JOSEPH ZEMO, CLAIMANT-APPELLEE and STAMFORD HOSPITAL, MEDICAL PROVIDER vs. FOUR WHEELS, INC., EMPLOYER and NATIONWIDE MUTUAL INSURANCE COMPANY, INSURER, RESPONDENTS-APPELLANTS

CASE NO. 821-CRD-7-89-2Workers’ 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.

The Stamford Hospital was represented by Griffith H. Trow, Esq., Burdett, Trow Sank, P.C.

The respondents were represented by David D. Chapman, Esq., Law offices of Larry H. Lewis.

This Petition for Review from the February 2, 1989 Finding and Award of the Commissioner for the Seventh District was heard February 23, 1990, before a Compensation Review Division panel consisting of the Commission Chairman, John Arcudi, and Commissioners Robin Waller and George Waldron.

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 injury, second degree burns to his hand and face, on October 16, 1987. The injury resulted in claimant’s confinement to the Stamford Hospital [Hospital] from October 16, 1987 through October 17, 1987. 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 $18,109.03. The Hospital’s billing rate on the basis of itemized charges would have been $17,300.38.

Respondents paid the Hospital the latter amount, $17,300.18. 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 that the appropriate amount was the DRG charge pursuant to Sec. 19a-165f. Consequently Tanner, supra, is dispositive of the issue here raised. Therefore, for all the reasons there set down we affirm the Seventh District.

Commissioners Robin Waller and George Waldron concur.

Tagged: