159 Conn.App. 180
Conn. App. Ct.2015Background
- Riveiro, a sanitation worker, alleged a work-related back injury on March 9, 2011 while moving a heavy dough container; physicians later recommended lumbar fusion.
- He reported the injury to employer HR on March 22, 2011 with inconsistent dates/history given to different providers; contemporaneous daily report for March 9 did not record an injury or a container of the claimed weight.
- Defendants (Fresh Start Bakeries and insurer) timely filed a Form 43 denying liability, stating there was a lack of medical evidence supporting a causal connection and ongoing disability.
- Commissioner found Riveiro not credible, discounted medical opinions that relied on his narrative, and denied benefits; plaintiff did not file a motion to correct factual findings.
- Workers’ Compensation Review Board affirmed, holding the Form 43 sufficiently notified defendants would contest causation and deferring to the commissioner’s credibility determinations.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Sufficiency of Form 43 notice under Conn. Gen. Stat. §31-294c(b) | Form 43 limited defense to sufficiency of medical evidence and thus conceded compensability; defendants should be precluded from contesting arising-out-of/employment element | Form 43’s reference to lack of medical evidence put plaintiff on notice defendants contested causal connection; it challenged an element of prima facie case | Form 43 was sufficient to contest causation; no preclusion of defenses |
| Credibility and weight of medical evidence based on claimant’s narrative | Medical providers agreed on injury; commissioner should have credited medical causation opinions | Medical opinions relied solely on Riveiro’s inconsistent, uncorroborated account; commissioner properly rejected those opinions | Commissioner reasonably found claimant not credible and permissibly discounted medical opinions dependent on his narrative |
| Procedural challenge to commissioner’s factual findings | (Implicit) Commissioner erred in weighing evidence | Plaintiff failed to file motion to correct; therefore cannot now challenge factual findings on appeal | Because no motion to correct filed, appellate review limited; board’s affirmance stands |
| Standard for overturning commissioner/board | Commissioner improperly denied claim despite medical consensus | Commissioner’s credibility determinations are binding if reasonable; diverse inferences are permitted | Appellate court defers to commissioner/board; decision not unreasonable or erroneous |
Key Cases Cited
- Tovish v. Gerber Electronics, 19 Conn. App. 273 (1989) (Form 43 contesting that injury arose in scope of employment is valid to challenge compensability)
- Pereira v. State, 228 Conn. 535 (1994) (notice need only reveal specific grounds contesting compensability; employer must promptly investigate)
- Lamar v. Boehringer Ingelheim Corp., 138 Conn. App. 826 (2012) (a disclaimer stating injury did not arise in course of employment notifies intent to challenge fifth prima facie element)
- Abbotts v. Pace Motor Lines, Inc., 106 Conn. App. 436 (2008) (commissioner may discredit medical evidence that depends on an unreliable claimant narrative)
- Donahue v. Veridiem, Inc., 291 Conn. 537 (2009) (employer’s failure to timely file Form 43 can lead to preclusion; distinguishable when disclaimer was timely filed)