WILBURN v. CITY OF STAMFORD, 809-CRD-7-89-1 (5-24-90)

DAVID E. WILBURN, CLAIMANT-APPELLEE and STAMFORD HOSPITAL MEDICAL PROVIDER v. CITY OF STAMFORD, EMPLOYER, RESPONDENT-APPELLANT

CASE NO. 809-CRD-7-89-1Workers’ Compensation Commission
MAY 24, 1990

The appeal in the above matter concerned issues between Stamford Hospital and the Respondent. Therefore, no appearance on behalf of the claimant was necessary. Further, by agreement of the parties before the Compensation Review Division, it was agreed that the matter would be decided on the basis of briefs submitted and oral argument was waived.

The Stamford Hospital was represented by Griffith H. Trow, Esq., and John Greiner, Esq., both of Murphy Beane.

The respondent was represented by George W. Waldron, Esq., and John Greiner, Esq., both of Murphy Beane.

The Petition for Review from the December 29, 1988 Finding and Award of the Commissioner for the Seventh District was decided pursuant to papers submitted for the February 2, 1990 hearing before the Compensation Review Division panel consisting of the Commission Chairman, John Arcudi, and Commissioners A. Paul Berte’ and Frank Verrilli.

OPINION

JOHN ARCUDI, CHAIRMAN.

This matter was heard below on stipulated facts. It concerns the appropriateness of hospital charges.

Claimant in the instant matter sustained a compensable back injury on or about October 23, 1987. As a result he was confined to the Stamford Hospital [Hospital] for inpatient care from October 24, 1987 to October 30, 1987. He sustained a 10% permanent partial disability of his back. This information is contained in a Voluntary Agreement approved May 24, 1988. The Hospital calculated its charges on the basis of Connecticut’s All Payor System, the so called Diagnostic Related Group [DRG] as provided in Sec. 19a-165 et seq. The DRG charges were $4,960.37. The Hospital’s billing rate on the basis of itemized charges would have been $2,759.23.[1]

Respondent paid the latter amount, $2,759.23. The Hospital sought to be paid the DRG amount. The Seventh District agreed with the Hospital.

Tanner v. Walgren Tree Experts, 748 CRD-8-88-7 (decided January 17, 1990) appeal docketed, No. A.C. 8865 (Conn.App. Feb. 2, 1990) is directly on point. In Tanner, we held the appropriate amount was the DRG charge pursuant to Sec. 19a-165f. Consequently Tanner is dispositive of the issue here raised. Therefore, for all the reasons there set out, we affirm the Seventh District.

Commissioners A. Paul Berte’ and Frank Verrilli concur.

[1] We note that the trial Commissioner’s Finding and Award reflects that the regular charge for services rendered by the Hospital in this instance would have been, $2,759.23 and the DRG charge was $4,960.37. The trial commissioner also noted that the respondent paid the regular charge of the Hospital and the Hospital sought payment of the difference between the DRG charge and the amount paid by the respondent. The trial commissioner mistakenly computed this difference as $3,301.14. Based on the annexed factual stipulation incorporated in the Finding and Award which stated in paragraph 8 that the amount which the Hospital claims as $2,201.14 we think it is clear that the trial Commissioner misstated the amount for which the Hospital seeks payment and the correct amount claimed by the Hospital is $2,201.14.