BAIGERT v. FOSDICK CORPORATION, 1784 CRB-8-93-7 (1-20-95)


DAVID E. BAIGERT, CLAIMANT and VETERANS MEMORIAL MEDICAL CENTER, MEDICAL PROVIDER, APPELLANT v. FOSDICK CORPORATION, EMPLOYER and WAUSAU INSURANCE, INSURER, RESPONDENTS-APPELLEES CARLOS FIGUEROA, CLAIMANT and VETERANS MEMORIAL MEDICAL CENTER, MEDICAL PROVIDER, APPELLANT v. C S BALL BEARING, EMPLOYER and CBIA COMPENSATION SERVICES INC., INSURER, RESPONDENTS-APPELLEES WILLIS CUSHMAN, CLAIMANT and VETERANS MEMORIAL MEDICAL CENTER, MEDICAL PROVIDER, APPELLANT v. CONNECTICUT CALENDAR COMPANY, EMPLOYER and HARTFORD INSURANCE GROUP, INSURER, RESPONDENTS-APPELLEES NEOMI ECHOLS, CLAIMANT and VETERANS MEMORIAL MEDICAL CENTER, MEDICAL PROVIDER, APPELLANT v. STATE OF CONNECTICUT/LONG LANE SCHOOL, EMPLOYER, SELF-INSURED and ALEXSIS, INC., ADMINISTRATOR, RESPONDENTS-APPELLEES KEVIN FITZGERALD, CLAIMANT and VETERANS MEMORIAL MEDICAL CENTER, MEDICAL PROVIDER, APPELLANT v. STATE OF CONNECTICUT/DMR, EMPLOYER, SELF-INSURED and ALEXSIS, INC., ADMINISTRATOR, RESPONDENTS-APPELLEES EDDIE FLUKER, CLAIMANT and VETERANS MEMORIAL MEDICAL CENTER, MEDICAL PROVIDER, APPELLANT v. FIDERIO SONS, EMPLOYER and NATIONAL GRANGE MUTUAL INSURANCE, INSURER, RESPONDENTS-APPELLEES TIMOTHY FULMER, CLAIMANT and VETERANS MEMORIAL MEDICAL CENTER, MEDICAL PROVIDER, APPELLANT v. LAWN PEOPLE, EMPLOYER and HARTFORD INSURANCE GROUP, INSURER, RESPONDENTS-APPELLEES EDWIN GONZALEZ, CLAIMANT and VETERANS MEMORIAL MEDICAL CENTER, MEDICAL PROVIDER, APPELLANT v. HOLLYWOOD’S, EMPLOYER and FIREMEN’S FUND, INSURER, RESPONDENTS-APPELLEES BARBARA GRAHAM, CLAIMANT and VETERANS MEMORIAL MEDICAL CENTER, MEDICAL PROVIDER, APPELLANT v. STATE OF CONNECTICUT/ALTOBELLO, EMPLOYER, SELF-INSURED and ALEXSIS, INC., ADMINISTRATOR, RESPONDENTS-APPELLEES EDWARD HENDERSON, CLAIMANT and VETERANS MEMORIAL MEDICAL CENTER, MEDICAL PROVIDER, APPELLANT v. STATE OF CONNECTICUT/RIVERVIEW HOSPITAL, EMPLOYER SELF-INSURED and ALEXSIS, INC., ADMINISTRATOR, RESPONDENTS-APPELLEES GILBERTO HERNANDEZ, CLAIMANT and VETERANS MEMORIAL MEDICAL CENTER, MEDICAL PROVIDER, APPELLANT v. DAYS INN, EMPLOYER and HARTFORD INSURANCE GROUP, INSURER, RESPONDENTS-APPELLEES THOMAS HICKS, CLAIMANT and VETERANS MEMORIAL MEDICAL CENTER, MEDICAL PROVIDER, APPELLANT v. NISSEN, EMPLOYER and LIBERTY MUTUAL INSURANCE, INSURER, RESPONDENTS-APPELLEES SHANNON IMPRONTO, CLAIMANT and VETERANS MEMORIAL MEDICAL CENTER, MEDICAL PROVIDER, APPELLANT v. AETNA LIFE CASUALTY, EMPLOYER and AETNA LIFE CASUALTY, INSURER, RESPONDENTS-APPELLEES CHARLES KIMBROUGH, CLAIMANT and VETERANS MEMORIAL MEDICAL CENTER, MEDICAL PROVIDER, APPELLANT v. CITY OF MERIDEN/WORKFARE PROGRAM, EMPLOYER, and TRAVELERS INSURANCE COMPANY, INSURER, RESPONDENTS-APPELLEES SUSAN CLARK, CLAIMANT and VETERANS MEMORIAL MEDICAL CENTER, MEDICAL PROVIDER, APPELLANT v. AMES DEPARTMENT STORE, EMPLOYER and GATES MACDONALD, INSURER, RESPONDENTS-APPELLEES GAIL KOKOSZKA, CLAIMANT and VETERANS MEMORIAL MEDICAL CENTER, MEDICAL PROVIDER, APPELLANT v. KENYON OIL COMPANY, INC., EMPLOYER and AMERICAN INTERNATIONAL ADJUSTING CO., INSURER, RESPONDENTS-APPELLEES LISA CHABOT, CLAIMANT and VETERANS MEMORIAL MEDICAL CENTER, MEDICAL PROVIDER, APPELLANT v. McDONALD’S INC., EMPLOYER and KEMPER INSURANCE, INSURER, RESPONDENTS-APPELLEES

CASE NOS. 1784 CRB-8-93-7, 1795 CRB-8-93-7, 1797 CRB-8-93-7, 1798 CRB-8-93-7, 1799 CRB-8-93-7, 1800 CRB-8-93-7, 1801 CRB-8-93-7, 1802 CRB-8-93-7, 1803 CRB-8-93-7, 1804 CRB-8-93-7, 1805 CRB-8-83-7, 1806 CRB-8-93-7, 1809 CRB-8-93-7, 1810 CRB-8-93-7, 1811 CRB-8-93-7, 1812 CRB-8-93-7, 1814 CRB-8-93-7.Workers’ Compensation Commission
JANUARY 20, 1995

The claimant did not appear.

In Case Nos. 1800 CRB-8-93-7, 1801 CRB-8-93-7, 1802 CRB-8-93-7, 1803 CRB-8-93-7, the claimant was not represented.

The medical provider was represented by Houston Putnam Lowry, Esq., and Thomas P. Malnati, Esq., Brown and Welsh, P.C.

The respondents did not appear.

This Petition for Review from the July 28, 1993 Indefinite Postponement of Hearing of the Chairman acting for matters arising in the Eighth District was heard January 14, 1994 before a Compensation Review Board panel consisting of Commissioners John A. Arcudi, Angelo L. dos Santos, and Nancy A. Brouillet.

OPINION

ANGELO L. dos SANTOS, COMMISSIONER.

The following is a consolidated opinion regarding the Veterans Memorial Medical Center’s filing of Petitions for Review from the Chairman of the Workers’ Compensation Commission’s declaration that an informal hearing concerning the payment of medical bills be postponed indefinitely.

The Veterans Memorial Medical Center provided as its reasons for appeal; (1) that they (Veterans Memorial Medical Center) have a right to appeal the indefinite continuation of a hearing, (2) that they are entitled to a hearing to determine whether or not certain medical services are compensable even if the employee fails to make a workers’ compensation claim, (3) they are entitled to a hearing for fee approval pursuant to Sec. 31-319[1]
even though the employee failed to file a claim, and (4) that the instant matter involves principles of law not free from reasonable doubt and should be transferred to the Appellate Court pursuant to Sec. 31-324 C.G.S.

Essentially, the appellant argues that it is entitled to a hearing before the workers’ compensation commission because the appellant alleges it rendered hospital services to employees for alleged work-related injuries. Only one case heard at the time of oral argument alleged that the injured employee asserted a claim for compensation under the Workers’ Compensation Act at the time the hearings were requested by the appellant. That claim isCookson v. G.R. Cummings Co., 1796 CRB-8-93-7 (Decided January 20, 1995) and is considered in a separate opinion. In the claims considered in this consolidated opinion, the assertions in the appellant’s brief and reasons for appeal concede that no claims were filed by the employees under the Workers’ Compensation Act. See appellant’s Reasons For Appeal dated July 28, 1993 and received August 2, 1993, Brief In Support of Grant of Request For Hearing As Submitted By Medical Provider dated and received November 15, 1993, pp. 1, 3. Thus, we conclude that we lack jurisdiction over the res as no claim was asserted by the alleged employees of their right to Chapter 568 benefits.

We understand appellant’s contention that this tribunal has held in previous decisions that a hospital has standing before the workers’ compensation commission. See, Gonzalez v. ElectricTransport, 1729 CRB-1-93-5 (Decided October 13, 1994). See also,Derman v. City of Norwalk, 8 Conn. Workers’ Comp. Rev. Op. 100, 860 CRD-7-89-5 (1990), Tanner v. Walgren Tree Experts,8 Conn. Workers’ Comp. Rev. Op. 16, 748 CRD-8-88-7 (1990). However, in each of the cases where we concluded and/or affirmed that a medical provider has standing before this commission, there was no question that an underlying compensation claim was asserted by the injured employee. We do not think that a medical provider has standing before this commission in the absence of a claim by an injured employee or his dependent(s) for benefits under Chapter 568. Without, at the very least, an underlying assertion by a claimant to an entitlement of workers’ compensation benefits, there is no basis upon which a commissioner would inquire as to the medical services provided. Furthermore, lacking any claim of connection to a compensable injury, we believe that the threshold requirements of subject matter jurisdiction are unsatisfied and the claims should be dismissed. See Castro v. Viera,207 Conn. 420 (1988).

Finally, because one of the reasons for appeal suggested that the instant claims be reserved for consideration by the Appellate Court pursuant to Sec. 31-324, we feel further comment is necessary. Recently, this majority were members of a panel which exercised its discretionary power to reserve a particular question to the Appellate Court pursuant to Sec. 31-324. SeeDixon v. United Illuminating, 36 Conn. App. 150 (1994) (matter reserved for the opinion of the Supreme Court).[2] However, in that case, unlike the instant claims, there was no question that a claim was asserted by the claimant and thus, the specific tenets of subject matter jurisdiction unasserted in these claims, was present in that case. While jurisdiction is arguably an important part of the question presently reserved in the case now pending before the Supreme Court, i.e., Dixon, the question(s) posed are more narrowly focused on the appellate authority of the Compensation Review Board pursuant to Sec. 31-301(a) and not the broader aspects of subject matter jurisdiction raised by the instant appeals.

We therefore dismiss the instant appeal.

Commissioner Nancy A. Brouillet concurs.

[1] While the appellant cites Sec. 31-319 C.G.S. as, in pertinent part, the basis for its contention to entitlement and given the various dates of the medical services for which payment is claimed it should be noted that the provisions regarding fee approval are now contained in Sec. 31-327(b) and were formerly contained in Sec. 31-319. Sec. 31-319 was repealed by Public Act 91-32. Sec. 31-327 provides: (a) Whenever any fees or expenses are, under the provisions of this chapter, to be paid by the employer or insurer and not by the employee, the commissioner may make an award directly in favor of the person entitled to the fees or expenses, which award shall be filed in court, shall be subject to appeal and shall be enforceable by execution as in other cases. The award may be combined with an award for compensation in favor of or against the injured employee or the dependent or dependents of a deceased employee or may be the subject of an award covering only the fees and expenses. (b) All fees of attorneys, physicians, podiatrists or other persons for services under this chapter shall be subject to the approval of the commissioner.
[2] Supreme Court Docket No. 15127.

JOHN A. ARCUDI, COMMISSIONER, Dissenting.

I dissent. In each of the cases considered, the Veterans Memorial Medical Center sought a hearing in the Eighth District. The district proceeded to schedule informal hearings. However, the commission chairman, apparently relying on Secs. 31-280(b)(6),(14) and (16)[3] issued an order indefinitely postponing informal hearings in each case.

The statute § 31-327(a)[4] recognizes a medical provider’s right to a hearing on a claim for payment when services are rendered to a workers’ compensation injured employee. Of course, without the testimony of the injured employee, it would be difficult for the medical provider to prove its claim at such a hearing. The CRB’s recent ruling in Gonzalezand Center for Physical Therapy v. Electric Transport (PENSKE),1729 CRB-1-93-5 (Decided October 13, 1994) held, “the medical provider stands in the shoes of the claimant. It has the same right to a hearing and award as does the claimant”. See also,Derman v. City of Norwalk, 8 Conn. Workers’ Comp. Rev. Op. 100, 860 CRB-7-89-5 (1990) and Tanner v. Walgren Tree Experts,8 Conn. Workers’ Comp. Rev. Op. 16, 748 CRD-8-88-7 (1990).

Gonzalez decided that a medical provider was entitled to an evidentiary hearing on the issue of whether a Stipulation executed between the claimant and the respondents should be opened where the sums owed the provider for medical services were not considered in reaching the Stipulation. I believe theGonzalez reasoning and conclusion is equally applicable here.Gonzalez involved the refusal to grant a formal evidentiary hearing. These matters involve the indefinite postponement of hearings. The “indefinite postponement” effectively deprives the Medical Center of any right to a hearing. Such an order violates due process rights to a determination of its claim. Ordinarily, an informal hearing in a matter is held to air disputed issues in an effort to resolve them. If disputed issues are not so resolved, then a formal evidentiary hearing is held. There can be no formal hearing unless an informal first occurs. Without a formal hearing and an evidentiary record there can be no adequate appellate review. See Levasseur v. General Dynamics,11 Conn. Workers’ Comp. Rev. Op. 34, 1244 CRD-2-91-6 (1993), Nevers v.Environmental Waste Removal, 10 Conn. Workers’ Comp. Rev. Op. 96, 1166 CRD-5-91-1 (1992).

There is no question that the 1991 amendments, P.A. 91-339, greatly expanded the chairman’s administrative powers, but adjudicatory powers in any specific case were left undisturbed in each individual commissioner acting in each individual case. Ordering an indefinite postponement of hearings in eighteen cases is not the exercise of administrative powers relating to the calendaring of cases under Sec. 31-280(b)(14) and (16). It is an adjudicatory act because it deprives the provider of its right to present evidence before a commissioner on the basis of which the commissioner may adjudicate its claim. The distinction between “indefinite postponement” and “denial” of a hearing is merely a semantic one. The order denied hearings and therefore denied due process.

The majority opinion holds the threshold requirements of subject matter jurisdiction are unsatisfied without an assertion by a claimant that there is a compensable injury.

Even assuming arguendo that the only method for establishing the existence of a compensable injury is through the claim or the evidence of the claimant, how can an appellate panel with no record to review, as no evidentiary hearing has been held, make the blanket assertion that there is present or there is lacking sufficient evidence to sustain subject matter jurisdiction? If a hearing were held, what would prevent the claimant hospital from subpoenaing the allegedly injured employee in order to supply evidence to prove jurisdiction?

Finally, the identical 1991 amendment which gave such added administrative powers deprived that same chairman of any nisi prius adjudicatory jurisdiction. That legislation, P. A. 91-339, added the following sentences to § 31-280(a): “The chairman may not hear any matter arising under this chapter, except appeals brought before the Compensation Review Board.” This provision was amended in 1993, P. A. 93-228, when § 31-280(b)(14) was amended by adding language as follows: “And if necessary, [the chairman may] preside over informal hearings in regard to compensation under provisions of this chapter.” Thus, the legislative intent was made abundantly clear, the chairman could not preside at formal hearings. And formal hearings are the only instrumentality employed by the commission to hear recorded evidence on the basis of which disputed issues may be resolved at the trial level.

If, as the majority opinion implies, although that is hardly clear from the device utilized, the chairman’s indefinite postponement of hearings was really a ruling that there existed no subject matter jurisdiction, there was no statutory power in the chairman to make that ruling. Such rulings can only be made by a commissioner at the trial level after a formal hearing is held and an opportunity is given for evidence to be presented pursuant to § 31-327.

I would therefore remand these matters for further proceedings.

[3] Sec. 31-280. Chairman of the workers’ compensationcommission. Powers and duties. Budget. Report of expenses.Sec. 31-280(b)(6) Allocate the resources of the commission to carry out the purposes of this chapter.Sec. 31-280(b)(14) Control the hearing calendars of the compensation commissioners in order to facilitate the timely and efficient processing of cases.Sec. 31-280(b)(16) Direct and supervise all administrative affairs of the commission.
[4] Sec. 31-327 Award of fees and expenses. (a)
Whenever any fees or expenses are, under the provisions of this chapter, to be paid by the employer or insurer and not by the employee, the commissioner may make an award directly in favor of the person entitled to the fees or expenses, which award shall be filed in court, shall be subject to appeal and shall be enforceable by execution as in other cases. The award may be combined with an award for compensation in favor of or against the injured employee or the dependent or dependents of a deceased employee or may be the subject of an award covering only the fees and expenses.