Opinion
In
Harpaz
v.
Laidlaw Transit, Inc.,
The commissioner’s decision and the record reveal the following undisputed facts and procedural histoiy. The plaintiff commenced employment with the defendant on January 3, 2002. On January 16, 2003, the workers’ compensation commission (commission) received a notice of claim from the plaintiff alleging that she had sustained an injury on January 17, 2002, arising out of and in the course of her employment. On January 21, 2003, the defendant received a written notice of claim alleging that, on January 17, 2002, the plaintiff had sustained an injury to her “lower back/ruptured disk” when she fell on a wet floor at the defendant’s corporate office. The defendant filed a notice contesting liability, which the commission received on February 24, 2003.
At the beginning of the formal hearing on her claim, held on October 21, 2005, 3 the plaintiff asserted that she intended to file a notice to preclude the defendant from contesting liability because its notice to contest her claim had been filed beyond the twenty-eight day period prescribed under § 31-294c (b). See footnote 1 of this opinion. Without objection from the plaintiff, the cоmmissioner proceeded with the hearing. The plaintiff was the only witness to testify, subject to the defendant’s cross-examination. The only exhibits put into evidence were those submitted by the plaintiff, principal among those being medical records and bills, including hospital bills for a December, 2002 back surgery.
On November 14, 2005, the plaintiff filed a motion to preclude the defendant from contesting liability. That day, the commissioner held a “[p]re-[f]ormal” hearing on the motion and the defendant’s objection thereto and added the issue of preclusion to those previously raised for consideration at the formal hearing. The defendant thereafter filed a fifteen page brief with the commission contending that the plaintiffs claim should be denied for several reasons, including that “[f]actually, the [plaintiff] has not proven that her back problems for which she ultimately underwent surgery arose out of and in the course of her employment,” and “the [plaintiff] has not established a prima facie medical case” to establish the causal link between her employment and her injury.
On December 19, 2005, the plaintiff submitted a motion to add additional evidence to the record that she had received that day, specifically, a letter from Inarn U. Kureshi, the neurosurgeon who had performed the plaintiffs back surgery. Kureshi opined in the letter that, after her December 3, 2002 lumbar discectomy, the plaintiff had a 6.67 percent permanent partial disability of the spine and that, within reasonable medical probability, this injury had been caused by the January 17, 2002 fall at work.
4
Over the defendant’s objection, the commissioner thereafter permitted
In her decision filed on April 3, 2006, the commissioner framed the case as raising three issues: (1) “Whether the [plaintiffs] motion to preclude under § 31-294c (b) should be granted”; (2) “Whether the [plaintiffs] January 17, 2002 back injury arose out of and in the course of her employment under [General Statutes] § 31-275”; and (3) “If found compensable, what benefits are due to the [plaintiff]?” The commissioner concluded that the motion to preclude should be granted and, therefore, that the plaintiffs January 17, 2002 back claim was compensable. The commissioner concluded, however, that the plaintiffs claim for reimbursement of medical bills and for permanent partial disability benefits should be denied. The commissioner found the plaintiffs testimony not to be credible or persuasive with respect to the extent of her disability. The commissioner similarly found Kureshi’s letter “[not] to be credible or persuasive relating [the plaintiffs] January, 2002 injury to her need for medical care and surgery or the 6.67 [percent] permanent partial disability of the back.”
In support of her decision, the commissioner cited the following evidence. The plaintiff did not fill out an accident report or file a notice of injury regarding the January, 2002 incident. The plaintiff was not sore on the day of the fall, but felt some soreness and noticed bruising on the back side of her hip and lower thigh the following day. She did not experience any problems as a result of the fall until the following month. The plaintiff thereafter sought treatment from her general practitioner for complaints of fatigue and muscle soreness, but never complained of back problems. Her general practitioner’s reports from February, March and April of 2002, made no reference to a work incident. On July 26, 2002, the plaintiff received a magnetic resonance imaging (MRI) that showed disc protrusions at multiple levels. A November 27, 2002 report from Hartford Hospital indicated that the plaintiff had alleged ongoing lower back pain since July, 2002, and did not indicate any reference to a work injury. 5 In reliance on the foregoing evidence, the commissioner denied the plaintiffs claim for compensation for medical care and disability.
The plaintiff appealed from the commissioner’s decision to the board, relying on the Appellate Court’s hold
ing
in DeAlmeida
v.
M.C.M. Stamping Corp.,
Pursuant to General Statutes § 31-301b, the plaintiff appealed from the board’s decision to the Appellate Court. While that аppeal was pending, this court issued its decision in
Harpaz
v.
Laidlaw Transit, Inc.,
supra,
In light of that decision, in the present case, the Appellate Court asked the parties to file supplemental briefs on the impact of
Harpaz
on the issues raised on appeal. After hearing oral argument and reviewing the supplemental briefs, the Appellate Court requested that the appeal be transferred to this court, pursuant to Practice
Book § 65-2.
6
We granted the Appellate
In their supplemental briefs, the parties take different positions as to an employer’s role in the proceedings after the commissioner grants a motion to preсlude. The plaintiff contends that, although she was required to prove her case, the defendant was precluded, by virtue of the conclusive presumption, from cross-examining witnesses, arguing against coverage and filing briefs in opposition to her claim. 7 The defendant takes the position that it was precluded only from putting forth its own expert and evidence, not from challenging the plaintiffs proof. 8 We conclude that, once a motion to preclude is granted, the only role an employer plays is to decide whether to stipulate to the compensation claimed. If the employer does not so stipulate, the claimant proceeds with her case, subject to examination by the commissioner.
In determining the meaning and effect of preclusion under § 31-294c (b), we note that we do not afford deference to an agency’s interpretation of a statute when, as in the present case, the construction of a statute previously has not been subjected to “judicial scrutiny” or to “a governmental agency’s time-tested interpretation . . . .” (Internal quotation marks omitted.)
Harpaz
v.
Laidlaw Transit, Inc.,
supra,
“When construing a statute, [o]ur fundamental objective is to ascertain and give effect to the appаrent intent of the legislature. ... In seeking to determine that meaning, General Statutes § l-2z directs us first to consider the text of the statute itself and its relationship to other statutes. If, after examining such text and considering such relationship, the meaning of such text is plain and unambiguous and does not yield absurd or unworkable results, extratextual evidence of the meaning of the statute shall not be considered. . . . When a statute is not plain and unambiguous, we also look for interpretive guidance
Neither party has contended that § 31-294c (b) is plain and unambiguous as to the question presented in this appeal. We agree. As the discussion that follows indicates, although the statute provides some guidance, it does not provide specific direction on the employer’s role once a motion to preclude has been granted. Therefore, we are not limited to the text of the statute to resolve the matter before us.
Turning first to that text, § 31-294c (b) provides in relevant part that “an employer who fails to contest liability for an alleged injury or death on or before the twenty-eighth day after receiving a written notice of claim and who fails to commence payment for the alleged injury or death on or before such twenty-eighth day, shall be conclusively presumed to have accepted the compensability of the alleged injury or death.” We have referred to this statute, or its predecessor, as setting forth a “conclusive presumption.”
Harpaz
v.
Laid-law Transit, Inc.,
supra,
In light of such settled principles, we would have expected the legislature not to have used such unequivocal language or, at a minimum, to have added some qualifying language to the conclusive presumption in § 31-294c (b) had it intended to permit employers subject to this sanctiоn to have some adversarial role in the proceedings. Compare General Statutes § 52-86 (c) (“[a] creditor appearing pursuant to the provisions of this section shall not be permitted to plead in abatement, to plead or give in evidence the statute of limitations, to plead that the contract was not in writing according to the requirements of the statute, or to plead any other statutory defense consistent with the justice of the plaintiffs
Appellate case law addressing the question of whether the granting of a motion to preclude constitutes a final judgment indicates that the employer does have a role to play following such a decision, albeit a rather limited one. In considering the final judgment question, the Appellate Court has noted: “The test for determining whether the defendants have appealed from a final judgment turns on the scope of the proceedings on remand.
Szudora
v.
Fairfield,
Two possible reasons come to mind as to why the employer should be able to participate in the proceeding to challenge the plaintiffs proof, both of which we ultimately reject. First, it could be argued that the employer’s participation would be consistent with the legislature’s goal to ensure payment of “ ‘bona fide claims.’ ”
Harpaz
v.
Laidlaw Transit, Inc.,
supra,
The plaintiff conceded at oral argument to this court that preclusion would not limit the commissioner’s ability to test her proof. We agree. Indeed, § 31-294c (b) and the workers’ compensation scheme generally indicate that the conclusive presumption under § 31-294c does not operate to bar
any
inquiry on the claim, but, rather, only the
employer’s
ability to do so.
10
By its own terms, § 31-294c (b)
The second possible reason to allow the defendant to test the plaintiffs proof is that, if the commissioner is allowed to examine the plaintiffs proof, there would be no meaningfully different effect than if the employer were to assume the same role. In other words, if the commissioner is not required to be a passive recipient of evidence submitted by a claimant, the employer should not be required to be a passive spectator at the evidentiary hearing. Although this argument has some superficial appeal, for the reasons previously set forth, there is no textual support for this construction of § 31-294c (b), and indeed the text suggests otherwise. Given that the policy concerns on both sides—ensuring that bona fide claims are paid and providing a strong incentive for employers either to commence payment or to provide timely notice of the basis for a contest to payment—are effectuated by a rule under which the commissioner holds a claimant to her proof without unsolicited assistance from the employer, 11 we reject this reason as well.
Our decision in this case is largely guided by our previous interpretation of § 31-294c (b)
In the present case, the defendant cross-examined the plaintiff and submitted a brief opposing her right to the compensation claimed. Although the commissioner cited to testimony adduced through direct examination of the plaintiff and exhibits submitted by the plaintiff in support of the vast majority of the factual findings, we are not convinced that the defendant’s challenges to the plaintiffs case had no effeсt on the commissioner’s decision. Therefore, the plaintiff is entitled to a new proceeding before a different commissioner.
The decision of the board is reversed and the case is remanded to the board with direction to reverse the commissioner’s decision and to remand the case to a new commissioner for further proceedings.
In this opinion the other justices concurred.
Notes
General Statutes § 31-294c (b) provides: “Whenever liability to pay compensation is contested by the employer, he shall file with the commissioner, on or before the twenty-eighth day after he has received a written notice of claim, a notice in accord with a form prescribed by the chairman of the Workers’ Compensation Commission stating that the right to compensation is contested, the name of the claimant, the name of the employer, the date of the alleged injury or death and the specific grounds on which the right to compensation is contested. The employer shall send a copy of the notice to the employee in accordance with section 31-321. If the employer or his legal representative fails to file the notice contesting liability on or before 1he twenty-eighth day after he has received the written notice of claim, the employer shall commence payment of compensation for such injury or death on or before the twenty-eighth day after he has received the written notice of claim, but the employer may contest the employee’s right to receive compensation on any grounds or the extent of his disability within one year from tlie receipt of the written notice of claim, provided the employer shall not be required to commence payment of compensation when the written notice of claim has not been properly served in accordance with section 31-321 or when the written notice of claim fails to include a warning that (1) the employer, if he has commenced payment for the alleged injury or death on or before the twenty-eighth day after receiving a written notice of claim, shall be precluded from contesting liability unless a notice contesting liability is filed within one year from the receipt of the written notice of claim, and (2) the employer shall be conclusively presumed to have accepted the compensability of the alleged injury or death unless the employer either files a notice contesting liability on or before the twenty-eighth day after receiving a written notice of claim or commences payment for the alleged iryury or death on or before such twenty-eighth day. An employer shall be entitled, if he prevails, to reimbursement from the claimant of any compensation paid by the employer on and after the date the commissioner receives written notice from the employer or his legal representative, in accordance with the form prescribed by the chairman of the Workers’ Compensation Commission, stating that the right to compensation is contested. Notwithstanding the provisions of this subsection, an employer who fails to contest liability for an alleged injury or death on or before the twenty-eighth day after receiving a written notice of claim and who fails to commence payment for the alleged injury or death on or before such twenty-eighth day, shall be conclusively presumed to have accepted the compensability of the alleged injury or death.”
We note that although § 31-294c was amended after the proceedings in this case by the addition of subsection (d), the remainder of the statute was unchanged. References herein to the statute are to the current revision.
Veridiem, Inc.’s insurer, OneBeacon Insurance, also is a defendant in this case. For convenience, we refer to Veridiem, Inc., as the defendant.
There is no evidence in the record to explain the one year and eight month lapse of time between the date the commission received notice of the defendant’s intent to contest the plaintiffs claim and the hearing on her claim. See General Statutes § 31-297 (setting forth time period for hearing of claims).
Kureshi’s letter stated in relevant part: “[The plaintiff] has been a patient of minе since 2002. She first saw Dr. Arnold Rossi, my partner, in August of 2002 after she suffered an injury on January 17, 2002. The [plaintiff] fell at work and as a result of that fall she developed severe back and leg pain. She was initially evaluated by Dr. Rossi and then by Dr. [John] Grady-Benson. The [plaintiff] was found to have a lumbar radiculopathy secondary to a disc herniation and some mild adductor hip pain, which was treated effectively by Dr. Grady-Benson.” After setting forth the progressive course of the plaintiffs medical treatment, which ultimately led to back surgery, Kureshi stated: “After reviewing her records, it is clear to me that [the plaintiff] suffered this injury as [a] direct result of her injury of her fall that she sustained [on] January 17, 2002 with reasonable medical probability.”
The plaintiff did file a motion to correct this finding, for reasons that are not evident to us upon review of her motion, which the commissioner denied. The plaintiff did not challenge that finding on appeal.
Practice Book § 65-2 provides in relevant part: “If, at any time before the final determination of an appeal, the appellate court is of the opinion that the appeal is appropriate for supreme court review, the appellate court may file a brief statement of the reasons why transfer is appropriate. The supreme court shall treat the statement as a motion to transfer and shall promptly decide whether to transfer the case to itself.”
We note that, in her original appellate brief, the plaintiff had claimed that the burden was not on her to establish that her disability was linked to the compensable injury. In light of our intervening decision in
Harpaz
v.
Laidlaw Transit, Inc.,
supra,
The defendant also contended in its supplemental brief, and later at oral argument to this court, that: (1) public policy concerns, namely, malfeasance by claimants seeking compensation for injuries not proximately caused by their employment, favor revisiting the holding in Harpaz-, and (2) our reasoning in Harpaz was flawed because, inter alia, we failed to comрly with General Statutes § l-2z by ignoring the plain meaning of the text, as manifested by the deletion of certain text as a result of the 1993 amendment to § 31-294c (b). We reject the defendant’s invitation. The defendant gives an unduly expansive interpretation to Harpaz as barring an employer from contesting any subsequent claim for additional compensation. We also note that the defendant’s arguments as to § l-2z misconstrues that statute, which limits courts to the current text of the statute to determine whether the meaning is unambiguous and only permits resort to extratextual sources, such as amendments to the statute, after there is a determination that the text is ambiguous.
We note, however, that in
Guinan
v.
Direct Marketing Assn., Inc.,
We recognize that an Appellate Court case and dicta in two cases from this court relying on that case have indicated that, once the conclusive presumption attaches, no further inquiry is permitted, even by the
commissioner.
See
Bush
v.
Quality Bakers of America,
We acknowledge the possibility that there may be circumstances in which the commissioner properly may seek records or information from the employer to aid in the adjudication of a claim and the calculation of benefits.
