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Soares v. Glass Industries

CASE NO. 4140 CRB-3-99-10

COMPENSATION REVIEW BOARD

WORKERS’ COMPENSATION COMMISSION

APRIL 10, 2001

JOSE SOARES

CLAIMANT-APPELLEE

v.

GLASS INDUSTRIES

EMPLOYER

and

AMERICAN POLICYHOLDERS INSURANCE COMPANY

INSURER

RESPONDENTS-APPELLEES

and

SECOND INJURY FUND

RESPONDENT-APPELLANT

APPEARANCES:

The claimant was not represented at oral argument. Notice sent to Loughlin, FitzGerald, Kamp, Henrici, Molloy, Rizzo & Reed, 150 South Main Street, Wallingford, CT 06492.

The respondents were represented by Dominick Statile, Esq., Montstream & May, L.L.P., Salmon Brook Corporate Park, 655 Winding Brook Drive, P. O. Box 1087, Glastonbury, CT 06033-6087.

The Second Injury Fund was represented by Mee Carolyn Wong, Esq., Assistant Attorney General, 55 Elm Street, P. O. Box 120, Hartford, CT 06141-0120.

This Petition for Review from the October 12, 1999 Finding and Award of the Commissioner acting for the Third District was heard October 27, 2000 before a Compensation Review Board panel consisting of the Commission Chairman John A. Mastropietro and Commissioners Leonard S. Paoletta and Ernie R. Walker.

OPINION

JOHN A. MASTROPIETRO, CHAIRMAN. The Second Injury Fund has petitioned for review from the October 12, 1999 Finding and Award of the Commissioner acting for the Third District. The Fund contends on appeal that the trier erred by refusing a portion of its request for reimbursement of benefits paid, and by awarding attorney’s fees without proper statutory authorization. Though we concur with the Fund’s legal interpretation of § 31-300, and reverse the attorney’s fee award, we affirm the remainder of the trial commissioner’s decision.

The claimant injured his left knee on November 22, 1982 and suffered a recurrence of that injury on November 9, 1987. Pursuant to a January 22, 1992 decision, the respondent American Policyholders Insurance Co. (APIC) was found to be liable for the resulting compensation claim. APIC had been paying benefits, including the costs of medical treatment and surgery, since the recurrence, but stopped its payments on August 22, 1991. January 22, 1992 Finding and Award, ¶ Q. The 1992 award instructed APIC to “put the claimant back on total disability benefits as of August 22, 1991 until such time as it is found that said benefits be reduced or discontinued.” Id. APIC and the claimant both filed petitions for review from that decision, which was affirmed by this board on May 4, 1994. Soares v. Glass Industries, 12 Conn. Workers’ Comp. Rev. Op. 189, 1377 CRB-3-92-1 (May 4, 1994).

The Second Injury Fund, meanwhile, became involved in this matter shortly after the parties’ appeals were filed. At that time, § 31-301 C.G.S. read, in pertinent part:

(f) During the pendency of any appeal of an award made pursuant to this chapter, the claimant shall receive all compensation and medical treatment payable under the terms of the award to the extent the compensation and medical treatment are not being paid by any health insurer or by any insurer or employer who has been ordered, pursuant to the provisions of subsection (a) of this section, to pay a portion of the award. The compensation and medical treatment shall be paid from the second injury and compensation assurance fund pursuant to section 31-354.
(g) If, upon completion of the appeal process, the claimant is found to have a compensable injury, the employer or insurer shall be responsible for payment of the compensation and shall reimburse the second injury fund for all sums previously expended, if any, on the claim pursuant to subsection (f) and this subsection, plus interest at the rate of ten per cent per annum. If the final adjudication results in the denial of compensation to the claimant, and he has previously received compensation on the claim pursuant to subsection (f) and this subsection, the claimant shall reimburse the second injury fund for all sums previously expended, plus interest at the rate of ten per cent per annum. Upon any such denial of compensation, the commissioner who originally heard the case or his successor shall conduct a hearing to determine the repayment schedule for the claimant.

As APIC had not yet resumed paying benefits pending the outcome of its appeal, the claimant had sought relief under § 31-301(f).1 The commissioner’s March 18, 1992 order stated that he was entitled to benefits pursuant to the January 22, 1992 award, and it instructed the Fund to “assume all liabilities contained in said Finding and Award of Compensation pending the outcome of the appeal of this case.” The Fund precisely complied with the terms of the award, and issued its first check to the claimant on April 17, 1992, including total disability benefits retroactive to August 22, 1991. The Fund continued to pay weekly benefits through April 30, 1994, when a Form 36 was approved discontinuing the claimant’s total disability benefits effective as of March 11, 1994.

Once the appeal process was complete, APIC issued a reimbursement check to the Fund for the payments that had been made in its stead. The check totaled $57,583.04, representing payments from September 9, 1991 to March 11, 1994. (A second check was issued nearly five years later for $15,701.81; the 1999 award does not specify what it was for.) Apparently unbeknownst to the Fund, APIC had paid compensation to the claimant through September 8, 1991, rather than the August 22, 1991 date cited in the Finding and Award. APIC declined to reimburse the Fund for the resulting overpayment of benefits that the claimant received for that 17-day period. APIC also refused to repay the Fund for the total disability benefits that the Fund had overpaid the claimant for the period of March 11, 1994 through April 30, 1994, as the claimant was not technically entitled to compensation for that span of time based on the Form 36 ruling. The Fund sought relief from this Commission, which ruled that APIC’s position on reimbursement was in accordance with § 31-301(g), and that the Fund’s contest of this reimbursement was unreasonable. The presiding commissioner awarded the claimant’s counsel an attorney’s fee of $1,000 as part of her award. She also denied the Fund’s Motion to Correct both on its merits and on account of the fact that it was filed one day late. See Admin. Reg. § 31-301-4. The Fund has appealed those rulings to this board.

The main issue in this case, the Fund’s entitlement to reimbursement, is governed by the language of § 31-301(g). This issue can fairly be characterized as one of first impression, as the reimbursement provisions of § 31-301 have not previously been interpreted by this board or by our courts. Further, decisions by the courts of other jurisdictions have little direct relevance to the claim now before us. None of our sister states have enacted laws that resemble the peculiar remedy that our own Workers’ Compensation Act provides to ensure the maintenance of a claimant’s compensation benefits pending appeal, while allowing reimbursement to be obtained from either insurer or claimant depending upon the final resolution of the case. See 8 Larson’s Workers’ Compensation Law (2000), § 130.08[4]. Thus, a solution must be derived primarily from the language of § 31-301(g) itself.

Statutory interpretation is a process that requires a reasoned search for the aim of the legislature, followed by a construction of the statute that effectuates that intent. Luce v. United Technologies Corp., 247 Conn. 126, 133 (1998); Green v. General Dynamics Corp., 245 Conn. 66, 71 (1998). In seeking to determine that meaning, we look first to the words of the statute itself, and resolve any ambiguities by studying the legislative history and policy behind the enactment and its relationship to existing legislation and common law principles governing the same general subject matter. Luce, supra; Carriero v. Naugatuck, 243 Conn. 747, 753 (1998). “It is the duty of the court to interpret statutes as they are written, and not by construction read into statutes provisions which are not clearly stated.” Luce, supra, quoting Glastonbury Co. v. Gillies, 209 Conn. 175, 179 (1988). We also presume that the legislature had a purpose for each sentence, clause or phrase in a statute, and that it did not intend to enact meaningless provisions. Hall v. Gilbert & Bennett Mfg. Co., 241 Conn. 282, 303 (1997).

The first sentence of § 31-301(g) states, “If . . . the claimant is found to have a compensable injury, the employer or insurer shall be responsible for payment of the compensation and shall reimburse the second injury fund for all sums previously expended, if any, on the claim pursuant to subsection (f) and this subsection, plus interest at the rate of ten per cent per annum.” (Emphasis added.) The Fund contends that this provision alone controls the disposition of this case, regardless of whether certain sums expended by the Fund were paid in error. However, we disagree with the Fund’s assertion that the second sentence of § 31-301(g), which requires the claimant to reimburse the fund for all sums previously expended in the event of denial of compensation, only applies to cases in which the claimant has received no money at all.

It is self-evident that § 31-301(g) is designed to require those parties who have been unjustly enriched via the “payment pending appeal” process to repay the Fund the money it has expended, plus interest. The phrase “denial of compensation” generally suggests cases in which the claimant has failed to prove his claim, but it might also include cases in which a claimant has received more money than he is entitled to collect. In this instance, the latter event has occurred. The claimant has erroneously been paid approximately two months of temporary total disability benefits. Since the legislature has found it fit to require the claimant to return overpayments directly to the Fund in some cases, we know of no practical obstacle that would prevent the Fund from likewise seeking a return of overpaid benefits here. It is the claimant, not the insurer, who has received too much compensation in this matter, and it should ultimately be he who makes restitution. Workers’ compensation proceedings are not meant to be unduly complicated. By requiring the insurer here to indemnify the Fund’s overpayment, we would be adding an extra level to the reimbursement process, thereby delaying the final resolution of this claim. Such a result would be counterintuitive, and it is not required by § 31-301(g)—a procedural provision that simply facilitates the return of funds to their rightful owners. We thus affirm the trier’s conclusion that the Fund’s recourse to any overpayment of benefits made to the claimant is against the claimant himself.

Though we have no ground to dispute the factual underpinnings of the trier’s finding that the Second Injury Fund’s contest of this claim was unreasonable; Findings, ¶ M; the finding itself is superfluous, as we agree with the Fund’s argument that neither § 31-300 nor § 31-288(b) authorizes an attorney’s fee award in this case. At the time of the claimant’s injuries, § 31-300 only allowed awards of attorney’s fees in cases where the claimant had prevailed and the trier found that the employer or insurer had unreasonably contested liability, or where payments to the claimant had been discontinued without proper notice being provided as per § 31-296 C.G.S. See Iacomacci v. Trumbull, 209 Conn. 219, 222 (1988) (law in effect on date of injury controls substantive obligations of employer). The statute did not allow for payments of attorney’s fees where a reimbursement claim was unreasonably made by the Fund against an insurer, and we may not ourselves read such a provision into the law.

As for § 31-288(b), it provides for civil penalties of up to $500 in the event that a party delays the completion of hearings without good cause. These fines are payable to the Second Injury Fund. Section 31-289. Despite the claimant’s argument in his brief, we cannot merge the spirit of § 31-288(b) with the text of § 31-300 and grant a $1000 payment to his attorney simply because it would be fiscally redundant to levy a § 31-288(b) fine against the Fund. The Workers’ Compensation Act does not allow for the spontaneous creation of an alternative remedy such as that. We note that a commissioner could impose a § 31-288(b) penalty against the Fund, though the action would be largely symbolic, as the Fund would technically be paying the fine to itself.

The trial commissioner’s decision is hereby affirmed in part, and reversed with respect to the award of attorney’s fees.

Commissioners Leonard S. Paoletta and Ernie R. Walker concur.

1 The trial commissioner’s order is entitled, “Finding and Order Pursuant to Section 31-301(b) C.G.S.” Prior to the passage of P.A. 91-32, and at the time of the claimant’s recurrence, § 31-301(b) contained the language that was revised slightly in 1991 and recodified as § 31-301(f) and (g). Because the legislative changes to § 31-301(f) (including subsequent changes in 1995) are procedural in nature, our courts have generally held that they apply retroactively. See, e.g., Coley v. Camden Associates, Inc., 243 Conn. 311 (1997) (P.A. 95-277, § 9(f) eliminated Fund’s responsibility for payment of benefits pending appeal to all cases irrespective of date of injury); Annechiarico v. Friendly Ice Cream Co., 6 Conn. Workers’ Comp. Rev. Op. 18, 640 CRD-7-87 (1988) (P.A. 86-27 applied retroactively to injury predating amendment, thus requiring Fund to pay benefits pending appeal; repayment provisions ensured that there was no new substantive obligation on the part of the Fund). By virtue of these holdings, we regard the version of § 31-301 as amended by P.A. 91-32 as that which applied to the trier’s March 1992 order. BACK TO TEXT

 



   You have reached the original website of the
   Connecticut Workers' Compensation Commission.

   Forms, publications, statutes, and most other
   information is now located at our NEW site:
   PORTAL.CT.GOV/WCC

CRB OPINIONS AND ANNOTATIONS
 
ARE STILL LOCATED AT THIS SITE WHILE IN THE
PROCESS OF BEING MIGRATED TO OUR NEW SITE.

Click to read CRB OPINIONS and CRB ANNOTATIONS.