CRB Case Annotations re: Section 31-294d

CRB affirmed commissioner’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, Fox, § 31-301. Factual findings, § 31-308(a), § 31-308a.

CRB affirmed trial commissioner’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, 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 those programs that were considered by the parties, and was properly considered 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, 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 those courses of treatment that will probably be successful, trier still has discretion to decide whether such courses of treatment will be approved. See, Phaiah, § 31-294f, § 31-301. Factual findings.

The acknowledged possibility that back surgery might improve the claimant’s quality of life was sufficient to satisfy the 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 choose between them was intended to allow parties the chance to make the choice themselves. Trier could choose a physician, and ergo, a surgical procedure, if parties later proved unable to reach agreement. Matter was remanded where trier failed to rule on issue of continuing narcotic medication as long-term treatment. See, 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, and also affirmed finding that authorized treatments were necessary medical care within meaning of statute, as they helped keep employee at work. See, DeFelippi, § 31-301. Appeal procedure.

The appellant medical care provider argued that the chiropractic care he provided was curative rather than palliative. However, it was within discretion of trier to rely upon the opinions of an independent medical examiner and a trial commissioner’s examiner who both opined that the care was palliative. Board noted that Medical Protocols are not absolute. See Lemelin, § 31-301, Appeal Procedure.

Employer refused to authorize initial treatment at Industrial Health Care due to claimant’s failure to report injury to employer in writing. Employer then attempted to argue 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 an employer to provide competent medical care as soon as it has knowledge of an injury. Though employer is free to have an internal policy requiring claimants to report injuries in writing, it cannot place that policy ahead of its obligation to provide care as soon as it is informed of an injury in any way. The Act does not require claimants to report injuries in writing. If a claimant fails to immediately report an injury, the remedy for prejudice caused by such failure is prescribed by § 31-294b, and does not include permission for employers to refuse care altogether. CRB also explained that medical care plans do not begin to play a role in claimant’s choice of treaters until the subscribing employer accepts responsibility for providing initial treatment. See, 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 claimant had not yet been assigned an authorized treater by respondents or by commissioner, as claim was in its infancy. See, 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 it succeeding 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 attempting, trier would normally be justified in approving such treatment. See, Cirrito, § 31-300, § 31-301. Factual Findings; also cited at Cirrito, § 31-298.

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

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 treating with Dr. M. Respondents did not object to Dr. P. being a treater until over a year after the § 31-294f exam, following Dr. P.’s referral of the claimant to Dr. S. See, Donaldson, § 31-298, § 31-301 Factual findings; also cited at Donaldson, § 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.

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.

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. Also cited at Rodriguez, § 31-278.

See, Bailey, § 31-300, § 31-307; also cited at Bailey, § 31-284b, § 31-301. Factual findings. Prior decisions in 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; 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.

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; cited at Trimachi, § 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.

See also, 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.

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 § 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 were 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.

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.

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.

DRG. 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.

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.