given commissioner’s finding that the non compensable. See also, Aguirre, § 31-275(1).

Claimant injured back and after passage of time, sought new surgery. Trial commissioner found evidence did not support this treatment but found the claimant needed detoxification from narcotics. Respondents appealed, arguing due process issue from ordering treatment not sought by claimant. CRB upheld trial commissioner. Respondents were on notice from commissioner’s examiner�s report and cross-examination of claimant that excessive narcotics use was an issue for the claimant. See also, DiDonato, § 31-298, § 31-301. Factual findings, § 31-307.

CRB affirmed trier’s finding that claimant’s depressive disorder was compensable on basis that medical reports and claimant’s testimony at trial supported reasonable inference of causation between claimant’s accepted back injury and contested psychiatric claim. CRB affirmed trier’s refusal to find undue delay and/or unreasonable contest against respondents relative to their failure to authorize psychiatric evaluation and to pay and/or reimburse claimant for medications prescribed by authorized treater on basis that record in its entirety did not support sanctions. Although CRB considered circumstances surrounding submission of surveillance videotape problematic, board did not find trier’s actions constituted reversible error given that surveillance was not germane to issues on appeal. Trier also properly refused to mark tape as full exhibit and allowed record to remain open pending investigator’s testimony but claimant requested trier close record before that occurred. CRB affirmed trier’s refusal to dismiss claimant’s amended Reasons for Appeal given that respondents did not appear to be prejudiced by claimant’s late filing. Both parties filed Motions to Correct which were denied save for two proposed corrections by claimant making two findings consistent with overall award. See also, Volmut, § 31-275(1), § 31-275(16), § 31-298, § 31-300, § 31-301. Factual findings, § 31-301-4.

CRB affirmed trier’s conclusion authorizing three-level disc replacement surgery. CRB satisfied trier’s conclusion complied with remand order of Vannoy-Joseph v. State/DMHAS, 5164 CRB-8-06-11 (January 29, 2008) in which commissioner was ordered to consider scientifically competent evidence. See Vannoy-Joseph, 5164 CRB-8-06-11 (January 29, 2008), §§ 31-294d, 31-298, 31-301-4, 31-301-9.

CRB affirmed trier’s approval of medical treatment which included weight loss and detoxification programs as well as surgery and conclusion that the claimant was entitled to reimbursement for medical expenses paid by the claimant relating to a back injury for which surgery was prescribed and approved some ten years earlier. Whether the medical treatment sought by the claimant was reasonable and necessary was a fact based question and unless without evidence, contrary to law or based on impermissible or unreasonable factual inferences would not be disturbed. Further, the trier’s conclusion that there were no intervening or superseding events sufficient to relieve the respondent’s liability was dependent on the weight and credibility accorded to the evidence and was also affirmed by the CRB. See also, Chimblo, § 31-301. Appeal procedure, § 31-301. Factual findings.

See also, Camp, § 31-301. Appeal procedure, § 31-301. Factual findings, § 31-307, § 31-307b.

Claimant suffered compensable back and psychiatric injuries. After receiving authorization for back surgery in the U.S. from trial commissioner, claimant decided against back surgery and relocated to home nation of Jordan to obtain psychiatric treatment. Respondents challenged reasonableness of treatment, Trail commissioner approved treatment in Jordan. Respondents appealed. CRB remanded matter. Justification for treatment in Jordan primarily in medical report prepared at 11th hour; respondents entitled to depose this witness in order to present defense. Trial commissioner must find foreign medical treatment is “reasonable and necessary” consistent with precedent in Melendez v. The Home Depot, 3835 CRB-04-98-06 (July 13, 1999), aff’d, 61 Conn. App. 653 (2001) and Pietraroia v. Northeast Utilities, 254 Conn. 60 (2000). See also, Ghazal, § 31-288, § 31-301. Appeal procedure, § 31-301. Factual findings, § 31-301-9. Additional evidence, § 31-307.

Claimant sought reimbursement for medical treatment claiming treatment was due to compensable injury. Trial commissioner concluded requested medical treatment was for noncompensable motor vehicle accident. As this goes to claimant’s credibibility, CRB cannot overturn trial commissioner. See also, Nicotera, § 31- 301. Appeal procedure, § 31-301. Factual findings, § 31-307.

Claimant suffered both compensable and then later, noncompensable back injuries. Trial commissioner ascribed need for surgery to earlier compensable injury. CRB upheld on appeal; expert witness testified original injury “substantial factor” in need for surgery. See also Santiago, § 31-275(23), § 31-301. Appeal procedure, § 31-301. Factual findings, § 31-349.

See also White, § 31- 294c C.G.S.; § 31-301. Factual findings C.G.S.

Claimant suffered compensable back injury and returned to work. He claimed he was unable to perform light duty work and was later terminated. Treating physician sought referral to specialist; which did not get approved for over a year. At that time claimant diagnosed with herniated disc and determined totally disabled. Trial commissioner ordered total disability from time of injury. Respondent appealed. CRB upheld. Respondent had obligation to provide necessary medical care and delay in determination of total disability not claimant’s fault. Trial commissioner could reasonably infer that claimant was totally disabled due to disc herniation for entire period claimed. See also, McInnis, § 31-301. Appeal procedure, § 31-301. Factual findings, § 31-307.

CRB affirmed trier’s dismissal of claimant’s request for additional medical care on grounds that pain management regimen sought was palliative and not curative and therefore did not constitute reasonable or necessary treatment. Claimant contended trial commissioner’s reliance on orthopedic surgeon’s opinion was in error as orthopedic specialist was not qualified to comment on efficacy of pain management. CRB determined that expert testimony contained in evidentiary record, along with medical reports from several experts, including a pain management specialist, provided adequate support for trial commissioner’s inferences regarding utility of pain management regimen. Trial commissioner also found claimant eligible for benefits pursuant to § 31-308a C.G.S. and awarded attorneys’ fees due to respondents’ unreasonable contest, which findings were not challenged on appeal. The claimant filed a Motion to Correct, which was denied in its entirety. See also, Dahle, § 31 298, § 31-301. Factual Findings. § 31-301-4.

Claimant sought disc replacement surgery for earlier compensable injury. Respondents challenged whether surgery was reasonable and necessary. Claimant’s doctor testified it would benefit patient; commissioner’s examiner opined he would not perform this surgery. Trial Commissioner relied on commissioner’s examiner and denied approval for surgery; left door open for future consideration. Claimant appealed, asserting Cirrito v. Resources Group Ltd. Of Conn., 4248 CRB 1-00-6 (June 19, 2001) compelled commissioner to approve procedure. CRB upheld commissioner; Cirrito stands for commissioner’s discretion to determine “reasonable and necessary” medical care. Commissioner could rely on commissioner’s examiner. No error in leaving door open for future consideration, see Serluca v. Stone & Webster Engineering, 5118 CRB-8-06-8 (July 13, 2007).

CRB remanded as evidentiary record did not provide scientifically based information as to concepts and methods supporting proposed 2 disc replacement non FDA approved surgery. Evidence should address efficacy in cases like that of the claimant, testing data, peer review analysis, and some detailing as to what aspects of the expert witness’ opinion is predicated on objective data as opposed to subjective beliefs and assessments. Trier’s findings and the evidentiary record did not conform to the guidelines set out in Vannoy-Joseph v. State/DMHAS, 5164 CRB-8-06-11 (January 29, 2008). See also, § 31-294d.

CRB affirmed commissioner’s conclusion respondent liable for cardiac diagnostic testing where claimant’s compensable injury to her chest and left shoulder caused her such pain that she presented to ER and it was not unreasonable or unnecessary for Hospital to test claimant so as to rule out cardiac issues.

Claimant denied further medical treatment for compensable injury. CRB cited Serluca v. Stone & Webster Engineering, 5118 CRB-8-06-8 (July 13, 2007) for proposition future medical care could be sought by the claimant. See also Diaz, § 31-307, § 31-301. Factual findings, § 31-355(b), § 31-301-9.

Claimant suffered compensable injury and sought to have respondents pay for reconstructive shoulder surgery. Expert witnesses differed on causation; commissioner’s examiner placed least weight on compensable injury. Trial Commissioner denied claim. CRB upheld on appeal. Burden on claimant to prove causation and commissioner was entitled to rely on expert testimony which did not find compensable injury a substantial factor. See also, Weir, Sec. 31-298.

Trier authorized three-level disc replacement surgery, relying on opinions, testing and recommendation of surgeon. CRB upheld subordinate findings regarding claimant’s medical condition and fitness for surgery, but remanded for further proceedings addressing scientific validity of three-level disc replacement surgery, which requires introduction of scientifically competent evidence that is methodologically sound. Reasonableness and necessity of proposed surgery remains question of fact dependent on circumstances. However, record did not contain enough evidence to explain concepts and methods that support three-level disc replacement, which is unproven and does not offer assurances of medical effectiveness one may infer from a procedure’s acceptance in standard medical practice. Thus, trier must examine methodology behind supportive medical opinions or theories. CRB provided examples of relevant methodological issues and evaluation techniques used in other forums, including techniques that promote validity of clinical studies. CRB also explained authorization of surgery need not depend on FDA approval for that particular use of legally marketed product, given FDA intent not to interfere with “off-label” uses. Also, experimental treatment standards in § 38a-483c and § 38a-513b C.G.S. do not apply to workers’ compensation as it is not general health insurance program, but quality of care caused by workplace injuries must not be inferior to health care generally available in community. See Vannoy-Joseph, §§ 31-298, 31-301-4, 31-301-9.

No error in trial commissioner’s finding that proposed four-level disc replacement surgery involved “real danger and suffering without fair assurance of effecting an improvement or restoration of health,” a test discussed in Pagliarulo v. Bridgeport Machines, Inc., 20 Conn. App. 154 (1989). Though treating spinal surgeon favored surgery and trier found his deposition testimony credible, there were areas of possible concern that trier may have identified. Food and Drug Administration had approved new artificial disc technology for use at only one level; claimant had shown low bone density upon initial testing; it was unclear how experienced surgeon was with disc replacement surgeries at more than two levels; and hospital would have required waiver of unexplained scope prior to authorizing surgery. Also, denial of fusion surgery was reasonable given surgeon’s description of its risks and probable ineffectiveness. CRB noted surgery was denied “at this time,” allowing claimant to reapply if factual circumstances change. See, Jolicoeur, § 31-301. Factual findings.

Respondents appealed Finding and Award that stated “pay all related workers’ compensation benefits due as a result of the injury”. CRB upheld. As per Schenkel v. Richard Chevrolet, Inc., 4639 CRB-8-03-3 (March 12, 2004), respondent is responsible for treatment in the future related to the injury. See also Hodio, § 31-301.Appeal procedure, § 31-307.

O’Connor v. Med-Center Home Healthcare, Inc., 5142 CRB-5-06-10 (August 28, 2007), dismissed for lack of final judgment, A.C. 29187 (January 10, 2008), appeal dismissed (for failure to appeal directly to board following trial commissioner’s May 30, 2008 Finding on remand), A.C. 30200 (March 12, 2009), cert. granted, 292 Conn. 910 (2009).

CRB affirmed commissioner’s conclusions authorizing knee replacement surgery, and reimbursement for prescription drugs and mileage. Remanded for findings as to specific amounts to be paid for prescription drugs and mileage. See also, O’Connor, § 31-301. Factual findings, § 31-301. Appeal procedure, § 31-307.

Trial commissioner determined claimant’s current back injury was due to a 2000 work-related injury. Claimant’s treating physician determined notwithstanding lapse of time claimant needed a “re-do” of original surgery. See also, Williams, § 31-301. Appeal procedure, § 31-301. Factual findings.

Claimant appealed from Finding & Award/Finding & Dismissal which determined that his current medical care was not curative. Claimant expressed concern terms of commissioner’s order would bar future medical care. citing Schenkel v. Richard Chevrolet, Inc., 4639 CRB-8-03-3 (March 12, 2004). CRB found determination of claimant’s current medical treatment is not probative regarding a determination as to claimant’s future medical treatment.

Schoolteacher filed claim for injury from science demonstration. Respondents denied liability. While treating for injuries claimant initiated treatment on own initiative at out-of-state clinic specializing in electric shock injuries. Trial commissioner found accident compensable and deemed certain ailments causally related to accident; but denied entire treatment at out-of-state clinic as unauthorized. CRB remanded on this issue. Claimant did not need authorization to commence treating when claim was contested. Record unclear whether entire treatment at out-of-state clinic was for injuries deemed noncompensable. Trial commissioner may retroactively authorize this treatment to extent it dealt with compensable injury and if “equally beneficial treatment is unavailable in Connecticut.” Cummings v. Twin Mfg. Co., 29 Conn. App. 249, 260 (1992). See also, Freel, § 31-301. Factual findings.

CRB affirmed trial commissioner’s decision to deny Respondents’ Medical Examination. Respondents alleged claimant, a volunteer fireman who was rendered a paraplegic when he fell from a ladder while fighting a fire, no longer satisfied the statutory conditions for collecting total incapacity benefits pursuant to § 31-307(c) C.G.S. Respondents contended that because medical reports indicated claimant’s paralysis was not complete and video surveillance showed claimant was able to walk and ambulate, trial commissioner’s refusal to authorize respondents’ medical examination constituted denial of due process. Trial commissioner found respondents had failed to challenge a prior trial commissioner’s finding in 2004 establishing claimant’s eligibility for permanent total incapacity benefits and also determined respondents had not adduced sufficient evidence of a change in claimant’s disability to warrant opening the voluntary agreement pursuant to § 31-315 C.G.S. See also, Gilbert, § 7-314a, § 31-294f, � 31-301. Factual findings, § 31-307, § 31-315.

Trier was entitled to order additional evaluation of claimant by treating physician where trier was unable to determine purpose of further treatment based on existing evidence. See Liebel, § 31-294c, § 31-295, 31-300, § 31-301. Appeal procedure, § 31-312; also cited at Liebel, § 31-278, § 31-298, § 31-307.

See, Jurado, § 31-279(c).

CRB affirmed commissioner’s conclusion that claimant’s shoulder replacement surgery was causally related to a 1996 injury and not a 1998 injury and thus carrier on the risk for the 1996 injury was liable for the surgery. See also, Fratino, § 31-301. Factual findings and § 31-301-9.

Claimant appealed decision of trial commissioner not to authorize current doctor as treating physician. CRB upheld trial commissioner, following precedent in Anderson v. R&K Spero Company, 4965 CRB-3-05-6 (February 21, 2007), aff’d, 107 Conn. App. 608 (2008). See also, Bond, § 31-307, § 31-301. Factual findings, § 31-308(a), § 31-308(b).

CRB upheld trial commissioner who determined claimant’s present physician was unauthorized. See also, Hernandez, § 31-301. Factual findings, § 31-295(c), § 31-307, § 31-308(b), § 31-288(c).

Claimant suffered compensable arm injury and was referred by treating physician to pain management specialist. Claimant sought to designate pain management doctor as treating physician and receive temporary total disability benefits. Respondents contested and commissioner had claimant examined by commissioner’s examiner, who deemed her medications excessive and recommended detoxification. Trial commissioner determined claimant’s present doctor unauthorized, directed respondent to pay for detoxification, and awarded temporary total disability benefits. Respondents appealed finding of disability, claiming disability was due to unauthorized medical care. CRB upheld trial commissioner. Former physician was in chain of authorization. While his care may not have been effectual, precedent in Student v. Corometrics Medical Systems, Inc., 3980 CRB-8-99-2 (February 9, 2000) is that respondents are responsible for the sequelae of the patient’s treatment. Trial commissioner properly found claimant disabled due to excessive medication. See also, Mana, § 31-301. Factual findings, § 31-307.

Trial commissioner determined treating physician provided reasonable and necessary care by implanting spinal cord stimulator in claimant following a shoulder injury. Commissioner’s examiner disagreed; believing claimant did not suffer from brachial plexopathy or complex regional pain syndrome and did not need a spinal cord stimulator. Trial commissioner agreed with treating physician and respondents appealed. CRB upheld trial commissioner. Trial commissioner may choose to rely on treating physician’s opinion over commissioner’s examiner if he provides justification , see Ben-Eli v. Lowes’s Home Improvement Center, 5006 CRB-3-05-10 (November 16, 2006) Treating physician offered competent medical testimony treatment was intended to return claimant to workforce. See also, Gallagher § 31-293; § 31-301. Factual findings.

Claimant suffered compensable 1997 injury which was aggravated at home. Claimant began treating with chiropractor on own initiative without obtaining authorization. Respondents contended treatment was not curative and claimant had reached maximum medical improvement. Trial commissioner adopted opinion of commissioner’s examiner that chiropractic treatment for claimant not justified as curative care. CRB upheld trial commissioner. Claimant did not meet his burden of persuasion. CRB cannot disturb a decision on whether to authorize a change in treating physicians unless it is unreasonable. See Dichello v. Holgrath Corp., 15 Conn. Workers’ Comp. Rev. Op. 441, 445, 2249 CRB-5-94-12 (September 5, 1996), affirmed, 49 Conn. App. 339 (1998). See also, Anderson § 31-301. Factual findings (chiropractic treatment not curative in this instance).

Claimant sought pain management treatment for 1990 compensable injury. Respondents contested claim stating claimant did not prove treatment met standards of curative care. Trial Commissioner denied claim. CRB upheld trial commissioner; finding of whether treatment is palliative or curative is factual decision for the trial commissioner to make, as per Carroll v. Flattery’s Landscaping, Inc., 4499 CRB-8-02-2 (March 25, 2003). See also, Kalinowski, § 31-301. Factual findings; § 31-308(a).

See, McMahon, § 31-301. Factual findings (further pain management treatment not curative); See also, McMahon, § 31-301-4, 31-307, § 31-315.

Claimant sought pain management treatment for 1990 knee injury. Respondents believed treatment was palliative as claimant was not in work force. Respondents’ expert testified treatment was intended to return claimant to workforce. Trier agreed with claimant. CRB affirmed. Curative/palliative care determination is factual issue. See also, Marra, § 31-300, § 31-301. Factual findings, § 31-307, § 31-308(b).

Claimant asserted he had suffered a work related injury to his right shoulder. Record indicated he had not filed a claim for the shoulder injury within one year of the alleged date of injury. Record also did not reflect that medical care had been provided for shoulder injury within one year of date of accident, as required under § 31-294d. Trial commissioner properly dismissed the claim as lacking jurisdiction. See also, Horvath § 31-294c, § 31-301. Factual findings.

Evidence before trial commissioner was that pain management medication was essential to keep the claimant in the work force. As therapy designed to keep the claimant at work is curative, commissioner properly approved treatment. See also, Palumbo, § 31-301. Factual findings.

Claimant sought to reverse findings that urogenital ailments were not due to compensable injury and that bowel ailments were not aggravated by compensable injury. Medical evidence before trial commissioner supported the commissioner’s findings. Treating physician testified problems had returned to “baseline” situation. See also, Dudley, § 31-301. Factual findings, § 31-307, § 31-308(a).

CRB affirmed trier’s authorization of left hip and left knee treatment with out-of-state physician where claimant had a complicated medical history and physician had previously performed total hip replacement on the same limb.

CRB affirmed trial commissioner’s denial of 31-294d order for payment for care provided by relatives where trier determined the care was not under the consent or direction of a physician.

CRB found no error in trier’s authorization of surgical procedure where medical evidence in record supports procedure as reasonable and necessary.

CRB found no error in trier’s refusal to authorize claimant’s treating physician where claimant changed providers on her own for her own reasons. CRB affirmed trier’s determination that proposed treatment by claimant’s physician was not reasonable or necessary based on medical evidence. CRB affirmed trier’s authorization of a new treating physician, however, reversed trier’s order for a treatment plan, which the physician had not acquiesced to. See also, Donaldson, § 31-298.

CRB affirmed commissioner’s award ordering the Second Injury Fund to pay for claimant’s residence in an assisted care facility and some hours per day for nursing care. Claimant sustained a compensable back injury and underwent unsuccessful back surgeries. Claimant’s spine deteriorated and claimant became wheelchair dependent and unable to live independently. Claimant appealed contending the trier erred in failing to award 24 hour/7 day per week in home care and in failing to order the Fund to pay for an equivalent facility in the event the claimant’s current living facility was unable to provide care. CRB affirmed the trier’s finding as to his present living situation as it was a factual determination to be made by the trial commissioner. CRB additionally dismissed claimant’s appeal contending the trier erred in failing to order the Fund to provide care on the basis of some subsequent future condition. CRB held it was not required to rule on hypothetical situations. See also, Papapietro, § 31-301, Appeal procedure, § 31-301. Factual findings.

Claimant retains right to seek medical treatment throughout life of claim absent execution and approval of full and final settlement. See also, Schenkel, § 31-295(c), § 31-301. Factual findings, § 31-307, § 31-308(b), § 31-349.

CRB affirmed trier’s order that the respondents pay for pain management and psychological treatment for claimant’s depression. Trier found claimant’s depression was related to his work injury and his subsequent back surgeries and thus authorized treatment. See also, Bernardo, § 31-301. Factual findings and § 31-300.

No error in failure to authorize treatment of out-of-state doctor where respondents did not accept compensability of cubital tunnel syndrome. Obligation of claimant to obtain referral and to adhere to approved list of physicians under § 31-280(10) only attaches to claims in which respondents have provided treatment required by § 31-294d(a). See also, Murray, § 31-296. Voluntary agreements (discontinuance of payments), § 31-300, § 31-301. Factual findings, § 31-307, § 31-308(a).

CRB affirmed trier’s ruling that medical treatments by physical therapist were palliative rather than curative. Trier had discretion to credit opinion of independent medical examiner that expressed doubt as to origin of pain symptoms, and indicated that further medical treatment would be of no benefit. CRB explained that respondents properly used Form 43 to contest liability for further treatment, rather than Form 36. See, Carroll, § 31-296. Voluntary agreements (discontinuance of payments).

Beaudry v. Uniroyal, 4505 CRB-5-02-3 (March 5, 2003), appeal dismissed, A.C. 24046 (June 6, 2003).

CRB affirmed trial commissioner’s dismissal of dependent spouse’s claim for death benefits where surgery was found not reasonable or necessary. The trier relied on the opinions of two physicians that decedent’s smoking habit and obesity made him a poor surgical candidate.

CRB affirmed trier’s order that MRI, bone scan and functional capacity evaluation be performed, rejecting respondents’ assertion that such tests were not “reasonable or necessary” treatment under § 31-294d. See also, Fox, § 31-301. Factual findings, § 31-308(a), § 31-308a.

CRB affirmed trier’s order that respondents reimburse claimant for cost of installing handrails in his house, and affirmed order that claimant be provided with wheelchair in certain situations requiring travel. See also, Covaleski, § 31-296. Voluntary agreements (discontinuance of payments); § 31-307.

CRB affirmed denial of authorization for pain management therapy program due to trier’s conclusion that claimant was addicted to narcotics. Issue of detoxification was closely tied to qualification for programs that parties had considered, and was properly addressed by trier. Social worker not classified as practitioner of “healing arts” under § 20-1. CRB remanded for trier to consider whether claimant should be admitted to detoxification program, as evidence suggested that she should be weaned off narcotics. See also, Cotugno, § 31-301-9.

Though alleviation of pain may be a valid basis for treatment, and reasonable or necessary medical care is not limited to courses of treatment that will probably succeed, trier still has discretion to decide whether such treatment will be approved. See also, Phaiah, § 31-294f, § 31-301. Factual findings.

Acknowledged possibility that back surgery might improve claimant’s quality of life was sufficient to satisfy standard of “reasonable or necessary” medical treatment. Authorization of surgery justified. Where two different surgical procedures were suggested (one anterior, one 360�), trier’s failure to elect between them was intended to give the parties the choice. Trier could later choose a physician, and ergo, a surgical procedure, if parties proved unable to agree. Matter remanded where trier failed to rule on issue of continuing narcotic medication as long-term treatment. See also, Irizarry, § 31-296. Voluntary agreements (discontinuance of payments).

CRB affirmed trier’s retroactive authorization of treating physician who was a colleague of approved physician listed on voluntary agreement. Also, authorized treatments were necessary medical care within meaning of statute, as they helped keep employee at work. See also, DeFelippi, § 31-301. Appeal procedure.

Medical care provider argued that chiropractic care was curative rather than palliative. However, trier permissibly relied on opinions of independent medical examiner and commissioner’s examiner, who both opined that care was palliative. Board noted that medical protocols are not absolute. See also, Lemelin, § 31-301. Appeal procedure.

Employer refused to authorize initial treatment at Industrial Health Care due to claimant’s failure to report injury in writing, then argued that medical care was not authorized because claimant initially treated with a doctor outside its plan. CRB affirmed trier’s rejection of this argument. Section 31-294d requires employer to provide competent medical care as soon as it knows of injury. Though employer is free to have an internal policy requiring claimants to report injuries in writing, it cannot place such policy ahead of obligation to provide care as soon as it somehow learns of an injury. Act does not require claimants to report injuries in writing. If claimant fails to immediately report injury, § 31-294b prescribes remedy for prejudice caused by such failure, which does not include permission for employers to refuse care altogether. CRB also explained that medical care plans do not play a role in choosing a treater until subscribing employer accepts responsibility for providing initial treatment. See also, Gonzalez, § 31-279(c).

In a footnote, panel noted that retroactive authorization of single-session treatment by an orthopedist that claimant went to see on his own was acceptable where claim was in its infancy, and he had not yet been assigned an authorized treater by respondents or by a commissioner. See also, Garofalo, § 31-301. Factual findings.

CRB affirmed trier’s authorization of epidural steroid injections. Both of the claimant’s doctors thought it reasonable to attempt such therapy, even if chance of success was only five percent. “Reasonable and necessary” medical care is not limited to courses of treatment that will probably be effective; if doctors believe that a given treatment is worth trying, a commissioner would normally be justified in approving such treatment. See also, Cirrito, § 31-300, § 31-301. Factual findings, § 31-298.

CRB affirmed trier’s approval of 32 visits by claimant to massage therapist/acupuncturist. Evidence supported finding that treatments helped claimant to return to work by alleviating her pain, which satisfies “curative” requirement of our case law.

It was within trier’s discretion to retroactively approve treatment by Drs. P. and S., where claimant had been sent to Dr. P. for a § 31-294f examination after she continued to experience pain for several years, despite having treated with Dr. M. Respondents did not object to new treater until over a year after § 31-294f exam, and following referral of the claimant to Dr. S. See also, Donaldson, § 31-298, § 31-301. Factual findings, § 31-307.

CRB affirmed trier’s finding that urologist’s treatment was compensable. Treating physician had referred claimant to urologist in attempting to diagnose cause of chronic pain following hernia surgeries. Urologist participated in a third surgical procedure to repair hernia, removing a hydrocele during the course of his own surgical investigation. He explained that his participation in the surgery was in the nature of an exploratory procedure, intended to identify and correct any potential urologic sources for the claimant’s pain. Ultimately, chronic pain resumed after surgery, and urologist opined that continuing pain was due to compensable hernia condition. See also, Ford, § 31-301. Factual findings, § 31-308(a), § 31-308(b).

CRB affirmed trier’s determination that claimant’s disability ceased effective April 30, 1998, and that medical treatment was not reasonable or necessary subsequent to that date. Issue was a factual issue for the trial commissioner to determine. See also, Covert, § 31-296 Voluntary Agreements (discontinuance of payments), § 31-301-4, § 31-301-9.

Trier found that recommended physical therapy, occupational therapy, and psychological treatment for the claimant’s pain constituted reasonable and necessary medical treatment. Respondent contended that physical and occupational therapy were not necessary, as claimant had already successfully completed these therapies. Board affirmed, as this was a factual determination and was supported by the medical evidence in the record. See also, Caprio, § 31-296 Voluntary agreements (approval of).

CRB affirmed trial commissioner’s decision that treatment for claimant’s binaural hearing loss was reasonable and necessary pursuant to § 31-294d, even though employment caused only his right-side hearing loss. Treating physician opined that in order to properly treat the right-side hearing loss, treatment must include both sides.

CRB affirmed trier’s order authorizing claimant to be evaluated and admitted as an inpatient at Massachusetts rehabilitation facility, rejecting the respondent’s argument that “equally beneficial” treatment was available in Connecticut pursuant to Cummings v. Twin Mfg., Inc., 29 Conn. App. 249 (1992). Trier could infer that better results would be obtained from focused, integrated inpatient program than could be achieved with outpatient treatment. Also, trier not required to rely upon § 31-294f examiner’s contrary opinion. Subsequent decision at D’Amico, 4287 CRB-5-00-9 (August 3, 2001), aff’d, 73 Conn. App. 718 (2002), cert. denied, 262 Conn. 933 (2003), § 31-301-9, § 31-307.

Treating physician ruled out surgery for claimant, who had reached maximum medical improvement but was still suffering back pain, and prescribed a TENS unit. Independent medical examiner did not challenge that recommendation. Respondents failed to reply to three requests by claimant’s attorney for a TENS unit, allegedly relying on the medical protocols’ description of passive modalities such as TENS units as inappropriate treatment for low back injuries. Trial commissioner noted protocols not absolute, and ruled that TENS unit was reasonable and necessary treatment. Trier also found that respondents had unreasonably contested liability by failing to inquire about possible alternative treatment. CRB affirmed. Doctors suggested no other form of treatment, and respondents had a duty to respond to claimant’s requests for neural stimulator, rather than waiting for a direct call from the claimant’s doctor. CRB chastised respondents for their conduct.

CRB affirmed trier’s decision to retroactively authorize 64 of claimant’s 225 visits to chiropractic physician where her condition did not improve prior to seeking outside care. Doctor testified that treatment had some value in bettering claimant’s condition, and medical protocols were neither in effect at time of her injury nor written to absolutely prohibit deviation from their standards. See also, Outlaw, § 31-301. Factual findings.

Trier had discretion to find doctors unauthorized due to lack of proper referral. See also, Schiaroli, § 31-301. Appeal procedure. Prior decision at Schiaroli, 3555 CRB-3-97-3 (December 30, 1997), § 31-301. Appeal procedure.

Respondents argued that because trial commissioner found psychiatrist’s treatment of claimant to be unreasonable, it was error to order respondents to pay for his treatment. Though trier described treatment as “unreasonable,” he did not hold that this treatment failed to constitute “reasonable or necessary” medical treatment as per § 31-294d. CRB thus affirmed the trier’s decision. See also, Student, § 31-275(1), § 31-298, § 31-308(c).

Medical care provider filed a claim to collect fee for medical services rendered to an employee who had not filed a workers’ compensation claim. CRB affirmed trial commissioner’s dismissal due to lack of subject matter jurisdiction. Board held that a medical provider does not have standing to furnish the notice required of an employee to invoke the jurisdiction of the commission. See also, Rodriguez, § 31-278.

See, Bailey, § 31-300, § 31-307, § 31-284b, § 31-301. Factual findings. Prior decisions at Bailey, 3694 CRB-1-97-9 (January 12, 1999), aff’d in part, rev’d in part, 65 Conn. App. 592 (2001), § 31-298, § 31-301. Appeal procedure and Bailey, 15 Conn. Workers’ Comp. Rev. Op. 433, 3152 CRB-5-95-8 (September 3, 1996), § 31-301. Appeal procedure, § 31-301. Factual findings.

CRB affirmed trier’s ruling that the insurer (St. Paul) was liable for medical treatment related to claimant’s right shoulder injury of 1992, including surgery for which claimant sought approval at the time of the formal hearing. St. Paul had entered into an approved voluntary agreement accepting his right shoulder injury, and, moreover, trial commissioner found that his right shoulder condition and symptoms were the same at the time of the formal hearing as they had been in 1992. Disputes regarding causation and need for surgery were issues of fact.

CRB affirmed trier’s decision that respondent was liable for payment of claimant’s medical treatment. Respondent argued that claimant unilaterally went to a chiropractor without referral from treating physician. CRB held that trier implicitly authorized a change in physician retroactively. See also, Murray, § 31-275(9), § 31-307. Prior decision at Murray, 3306 CRB-3-96-3 (August 21, 1997), § 31-315.

Respondents conducted selves in an “uncooperative and callous” manner by refusing to communicate with claimant or authorize any treatment at all, thereby failing to discharge their responsibility to provide a physician under § 31-294d(a). Claimant, who lived in New York, sought treatment with out-of-state doctor as result. No error in retroactive approval of that treatment. See also, Johnson, § 31-275(9), § 31-298.

CRB affirmed trial commissioner’s determination that trigger point injection did not constitute reasonable or necessary medical treatment of claimant’s shoulder injury. See also, Norwood, § 31-298.

Dudley v. Wadsworth Glen, 3942 CRB-8-98-12 (October 14, 1999), aff’d, 60 Conn. App. 907 (2000)(per curiam).

Trial commissioner found that claimant was unhappy with treating physician’s opinion and went to see other medical care providers without a referral. CRB found no abuse of discretion in trier’s refusal to retroactively authorize those other medical care providers. See also, Dudley, § 31-301-9.

Board affirmed trier’s decision that Commission did not have jurisdiction to consider medical provider’s bill for services where the named claimant chose to file a claim in New York rather than in Connecticut. Where, as here, claimant has chosen not to file a claim in this state, it would contradict the court’s reasoning in Figueroa v. C&S Ball Bearing, 237 Conn. 1 (1996) to allow a medical provider to invoke jurisdiction based upon the alleged furnishing of medical care by the employer.

CRB reversed denial of payment for neurologist’s treatment where claimant had been seen by a physician at the request of the respondent, and that physician referred her to a neurologist. CRB noted that claimant had chosen the neurologist from the network of physicians listed in employer’s medical care plan under § 31-279(c). See also, Trimachi, § 31-307, § 31-279(c).

Board affirmed trial commissioner’s conclusion that medical treatment requested by claimant (intrathecal infusion pump or “morphine pump”) was not reasonable and necessary.

Melendez v. Home Depot, 3835 CRB-4-98-6 (July 13, 1999), aff’d, 61 Conn. App. 653 (2001).

CRB affirmed trier’s approval of out-of-state medical treatment for claimant who relocated to Pennsylvania, then Texas. Retroactive authorization of out-of-state medical care is not precluded by Cummings v. Twin Mfg., Inc., 29 Conn. App. 249 (1992), which respondents attempted to argue. Humanitarian and constitutional considerations forbid a blanket prohibition against allowing medical care by out-of-state doctors.

CRB affirmed trial commissioner’s refusal to authorize treatment by seven doctors. Trier declined to authorize additional treatment by claimant’s optometrist subsequent to opinion of ophthalmologist that pronounced claimant ready to work. Doctors to whom the optometrist referred the claimant were likewise unauthorized. Adoption of medical report stating that claimant’s problems were essentially psychological and were not caused by her compensable injury provided support for trier’s denial of authorization. See also, Barton, § 31-294f. Prior decision at Barton, 16 Conn. Workers’ Comp. Rev. Op. 216, 3428 CRB-5-96-9 (June 6, 1997).

See, Wooten, § 31-301. Appeal procedure, § 31-301. Factual findings (concerning payment of validly referred physician).

Trier did not err by authorizing treatment retroactively. Claimant was not given opportunity to choose a physician initially when he went to a walk-in medical clinic. The physician he chose after returning to work and not receiving treatment for two months was the initial authorized treating physician under § 31-294d(b).

CRB affirmed trial commissioner’s determination that installation of dry sauna in claimant’s home constituted reasonable medical treatment, as opined by claimant’s treating psychologist.

Employer’s responsibility for necessary and reasonable medical care generally means that all unpaid medical bills should be paid. Trier’s general order to that effect did not require respondents to compensate claimant for bills already covered by a group medical insurer. See, Pokorny v. Getta’s Garage, 219 Conn. 439 (1991). Trier did not err in ordering payment of doctor whom claimant testified treated her, as no evidence contradicted this fact. See also, Vargas, § 31-295, § 31-300.

Claimant argued that trier erred by denying her compensation for the cost of home housekeeping services. Affirmed. It would not be reasonable to read § 31-294d to include in the definition of “medical aid” housekeeping services unrelated to other home nursing or medical care. Such an interpretation would stray too far from legislative intent. Trier’s focus on whether housekeeping services were “incidental to” medical treatment was proper.

CRB affirmed trial commissioner’s decision ordering the respondents to pay medical bills for treatment by Dr. Steckler. The respondents contended that the trial commissioner erred because there was no referral from Dr. Rivera. CRB disagreed, as the trial commissioner found Dr. Steckler rather than Dr. Rivera to be the claimant’s treating physician. The trial commissioner found that on the day following the injury, the respondent employer directed the claimant to a walk-in health clinic where he was seen by Dr. Rivera, but that the claimant did not select him as his treating physician. See also, Zering, § 31-300.

CRB affirmed the trial commissioner’s conclusion that the claimant failed to meet his burden of proof that the medical treatment which he received was reasonable or causally connected to his prior compensable injury. Whether the claimant’s alleged depression and the medical conditions for which he received treatment were causally related to the compensable injury were questions of fact for the trial commissioner. See also, Figueroa, § 31-301. Factual findings, § 31-308a.

Claimant required a motorized wheelchair to move about independently, and respondents paid for modifications to his home creating wheelchair access. Commissioner ruled claimant had not met his burden of proving that respondents should purchase him a special motor vehicle, as no estimate of its cost was in evidence. Reversed and remanded for further findings regarding medical necessity of vehicle; commissioner should have considered more than the lack of evidence regarding the cost of the vehicle in making his decision, given its importance to the claimant’s ability to remain active in society. See also, Jaworski, § 31-349 and § 31-301. Factual findings.

Respondents objected to order requiring them to pay for home improvements and custom van. Respondents’ representative had specifically agreed to pay for these items, however; fact that they were not compelled by § 31-294 to make such payments did not entitle them to breach agreement, on which claimant relied. See also, Infante, § 31-296, and § 31-315.

Where retroactive authorization of treatment is sought, claimant has burden of proving that it was provided pursuant to valid referral or was otherwise appropriate for authorization. Claimant did not show either a valid referral or a request by a party that the doctor in question be allowed to treat him, so denial of authorization was reasonable. See also, Mahoney, § 31-298 notes. Subsequent decision at Mahoney, 4095 CRB-4-99-8 (August 10, 2000), aff’d, 67 Conn. App. 134 (2001), § 31-303(b), § 31-308a.

VMMC actually filed two separate appeals in this case; the first was addressed in the May 20, 1996 VMMC decision by the CRB. Doctrine of law of the case did not prevent board from addressing appellate arguments, as prior VMMC decision focused on medical provider’s rights in absence of colorable claim, and compensable injury was alleged by claimant here. Consistent with Gonzalez v. Electric Transport, 13 Conn. Workers’ Comp. Rev. Op. 6, 1729 CRB-1-93-5 (October 13, 1994), board ruled that provider had right to intervene in proceedings, and remanded case to trial commissioner for a determination as to whether or not stipulation should be opened.

Dichello v. Holgrath Corporation, 15 Conn. Workers’ Comp. Rev. Op. 441, 2249 CRB-5-94-12 (September 5, 1996), aff’d, 49 Conn. App. 339 (1998).

Fact that one physician referred claimant to doctors who were accepted as treating physicians by trial commissioner did not mean that first physician had to be authorized. Second physician was the first link in the chain of authorized treaters pursuant to voluntary agreement; first physician was never authorized to begin with. See also, Dichello, § 31-296, and § 31-300.

Authorization of treating physician is largely within commissioner’s discretion; no error in approving Wisconsin physician as claimant’s treater during time period claimant was out-of-state. See also, Landry, § 31-296, and § 31-301.

Claimant’s appeal resolved where pursuant to an agreement of the parties the CRB issued a bench ruling authorizing a medical treater for claimant’s injury.

Commissioner ordered respondents to pay claimant’s wife $100 per week for home health care services. Affirmed. Medical evidence existed to support the finding that the claimant needed such care. Section 31-294 does not prevent insurer from compensating claimant’s family for providing health care, especially where services are provided in lieu of professional health care. Although not all spousal and family care need be compensated, the facts of this case support this award.

Medical provider (VMMC) sought payment for medical treatment alleged to have been provided as a result of a work related injury. The putative employer stated claimant was never an employee and requested claim be dismissed. CRB applied the same reasoning it applied in In re Veterans Memorial Medical Center, infra. VMMC alleged insufficient jurisdictional facts in support of its request for a hearing on subject matter jurisdiction before the workers’ compensation commission.

In re Veterans Memorial Medical Center, 15 Conn. Workers’ Comp. Rev. Op. 244, 3063 CRB-8-95-5 (May 20, 1996), aff’d, 45 Conn. App. 922 (1997)(per curiam).

Medical provider sought hearings in 700 cases where no workers’ compensation claim had been filed by employee. No proof of compensable injury was filed with hearing requests. Held, ruling in Figueroa v. C & S Ball Bearing, 237 Conn. 1 (1996), dispositive of issue; only employee has standing to initiate claim. Medical provider may not initiate a claim on the employee’s behalf under Workers’ Compensation Act, although it may request a hearing regarding medical bills if a claim has already been filed. Proof that colorable claim exists must be provided by medical provider in order to support jurisdiction of Commission, and other conditions precedent must be satisfied to warrant a hearing. See also, Memeti v. Ray’s Construction, 15 Conn. Workers’ Comp. Rev. Op. 263, an identical VMMC case in which a separate opinion was issued on May 24, 1996, (this section, supra).

Bertalovitz v. Danbury, 15 Conn. Workers’ Comp. Rev. Op. 186, 2204 CRB-7-94-11 (April 1, 1996).

See, Bertalovitz, § 31-308(b) and (c) (no hearing required for commissioner to change treating physician).

Leiner v. Newmark & Lewis, 15 Conn. Workers’ Comp. Rev. Op. 147, 2202 CRB-8-94-10 (January 18, 1996).

CRB reversed trial commissioner’s retroactive authorization of medical treatment. Voluntary agreement established another doctor as treating physician, and no good reason was shown for unilateral change of providers. No gap in medical treatment occurred here, and acting commissioner earlier had denied request to change physicians.

McVety v. Sidetex Corp., 14 Conn. Workers’ Comp. Rev. Op. 340, 2050 CRB-3-94-5 (September 20, 1995), aff’d, 43 Conn. App. 912 (1996)(per curiam).

Trial commissioner found that doctor’s treatment was not obtained pursuant to valid referral. Claimant argued that said ground was not raised in the Form 43 or in the hearing notice. Held, due process requires meaningful opportunity to be heard, and notice of hearing provided such. Issue in Form 43 was causal relation of medical treatment to accident; existence of valid referral was necessary to qualify doctor as an authorized treating physician under the statute. Referral issue was not removed from dispute by parties. Finding of no referral was legally sufficient to support conclusion that treatment should not be authorized.

McGowan v. Waterbury Farrell, 14 Conn. Workers’ Comp. Rev. Op. 319, 1964 CRB-1-94-2 (September 15, 1995), aff’d, 43 Conn. App. 917 (1996)(per curiam).

Commissioner ruled that an unauthorized treater had made a referral to another doctor; latter’s treatment also unauthorized. Evidence supported decision that doctor was outside the chain of authorized physicians. See also, McGowan, § 31-308a.

Cummings v. Twin Tool Manufacturing, 13 Conn. Workers’ Comp. Rev. Op. 225, 2008 CRB-1-94-4 (April 12, 1995), appeal dismissed, A.C. 14747 (June 29, 1995).

Respondents objected to commissioner authorizing a psychologist to treat claimant. CRB found no error in commissioner’s decision which authorized a psychologist to assist the treating physician. See also, Cummings, § 31-298.

Insurer’s representative agreed to pay family members to care for seriously traumatized claimant at $10.50 hourly rate instead of placing claimant in rehabilitation facility. Respondents later refused to pay for 24-hour care at that rate on ground that § 31-294 does not require them to compensate family for home nursing services because statutory definition of “nurse” not met. Held, statute does not prevent insurer from agreeing to compensate claimant’s family for taking care of him, as was done here by agent of insurer. Valid contract.

Workers’ compensation commission lacks jurisdiction to adjudicate medical provider’s request for an informal hearing on unpaid medical services where no claim for benefits is asserted by the injured employee. Distinguished from Gonzalez, Derman, and Tanner, infra, where compensation claim existed. Chairman’s directive postponing request for hearing indefinitely was proper where there was no evidence an underlying workers’ compensation claim existed. Appeal dismissed as commission lacked subject matter jurisdiction. (Arcudi, C., DISSENTING) (Chairman does not have statutory power to deny medical provider due process). See also, Baigert, § 31-280, and § 31-297.

Medical provider is entitled to a hearing on unpaid medical services furnished where it appears the injured employee filed a workers’ compensation claim. See also, Cookson, § 31-297.

CRB affirmed trier’s determination that weight loss program would be palliative treatment and not a curative remedy. Thus, payment for weight loss program denied. See also, Burgos, § 31-301-9 and § 31-308a.

Where treating physician refers claimant to another physician yet continues to treat claimant, commissioner’s conclusion that treating physician remained an authorized treater affirmed. However, order for reimbursement of prescription charges modified to cover only medications prescribed during period covered in treater’s written statement. See also, Besitko, § 31-298.

Farkash v. Gerelco, Inc., 12 Conn. Workers’ Comp. Rev. Op. 9, 1566 CRB-8-92-11 (January 12, 1994).

CRB reversed trier’s retroactive authorization of change of physician where authorized treater intended to continue treatment. Claimant sought to change the course of his treatment and on his own obtained treatment from a chiropractic physician, thereby failing to satisfy § 31-294d(c). See also, Farkash, § 31-307.

Davis v. New London/Board of Education, 11 Conn. Workers’ Comp. Rev. Op. 245, 1346 CRD-2-91-11 (November 10, 1993), dismissed for lack of final judgment, A.C. 13053 (February 16, 1994).

Medical treatment found to be reasonable and necessary where treating physician suggested claimant seek further medical advice without providing a referral to any specific physician. Also, CRB affirmed trier’s retroactive authorization of change of medical providers. Remanded on other issues. See also, Davis, § 31-301. Factual findings.

Atherton v. Rutledge, 11 Conn. Workers’ Comp. Rev. Op. 172, 1339 CRD-7-91-11 (September 2, 1993).

CRB held trier is authorized to retroactively approve a change of physician or medical provider(s).

Galgano v. Torrington, 11 Conn. Workers’ Comp. Rev. Op. 133, 1280 CRD-5-91-8 (June 30, 1993).

Absent a timely notice of claim an independent medical examination does not constitute the furnishing of medical care.

Byars v. Whyco Chromium Company, 11 Conn. Workers’ Comp. Rev. Op. 39, 1257 CRD-5-91-7 (March 10, 1993), dismissed for lack of final judgment, 33 Conn. App. 667 (1994).

Authorization of a treating physician is largely a factual determination within trier’s discretion. See also, Byars, § 31-296, § 31-300 and § 31-301-9. Additional evidence.

Mulligan v. N.C.H. Corporation, 10 Conn. Workers’ Comp. Rev. Op. 131, 1135 CRD-7-90-11 (June 2, 1992).

Remanded. Trier found claimant’s trip to Arizona and California was prescribed by treating physician. Since physician’s report is dated eight months after claimant’s trip, it is not clear whether the trip was prescribed as reasonable or necessary at the time it was taken.

Marzano v. Luis, 10 Conn. Workers’ Comp. Rev. Op. 129, 1181 CRD-5-91-2 (May 21, 1992), aff’d, 30 Conn. App. 916 (1993)(per curiam).

Trier’s conclusion as to physician’s status as an unauthorized treater supported by evidence. Evidence reveals physician’s bills for treatment were not related to claimant’s compensable injury. Also, factual finding claimant’s injury to his right index finger did not arise out of and in the course of employment is supported by evidence and will not be disturbed on appeal. Further, no Motion to Correct was filed. Therefore, the facts found by the trial commissioner must stand.

Corona v. Briganti, 10 Conn. Workers’ Comp. Rev. Op. 113, 1160 CRD-7-91-1, 1240 CRD-7-91-5 (May 8, 1992).

CRB affirmed trier’s finding physicians were authorized treaters as conclusions were based on evidence presented. See also, Corona, § 31-307.

Canfield v. Consolidated Freightways, 10 Conn. Workers’ Comp. Rev. Op. 59, 1125 CRD-7-90-10 (February 21, 1992).

See, Canfield, § 31-301-9. Additional evidence.

Keating v. Allegheny Ludlum Steel Corp., 10 Conn. Workers’ Comp. Rev. Op. 28, 1102 CRD-3-90-8 (January 13, 1992).

Testimony of two medical specialists that further lumbar surgery was not a reasonable alternative or would appreciably improve claimant’s condition supports trier’s conclusion claimant had not refused reasonable medical treatment. See also, Keating, § 31-315, Remanded under § 31-349.

Cummings v. Twin Manufacturing, Inc., 9 Conn. Workers’ Comp. Rev. Op. 199, 1023 CRD-1-90-5 (August 29, 1991), aff’d, rev’d in part; further proceedings, 29 Conn. App. 249 (1992).

CRD held trial commissioner has power to grant claimant treatment for traumatic brain injury at an out of state medical facility without an evidentiary hearing where good reason exists. See also, Cummings, § 31-301. Factual findings, § 31-300. Appellate Court reversed CRB in part and held Workers’ Compensation Commissioner should have held an evidentiary hearing to determine whether treatment out of state was reasonable or necessary.

Gruss v. Neurological Group, 9 Conn. Workers’ Comp. Rev. Op. 83, 888 CRD-2-89-6 (February 26, 1991).

CRD affirmed trial commissioner’s findings of total disability and authorization of treating physician. See, Greiger v. Leake & Nelson, 9 Conn. Workers’ Comp. Rev. Op. 17, 890 CRD-4-89-6 (January 10, 1991). Remanded to determine which physician services are included in trier’s order to pay reasonable medical expenses.

DRG. See, Tanner v. Walgren Tree Experts, 8 Conn. Workers’ Comp. Rev. Op. 16, 748 CRD-8-88-7 (January 17, 1990), infra.

See, Tanner v. Walgren Tree Experts, 8 Conn. Workers’ Comp. Rev. Op. 16, 748 CRD-8-88-7 (January 17, 1990), infra.

Greiger v. Leake & Nelson, 9 Conn. Workers’ Comp. Rev. Op. 17, 890 CRD-4-89-6 (January 10, 1991).

Remanded as trier’s conclusion as to physician’s status as an unauthorized treater was not supported by sufficient factual findings. CRB opinion also includes discussion of case law and legislative history concerning employees’ choice of physician. See also, Greiger, § 31-307b.

Gervais v. Atlantic Builders, 8 Conn. Workers’ Comp. Rev. Op. 120, 1046 CRD-2-90-6 (June 29, 1990).

See, Derman, infra. Also remanded to determine actual date hospital provided services. If date of hospital’s services preceded the effective date of the DRG legislation, DRG rate was improper.

Pont v. Old Lyme, 8 Conn. Workers’ Comp. Rev. Op. 118, 1036 CRD-2-90-6 (June 29, 1990).

Derman v. Norwalk, 8 Conn. Workers’ Comp. Rev. Op. 100, 860 CRD-7-89-5 (May 24, 1990).

CRD relied on Tanner v. Walgren Tree Experts, 8 Conn. Workers’ Comp. Rev. Op. 16, 748 CRD-8-88-7 (January 17, 1990), infra, in its ruling that the medical provider was entitled to DRG rate payment under § 31-294. Further the Commission has jurisdiction to resolve disputes as to appropriateness of fees under § 31-294, § 31-319 and § 31-327. Note: Derman was one of a series of cases on this issue and as the issues raised were substantially the same please see 8 Conn. Workers’ Comp. Rev. Op. p. viii, Appendix A for a complete listing of cases.

Spataro v. Mattioli Construction, 8 Conn. Workers’ Comp. Rev. Op. 41, 784 CRD-4-88-10 (February 21, 1990).

Claimant, a paraplegic, failed to sustain burden of proof as to the causal connection between the need for a specially equipped van and his psychiatric problems. See also, Spataro, § 31-301. Appeal procedure.

McConnell v. Hewitt Associates, 8 Conn. Workers’ Comp. Rev. Op. 32, 764 CRD-7-88-8 (February 5, 1990).

Commissioner has authority to authorize treatment by medical provider even though respondents claim treatment was rendered before referral. See also, McConnell, § 31-301c(b), § 31-307.

Tanner v. Walgren Tree Experts, 8 Conn. Workers’ Comp. Rev. Op. 16, 748 CRD-8-88-7 (January 17, 1990).

Respondents to pay DRG charge as set under § 19a-165f as it is consistent with § 31-294 in that it satisfies prevailing community standard criterion. Retrospective application is permitted where legislative history indicates that it was intended to clarify a prior existing law. See also, Tanner, § 19a-165.

Todd v. Jazlowiecki, 6 Conn. Workers’ Comp. Rev. Op. 9, 493 CRD-6-86 (August 26, 1988), no error, 20 Conn. App. 805 (per curiam).

Affirmed trial commissioner’s finding as to authorized treating physician. See also, Todd, § 31-278, § 31-298.

Botelho v. Power Systems, 4 Conn. Workers’ Comp. Rev. Op. 92, 331 CRD-1-84 (June 10, 1987).

Questions of authorization of treating physician are factual questions.

Adams v. Stop & Shop, 4 Conn. Workers’ Comp. Rev. Op. 80, 380 CRD-2-85 (June 4, 1987).

Commissioner is empowered to authorize a change of physicians after informal hearing.

Lupulio v. General Data Communications, 4 Conn. Workers’ Comp. Rev. Op. 29, 554 CRD-7-87 (March 11, 1987).

Commissioner has power to order treatment without hearing.

Veillette v. State, 3 Conn. Workers’ Comp. Rev. Op. 135, 288 CRD-2-83 (January 21, 1987).

Out of state medical treatment can be authorized when the employee resides in a sparsely populated Connecticut area and seeks medical treatment from nearby metropolitan medical community.

Kiley v. Executone of Fairfield, Inc., 2 Conn. Workers’ Comp. Rev. Op. 103, 107 CRD-7-81 (August 29, 1984).

Employer liable for psychological treatment from date of treating physician’s statement as long as fee complied with § 31-298.

Phelps v. State, 2 Conn. Workers’ Comp. Rev. Op. 92, 133 CRD-2-82 (July 30, 1984).

Employer cannot terminate compensation where claimant does not visit treating physician because claimant moved out of state and authorization for out of state medical treatment may be permitted.

Aguino v. Mt. Vernon Die Casting Co., 2 Conn. Workers’ Comp. Rev. Op. 72, 159 CRD-7-82 (July11, 1984).

Commissioner is empowered to determine reasonableness or necessity of medical treatment.

Bowen v. Stanadyne, Inc., 2 Conn. Workers’ Comp. Rev. Op. 60, 232 CRD-1-83 (June 19, 1984).

Reasonableness or necessity of medical treatment is to be decided by commissioner.

CRB Case Annotations re: Section 31-294d

Medical treatment; physician authorization; pecuniary liability.