CASE NO. 164 CRD-6-82Workers’ Compensation Commission
AUGUST 16, 1985
The Claimant was represented by Edward T. Dodd, Jr., Esq.
The Respondents-Appellants were represented by Brian Prindle, Esq.
The Second Injury and Compensation Assurance Fund was a Respondent in the hearing before the Commissioner and was noticed for this argument before the Compensation Review Division. The Second Injury and Compensation Assurance Fund is not involved in the issues in this appeal, and did not appear at the argument before this tribunal.
This Petition for Review from the August 31, 1982 Finding and Award of the Commissioner at Large acting for the Sixth District was argued on October 28, 1983 before a Compensation Review Division panel consisting of Commissioners A. Paul Berte, Rhoda Loeb and Frank J. Verrilli.
OPINION
A. PAUL BERTE, Commissioner.
On August 31, 1982, the Commissioner at Large (hereinafter the Commissioner) acting for the Sixth District entered a Finding and Award awarding the claimant compensation for temporary total disability for the period July 10, 1980 through December 2, 1980. The respondents filed a timely appeal, and on February 3, 1983, they filed a three paragraph Motion to Correct. The respondents’ Motion to Correct was denied by the Commissioner on February 15, 1983.
The respondents’ Reasons of Appeal and brief, they addressed three (3) issues as follows:
1. That the Commissioner erred in denying Paragraphs 1 thru 3 of the Respondents’ Motion to Correct.
2. The Commissioner erred as a matter of law in finding that the Respondents must pay temporary total disability due to a failure to file a Form 36, because the Claimant actually returned to work when benefits were terminated, and under such circumstances a Form 36 is not required.
3. The Commissioner erred in finding the Claimant entitled to temporary total disability, as the record is devoid of any evidence to support a finding of total incapacity.
There is no dispute that on April 16, 1979, claimant sustained a compensable injury to his left shoulder. A Voluntary Agreement was issued, and was approved July 1, 1980. Claimant had surgery for his compensable injury on November 20, 1979, and was totally disabled and paid benefits for temporary total disability for a time thereafter. In his Finding and Award, the Commissioner found that the “Respondent did not file a Form 36 between the date of surgery, November 20, 1979 and July 9, 1980, the date when payments were terminated.” (Paragraph 8.). The Commissioner also found that “Termination of payments without the filing and approval of a Form 36 was improper”. (Paragraph 9.).
The issues in this appeal involve questions of first instance interpreting 31-296[1] of the Connecticut General Statutes, and the Form 36[2] procedure.[3] Form 36 is the Workers’ Compensation Commission Form entitled “NOTICE TO COMPENSATION COMMISSIONER AND EMPLOYEE OF INTENTION TO DISCONTINUE PAYMENTS” required to be filed and approved by the Commissioner in certain instances before the employer is allowed to discontinue payments of compensation for total or partial incapacity.
The respondents have argued that the Commissioner found the claimant entitled to further temporary total incapacity benefits for the period July 10, 1980 through December 2, 1980, due to the respondents failure to file a Form 36, i.e. there can be no discontinuance of benefits for temporary total incapacity without an approved Form 36. The respondents further contended that the Commissioner failed to find undisputed facts material to this appeal which established that the claimant returned to work on May 14, 1980, at which time compensation benefits were discontinued until December 3, 1980 when payments for specific injury of 15% permanent partial impairment of the left shoulder[4] were commenced. The respondents further argued that once claimant returned to work on May 14, 1980, they had no further obligation to pay claimant benefits for temporary total incapacity, and that if the claimant was entitled to any additional incapacity benefits, for instance temporary partial, the burden was on the claimant to establish those additional benefits.
The claimant argued that under 31-296 the respondents are not permitted to discontinue payments for temporary total or temporary partial incapacity benefits in any case without filing a Form 36 and having it approved in writing by the Commissioner. In the present case the respondents filed no Form 36 applicable to the period July 10, 1980 through December 2, 1980,[5] and the Commissioner found, that, the respondents are obligated to pay claimant temporary total incapacity benefits for said period.
The respondents contended that 31-296 requires only that the employer obtain an approved Form 36 before discontinuing benefits when the claimant claims “that his incapacity still continues”. 31-296, see Footnote 1, supra.
In the present case, the claimant did not maintain that his total incapacity continued at the time his benefits were discontinued on May 14, 1980, but in fact worked for the employer as a seam welder from May 14, 1980 for about one month. (Transcript, July 2, 1982 hearing, claimant’s testimony, pages 9-10).
We agree with the respondents that the statute does not require a Form 36 to be filed and approved in writing by the Commissioner in every case in which the employer intends to discontinue payments for total or partial incapacity. And we also agree with the claimant that 31-296 is clear and unambiguous. It is clear and unambiguous as to when an employer must have an approved Form 36 before discontinuing benefits.
The rule to be followed is that the only time a Form 36 must be filed and approved in writing by the Commissioner is as follows: When an employee is receiving compensation for total or partial incapacity under an agreement, oral or written, an award, or where the employer’s acceptance of compensability has been conclusively presumed under subsection (b) of 31-297, C.G.S., and the employee contends that his incapacity still continues, if the employer intends to discontinue such payments, the employer must notify the Commissioner and employee of the proposed discontinuance, i.e. the notification must be [before the date of proposed discontinuance],[**] by filing Form 36 with the Commissioner and the employee (underlining ours) Such proposed discontinuance shall not become effective unless specifically approved in writing by the Commissioner. Under this procedure, the burden is on the employer to determine before the employer files Form 36 to discontinue payments whether or not the employee who is receiving compensation for total or partial incapacity claims that his incapacity still continues. If the employee claims his incapacity continues, the Form 36 procedure is mandated by the statute. If the employee is not claiming that his incapacity continues, there is no obligation on the employer to file a Form 36.
We emphasize that the Form 36 is to be submitted to the Commissioner and employee [before][**] the date of intended discontinuance. (underline ours). The focus of the Form 36 is prospective i.e. NOTICE TO COMPENSATION COMMISSIONER AND EMPLOYEE OF [INTENTION TO DISCONTINUE PAYMENTS][**] (underline ours). Frequently the Form 36 is submitted by the employer to the Commissioner and the employee after the date of discontinuance, which is contrary to the intention of the Form 36 and the law. Such improper actions by the employer in illegally discontinuing benefits before the Commissioner’s approval causes much unnecessary hardship on employees whose benefits are discontinued without authority, unnecessary litigation for the parties to the claim, unnecessary hearings before the Commissioners, and subjects the employer and carrier to potential punitive actions under the Workers’ Compensation Act.[6]
Another issue that presents itself in this case concerning the Form 36 procedure is what obligation does an employer have to file a Form 36 and have it approved by the Commissioner when a claimant has in fact returned to work. Considering our rule above that the only time an employer has the obligation to file a Form 36 is when claimant contends his incapacity continues, one could argue that since the claimant returned to work he could not be prejudiced by the absence of a Form 36 since he could not have expected to continue receiving incapacity benefits once he returns to work. Under this analysis there would be no obligation on an employer to file a Form 36 when an employee has returned to work. Such a rule would be too broad however in light of the fact that the law contemplates the determination concerning whether or not a Form 36 must be filed would be made by the employer in all cases [before][**] the claimant returns to work. (underline ours)
The language in 31-296 and 31-296a concerning discontinuing benefits on account of total or partial incapacity that states “if it is claimed by or on behalf of the injured person that [his incapacity still continues”][**] (underlining ours), refers to the very same incapacity which the parties agreed[7] claimant had, and for which the respondents were paying compensation. Accordingly, if claimant is receiving compensation for total incapacity and the employer intends to discontinue payments for total incapacity, the employer must determine if the employee claims that his [total incapacity][**] still continues. (underlining ours) If the employee does not claim his total incapacity continues there would be no obligation on the employer to file a Form 36 to discontinue payments for total incapacity. If the employee does not claim his total incapacity continues but claims he is now partially incapacitated, the claimant would make claim pursuant to 31-308(a) for partial incapacity benefits, and if agreement is reached, the law contemplates the parties would enter into a written agreement for partial incapacity pursuant to 31-296.
If, however, the employee is receiving benefits for partial incapacity and is out of work, it would not be inconsistent with his partial incapacity status and the continued receipt of partial incapacity benefits, for the employee to return to work and still claim to be partially incapacitated. Under these circumstances, the employer would be violating the provisions of 31-296 and the Form 36 procedure, by discontinuing payments for partial incapacity just because the claimant has returned to work. For instance, assume claimant is out of work, receiving temporary partial incapacity benefits, and has a comparable wage under the provisions of 31-308(a) of $450.00 per week. Claimant then returns to work and has an earnings ability of $300.00 per week. Under 31-308(a) claimant would be entitled to continuing benefits for partial incapacity.
Form 36 procedure is applicable to both forms of incapacity, partial and total. Since the burden is on the employer to determine whether or not incapacity, whether total or partial, continues before the employer is allowed to discontinue benefits, we see no reason to establish a special rule for the situation where an employee has returned to work. The law requires that the employer will be monitoring the status of the case concerning the employee’s incapacity status,[8] and it is presumed that the employer would know when the employee will be returning to work. Since the Form 36 procedure is prospective, there should be no prejudice to the employer under any circumstances, since if the employee is receiving temporary total incapacity benefits and is certified by the attending physician as able to return to work on some date in the future, and that employee still contends to be totally incapacited, [incapacitated] the employer can File Form 36 and request an immediate informal hearing before the Commissioner.
The short answer to the question as to what obligation does an employer have to file a Form 36 after an employee has returned to work is that the law contemplates that the determination whether or not a Form 36 is required to be filed would always be made before an employee returns to work because the law presumes there would be a medical certification that claimant is able to return to work before the claimant does in fact return to work. Under those circumstances there would be no reason to address the question of what procedure should be followed when a claimant has in fact returned to work.
The first issue for consideration in the respondent’s Reasons of Appeal is their contention that the Commissioner erred in denying their Motion to Correct. Sec. 31-301-4, Administrative Regulations,[9] states the procedure to be followed to correct the finding. One requirement is that respondents file with their Motion to Correct, “such portions of the evidence as [t]he[y] deem[s] relevant and material to the corrections asked for, certified by the stenographer who took it.” The respondents filed no evidence with their Motion to Correct, but did file a brief with this tribunal in which they specifically referenced the transcript and exhibits entered into the record before the Commissioner. We reviewed that transcript and those exhibits certified as part of this appeal. The respondents by not filing such portions of the evidence as they deemed relevant to the corrections they sought have failed to comply with Regulations Sec. 31-301-4. Perez v. U.S. Prolam, Inc., 1 Conn. Workers’ Comp. Rev. Op. 74
(1981). It is not the responsibility of the Commissioner to cull out of the record the evidence the respondents rely upon to support the corrections they seek. That is the responsibility of counseling seeking corrections. Sorrentino v. Cersosimo, 103 Conn. 426
(1925).
The respondents have argued that they are entitled to a correction of the finding if it omits material facts that are admitted or undisputed. True v. Longchamps, 171 Conn. 476, 478 (1976); Glenn v. Stop Shop, Inc., 168 Conn. 413, 416 (1975). We agree.
The first two corrections sought by the respondents requested the Commissioner to add to his finding that “the claimant returned to work for a period of one month from May 14, 1980 through June 13, 1980” (Par. 1, Motion to Correct), and to correct Paragraph 7 of the Finding and Award “to reflect that the claimant was only partially disabled at sometime prior to May, 1980, and that compensation payments were terminated on May 14, 1980 when claimant returned to work.” We have reviewed the transcript, and are satisfied that the facts sought in the corrections are not in dispute. (Record, Transcript July 2, 1982, Formal Hearing, Pg. 9). In addition, in argument before this tribunal the parties joined in stipulating that there were no payments for temporary total incapacity after May 14, 1980, and that claimant worked sporadically between May 14, 1980 and July 10, 1980. Our review of the record supports the parties stipulation, which is not consistent with Paragraphs 7 and 8 of the Finding and Award. Paragraph 7 states:
7. Claimant had surgery for the compensable injury on November 20, 1979, and was totally disabled for a time thereafter and temporary total benefits were paid continuing to July 9, 1980.
Paragraph 8 states:
8. Respondent did not file a Form 36 between the date of surgery, November 20, 1979 and July 9, 1980, the date when payments were terminated.
We find no support in the evidence for the Commissioner’s Finding that “temporary total benefits were paid continuing to July 9, 1980.” (Paragraph 7.), nor do we find any support in the record that any payments were terminated July 9, 1980. (Paragraph 8.) Furthermore, Paragraph 9 of the Finding and Award recites “Termination of payments without the filing and approval of a Form 36 was improper.”, in apparent reference to the finding in Paragraph 8 that payments were terminated July 9, 1980, which is not supported in the evidence.
For the corrections sought by the respondents to be added to the Finding, they must not only be undisputed or admitted, they must also be material. True v. Longchamps, supra. In order to determine whether or not the facts sought to be added are material it is necessary to determine whether or not the facts are “essential to the case in hand”. Sec. 31-301-3,[10]
Administrative Regulations. Sec. 31-301-3 states what the Commissioner’s finding should contain. The finding is to include a statement of his conclusions and [the claims of law made by the parties.][**] (underline ours) Sec. 31-301-3, supra. It is from those claims of law made by the parties that we test the facts to determine whether or not they are material, i.e. essential to the case, and without which the case could not be supported.
For us to rule on the respondents’ contention that the Commissioner erred in refusing to grant their Motion to Correct we need a Finding and Award that includes the claims of law made by the parties and the conclusions of the Commissioner related to those claims. At the Formal Hearing before the Commissioner July 2, 1982, and in the parties’ briefs filed with the Commissioner the parties stated their claims of law which raise numerous issues concerning 31-296 and the Form 36 procedure. The Commissioner has not included those claims of law or any claims of law in his Finding and Award.[11]
We are also satisfied that once the Commissioner includes the claims of law made by the parties he will also have to make additional findings to support his conclusions related to those claims of law. After particular note of Sec. 31-301-8,[12]
Administrative Regulations, which details the function of this tribunal on appeal, see Balkus v. Terry Steam Turbine Co., 167 Conn. 170, 173-4 (1974), we are of the opinion that the Commissioner’s finding does not contain all the subordinate facts which are pertinent to the claim and the conclusions of the Commissioner therefrom. And, therefore, this tribunal is not in a position to decide whether the award was correct and just or not. McQuade v. Ashford, 130 Conn. 478, 482 (1944); Carlino v. Danbury Hospital, 1 Conn. Workers’ Comp. Rev. Op. 119
(1981). Until the Finding and Award is in compliance with the Regulations and the interpretive case law, we are not able to determine the corrections sought by the respondents.
We have determined that in order for us to rule on the respondents’ first reason of appeal that the Commissioner erred in denying their Motion to Correct, we must remand this case for an amended Finding and Award to include the claims of made by the parties, the Commissioner’s conclusions therefrom, and any further additions to the Finding and Award as necessary to comply with this opinion.
This tribunal finds it unnecessary to discuss the respondents’ second and third reasons of appeal inasmuch as a resolution of the first issue requires us to remand this matter to the Commissioner for an amended Finding and Award.
Commissioners Rhoda Loeb and Frank J. Verrilli concur in this opinion.
WORKERS’ COMPENSATION COMMISSION OF CONNECTICUT NOTICE TO COMPENSATION COMMISSIONER AND EMPLOYEE OF INTENTION TO DISCONTINUE PAYMENTS.
To the Compensation Commissioner for the . . . . Congressional District and to . . . ., employee:
You are hereby notified that the undersigned employer will on the . . . . day of . . . ., 19. ., discontinue the payments of compensation to the above-named employee for the following reason, to wit:
. . . .Employer by . . .(Indicate Official Position), Insurer of Agent
I HEREBY CERTIFY that the above named employee is able to return to usual light work on the . . . . day of . . . ., 19. . . selected
will There will not be permanent loss or loss of use of . . . .(member) . . . . Attending Surgeon
The following blanks are to be filled out in order that the case may be properly located in the records of the Commissioner.
Date of Injury . . . .
Date of Award or approval of agreement . . . .
Date when mailed by respondents . . . .