Graham v. State of Connecticut/University of Connecticut Health Center

The claimant was represented by Scott Camassar, Esq., The Reardon Law Firm, 160 Hempstead Street, P.O. Box 1430, New London, CT 06320.

The respondent was represented by Taka Iwashita, Esq., Assistant Attorney General, 55 Elm Street, P. O. Box 120, Hartford, CT 06141-0120.

Appearing as an amicus curiae was the City of Bridgeport, represented by Frank May, Esq., Montstream & May, L.L.P., Salmon Brook Corporate Park, 655 Winding Brook Drive, P. O. Box 1087, Glastonbury, CT 06033-6087.

This Petition for Review from the July 5, 2001 Finding and Award of the Commissioner acting for the Second District was heard March 22, 2002 before a Compensation Review Board panel consisting of the Commission Chairman John A. Mastropietro and Commissioners Donald H. Doyle, Jr. and Amado J. Vargas.

OPINION

JOHN A. MASTROPIETRO, CHAIRMAN. The respondent has petitioned for review from the July 5, 2001 Finding and Award of the Commissioner acting for the Second District. It contends on appeal that the trial commissioner erred by allowing the claimant’s § 31-284b group health benefits to continue while he was receiving medical treatment for his compensable injury, but was no longer receiving any type of indemnity benefit. We find error on review, and reverse the trier’s decision.

The relevant facts here are concise. The claimant suffered a compensable wrist injury on June 29, 1993. This resulted in an 8% permanent partial disability, with a maximum medical improvement date of September 11, 1996. The claimant last received a check for disability payments on May 1, 2000, and has not received weekly indemnity benefits since. Though the claimant would continue to qualify as partially disabled based upon his wrist injury, he is currently totally disabled due to a non-work-related problem, and is not actively seeking indemnity benefits. He does continue to receive medical care for his wrist condition. The respondent had been providing the claimant with health insurance coverage pursuant to § 31-284b, but ceased to do so following the discontinuance of his weekly indemnity benefits. As of November 30, 2000, the claimant began making bi-monthly payments to continue his health insurance through COBRA. The trial commissioner found that the claimant was still receiving “compensation” pursuant to § 31-284b by virtue of his continuing medical treatment, and ordered the respondent to reinstate his health insurance coverage and to reimburse him for premiums already paid. The respondent herein appeals from that decision.

We begin our discussion of § 31-284b with a look at the statute as it existed on the date of the claimant’s injury, for it is invariably the law on the date of injury that serves as the substantive legal framework of a workers’ compensation matter, absent a clear demonstration of legislative intent to the contrary. Hall v. Gilbert & Bennett Mfg. Co., 241 Conn. 282, 302 (1997). As of June 29, 1993, § 31-284b(a) provided as follows:

The term “compensation,” meanwhile, was listed in the general definitions section of the Workers’ Compensation Act as meaning “benefits or payments mandated by the provisions of this chapter, including, but not limited to, indemnity, medical and surgical aid or hospital and nursing service required under section 31-294d and any type of payment for disability, whether for total or partial disability of a permanent or temporary nature, death benefit, funeral expense, payments made under the provisions of section 31-284b, 31-293a or 31-310, or any adjustment in benefits or payments required by this chapter.” Section 31-275(4). This and all other general definitions listed in § 31-275 apply to all of Chapter 568 “unless the context otherwise provides.”

A straightforward reading of the word “compensation” as defined by § 31-275(4) would readily lead to the inference that § 31-284b applies on its face to any employee of the state or a municipality1 who is eligible to receive medical and surgical aid, as well as disability payments. Essentially, this was the approach taken by the trier in her memorandum of law, and the claimant endorses that interpretation on appeal. The matter is complicated, however, by the previous incarnation of the statute and those cases that have interpreted its language. Prior to July 1, 1991, § 31-284b required employers to provide equivalent insurance coverage while an employee was receiving “workers’ compensation payments pursuant to this chapter, or while the employee is receiving wages under a provision for sick leave payments for time lost due to an employment-related injury.” (Emphasis added.) Also, the definition of “income” that is now in § 31-284b had been codified in § 31-275(14) of the general definitions, while the definition of “compensation” now found in § 31-275(4) was part of § 31-293, where it purported to describe “compensation” only “as used in this section.” Each of these linguistic and structural features was changed by Public Act 91-32.

Our Supreme Court has reviewed the legislative history of P.A. 91-32, which repeatedly asserts that its technical revisions were meant to simplify and better organize the language of the Act, without changing anything in the way of substantive meaning. See, e.g., 34 S. Proc., Pt. 3, 1991 Sess., p. 836 (comments of Sen. Maloney, describing bill as “technical recodification”); Conn. Joint Standing Committee Hearings, Labor & Public Employees, 1991 Sess., p. 16-17 (comments of Sen. Maloney and Workers’ Compensation Commission Chairman John Arcudi). Consequently, the Court has held that the addition of “compensation” to the general definitions in § 31-275 merely clarified the meaning of the word “compensation” as it had already been used throughout the Act, and did not enact a substantive change in the law; Weinberg v. ARA Vending Co., 223 Conn. 336, 347 (1992); while the legislature’s movement of “income” from § 31-275 to § 31-284b was not intended to change its import or effect concerning other provisions in the Act. Luce v. United Technologies Corp., 247 Conn. 126, 137 (1998); see also, Vaillancourt v. New Britain Machine/Litton, 224 Conn. 382, 393-94 (1993)(construing 104-week period as defined by § 31-349 C.G.S.) It would seem to stand to reason, therefore, that the legislature did not wish to change the substantive meaning of § 31-284b when it replaced the phrase “workers’ compensation payments” with the single word “compensation,” as now defined by § 31-275(4). Presumably, the revisions of P.A. 91-32 were intended only to clarify that law, not to change it.

Several years ago, this board was confronted with Kelly v. Bridgeport, 3761 CRB-4-98-1 (March 11, 1999), a case similar to the one before us today. The key difference was the date of injury: the claimant there had been injured on March 6, 1991, prior to the enactment of P.A. 91-32. The respondent had argued that the term “workers’ compensation payments” in § 31-284b was narrower than the general definition of “compensation,” as the receipt of a payment by a claimant is markedly different from a claimant’s receipt of medical care, where payment is ultimately tendered to the medical provider. This board held that this distinction was irrelevant, given the definition of “compensation” in § 31-293 that included both weekly disability payments and sums paid out for surgical, medical and hospital services. We cited our Supreme Court’s rulings concerning the technical nature of P.A. 91-32 and its intent not to make substantive changes in the law. Because the definition of “compensation” had been moved to § 31-275(4) in order to clarify the meaning of that term throughout the Act, we held that it applied to the pre-amendment use of the term “compensation payments” in § 31-284b. Cf. Green v. General Dynamics Corp., 245 Conn. 66, 78 (1998)(legislative act that is intended to clarify existing law necessarily has retroactive effect).

A similar result was reached in Auger v. Stratford, 3944 CRB-4-98-12 (Jan. 14, 2000), a case involving a 1990 date of injury, in which we relied on Kelly while adding the caveat, “The concerns expressed in Kelly favor an inclusive approach to § 31-284b benefits, but they do not imply that a claimant inherits automatic lifetime entitlement to insurance coverage each time he or she suffers a compensable injury.” In Auger, we also distinguished the Supreme Court’s decision in Crocetto v. Lynn Development Corp., 223 Conn. 376 (1992), which held that a claimant’s receipt of a subsistence allowance during his participation in vocational rehabilitation did not trigger the mandatory health insurance requirement of § 31-284b, as such a payment is neither authorized by the Act itself, or by administrative regulation.

However, both Kelly and Auger were later reversed by our Appellate Court. Kelly v. Bridgeport, 61 Conn. App. 9 (2000); Auger v. Stratford, 64 Conn. App. 75 (2001)(relying on the analysis in Kelly). The court reached its decision in Kelly by looking at the language of § 31-284b(a) at the time of the claimant’s injury, and reasoning that the meaning of “compensation payments” does not include payments for medical care after the indemnity compensation period has ceased. Id., 16. The court rejected this board’s reliance on the broader definition of “compensation” that was moved from § 31-293 to § 31-275(4), holding that the version of the statute in place on the date of the claimant’s injury restricted that definition to § 31-293 only. “The claimant’s substantive right to benefits is governed by the law as it existed on the date of his injury.” Id. The court cited Civardi v. Norwich, 231 Conn. 287, 293 n.8 (1994), where our Supreme Court noted, “There is nothing in the legislative history . . . to indicate even remotely that [the revised definition of “compensation”] was intended to apply to employees previously injured, and thereby to depart from the date of injury rule.” The Kelly court also observed that the subsistence allowance at issue in Crocetto, supra, was held not to qualify as a workers’ compensation payment under § 31-284b, and concluded that “the payments received in this case are less like compensation than the ones in Crocetto and therefore do not trigger § 31-284b benefits.” Id., 19. Significantly, when the claimant appealed from that decision, our Supreme Court declined to grant certiorari. Kelly, supra, 255 Conn. 933 (2001). We are obligated to infer, therefore, that our Supreme Court agrees with the Appellate Court’s opinion.

The question then becomes, should the claimant in the instant matter be treated differently than the claimants in Kelly and Auger based on the changes in statutory language effected by P.A. 91-32? The trial commissioner found that Kelly was inapposite, as the language of § 31-284b(a) now refers to eligibility to receive “compensation,” which is defined by § 31-275(4) as including medical and surgical aid. The respondent, meanwhile, invokes the aforementioned statements in the legislative history reflecting that P.A. 91-32 was not intended to create substantive changes in the law, and urges this board to rely on Kelly and Auger in order to determine the meaning and effect of the current language in § 31-284b. The amicus curiae echoes that request in its brief. Of course, where the language of a statute is clear and unambiguous, we must presume that the legislature meant what it said. Trankovich v. Frenish, Inc., 47 Conn. 628, 631 (1998). A court need not consult the legislative history of a statute unless there is a need to resolve an ambiguity of some type; All Brand Importers, Inc. v. Department of Liquor Control, 213 Conn. 184, 195 (1989); though occasional exceptions appear to have been made to that rule of statutory interpretation. See, e.g., Sienkiewicz v. Sienkiewicz, 178 Conn. 675, 683 (1979)(concerning enforcement of support orders via execution against pension fund).

This board has stated that “[t]he question of continuing entitlement to § 31-284b benefits is not readily settled by the plain language of the statute, and absent controlling precedent, is one upon which reasonable minds could differ.” Auger, supra. We believe that there is still latent ambiguity in the revised version of § 31-284b. Although the term “compensation” is now present in the general definitions of § 31-275, the preamble to those definitions specifies that they should control only where the context of a statute does not otherwise provide. When one looks at the language of § 31-284b(a), one sees that the time period in which “the employee is eligible to receive or is receiving compensation pursuant to this chapter” is associated with, and implicitly likened to, a time period in which an employee “is receiving wages under a provision for sick leave payments for time lost due to an employment-related injury.” This language creates a context within which one could reasonably speculate that a claimant’s right to the maintenance of health and life insurance coverage is only protected while he is being paid some sort of wage loss benefit or related disability benefit. Therefore, there is uncertainty in the meaning of the statute, and other factors aside from its plain language may be studied in determining whether the definition of “compensation” in § 31-275(4) should be applied to § 31-284b(a).

Both this board and our Appellate Court noted in Kelly that the legislative history of § 31-284b is not directly helpful in defining the breadth of the term “compensation payments” (or the now-substituted term “compensation”), because the comments of the legislators appear to be geared solely to the period where the employee is receiving regular weekly compensation payments. Kelly, supra, 61 Conn. App. 9, 17 n.6; Kelly, supra, 3761 CRB-4-98-1. The legislature never specifically addressed the question of whether § 31-284b coverage should continue while an employee is receiving medical care for his compensable injury, but not weekly benefits. However, the corollary to this observation is that the legislative history and the language of § 31-284b appear to be focused solely on the maintenance of the employee’s income while he or she is incapacitated and unable to work due to a compensable injury, and thus do not suggest a broader interpretation any more than they specifically preclude it. In fact, it would be reasonable to say that the legislature enacted a statute designed to maintain employer-provided insurance coverage while an injured employee is unable to return to work, in recognition of the hardship that it would cause an employee and his or her family if such a guarantee were not available. Likewise, our courts have seemingly presumed that § 31-284b coverage must be provided while a claimant is entitled to some sort of weekly compensation benefit, but have never required any inquiry to be made concerning subsequent continuation of medical treatment. Crocetto, supra, 383; Deschnow v. Stamford, 214 Conn. 394, 399 (1990).

Our expansion of that coverage via Kelly and Auger may have been technically based on the broader definition of “compensation” now present in § 31-284b(a), but it was philosophically informed by the remedial and humanitarian purpose of the Workers’ Compensation Act and our fundamental concern for the welfare of injured claimants. Such concerns have not been abandoned by this board or by the Act, nor should they be. Still, we now know that our viewpoint in Kelly and Auger is not shared by the higher courts. As the respondents assiduously point out, we also know that our legislature did not intend to affect the substantive meaning of § 31-284b(a) when it amended the language of that section (and many other sections of the Act) by passing P.A. 91-32. Further, the amicus curiae has convincingly argued that it would be extraordinarily difficult and expensive to administer a system in which the provision of any medical treatment for a compensable injury triggered an employer’s obligations under § 31-284b(a), regardless of how much time had elapsed since weekly benefits were last paid, or whether the employee had since returned to work and obtained further insurance coverage. (Of course, even without such a system in place, an injured employee would continue to be entitled to medical treatment that is necessitated by the effects of a compensable injury. That basic protection of the Act would not be lost.)

Given all of these factors, we conclude that we must interpret § 31-284b(a) to require the continuation of insurance coverage only during the period of time that a claimant is eligible to receive weekly compensation benefits, despite the current language of § 31-284b(a) that suggests the possibility of a more liberal reading. Our lawmakers did not intend to effect a change in the coverage provided by that statute in 1991, and this board would be sanctioning an unintended result if we were to rule that a spontaneous expansion of that coverage nonetheless occurred due to the minor changes in language that were implemented by P.A. 91-32. Therefore, we reverse the decision of the trial commissioner.

Commissioners Donald H. Doyle, Jr. and Amado J. Vargas concur.

1 Our Supreme Court has ruled that § 31-284b may not be applied to private employers due to the pre-emptive effect of the federal Employee Retirement Income Security Act (ERISA), as defined by the United States Supreme Court in District of Columbia v. Greater Washington Board of Trade, 506 U.S. 125 (1992). Luis v. Frito-Lay, Inc., Docket No. S.C. 14536 (order, April 27, 1993). However, where a claimant is a government employee, § 31-284b benefits are not pre-empted by ERISA. Civardi v. Norwich, 231 Conn. 287, 298-99 n.14 (1994). BACK TO TEXT