Opinion
In this wоrkers’ compensation action, the defendant insurance carriers (insurers) for the named defendant, Brescóme Barton, Inc. (employer), contest their rights of apportionment, if any, for indemnity benefits paid to the plaintiff, Ronald F. Gill, Jr.
The commissioner found the following facts concerning the plaintiffs injuries, which the insurers do not dispute. The plaintiff sustained an injury to his left knee that arose out of and in the course of his employment on July 2, 1997 (first injury). The plaintiff, employer and Liberty Mutual entered into a voluntary agreement as to the plaintiffs permanent partial disability rating. Attached to the voluntary agreement is an office note dated April 10, 2008, from Norman R. Kaplan, the plaintiffs treating orthopedic surgeon. Kaplan stated in the note that the plaintiffs condition had worsened since 2003 and that he “will definitely need a total knee replacement” within the next three to five years. On April 3, 2002, the plaintiff sustained an injury to his right knee that arose out of and in the course of his employment (second injury). The employer, who was then insured by Chubb, accepted the second injury.
The commissioner found that the plaintiff was scheduled for bilateral knee replacement surgery (surgeries) pursuant to the recommendation of his physician and that the insurеrs agreed that the surgeries were reasonable and medically necessary. Pursuant to an agreement dated March 10, 2010 (2010 agreement), the insurers agreed that Chubb would authorize and administer the surgeries and that Liberty Mutual would reimburse Chubb 50 percent of the surgical costs, incidental expenses and prescriptions related to the surgeries.
The commissioner also found that the plaintiff had accepted, without prejudice, Chubb’s offer to pay him indemnity at the relapse rate of $692.75 for his disability period following the surgeries pursuant to General Statutes § 31-307b, commonly known as the relapse statute. Liberty Mutual, however, contended that it is not responsible for 50 percent of the indemnity and offered to pay 37 percent of Chubb’s bаse rate, or $181.36. Chubb rejected the offer.
A formal hearing was held before the commissioner on January 10, 2011, and the record was closed on February 14, 2011. The commissioner framed the hearing issue as what amount are the insurers, respectively, obligated to pay the plaintiff for periods of total and temporary partial disability following the bilateral knee surgeries, where each surgery concurrently disables the plaintiff.
The commissioner’s findings and award is dated May 19, 2011. In it he found that the plaintiff had reached maximum medical improvement for both injuries, but his conditions had worsened, necessitating that both of his knees be replaced and that § 31-307b applied to each injury. He farther found that the injuries were separate and distinct, and that the plaintiff could have elected to undergo separate surgeries resulting in dupli-cative medical costs. Each knee replacement surgeiy concurrently disabled the plaintiff, who was entitled to indemnity at the relapse rate of $692.75. Chubb was to administer the surgeries and payments. Liberty Mutual was to reimburse Chubb 50 percent of the indemnity it paid the plaintiff in addition to 50 percent of the medical costs agreed upon by the insurers.
Liberty Mutual appealed from the corrected finding and award to the board, primarily claiming that the commissioner erred by requiring Liberty Mutual to reimburse Chubb 50 percent of indemnity paid the plaintiff postsurgery.
In affirming the commissioner’s finding and award, the board reasoned that if the plaintiff had not sustained the second injury, Liberty Mutual would have been obligated to pay the entire cost and indemnity attributable to knee replacement surgery resulting from the first injury. The board noted that double recoveries are disfavored under the Workers’ Compensation Act (act); see Nichols v. Lighthouse Restaurant, Inc.,
The board, however, foresaw a potential for inequity in the award during the period of the plaintiffs recovery. The board found that the commissioner’s award operates only as long as each of the plaintiffs knees renders him totally disabled, but the board recognized that one of the plaintiffs knees may recover its function before the other. At that time, the insurer on the risk for the “healthy knee” will be forced to pay one half of the cost of § 31-307b benefits and the insurer on the risk for the “injured knee” will reap a windfall. The board stated that postsurgical apportionment of disability benefits must be based on contemporaneous medical evidence: “Onсe it is possible to ascertain which body part is responsible for disabling the [plaintiff], the burden of continuing temporary total disability benefits should rest on the [insurer] responsible for [that] body part.” For this reason, the board found that any challenge to the commissioner’s award regarding indemnity apportionment was premature. The board stated that when one of the plaintiffs knees is responsible for disabling the plaintiff, the insurer responsible for that injury may file a motion pursuant to General Statutes § 31-315. The board affirmed the commissioner’s
Our resolution of the claims on appeal begins with the applicable standard of review. “The principles that govern our stаndard of review in workers’ compensation appeals are well established. 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. ... It is well established that [although not dispositive, we accord great weight to the construction given to the workers’ compensation statutes by the commissioner and review board. ... A state agency is not entitled, however, to special deference when its determination of a question of law has not previously been subject to judicial scrutiny. . . . Where [a workers’ compensation] appeal involves an issuе of statutory construction that has not yet been subjected to judicial scrutiny, this court has plenary power to review the administrative decision.” (Internal quotation marks omitted.) Hardt v. Watertown,
I
Liberty Mutual claims that the board failed to adhere to the doctrine of stare decisis when resolving Liberty Mutual’s appeal. Liberty Mutual claims that under appellate decisions concerning General Statutes § 31-299b,
“The doctrine of stare decisis counsels that a court should not overrule its earlier decisions unless the most cogent reasons and inescapable logic require it. . . . Stare decisis is justified because it allows for predictability in the ordering of conduct, it promotes the necessary perception that the law is relatively unchanging, it saves resources and it promotes judicial efficiency.” (Internal quotation marks omitted.) Commission on Human Rights & Opportunities v. Sullivan,
“It is a rare case in which a court will reverse an administrative body because of its failure to apply the doctrine of stare decisis, or because in a particulаr case it has departed from the policy expressed in earlier cases. ... In those cases where reversal is justified, the administrative decision must be palpably arbitrary, unreasonable or discriminatory. . . . Reconsideration of a previously stated policy is a prerogative of administrative agencies, which are ordinarily not restrained under
Liberty Mutual claims that the board failed to follow the precedent established by Hatt v. Burlington Coat Factory, supra,
In Hatt, the issue with respect to § 31-299b was whether the statute “permits apportionment only in cases of repetitive trauma or occupational disease and, therefore, does not provide a basis for apportionment of liability among insurers when the claimant has suffered two separate and distinct injuries . . . .” Hatt v. Burlington Coat Factory, supra,
Here, the commissioner found that the plaintiffs knee injuries were separate
II
The essence of Liberty Mutual’s claims on appeal is that the board (a) failed to adhere to the applicable standard of review because it found facts with regard to the 2010 agreement not found by the commissioner and (b) improperly affirmed the commissioner’s finding and award as a matter of law. We conclude that the facts found by the board were gratuitous and unnecessary to the resolution of the legal issue before it, but that the board’s error, if any, was harmless. See Testone v. C. R. Gibson Co.,
A
Liberty Mutual claims that the board improperly found facts concerning the 2010 agreement that were not found by the commissioner. Assuming, without deciding; see footnote 10 of this opinion; that the board violated the standard of review by finding facts with respect to the 2010 agreement, we conclude that any error was harmless.
We begin our analysis by setting forth the scope of our review on which Liberty Mutual relies.
The following facts are relevant to Liberty Mutual’s claims. In its finding and award, the commissioner found that, pursuant to the 2010 agreement, Chubb was to administer the plaintiffs knee replacement surgeries and pay the surgical costs, incidental expenses, and prescriptions related to the surgery, and that Liberty Mutual would reimburse Chubb 50 percent of those costs. The commissioner specifically found that the 2010 agreement did not address the rate of indemnity benefits to be paid the plaintiff nor the insurers’ respective contributions toward indemnity. During the formal hearing, the commissioner stated that the purpose of the hearing was to determine the respective amount each of the insurers was obligated to pay the plaintiff for indemnity. See footnote 3 of this opinion. The commissioner’s award set the plaintiff a relapse rate at $692.75 per week and directed Liberty Mutual to reimburse Chubb 50 percent of the indemnity in addition to 50 percent of the costs agreed upon by the parties.
In its decision, the board noted the commissioner’s finding that the 2010 agreement did not address the plaintiff’s relapse rate or the contribution each insurer was obligated to pay for indemnity. The board
The board stated that lacunae are present in the act, and, that when issues are presented to it, the board has an obligation to reach a reasoned outcome consistent with the act. It found that the commissioner’s finding and award simply implemented the expressed intent of the parties’ 2010 agreement. Although the 2010 agreement does not define surgical costs or incidental expenses, in this instance, the board found that incidental expenses would include the unavoidable expense of § 31-307b benefits due the plaintiff for the period of temporаry total disability he would experience following his surgeries. It is these findings to which Liberty Mutual takes exception on appeal.
Our Supreme Court has noted that “[o]ver the course of the last 100 years, [it] frequently has interpreted the provisions of our workers’ compensation statutory scheme by looking at the purpose and the legislative history of the act.” Marandino v. Prometheus Pharmacy,
On the basis of this analysis, we conclude that the commissioner’s findings are sufficient to support his award. If the board’s findings with respect to the insurers’ intent regarding incidental expenses deviated from the standard of review, we conclude that any error was harmless. See State v. Burney,
B
Liberty Mutual also claims that thе board’s decision is not supported by competent evidence and that the order to reimburse Chubb 50 percent of the indemnity it pays to the plaintiff is erroneous as a matter of law. We disagree.
The commissioner found that neither insurer disputed that the plaintiffs need for bilateral knee surgery was reasonable and medically necessary. He also found that knee replacement surgery for either knee would result in a period of disability. Moreover, the plaintiffs “decision to undergo both knee replacements simultaneously benefits [him] in that he has only one period of recovery and also benefits both insurance carriers in that they are
In deciding the claim, we are mindful of the act’s remedial purpose. “[T]he act indisputably is a remedial statute that should be construed generously to accomplish its purpose. . . . The humanitarian and remedial purposes of the act counsel against an overly narrow construction that unduly limits eligibility for workers’ compensation. . . . Accordingly, [i]n construing workers’ compensation law, we must resolve statutory ambiguities or lacunae in a manner that will further the remedial purpose of the act. . . . [T]he purposes of the act itself are best served by allowing the remedial legislation a reasonable sphere of operation considering those purposes.” (Citations omitted; internal quotation marks omitted.) Pizzuto v. Commissioner of Mental Retardation,
On appeal to this court, Liberty Mutual contends that the commissioner’s finding and award is erroneous as a matter of law because enforcement of the 2010 agreement pursuant to General Statutes § 31-303 was not identified in the notice of the formal hearing as an issue to be resolved.
Liberty Mutual argues that Hatt v. Burlington Coat Factory, supra,
We also disagree with Liberty Mutual’s claim that the board’s decision cites no law to support it. The board relied upon § 31-278, which provides in relevant part that “[e]ach commissioner . . . shall have all powers necessary to enable him to perform the duties imposed upon him by the provisions of’ the act. “The purpose of the [act] is to compensate the worker for injuries arising out of and in the course of employment, without regard to fault, by imposing a form of strict liability on the employer .... [The act] compromise^] an employee’s right to a common law tort action for work related injuries in return for relatively quick and certain compensation. . . . The act indisputably is a remedial statute that should be construed generously to accomplish its purpose. . . . The humanitarian and remedial purposes of the act counsel against an overly narrow construction that unduly limits eligibility for workers’ compensation. . . . Further, our Supreme Court has recognized that the state of Connecticut has an interest in compensating injured employees to the fullest extent possible . . . .” (Internal quotation marks omitted.) Jones v. Connecticut Children’s Medical Center Faculty Practice Plan,
We agree with the reasoning of the commissioner and the board that the remedial purposes of the act are fostered by the plaintiffs undergoing bilateral knee replacement surgery with one period of recovery. The act is to provide for “relatively quick and certain compensation.” Mingachos v. CBS, Inc., supra,
The decision of the workers’ compensation review board is affirmed.
In this opinion the other judges concurred.
Notes
Neither the plaintiff nor the employer is a party to this appeal.
On appeal, Liberty Mutual has not contested the commissioner’s finding and award as to the plaintiffs relapse rate.
In its brief on appeal, Liberty Mutual cites a colloquy among the commissioner and counsel for the insurers during the formal hearing. The relevant portions of the transcript reveal the following exchange:
“[Commissioner]: And there is no dispute as to the medical necessity or the reasonableness of the surgeries, correct?
“[Counsel for Liberty Mutual]: Correct, commissioner, I believe there is even an agreement in your file. . . .
“[Commissioner]: And that will be administered by the last carrier, which is Chubb, correct . . . ?
“[Counsel for Chubb]: Yes, commissioner, pursuant to an agreement entered into by the parties at an informal hearing with a writing on March 10, 2010. Chubb will administer the bilateral total knee replacements and seek reimbursement from the Liberty for 50 percent of all expenses related to the surgery and prescription meds.
“[Commissioner]: My understanding is the issue had to do with the rate for which [the plaintiff] will be paid. I know Chubb is, will do the relapse rate of, and you have the amount?
“[Counsel for Chubb]: Let me just, for the record, the argument of Chubb is that as each one of these surgeries are from separate and distinct injuries and each one of these surgeries in and of itself could make the [plaintiff] temporarily totally disabled medically, that any other law other than a 50/ 50 apportionment between Liberty and the Chubb is inappropriate because they aren’t, they aren’t melding together to make the [plaintiff] temporarily totally disabled, the surgeries aren’t melding together, they are separate and distinct, and each one could make the claimant temporarily totally disabled. ... We would seek 50 percent of the temporary total disability payments from the Chubb as it would pertain to [the plaintiffs] recuperative period. ... If the commission should so find that the relapse rate is the appropriate rate in this case, I would ask that that relapse rate of $692.75 be apportioned 50/50 between the Chubb and Liberty. Obviously, if the commission chooses no relapse rate and reverts to the prior temporary total disability rate ... I would argue 50 percent of whatever rate is chosen by the commissioner. . . .
* * *
“[Commissioner]: Okay. So the only issue I need to sort out is what, if any, amount Liberty will have to pay.
* * *
“[Commissioner]: You are going to have the surgery, [plaintiff], and you’re going to have it at the relapse rate that [Chubb’s counsel] described. The issue of who is to pay what, Chubb is going to pay for the surgery and authorize the surgery, Chubb is going to administer the claim, and I will determine what amount if any liberty has to pay back Chubb in regards to the weekly paycheck, the indemnity portion but not the medical portion, they already worked out, okay?”
The plaintiffhad bilateral knee replacement surgery on February 24,2011.
Liberty Mutual filed a motion to correct the finding and award. The commissioner accepted two corrections that do not affect the issues on appeal.
Liberty Mutual gave the following reasons for its appeal to the board: (1) the commissioner erred in ordering it to reimburse Chubb 50 percent of the indemnity paid to the plaintiff postsurgery, (2) the finding and award fails to cite any statute or case law that provides a legal basis for reimbursement, (3) there is no legal basis for the reimbursement ordered, (4) Chubb’s reliance on common law apportionment andMund v. Farmers’ Cooperative, Inc.,
General Statutes § 31-278 provides in relevant part: “Each commissioner shall . . . have the power to certify official acts and shall have all powers necessary to enable him to perform the duties imposed upon him by the provisions of this chapter. . . .”
General Statutes § 31-299b provides in relevant part: “If an employee suffers an injury or disease for which compensation is found by the commissioner to be payable according to the provisions of this chapter, the employer who last employed the claimant prior to the filing of the claim, or the employer’s insurer, shall be initially liable for the payment of such compensation. The commissioner shall, within a reasonable period of time after issuing an award, on the basis of the record of the hearing, determine whether prior employers, or their insurers, are liable for a portion of such compensation and the extent of their liability. If prior employers are found to be so liable, the commissioner shall order such employers or their insurers to reimburse the initially liable employer or insurer according to the proportion of their liability. • • •”
The board concluded that none of the following cases relied upon by the parties controlled the issue in this case. We agree.
In Mages v. Alfred Brown, Inc., supra,
The case of Marroquin v. F. Monarca Masonry, supra,
Malz v. State/University of Connecticut Health Center, supra, No. 4701 CRB-6-03-07, also is distinguishable. In that case, Stephania Malz suffered an injury to her lumbar spine and cervical spine in 1990. She suffered a second injury to her cervical spine in 1994. The commissioner concluded that the insurance carrier for the 1994 injury was not entitled to apportionment pursuant to Hatt v. Burlington Coat Factory, supra,
Before the board, Chubb relied on Mund v. Farmers’ Cooperative, Inc., supra,
We note that the general principles governing the construction of a contract are well established. “If a contract is unambiguous within its four comers, intent of the parties is a question of law requiring plenary review. . . . When the language of a contract is ambiguous, the determination of the parties’ intent is a question of fact, and the trial court’s interpretation is subject to reversal on appeal only if it is clearly erroneous.” (Internal quotation marks omitted.) Sagalyn v. Pederson,
The formal hearing notice listed three issues: “§ 31-299b—Apportion-ment of Liability; § 31-307b—Recurrence of Prior Injury; [General Statutes] § 31-310—Compensate Rate/Average Weekly Wage.”
The corollary to this acknowledgement is that Liberty Mutual is liable to pay the plaintiff indemnity for the disability resulting from knee replacement surgery due to the first injury whether it is done separately or in combination with the second injury knee replacement surgery. If both Liberty Mutual and Chubb paid the plaintiff temporary total disability for the same period of time, the plaintiff would receive a double recovery. The board properly noted that double recoveries under the act are disfavored. See Enquist v. General Datacom,
