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Harkins v. State of Connecticut/Department of Mental Retardation Southbury Training School

CASE NO. 4650 CRB-5-03-3

COMPENSATION REVIEW BOARD

WORKERS’ COMPENSATION COMMISSION

MARCH 4, 2004

ROBERT W. HARKINS

CLAIMANT-APPELLANT

v.

STATE OF CONNECTICUT/DEPARTMENT OF MENTAL RETARDATION SOUTHBURY TRAINING SCHOOL

SELF-INSURED

EMPLOYER

RESPONDENT-APPELLEE

APPEARANCES:

The claimant was represented by Edward T. Dodd, Jr., Esq., Dodd, Lessack, Ranado & Dalton, 700 West Johnson Avenue, Cheshire, CT 06410.

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

This Petition for Review from the March 18, 2003 Memorandum of Decision of the Commissioner acting for the Fifth District was heard September 26, 2003 before a Compensation Review Board panel consisting of the Commission Chairman John A. Mastropietro and Commissioners James J. Metro and Stephen B. Delaney.

OPINION

JOHN A. MASTROPIETRO, CHAIRMAN. The claimant, Robert W. Harkins, has appealed from the March 18, 2003 Memorandum of Decision of the Commissioner acting for the Fifth District. We affirm the decision of the trial commissioner.

The pertinent facts are as follows. The claimant filed a notice of claim for compensation (Form 30C) received on May 1, 2001. In this Form 30C, he described his injury as “cumulative and repetitive trauma, including but not limited to physical and/or mental stress from 11/94 to 5/4/00 resulting in traumatic cerebral event.” In response, on May 10, 2001 the respondent filed a Notice of Intention to Contest Liability to Pay Compensation (Form 43) which stated, “Mental stress is not covered in accordance with SEC. 31-275 of the CGS. Lack of medical documentation to support causal relationship of Claimant’s injury to employment. Lack of documentation to support injury was incurred.”

On October 19, 2001, the claimant filed a second Form 30C in which he alleged his injury was “brain-cerebellar cerebrovascular infarction; aggravation of pre-existing hypertension; stroke.” In the second Form 30C the dates of injury alleged were “12/15/00, 12/16/00, 12/17/00, 12/18/00 – stress in December, 2000 as a result of appearing for grievance hearing regarding reinstatement of employment.” In response, on October 25, 2001 the respondent filed a second Form 43 with the same grounds for contesting the claim which had been stated in their prior Form 43.

The claimant filed a Motion to Preclude the respondent’s defense claiming the Forms 43 were “insufficiently specific” and were equivalent to a “general denial.” The trial commissioner denied the claimant’s Motion to Preclude. He held the Form 43s were sufficient to frame the issues and apprise the claimant of the specific reasons for their denial.

Preclusion is a harsh remedy. It would therefore be inappropriate to grant a Motion to Preclude in a case where a respondent’s disclaimer reveals a concrete reason for contesting a claim. West v. Heitkamp, Inc., 4587 CRB-5-02-11 (October 27, 2003). While a general denial is an insufficient basis to contest a claim; Tovish v. Gerber Electronics, 19 Conn. App. 273 (1989); a statement that the respondent contests a specific element of the claimant’s prima facie case is valid. Pereira v. State, 228 Conn. 535 (1994).

In this case the respondent presented three possible defenses in its Forms 43. Firstly, the respondent stated mental stress was not covered by § 31-275. It appears the respondent attempted to argue the claimant’s injury was purely mental and barred under 31-275(16)(B)(ii). The Form 30C itself mentions mental stress so it does not seem problematic to raise this issue in the Form 43. However, this defense is at best irrelevant because the claimant alleged a physical injury as well, i.e., stroke.

Secondly, the respondent stated the claimant lacked the medical documentation to support a causal relationship of the claimant’s injury to his employment. The disclaimer statement here is very similar to that in Marshall v. UTC/Pratt & Whitney, 3623 CRB-1-97-6 (August 20, 1998), aff’d, 55 Conn. App. 902 (1999)(per curiam), cert. denied, 252 Conn. 904 (1999). In Marshall the respondent’s disclaimer stated, “no proof of 8/27/87 alleged exposure arising in and out of the course of employment. No medical substantiation.” The respondent in Marshall and in this case questioned whether the claimant’s disability was causally related to a compensable injury. This causal relationship is necessary for the claimant to make a prima facie case and is a valid defense. Green v. State/University of Connecticut, 15 Conn. Workers’ Comp. Rev. Op. 412, 2283 CRB-2-95-1 (August 28, 1996). We find the respondent’s disclaimer in this case substantially similar to the Marshall disclaimer and similarly uphold the trial commissioner’s denial of the claimant’s Motion to Preclude.

Thirdly, the respondent alleged the claimant submitted a lack of documentation to support the injury incurred. Some injuries, such as a severed limb, might be self-evident while other injuries will surely require some sort of documentation, such as medical records, to prove they occurred. Dengler v. Special Attention Health Services, 62 Conn. App. 440 (2001). Inherent in proving that an injury arose out of and in the course of employment is proving the claimant actually incurred the claimed injury. Prescott v. Echlin, Inc., 15 Conn. Workers’ Comp. Rev. Op. 339, 2242 CRB-3-94-12 (June 25, 1996), appeal dismissed, A.C. 16150 (February 5, 1997). Therefore, the respondent’s allegation there is no documentation to support the injury incurred is a valid defense. The claimant would have to prove that he incurred a stroke in order to go forward with his claim. The Form 43 taken in its entirety reveals the respondent put forth valid reasons for contesting the claim; therefore, it would be improper to preclude its defense.

Therefore, we affirm the March 18, 2003 Memorandum of Decision of the Commissioner acting for the Fifth District.

Commissioners James J. Metro and Stephen B. Delaney concur.

 



   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.