JAMES ARRICO v. BOARD OF EDUCATION OF THE CITY OF STAMFORD ET AL.
(AC 44409), (AC 44488)
Connecticut Appellate Court
April 26, 2022
Elgo, Moll and Pellegrino, Js.
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Syllabus
The defendants, an employer and its third-party administrator appealed to this court from the decision of the Compensation Review Board, which reversed in part the Workers’ Compensation Commissioner‘s decision approving a form 36 filed by the defendants. During the course of his employment as a custodian, the plaintiff sustained a compensable injury and entered into two voluntary agreements with his employer. The plaintiff thereafter sustained another injury and two voluntary agreements were approved with respect to that injury. Subsequently, the defendants filed a form 36 seeking to discontinue or to reduce the plaintiff‘s workers’ compensation benefits, asserting that the plaintiff had a work capacity and had reached maximum medical improvement. After formal hearings on the form 36 and on the plaintiff‘s entitlement to total disability benefits pursuant to statute (
1. The defendants could not prevail on their claims that the board improperly reversed in part the commissioner‘s decision approving their form 36:
a. The defendants’ claim that the board misconstrued the commissioner‘s decision regarding the plaintiff‘s claim for
b. The board did not err in vacating the commissioner‘s conclusions as to the issue of further medical care for the plaintiff‘s work-related injuries and remanding that issue for further proceedings on the ground that the parties did not receive notice and an opportunity to present argument and evidence on that issue: the defendants conceded that the question of whether the plaintiff required further medical care was not at issue during the formal hearings; moreover, contrary to the defendant‘s contention, this court did not construe the commissioner‘s determination regarding further medical care as reinforcing her finding that the plaintiff had reached maximum medical improvement, rather, this determination implicated the issue of whether further medical care was reasonable or necessary, which was not at issue before the commissioner; furthermore, if the parties agree that the issue of further medical care is not germane to the proceedings and decline to litigate it, they may alert the commissioner in order to remove the issue from consideration on remand.
2. The plaintiff could not prevail on his claim that the board improperly denied his motion for articulation or reconsideration in violation of statute (
Argued November 18, 2021—officially released April 26, 2022
Procedural History
Appeal from the decision of the Workers’ Compensation Commissioner for the Seventh District finding, inter alia, that the plaintiff had reached maximum medical improvement with respect to his claim for certain workers’ compensation benefits, brought to the Compensation Review Board, which reversed in part the commissioner‘s decision and remanded the case for further proceedings; thereafter, the board denied the plaintiff‘s motion for articulation or reconsideration, and the plaintiff and the defendants filed separate appeals to this court. Affirmed.
Scott Wilson Williams, for the appellants in Docket No. AC 44409 and for the appellees in Docket No. AC 44488 (defendants).
Opinion
MOLL, J. In this workers’ compensation dispute, the plaintiff, James Arrico, and the defendants, the Board of Education of the City of Stamford (city) and PMA Management Corporation of New England,1 each appeal from separate decisions of the Compensation Review Board (board).2 In Docket No. AC 44409, the defendants appeal from the decision of the board reversing in part the decision of the Workers’ Compensation Commissioner for the Seventh District (commissioner) of the Workers’ Compensation Commission approving a form 363 that the defendants filed.4 The board vacated the majority of the commissioner‘s conclusions in her decision approving the form 36 and remanded the matter to the commissioner for further proceedings on several issues. On appeal, the defendants claim that the board (1) misconstrued the commissioner‘s decision as including a finding that the plaintiff was totally disabled as a result of preexisting, noncompensable injuries, (2) failed to affirm the commissioner‘s decision on the basis of her purported finding, as supported by sufficient evidence, that the plaintiff had a work capacity, and (3) misconstrued the commissioner‘s conclusion that further medical care of the plaintiff‘s compensable injuries was palliative. In Docket No. AC 44488, the plaintiff appeals from the decision of the board denying his motion for articulation or reconsideration vis-a-vis its ruling on the commissioner‘s decision approving the form 36. On appeal, the plaintiff claims that the board improperly denied his request for an order that the matter be remanded to a different commissioner for a de novo trial. We affirm the decisions of the board.
The following facts, which are not in dispute, and procedural history are relevant
On February 28, 2018, the defendants filed a form 36 seeking to discontinue or to reduce the plaintiff‘s workers’ compensation benefits. Relying on a report dated February 20, 2018, by Stuart Belkin, an orthopedic surgeon who had examined the plaintiff, the defendants asserted that the plaintiff had a work capacity and had reached maximum medical improvement with an addi-tional 5 percent permanent partial disability rating as to his back. On March 5, 2018, the plaintiff filed an objection to the form 36. On September 7, 2018, following an informal hearing, the form 36 was approved.
Formal hearings on the form 36 were held on December 12, 2018, and January 29, 2019.7 The commissioner (1) heard testimony from the plaintiff and his wife and (2) admitted exhibits, including medical records, into evidence. During the January 29, 2019 formal hearing, in response to a request by the plaintiff‘s counsel, the commissioner stated that the notice issued in relation to the formal hearings listed two disputed issues: (1) the form 36 filed by the defendants pursuant to General Statutes
“Carlesi examined the [plaintiff] on March 7, 2017, and diagnosed him with lumbar radiculopathy and lumbar spinal stenosis. Carlesi noted the [plaintiff‘s] medical history included colitis, ulcerative colitis, disc disease, degenerative joint disease, and that he is currently an ‘every day smoker.’ . . . Carlesi also noted that the [plaintiff‘s] prior treatment had included the use of a number of steroids. . . .”
“The [defendants] had their expert, [Belkin], examine the [plaintiff] on February 20, 2018. Belkin found the [plaintiff] had reached maximum medical improvement . . . with a 5 percent permanent partial disability of the lumbar spine, independent of any previous impairment. . . .”
“On March 12, 2018, Carlesi sent a letter to [the plaintiff‘s] counsel stating that the [plaintiff‘s] 2017 injury had ‘exacerbated his underlying pain and that he has been incapable of returning to work due to the severity of his pain. He is unable to ambulate without a cane and he has severe pain [from his] back radiating [into] both lower extremities. [His] pain worsens with activity, [and there is a] significant decrease in [his] ability to lift, bend, and carry anything at this point in time. [He] is unable to perform most of his activities of daily living and pretty much rests in a recliner or in a [bed]. He lacks physical endurance and frequently awakens from sleep due to pain.’ . . .”
“Carlesi deemed the [plaintiff] totally disabled from all work activities as a result of the progressive degenerative disc disease, lumbar spinal stenosis, and sacral insufficiency fractures. He did agree the [plaintiff] was at [maximum medical improvement] and assigned an 11 percent permanent partial disability rating of the lumbar spine. On March 20, 2018, Carlesi further assessed the [plaintiff] as to his pain level and medication use, and noted the [plaintiff] was using a cane and was unable to return to work. Carlesi‘s notes also indicate the [plaintiff] suffered from a number of digestive system ailments.”
“A commissioner‘s examination was performed by Michael F. Karnasiewicz . . . on June 28, 2018.9 Karnasiewicz opined that
“a. The [plaintiff‘s] underlying spinal stenosis was probably aggravated by the injury of February 10, 2017, and is causing the radiculopathy the [plaintiff] is experiencing. . . .”
“b. The [plaintiff‘s] need for treatment is multifactorial in that both the [2008 injury] and the [2017 injury] were ‘substantial factors’ in the production of the [plaintiff‘s] need for treatment. . . .”
“c. Other factors complicating the [plaintiff‘s] current inability to work are ulcerative colitis, acid reflux and seizure disorder. He also has poor concentration skills and a slowed thought process. He is an ‘easy’ bruiser and bleeder and has unspecified difficulty with his immune system. He uses a cane for ambulation, his ankle reflexes are absent bilaterally with diminished sensation bilaterally in both of his feet. . . .”
“d. Between the [plaintiff‘s] first injury in 2008 and his second injury in 2017, his diagnostics reveal a steady worsening of his stenotic condition. In addition, an EMG study with [another physician] shows multiple level radiculopathy consistent with spinal stenosis.”
“e. [Karnasiewicz] gives the [plaintiff] a sedentary work capacity and recommends that the [plaintiff] be reevaluated by [Scott Simon, a neurosurgeon] for decompressive surgery in the treatment of his bilateral pain. . . .”
“The [plaintiff] continued to treat for his ailments with Carlesi who [i]n July . . . 2018, examined him and noted he ‘continues to experience chronic lower back pain, sacral pain and radicular pain in both lower extremities associated numbness, tingling and pins and needles in his feet.’ . . . Carlesi said the [plaintiff] was a surgical candidate for either a lumbar laminectomy and decompression surgery to treat the spinal stenosis or a spinal cord stimulator trial for pain relief. He also opined that the [plaintiff] was still disabled. . . .”
“Belkin was deposed on December 5, 2018, and discussed his prior February, 2018 examination and his review of the [the plaintiff‘s] medical records. He noted the [plaintiff] had a bilateral sacral fracture on February 10, 2017, and needed no additional treatment as of February, 2018. He deemed the [plaintiff] at [maximum medical improvement] with a 5 percent permanent partial disability rating in addition to any previous rating. He opined that the [plaintiff] could return to work as a custodian based solely on his lumbar spine condition ‘but that any current disability at the time [he] examined [the plaintiff] was as a result of [the plaintiff‘s] [preexisting] chronic spinal problems,’ which he testified were ‘diffuse degenerative disc disease and
On the basis of the record, the commissioner concluded that the plaintiff had “reached maximum medical improvement on his low back with an additional 5 percent due on his sacrum. The combined permanent partial disability rating from the 2008 [injury] and the 2017 [injury] is 21 percent to the low back.”
The commissioner made the following additional conclusions. The commissioner rejected (1) Carlesi‘s opinion that the 2017 injury “had aggravated the plaintiff‘s underlying pain” and (2) Karnasiewicz’ opinion that the plaintiff‘s “underlying spinal stenosis was ‘probably aggravated’ by the [2017 injury] and is causing the radiculopathy the [plaintiff] is experiencing and the need for treatment of [the] same.” The commissioner rejected those opinions because (1) in 2008, Carlesi had reported that the plaintiff had a ” ‘history of chronic back pain’ ” that radiated down his body ” ‘with associated numbness and weakness,’ ” which ” ‘precluded him from working and performing his daily activities,’ ” (2) a 2008 MRI revealed, among other ailments suffered by the plaintiff, ” ‘degenerative disc narrowing,’ ” (3) the plaintiff was a daily smoker, and (4) the plaintiff had declined to undergo surgery in 2008, opting to pursue conservative care and accepting a 16 percent permanent partial disability rating as to his back.
With regard to the plaintiff‘s decision to reject surgery, the commissioner stated that, “[f]or eleven years, the [plaintiff] has turned down the surgical option to remediate his back condition, despite recommendations from his treating physicians to do this at an earlier point in time. Now, due to the passage of time and the [plaintiff‘s] various non-work related [comorbidities], some of which are progressively degenerative in nature . . . he is no longer a surgical candidate. The [plaintiff] is entitled to turn down recommended surgery and opt for conservative or palliative care, however, he must do so with the understanding that the [Workers’ Compensation Act, General Statutes
The commissioner then concluded that Belkin, Karnasiewicz, and Carlesi all had determined that the plaintiff had reached maximum medical improvement with respect to his back, which “signal[ed] to the parties and to the commissioner that there is no further ‘curative’ treatment available
On September 3, 2019, the plaintiff filed a motion to correct and a motion for reconsideration, both of which the commissioner denied. On September 10, 2019, the plaintiff filed a petition for review with the board.
On November 17, 2020, the board reversed in part the commissioner‘s decision approving the form 36. At the outset of its decision, the board concluded that there was substantial evidence supporting the commissioner‘s decision approving the form 36. Nevertheless, the board was “persuaded by the [plaintiff] . . . that the manner in which the commissioner addressed this evidence was sufficiently unorthodox as to impair his right to a fair hearing based on established standards in this forum.” Specifically, the plaintiff claimed, inter alia, that the commissioner improperly (1) concluded that further medical care of his compensable injuries would be palliative when that issue was neither noticed for, nor litigated, during the formal hearings and (2) failed to apply the proper standard in determining that his current disability was the result of preexisting, noncompensable injuries and, thus, not compensable under
The board first addressed the commissioner‘s conclusions that further medical care of the plaintiff‘s compensable injuries was palliative, which the board construed as implicating the question of whether further medical care was reasonable or necessary pursuant to General Statutes
The board next considered whether the commissioner had applied the proper standard in determining that the plaintiff‘s disability was the consequence of preexisting, noncompensable injuries and, therefore, not compensable under
The board then explained that, in situations where a claimant suffers from both a compensable and a noncompensable injury, the claimant must demonstrate that his or her compensable injury “was a substantial factor in the claimed disability.” (Internal quotation marks omitted.) The board cited decisions in which trial commissioners had resolved similar claims, stating that “[i]n all of those cases [the board] could ascertain the manner in which the trial commissioners reached their conclusions, which was by weighing the probative value of conflicting contemporaneous opinions.” The board concluded that the commissioner improperly failed to identify “the specific expert witness or witnesses who offered recent testimony supportive of the result in this case. In the absence of the commissioner stating this specifically in the text of the ruling, [the board] cannot, as an appellate panel, sustain the conclusion[s] reached [in the commissioner‘s decision].” Accordingly, the board vacated the commissioner‘s conclusions concerning the plaintiff‘s claim for
On November 25, 2020, the plaintiff filed a motion for articulation or reconsideration. The plaintiff asserted that the board had concluded that the facts found by the commissioner were incorrect and lacked a sufficient evidentiary foundation, such that a de novo trial was required before a different commissioner on remand. Accordingly, the plaintiff requested that the board issue an order to that effect. On December 2, 2020, the defendants filed a response arguing that any additional formal hearings on remand should be held by the commissioner.
On December 23, 2020, the board denied the plaintiff‘s motion for articulation or reconsideration. In doing so, the board stated that, in its November 17, 2020 decision, it had “remand[ed] the [commissioner‘s decision] back to the . . . commissioner for findings consistent with the appropriate standard of causation . . . .” The board then reviewed this court‘s opinion in Fantasia v. Milford Fastening Systems, 86 Conn. App. 270, 860 A.2d 779 (2004), cert. denied, 272 Conn. 919, 866 A.2d 1286 (2005), which the plaintiff had cited in support of his motion, and deemed it to be distinguishable. In addition, the board noted that, following Fantasia, it had “often ordered remands of decisions back to the original trial commissioners with direction to rule based on the appropriate legal standards. . . . [The board] find[s] no compelling reason not to do so likewise in this case.” (Citation omitted.)
The board also cited the precept of administrative economy in denying the plaintiff‘s motion, stating that it had “vacated various conclusions from the commissioner‘s [decision approving the form 36] as either not having been litigated between the parties or having been based on the application of an erroneous standard of law. The issues which were litigated have already involved the submission of a great deal of testimony and documentary evidence and [the board] believe[s] that a de novo hearing would result in substantial delay and redundancy. Permitting the . . . commissioner familiar with the record to rule on this record serves the purpose of administrative economy.” Thereafter, the plaintiff appealed from the board‘s denial of his motion (AC 44488).
I
AC 44409
In AC 44409, the defendants appeal from the board‘s November 17, 2020 decision reversing in part the commissioner‘s decision approving their form 36 and remanding the matter for further proceedings as to the issues of total disability and further medical care. The defendants raise three distinct claims on appeal, two of which are interrelated. First, the defendants assert that the board (1) misconstrued the commissioner‘s decision to include a finding that the plaintiff was totally disabled as a result of preexisting, noncompensable injuries and (2) failed to affirm the commissioner‘s decision on the basis of her purported finding that the plaintiff had a work capacity, which the defendants maintain was supported by sufficient evidence. Second, the defendants contend that the board misconstrued the
“The standard of review in workers’ compensation appeals is well established. When the decision of a commissioner is appealed to the board, the board is obligated to hear the appeal on the record of the hearing before the commissioner and not to retry the facts. . . . The commissioner has the power and duty, as the trier of fact, to determine the facts. . . . The conclusions drawn by [the commissioner] from the facts found must stand unless they result from an incorrect application of the law to the subordinate facts or from an inference illegally or unreasonably drawn from them. . . .”
“[O]n review of the commissioner‘s findings, the [board] does not retry the facts nor hear evidence. It considers no evidence other than that certified to it by the commissioner, and then for the limited purpose of determining whether or not the finding should be corrected, or whether there was any evidence to support in law the conclusions reached. It cannot review the conclusions of the commissioner when these depend upon the weight of the evidence and the credibility of witnesses. . . . Our scope of review of the actions of the board is similarly limited. . . . The role of this court is to determine whether the . . . [board‘s] decision results from an incorrect application of the law to the subordinate facts or from an inference illegally or unreasonably drawn from them.” (Citation omitted; internal quotation marks omitted.) Ayna v. Graebel/CT Movers, Inc., 133 Conn. App. 65, 69-70, 33 A.3d 832, cert. denied, 304 Conn. 905, 38 A.3d 1201 (2012).
A
The defendants first claim that the board, in vacating the commissioner‘s conclusions made in connection with her rejection of the plaintiff‘s claim for
First, the defendants’ contention that the commis-sioner found that the plaintiff had a work capacity is belied by the commissioner‘s decision. Although the commissioner, in summarizing the evidence in the record, noted that certain physicians had opined that the plaintiff had a work capacity, the commissioner neither indicated that she deemed those opinions to be credible nor made a finding, express or implied, that the plaintiff had a work capacity. The board could not have affirmed the commissioner‘s decision on the basis of a finding that the commissioner never made. Thus, whether the record contained sufficient evidence to support a finding that the plaintiff had a work capacity is of no moment.
Second, we agree with the board that the commissioner made a determination that the plaintiff remained totally disabled as a result of preexisting, noncompensable
In sum, we reject the defendants’ claim that the board committed error in vacating the commissioner‘s conclusions regarding the plaintiff‘s claim for
B
The defendants next claim that the board, in vacating the commissioner‘s conclusions regarding further medical care and in remanding that issue for further proceedings, misconstrued the commissioner‘s determination that “[f]urther treatment on the [plaintiff‘s] [work related] injuries to [his] low back is palliative.” The defendants concede that the question of whether the plaintiff required further medical care was not at issue during the formal hearings; however, they contend that the commissioner‘s determination regarding further medical care was made to support her finding that the plaintiff had reached maximum medical improvement as to the 2017 injury. In addition, the defendants maintain that, even if the board properly vacated the commis-sioner‘s conclusions as to further medical care, the board improperly remanded that issue for further proceedings. We are not persuaded.
General Statutes
Mindful of this context, we turn to the defendants’ contention that the commissioner‘s
The defendants further assert that, even if vacating the commissioner‘s conclusions as to further medical care was proper, the board should not have remanded the issue for further proceedings because (1) further medical care is not a current issue between the parties, (2) no request for medical treatment has been denied, and (3) the plaintiff is not precluded from seeking authorization for further medical care. Under the circumstances of this case, we perceive no harm in the remand order. Should both parties agree that the issue of further medical care is not germane to the proceedings and decline to litigate it, they may alert the commissioner of the same in order to remove the issue from consideration on remand.15
In sum, we reject the defendants’ claim that the board committed error in vacating the commissioner‘s conclusions regarding the issue of further medical care and in remanding that issue for further proceedings.
II
AC 44488
In AC 44488, the plaintiff appeals from the board‘s denial of his motion for articulation or reconsideration. The plaintiff contends that the board violated General Statutes
“Whether a case should be remanded, and the scope of that remand, presents questions to be determined by
“The principles that govern statutory construction are well established. When construing a statute, [o]ur fundamental objective is to ascertain and give effect to the apparent intent of the legislature. . . . In other words, we seek to determine, in a reasoned manner, the meaning of the statutory language as applied to the facts of [the] case, including the question of whether the language actually does apply. . . . In seeking to determine that meaning, General Statutes
We first turn to the text of
In light of the plain language of
The plaintiff relies on Fantasia v. Milford Fastening Systems, supra, 86 Conn. App. 270, to support his claim that the board committed error in failing to remand the matter to a different commissioner for a de novo trial. In Fantasia, a workers’ compensation commissioner awarded a claimant temporary partial disability benefits but denied the claimant‘s request for temporary total disability benefits. Id., 275. On appeal, the board concluded that the commissioner‘s decision contained inconsistent findings because the commissioner credited a physician‘s opinion that the claimant was temporarily totally disabled but failed to award the claimant temporary total disability benefits, and remanded the matter to the original commissioner for an articulation. Id., 276. On remand, the commissioner articulated that he had awarded the claimant temporary total disability benefits. Id. The board later affirmed the articulation. Id., 277.
On appeal following the board‘s decision affirming the articulation, this court concluded that (1) the board properly exercised its discretion, pursuant to its statutory authority, to remand the matter to the commissioner for an articulation, (2) the board improperly accepted the commissioner‘s articulation because the commissioner, rather than issuing an articulation in compliance with the board‘s remand order, made a new finding and entered a new award for benefits, and (3) the board should have remanded the matter to a different commissioner for a formal hearing on the issue of whether the claimant was entitled to temporary total disability benefits. Id., 278-89. As to the third point, this court determined that (1) “the board‘s statutory authority over appeals [pursuant to General Statutes
The plaintiff‘s reliance on Fantasia is misplaced. Although Fantasia recognized that the board has statutory authority to remand a matter to a different commissioner for a new hearing, Fantasia does not compel such a remand under the circumstances of this case. In Fantasia, this court concluded that remanding the case for a new hearing before a different commissioner was the proper remedy when the original commissioner had issued inconsistent decisions that had left the board “in the untenable position of retrying the facts, which it may not do . . . .” Id. In the present case, the board did not remand the
The plaintiff also cites Cantoni v. Xerox Corp., 251 Conn. 153, 740 A.2d 796 (1999), in support of his claim. In Cantoni, an employer and its insurer appealed from the board‘s decision reversing a workers’ compensation commissioner‘s dismissal of a workers’ compensation claim with an attendant remand for a new hearing before a different commissioner. Id., 155 and n.1. This court, in an unpublished order, dismissed the appeal for lack of a final judgment. Id. After granting certiorari, our Supreme Court affirmed this court‘s judgment; id., 154; concluding that the board‘s decision “direct[ing] a rehearing to be held before a commissioner other than the one who originally heard the case does not raise a colorable claim of jurisdiction and, therefore, is not an appealable final judgment.” Id., 168.
In affirming this court‘s judgment dismissing the appeal in Cantoni, our Supreme Court rejected an argument by the employer and its insurer that the board needed to have express statutory authority to remand the matter to a different commissioner. Id., 166-67. Our Supreme Court stated that, “[i]n light of the broad authority conferred upon the . . . board by the terms of
In sum, we reject the plaintiff‘s claim that the board improperly denied his motion for articulation or reconsideration, in which he requested an order that the issues remanded by the board in its November 17, 2020 decision be tried de novo before a different commissioner.
The decisions of the Compensation Review Board are affirmed.
In this opinion the other judges concurred.
Notes
As all events underlying this appeal occurred prior to October 1, 2021, we will refer to the workers’ compensation commissioner who approved the defendants’ form 36 in this matter as the commissioner, and all statutory references herein are to the 2021 revision of the statutes.
We note that
Additionally, in his principal appellate brief, the plaintiff cites
