THESE ANNOTATIONS ARE PROVIDED FOR INFORMATIONAL PURPOSES ONLY
Full texts of opinions, statutes and court decisions should be consulted and all citations and references fully researched by the reader.
The Annotations to Compensation Review Board Opinions are presented “as is” and the Commission makes no warranties as to the suitability of this information for any given purpose.
Please note also that Annotations change periodically due to several factors including, but not limited to, Appellate and Supreme Court decisions issued in workers’ compensation cases.
Zezima v. Stamford, 5918 CRB-7-14-3 (May 12, 2015).
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.
Attardo v. Temporaries of New England, Inc., 5858 CRB-2-13-7 (June 19, 2014).
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.
Van Fleet v. Balfour Beatty Construction, 5801 CRB-4-12-11 (March 17, 2014).
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.
Vallier v. Cushman & Wakefield, 5822 CRB-1-13-2 (February 21, 2014).
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.
Osborn v. Lowe’s Home Centers, Inc., 5800 CRB-5-12-11 (October 28, 2013).
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.
Kingston v. Town of Seymour, 5789 CRB-5-12-10 (September 10, 2013).
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.
Wilson v. Maefair Health Care Centers, 5773 CRB-4-12-8 (August 8, 2013).
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).
Sellers v. Sellers Garage, 5755 CRB-5-12-5 (June 12, 2013).
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.
Aylward v. City of Bristol/Board of Education, 5756 CRB-6-12-5 (May 15, 2013).
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.
Bombria v. Anthony J. Bonafine, 5740 CRB-2-12-3 (March 6, 2013).
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.
Putney v. Town of Guilford, 5732 CRB-3-12-2 (February 5, 2013).
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.
Bryant v. Pitney Bowes, Inc., 5723 CRB-7-12-1 (January 24, 2013).
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.
Montenegro v. Palmieri Food Products, 5701 CRB-3-11-11 (November 15, 2012).
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.
Gendron v. Griffin Health Services Corporation, 5686 CRB-4-11-10 (October 11, 2012).
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).
Tedesco v. Decorator Services, 5693 CRB-4-11-11 (September 27, 2012).
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.
Dubrosky v. Boehringer Ingleheim Corporation, 5682 CRB 4-11-9 (September 5, 2012), rev’d, 145 Conn. App. 261 (2013), cert. denied, 310 Conn. 935 (2013).
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.
Briggs v. Waterbury, 5665 CRB-5-11-7 (July 6, 2012).
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.
Morales v. FedEx Ground Package Systems, Inc., 5666 CRB-2-11-7 (July 6, 2012).
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.
Gonzalez v. Premier Limousine of Hartford, 5635 CRB 4-11-3 (April 17, 2012).
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.
Turrell v. State/DMHAS, 5640 CRB-8-11-3 (March 21, 2012).
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.
Jodlowski v. Stanley Works, 5627 CRB-6-11-2 (March 13, 2012).
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.
McClaren v. Fed/Ex Ground Package System, Inc., 5619 CRB-1-11-1 (January 24, 2012).
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.
Chimblo v. Connecticut Light Power, 5417 CRB-7-09-1. (December 30, 2009).
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.
Camp v. State/Capital Community Technical College, 5401 CRB-1-08-11 (November 17, 2009).
See also, Camp, § 31-301. Appeal procedure, § 31-301. Factual findings, § 31-307, § 31-307b.
Ghazal v. Cumberland Farms, Inc., 5397 CRB-8-08-11 (November 17, 2009).
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.
Nicotera v. Hartford, 5381 CRB-8-08-10 (September 2, 2009).
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.
Santiago v. Laidlaw Transportation, Inc., 5379 CRB-5-08-9 (July 27, 2009).
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.
White v. Wal-Mart Stores, Inc., 5363 CRB-2-08-7 (June 30, 2009).
See also White, § 31- 294c C.G.S.; § 31-301. Factual findings C.G.S.
McInnis v. Shelter Workz, 5299 CRB-3-07-11 (June 11, 2009).
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.
Dahle v. Stop & Shop Companies, Inc., 5356 CRB-6-08-6 (June 5, 2009).
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.
Cervero v. Mory’s Association, Inc., 5357 CRB-3-08-6 (May 19, 2009).
Gilbert v. Ansonia, 5342 CRB-4-08-5 (May 14, 2009).
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, Sec. 31-294f, § 31-301. Factual findings, § 31-307, § 31-315.
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).
Carnes v. State/Department of Correction, 5308 CRB-8-07-12 (December 8, 2008).
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.
Pue v. First Student, 5270 CRB-3-07-9 (August 22, 2008).
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.
Diaz v. Jaime Pineda, a/k/a Jamie Pineda d/b/a J.P. Landscaping Company, 5244 CRB-7-07-7 (July 8, 2008).
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.
Weir v. Transportation North Haven, 5226 CRB-1-07-5 (April 16, 2008).
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.
Vannoy-Joseph v. State/DMHAS, 5164 CRB-8-06-11 (January 29, 2008).
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.
Jolicoeur v. Duncklee, Inc., 5150 CRB-2-06-10 (November 8, 2007).
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.
Hodio v. Staples, Inc., 5152 CRB-3-06-10 (October 3, 2007).
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.
Williams v. Bantam Supply Co., 5132 CRB-5-06-9 (August 30, 2007).
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.
Serluca v. Stone & Webster Engineering, 5118 CRB-8-06-8 (July 13, 2007).
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.
Freel v. West Haven Board of Education, 5102 CRB-3-06-6 (June 1, 2007).
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.
Liebel v. Stratford, 5070 CRB-4-06-3 (May 17, 2007).
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.
Jurado v. New Milford Nursing Home, 5089 CRB-7-06-5 (May 10, 2007).
See, Jurado, § 31-279(c).
Fratino v. Harry Grodsky & Co., Inc., 5087 CRB-7-06-5 (May 8, 2007).
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.
Bond v. The Monroe Group, LLC, 5093 CRB-3-06-5 (May 3, 2007).
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).
Hernandez v. American Truck Rental, 5083 CRB-7-06-4 (April 19, 2007).
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).
Mana v. SARAH, Inc., 5073 CRB 3-06-3 (March 22, 2007).
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.
Gallagher v. John A. Dudley, DMD, 5067 CRB-4-06-3 (March 20, 2007).
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.
Anderson v. R&K Spero Company, 4965 CRB-3-05-6 (February 21, 2007), aff’d, 107 Conn. App. 608 (2008).
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).
Kalinowski v. Meriden, 5028 CRB-8-05-11 (January 24, 2007).
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).
McMahon v. Emsar, Inc., 5049 CRB-4-06-1 (January 16, 2007).
See, McMahon, § 31-301. Factual findings (further pain management treatment not curative); See also, McMahon, § 31-301-4, 31-307, § 31-315.
Marra v. Ann Taylor Stores Corp., 5027 CRB -3-05-11 (December 29, 2006).
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).
Horvath v. State/Department of Correction, 5008 CRB-8-05-10 (September 13, 2006).
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.
Palumbo v. Bridgeport, 4991 CRB-4-05-9 (September 7, 2006).
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.
Dudley v. Radio Frequency Systems, 4995 CRB-8-05-9 (July 17, 2006).
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).
Fallon v. Rite Aid Corp., 4813 CRB-4-04-5 (May 16, 2005).
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.
Estate of James Tracy v. Scherwitzky Cutter Company, 4797 CRB-1-04-3 (March 21, 2005), aff’d, 279 Conn. 265 (2006).
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.
Thomas v. Mohegan Sun Casino, 4754 CRB-2-03-11 (February 18, 2005).
CRB found no error in trier’s authorization of surgical procedure where medical evidence in record supports procedure as reasonable and necessary.
Donaldson v. Continuum of Care, Inc., 4581 CRB-3-02-10 (October 6, 2004), aff’d, 94 Conn. App. 334 (2006).
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.
Papapietro v. Bristol, 4674 CRB-6-03-6 (May 3, 2004).
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.
Schenkel v. Richard Chevrolet, Inc., 4639 CRB-8-03-3 (March 12, 2004).
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.
Bernardo v. Capri Bakery, 4570 CRB-3-02-9 (February 10, 2004).
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.
Murray v. Mass Mutual Life Ins. Co., 4590 CRB-1-02-11 (November 20, 2003).
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).
Carroll v. Flattery’s Landscaping, Inc., 4499 CRB-8-02-2 (March 25, 2003).
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.
Fox v. New Britain General Hospital, 4414 CRB-6-01-7 (August 6, 2002).
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.
Covaleski v. Casual Corner, 4419 CRB-1-01-7 (June 27, 2002).
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.
Cotugno v. Lexington Caterers, Inc., 4390 CRB-2-01-5 (June 21, 2002).
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.
Phaiah v. Danielson Curtain, 4409 CRB-2-01-6 (June 7, 2002).
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.
Irizarry v. Purolator Courier Corp., 4382 CRB-4-01-4 (May 2, 2002).
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).
DeFelippi v. Wal-Mart Stores, Inc., 4349 CRB-5-01-1 (January 15, 2002).
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.
Lemelin v. MRC Bearings, Inc., 4320 CRB-05-00-12 (December 27, 2001).
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.
Gonzalez v. Coca-Cola Bottling Co. of New York, 4284 CRB-8-00-8 (September 13, 2001).
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).
Garofalo v. Jarvis Products Corp., 4249 CRB-8-00-6 (September 12, 2001).
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.
Cirrito v. Resource Group Ltd. of Conn., 4248 CRB-1-00-6 (June 19, 2001).
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.
Zalutko v. Danbury Hospital, 4229 CRB-7-00-4 (May 23, 2001).
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.
Donaldson v. Duhaime, 4213 CRB-6-00-3 (April 30, 2001).
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.
Ford v. Carpenter Chapman, 4128 CRB-3-99-9 (November 30, 2000).
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).
Covert v. Patterson, 4094 CRB-3-99-8 (September 29, 2000).
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.
Caprio v. Stop & Shop, 4028 CRB-3-99-4 (July 26, 2000).
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).
Telesca v. Pratt & Whitney, 4056 CRB-6-99-6 (July 11, 2000).
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.
D’Amico v. State/Dept. of Correction, 4029 CRB-5-99-4 (May 18, 2000).
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.
Fyler v. Barrieau Moving & Storage, 3985 CRB-1-99-3 (April 18, 2000).
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.
Outlaw v. Pray Automotive of Greenwich, 3981 CRB-7-99-2 (March 23, 2000).
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.
Schiaroli v. UTC/Pratt & Whitney, 3988 CRB-5-99-3 (March 7, 2000).
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.
Student v. Corometrics Medical Systems, Inc., 3980 CRB-8-99-2 (February 9, 2000).
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).
Rodriguez v. Seal Rite Mfg., 3954 CRB-4-98-12 (January 20, 2000).
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.
Bailey v. State/Greater Hartford Community College, 3922 CRB-2-98-10 (November 30, 1999), aff’d in part, rev’d in part, 65 Conn. App. 592 (2001).
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.
Spencer v. Merocel Corporation, 3919 CRB-2-98-10 (November 23, 1999).
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.
Murray v. Black Tie Limousine, 3899 CRB-3-98-9 (November 4, 1999).
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.
Johnson v. Braun Moving, Inc., 3861 CRB-7-98-7 (November 2, 1999).
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.
Norwood v. Custom Design Services, Inc., 3844 CRB-7-98-6 (November 2, 1999).
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.
DelGardo v. ARRA Construction, 3913 CRB-4-98-10 (August 30, 1999), aff’d, 57 Conn. App. 904 (2000).
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.
Trimachi v. State/Workers’ Compensation Commission, 3749 CRB-1-97-12 (August 25, 1999).
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).
Rodenbaugh v. F.R. Tetro Enterprises, 3823 CRB-5-98-5 (August 18, 1999).
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.
Barton v. Waterbury Company, 3786 CRB-5-98-3 (June 3, 1999).
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).
Wooten v. UTC/Pratt & Whitney, 3674 CRB-6-97-9 (May 7, 1999).
See, Wooten, § 31-301. Appeal procedure, § 31-301. Factual findings (concerning payment of validly referred physician).
Castano v. Astrophonic Corp. of America, 3714 CRB-7-97-11 (December 29, 1998).
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).
Haskos v. NROE-Ernest DePalma, 3421 CRB-3-96-9 (January 22, 1998).
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.
Vargas v. King-Conn Enterprises d/b/a Burger King Corporation, 3333 CRB-4-96-4 (October 24, 1997).
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.
Cormier v. The Macke Company, 3266 CRB-2-96-2 (August 20, 1997).
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.
Zering v. UTC/Pratt & Whitney, 3321 CRB-6-96-4 (August 8, 1997).
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.
Figueroa v. Laidlaw Transit, 3154 CRB-4-95-9 (March 4, 1997).
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.
Jaworski v. A.B. Chance Co., 3006 CRB-3-95-2 (January 6, 1997).
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.
Infante v. Mansfield Construction, 3067 CRB-4-95-5 (December 18, 1996), aff’d, 47 Conn. App. 530 (1998).
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.
Mahoney v. Bill Mann Tree Service, 16 Conn. Workers’ Comp. Rev. Op. 17, 3025 CRB-4-95-3 (October 4, 1996).
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.
Cuascut and VMMC v. Waldbaum’s Foodmart, 16 Conn. Workers’ Comp. Rev. Op. 3, 3111 CRB-8-96-6 (October 1, 1996).
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.
Landry v. North American Van Lines/Transtar, Inc., 15 Conn. Workers’ Comp. Rev. Op. 397, 1971 CRB-2-94-2 (August 16, 1996).
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.
Peet v. United Parcel Service, 3136 CRB-7-95-8 (July 1, 1996).
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.
Boiano v. Eppoliti Construction, 15 Conn. Workers’ Comp. Rev. Op. 342, 2108 CRB-4-94-7 (June 26, 1996).
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.
In re Veterans Memorial Medical Center and Abduraim Memeti v. Ray’s Construction, 15 Conn. Workers’ Comp. Rev. Op. 263, 3063 CRB-8-95-5 (May 24, 1996), aff’d, 45 Conn. App. 922 (1997)(per curiam).
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.
Valentino v. United Parcel Service, 13 Conn. Workers’ Comp. Rev. Op. 142, 1907 CRB-4-93-11 (February 1, 1995).
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.
Baigert v. Fosdick Corporation, 13 Conn. Workers’ Comp. Rev. Op. 78, 1784 CRB-8-93-7 (January 20, 1995).
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.
Cookson v. G.R. Cummings Company, 13 Conn. Workers’ Comp. Rev. Op. 76, 1796 CRB-8-93-7 (January 20, 1995).
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.
Burgos v. United Technologies/Sikorsky Aircraft Division, 12 Conn. Workers’ Comp. Rev. Op. 204, 1441 CRB-4-92-6 (March 15, 1994).
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.
Besitko v. McDonald’s Restaurant, 12 Conn. Workers’ Comp. Rev. Op. 111, 1415 CRB-8-92-5 (February 28, 1994).
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.
Burdick v. Frito-Lay, Inc., 1048 CRD-2-90-6 (February 7, 1991).
DRG. See, Tanner v. Walgren Tree Experts, 8 Conn. Workers’ Comp. Rev. Op. 16, 748 CRD-8-88-7 (January 17, 1990), infra.
Delaney v. Camelot Nursing Home, 1049 CRD-2-90-6 (February 7, 1991).
DRG. See, Tanner v. Walgren Tree Experts, 8 Conn. Workers’ Comp. Rev. Op. 16, 748 CRD-8-88-7 (January 17, 1990), infra.
Myles v. Beach, 975 CRD-8-90-2 (February 7, 1991).
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).
See, Derman, infra.
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.