61 Conn. App. 9 | Conn. App. Ct. | 2000
The defendant, the city of Bridgeport (city),
The plaintiff sought reinstatement of his dental, vision and life insurance coverage pursuant to § 31-284b. He claimed that as long as he received benefits under § 7-433c, he was entitled to dental and vision benefits, and life insurance at the city’s expense. The city contended that the plaintiff no longer was entitled to those benefits under § 31-284b because he no longer was receiving a weekly indemnity benefit intended to compensate him for disability, wage loss or lost earning capacity. The commissioner found that the plaintiff
As a threshold matter, we set forth the standard of review applicable to workers’ compensation appeals. “The principles that govern our standard 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. . . . Besade v. Interstate Security Services, 212 Conn. 441, 449, 562 A.2d 1086 (1989). . . . 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. . . . Duni v. United Technologies Corp., 239 Conn. 19, 24-25, 682 A.2d 99 (1996); Davis v. Norwich, 232 Conn. 311, 317, 654 A.2d 1221 (1995). Where ... [a workers’ compensation] appeal involves an issue of statutory construction that has not yet been subjected to judicial scrutiny, this court has plenary power to review the administrative decision. ” (Citations omitted; internal quotation marks omitted.) Dowling v. Slotnik, 244 Conn. 781, 797-98, 712 A.2d 396, cert. denied sub nom. Slotnik v. Considine, 525 U.S. 1017, 119 S. Ct. 542, 142 L. Ed. 2d 451 (1998).
The interpretation of § 31-284b is a matter of statutory construction. “Statutory construction is a question of law and therefore our review is plenary. . . . [0]ur fundamental objective is to ascertain and give effect to the apparent intent of the legislature. ... In seeking to discern that intent, we look to the words of the
In this appeal, the city argues that § 31-284b does not require an employer to provide health insurance coverage to an employee receiving coverage for medical care and prescriptions after indemnity payments have ceased, and that the board therefore improperly affirmed the commissioner’s conclusion that the city was obligated to provide health insurance coverage to the plaintiff and his family. We agree.
General Statutes (Rev. to 1991) § 31-284b (a), which was in effect at the time of the plaintiffs injury, provides in relevant part: “In order to maintain, as nearly as possible, the income of employees who suffer employment-related injuries, any employer . . . who provides accident and health insurance or life insurance coverage for any employee . . . shall provide to such employee equivalent insurance coverage . . . while the employee is eligible to receive or is receiving workers’ compensation payments pursuant to this chapter, or while the employee is receiving wages under a provision for sick leave payments for time lost due to an employment-related injury.” (Emphasis added.)
The board, in affirming the decision of the commissioner, held that the commissioner correctly ruled “that although the claimant was not currently receiving indemnity benefits, the medical bills being paid by the city constituted compensation benefits. Thus, the claimant was receiving or eligible to receive compensation payments within the meaning of § 31-284b.” (Emphasis added.) In so concluding, the board relied on a definition of compensation from General Statutes § 31-293 because neither § 31-284b nor General Statutes (Rev. to 1991) § 31-275, the general definitional section for the Workers’ Compensation Act, contained such a definition. The board stated that “ja]t the time of the claimant’s injuiy, § 31-293 stated that [t]he word compensation, as used in this section, shall be construed to include not only incapacity payments to an injured employee and payments to the dependents of a deceased employee, but also sums paid out for surgical, medical and hospital services to an injured employee . . . .” (Emphasis added; internal quotation marks omitted.) The board recognized that Public Acts 1991, No. 91-32 (P.A. 91-32), had amended §31-275
The city argues that the board’s reliance on the definition of “compensation” contained in § 31-293, the third party lien statute, to define “compensation payments” in § 31-284b is improper. We agree. Section 31-293 provides that “the word ‘compensation,’ as used in this section, shall be construed to include . . . sums paid out for surgical, medical and hospital services . . . .” (Emphasis added.) By the words of the statute themselves, that definition of “compensation” applies only to § 31-293 and not to § 31-284b. Furthermore, § 31-275, as amended by P.A. 91-32 to include a definition of compensation similar to that previously contained in § 31-293, does not apply to this case. The claimant’s substantive right to benefits is governed by the law as it existed on the date of his injury. Iacomacci v. Trumbull, 209 Conn. 219, 222, 550 A.2d 640 (1988); see Civardi v. Norwich, 231 Conn. 287, 293 n.8, 649 A.2d 523 (1994) (applying version of § 31-275 at time of injury rather than using amended version to define “compensation”).
Construing the statutes as they existed at the time of the plaintiffs injury, we conclude that the term “compensation payments” as used in § 31-284b (a) does not include payments for medical care after the indemnity compensation period has ceased. The statute mandates that an employer is required to continue insurance benefits only while an employee is receiving “compensation
The plaintiff argues that the board’s decision should be affirmed because the board sought to further the underlying purpose of the Workers’ Compensation Act by enforcing the express objective of § 31-284b (a) that seeks to “maintain, as nearly as possible, the income of employees who suffer employment-related injuries . . . .” General Statutes (Rev. to 1991) § 31-275 (14) defines the term “income” as “all forms of remuneration to an individual from his employment, including wages, accident and health insurance coverage . . . .” In addition, the plaintiff, quoting Misenti v. International Silver Co., 215 Conn. 206, 210, 575 A.2d 690 (1990), argues that“ ‘[bjecause the Workers’ Compensation Act is a remedial statute, this court should not impose limitations on the benefits provided for a disabled worker that the statute itself does not clearly specify.’ ” In Carriero v. Naugatuck, 243 Conn. 747, 707 A.2d 706 (1998), the plaintiff made a similar claim. The court in that case stated: “[T]he plaintiff argues that our determination of the present case should be controlled by application of the interpretive axiom that, in order to facilitate the accomplishment of the objectives of remedial legisla
In Crocetto v. Lynn Development Corp., 223 Conn. 376, 612 A.2d 1212 (1992), the issue was whether a subsistence allowance provided to a plaintiff who had exhausted his disability benefits and subsequently had his health insurance coverage terminated, constituted “workers’ compensation payments” within the meaning of § 31-284b. The Supreme Court determined that the subsistence payments did not qualify as workers’ compensation payments under § 31-284b. Id., 381. As such, they could not be used to support an award of § 31-284b benefits. The court in Crocetto viewed the case in the light of a need for the plaintiff to be receiving pay
We conclude, therefore, that the board incorrectly interpreted § 31-284b as requiring the city to continue insurance coverage for the plaintiff and his family once the plaintiffs workers’ compensation payments ended.
The decision of the workers’ compensation review board is reversed and the case is remanded to the board with direction to reverse the decision of the commissioner.
In this opinion the other judges concurred.
The Connecticut department of administrative services, the Connecticut conference of municipalities and the Connecticut interlocal risk management agency filed briefs in support of the city.
General Statutes (Rev. to 1991) § 31-284b (a) provides: “In order to maintain, as nearly as possible, the income of employees who suffer employment-related injuries, any employer, as defined in section 31-275, who provides accident and health insurance or life insurance coverage for any employee or makes payments or contributions at the regular hourly or weekly rate for full-time employees to an employee welfare fund, as defined in section 31-53, shall provide to such employee equivalent insurance coverage or welfare fund payments or contributions while the employee is eligible to receive or is receiving workers’ compensation payments pursuant to this chapter, or while the employee is receiving wages under a provision for sick leave payments for time lost due to an employment-related injury.”
General Statutes § 7-433c (a) provides: “Notwithstanding any provision of chapter 568 or any other general statute, charter, special act or ordinance to the contrary, in the event a uniformed member of a paid municipal fire department or a regular member of a paid municipal police department who successfully passed a physical examination on entry into such service, which examination failed to reveal any evidence of hypertension or heart disease, suffers either off duty or on duty any condition or impairment of health caused by hypertension or heart disease resulting in his death or his temporary or permanent, total or partial disability, he or his dependents, as the case may be, shall receive from his municipal employer compensation and medical care in the same amount and the same manner as that provided under chapter 568 if such death or disability was caused by a personal injury which arose out of and in the course of his employment and was suffered in the line of duty and within the scope of his employment, and from the municipal or state retirement system under which he is covered, he or his dependents, as the case may be, shall receive the same retirement or survivor benefits which would be paid under said system if such death or disability was caused by a personal injury which arose out of and in the course of his employment, and was suffered in the line of duty and within the scope of his employment. If successful passage of such a physical examination was, at the time of his employment, required as a condition for such employ
Section 31-284b (a) was amended by Public Acts 1991, No. 91-32, to condition the employer’s obligation to provide insurance coverage on the employee’s receipt of “compensation pursuant to this chapter” as opposed to “workers’ compensation payments pursuant to this chapter.”
Subsequent to its amendment in 1991, General Statutes § 31-275 (4) provides: “ ‘Compensation’ means benefits or payments mandated by the provisions of this chapter, including, but not limited to, indemnity, medical and surgical aid or hospital and nursing service required under section 31-294d and any type of payment for disability, whether for total or partial disability of a permanent or temporary nature, death benefit, funeral expense, payments made under the provisions of section 31-284b, 31-293a or 31-310, or any adjustment in benefits or payments required by this chapter. ”
Although both parties maintain that the wording of General Statutes § 31-284b is clear and that no legislative history is necessary to clarify its meaning, the city has cited to several remarks of legislators relating to § 31-284b that it claims support its position. The plaintiff argues that the cited remarks are insufficient to support the city’s claim. After reviewing the legislative history, we find that it does not help us to define clearly the term “compensation payments” as it is used in § 31-284b. While it is correct that the portions of legislative history referred to by the city suggest that continuing insurance coverage of an injured employee by his or her employer is for an employee who is “drawing workmen’s compensation pay or sick pay,” “while they are incapacitated” or “while they’re out on workmen’s compensation,” there are no comments directed to the situation presented in this case where indemnity payments have ceased. The focus of the legislative comments are on the period when the employee is receiving regular compensation payments.
