Justia.com Opinion Summary: In 1996, Plaintiff was working as a police officer when he felt a sharp pain in his right shoulder after attempting to lift a heavy person. A physician determined that Plaintiff had a labral tear, and Plainiff later underwent shoulder surgery. Plaintiff's pain continued. In 2000, Plaintiff suffered an acute myocardial infarction and was transferred to the hospital where he had bypass surgery. Plaintiff filed a claim in 2001, contending that his shoulder condition was misdiagnosed and that his 1996 symptoms were caused by a cardiac problem. The workers compensation commissioner dismissed the claim for lack of subject matter jurisdiction, concluding that the statute of limitations was not tolled by Plaintiff's allegation that his heart condition was misdiagnosed following the 1996 incident, and that his 2001 notice of claim was untimely. The compensation review board affirmed. The Supreme Court affirmed, holding that the board properly concluded that Plaintiff had failed to establish that the medical care exception to the applicable one year statute of limitations applied to toll the statute of limitations, as Plaintiff failed to prove a connection between the 1996 incident and his heart disease.
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JOHN A. CARTER v. TOWN OF CLINTON
(SC 18200)
Rogers, C. J., and Norcott, Palmer, Zarella, McLachlan, Eveleigh and
Harper, Js.
Argued February 1—officially released May 1, 2012
Jill Morrissey, with whom was David J. Morrissey,
for the appellant (plaintiff).
Henry J. Zaccardi, with whom was Sheila A. Huddleston, for the appellee (defendant).
Opinion
McLACHLAN, J. This appeal requires us to consider
the application of the medical care exception to the
one year statute of limitations set forth in General Statutes § 31-294c.1 The plaintiff, John A. Carter, appeals2
from the decision of the compensation review board
(board), affirming the decision of the workers’ compensation commissioner for the third district (commissioner) dismissing his claim seeking heart and
hypertension benefits pursuant to General Statutes § 7433c3 for lack of subject matter jurisdiction on the basis
that the notice of claim was untimely filed. The plaintiff
argues that the board improperly rejected his argument
that the statute of limitations was tolled by the medical
care exception set forth in § 31-294c (c). Because we
conclude that the board properly concluded that the
plaintiff had failed to establish that the medical care
exception applied to toll the statute of limitations, we
affirm the decision of the board.
The board’s decision sets forth the following relevant
facts and procedural history. ‘‘The [plaintiff] worked
for the [defendant, the] town of Clinton as a police
officer from 1972 through 1998. He sustained a right
shoulder injury on February 20, 1996, that required surgery, and returned to regular duty in July, 1996. On
October 2, 1996, [in] the line of duty, he was attempting
to lift a heavy person when he felt a pop and sharp
pain in his right shoulder that traversed his upper back.
He also reported a sense of going into shock, with
dizziness, shortness of breath, lightheadedness, and a
crushing pain in the front and back. He completed an
injury report for [the defendant], and went to the hospital for treatment, reporting increasing pain and discomfort in his shoulder.
‘‘The attending physician at the hospital opined that
he had a labral tear. A [computed tomography scan] of
his scapula showed no abnormalities, and the [plaintiff]
was referred to [John Daigneault, an orthopedic surgeon] for an orthopedic evaluation. After the [plaintiff]
reported pain, clinking and grinding in the scapular
area, [Daigneault] performed scapular reduction surgery in 1997, which was authorized by the [defendant].
In 1998, pain continued, beginning to radiate into the
neck and jaw. A cervical spine [magnetic resonance
imaging] showed two herniated discs and degenerative
changes, leading to fusion surgery in April, 1998. The
[plaintiff] then retired from the police force because
of his injuries. [Daigneault] identified a 20 [percent]
permanent partial impairment of the right shoulder
from the October, 1996 injury, and a 10 [percent] impairment from the February, 1996 injury. [Myron E. Shafer,
an orthopedic surgeon] rated the [plaintiff] with a 25
[percent] permanent impairment of the right arm on
January 7, 1998, noting a great deal of pain, discomfort
and sensitivity.
‘‘At the request of the [plaintiff’s] primary physician,
[Bernard Sheehan], the [plaintiff] underwent an [electrocardiogram] in September, 1998, that showed no
acute changes. According to the [plaintiff], [Sheehan]
had thought a stress test unnecessary despite the [plaintiff’s] spoken fear that something was wrong with his
heart. In March, 2000, another [electrocardiogram] was
described as normal by [Sheehan]. The [plaintiff] was
given pills to provide relief from presumed acid buildup. [Sheehan] prescribed a stronger antacid on April 3,
2000, noting the continuation of severe shoulder pain.
On April 5, 2000, the [plaintiff] suffered an acute myocardial infarction, and was transported to the hospital
where he had an angioplasty, followed by four-vessel
coronary artery bypass surgery on April 7, 2000.
‘‘The [plaintiff] filed a form 30C4 on June 20, 2001,
claiming that the right shoulder condition was misdiagnosed and that his October 2, 1996 symptoms were
caused by a cardiac problem. The [defendant] contested
this claim both on the basis of a lack of direct causal
relation between the lifting incident and the myocardial
infarction, and because the 2001 form 30C was untimely
for a 1996 injury.’’ On January 5, 2007, the commissioner
dismissed the claim due to lack of subject matter jurisdiction, finding that the plaintiff had not produced sufficient evidence to show that his April 5, 2000 myocardial
infarction was causally related to the October 2, 1996
incident. The commissioner also found that the statute
of limitations was not tolled by the plaintiff’s allegation
that his heart condition was misdiagnosed following
the October 2, 1996 incident, and that his June 20, 2001
notice of claim was untimely. The commissioner denied
the plaintiff’s motions to correct and for reconsideration. The board subsequently affirmed the decision of
the commissioner, and this appeal followed.
The sole issue in this appeal is whether the board
correctly concluded that the medical care exception in
§ 31-294c did not apply to toll the statute of limitations
for the plaintiff’s claim for benefits pursuant to § 7433c. The plaintiff contends that, because he claims that
the October 2, 1996 incident caused him to experience
symptoms of angina, his claim for benefits pursuant to
§ 7-433c falls under the medical care exception in § 31294c (c), regardless of the commissioner’s factual finding of no causal connection between the October 2,
1996 incident and his heart disease. In response, the
defendant argues that, under the board’s time-tested
interpretation of § 31-294c (c), in order for a claimant
to fall under the medical care exception, he must prove
either: (1) that his employer previously furnished medical care for the specific condition at issue in the late
claim; or (2) that a late claimed condition was causally
related to a timely reported incident for which the
employer furnished medical care. Because the plaintiff
has not satisfied either of these showings, the defendant
argues, the board correctly affirmed the decision of the
commissioner dismissing the claim for lack of subject
matter jurisdiction. We agree with the defendant.
‘‘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. . . . It is well established that [a]lthough
not dispositive, we accord great weight to the construction given to the workers’ compensation statutes by the
commissioner and [the] board. . . . [W]e do not afford
deference to an agency’s interpretation of a statute
when . . . the construction of a statute previously has
not been subjected to judicial scrutiny or to a governmental agency’s time-tested interpretation . . . .’’
(Citation omitted; internal quotation marks omitted.)
Jones v. Redding, 296 Conn. 352, 362–63, 995 A.2d 51
(2010).
Pursuant to § 7-433c (a), a firefighter or police officer5
who has passed a preemployment physical examination
that did not reveal any evidence of hypertension or
heart disease, and who subsequently develops ‘‘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 . . . .’’ General Statutes § 7-433c (a).
‘‘It is well settled that the special compensation, or the
outright bonus, of § 7-433c is that the claimant is not
required to prove that the heart disease is causally connected to [his or her] employment, which he [or she]
would ordinarily have to establish in order to receive
benefits pursuant to the Workers’ Compensation Act.
. . . The benefits provided under § 7-433c are, however, payable and administered under the Workers’
Compensation Act . . . and the type and amount of
benefits available pursuant to § 7-433c are the same as
those under the Workers’ Compensation Act . . . .’’
(Internal quotation marks omitted.) Ciarlelli v. Hamden, 299 Conn. 265, 276–77, 8 A.3d 1093 (2010).
Although a claimant need not prove that his heart
disease is causally connected to his employment in
order to qualify for benefits pursuant to § 7-433c, he
must prove that he satisfies the jurisdictional threshold
set forth in § 31-294c (a), which requires that a claimant
provide his employer a ‘‘written notice of claim for
compensation . . . within one year from the date of
the accident . . . which caused the personal injury
. . . .’’ See, e.g., Malchik v. Division of Criminal Justice, 266 Conn. 728, 739, 835 A.2d 940 (2003) (‘‘[c]ompliance with [§ 31-294c] is essential to maintaining a claim
for compensation under chapter 568 and therefore
under . . . § 7-433c . . . because timely notice is a
jurisdictional requirement that cannot be waived’’
[internal quotation marks omitted]). We recently have
explained that ‘‘the one year limitation period for claims
under § 7-433c begins to run only when an employee
is informed by a medical professional that he or she has
been diagnosed with hypertension [or heart disease].’’6
Ciarlelli v. Hamden, supra, 299 Conn. 300.
Section 31-294c (c) excuses a claimant from compliance with § 31-294c (a) ‘‘if within the applicable period
an employee has been furnished, for the injury with
respect to which compensation is claimed, with medical or surgical care as provided in section 31-294d. . . .’’
(Emphasis added.) The claimant bears the burden to
show that the medical care exception applies. We have
observed that the ‘‘purpose of the notice [requirement
of § 31-294c (a)] is to inform the employer that an injury
has been suffered upon which a claim for compensation
will or may be founded. . . . The exception [in § 31294c (c)] is, no doubt, based upon the fact that if the
employer furnishes medical treatment he must know
that an injury has been suffered which at least may be
the basis of such a claim.’’ (Citation omitted.) Gesmundo v. Bush, 133 Conn. 607, 612, 53 A.2d 392 (1947).
Any interpretation of the scope of § 31-294c (c), accordingly, must be consistent with the principle that the
employer’s provision of medical care demonstrates that
it was on notice that the claimant had suffered a compensable injury. In Gesmundo, we indicated that in
order to find the medical care exception applicable,
there must be some connection between the initial
‘‘injury’’ and the later claimed condition, but we did not
have occasion in that case to explore in detail the nature
of the required relation. Id., 612–13. During the course
of his employment, on the evening of December 31,
1943, the plaintiff in Gesmundo was driving a truck that
had no heater and a drafty cab area due to broken
floorboards. Id., 609. It was a cold night, and his feet
were frostbitten as a result of the ride. Id. He filed
no notice of claim, but he reported his injury to his
supervisor, who referred him to a physician for treatment. Id. Over the course of the next two years, the
plaintiff consulted with various physicians, ultimately
receiving a diagnosis of a ‘‘vasomotor disturbance of
the causalgic type, probably related to his frostbite.’’
Id., 610. In concluding that the commissioner correctly
had concluded that the medical care exception applied,
we specifically noted that the plaintiff had ‘‘suffered
continuously since [the incident] and no other intervening cause of his condition has been proved.’’ (Emphasis
added.) Id., 613.
Although Gesmundo is somewhat helpful in guiding
our analysis, that case did not directly present the question of whether the medical care exception applies
when a claimant receives treatment for an injury sus-
tained in connection with an incident and later seeks
coverage for a different injury or condition that has
arisen from the same incident. The board, however, has
had occasion to address this issue, and has interpreted
the phrase in § 31-294c (c), ‘‘for the injury with respect
to which compensation is claimed,’’ to mean that a
claimant can satisfy the medical care exception by proving either: (1) that his employer previously furnished
medical care for the specific condition at issue in the
late claim; or (2) that a late claimed condition was
causally related to a timely reported incident for which
the employer furnished medical care. The first method
of proof is consistent with Gesmundo, in which the
plaintiff’s later condition of vasomotor disturbance
developed from the initial condition of frostbite. Gesmundo v. Bush, supra, 133 Conn. 610; see also Cessario
v. Meriden, No. 5467, CRB-6-09-5 (May 21, 2010) (later
claimed myocardial infarction ‘‘sequelae of a previous
compensable injury,’’ hypertension).
The second method of proof to which the medical
care exception applies is a bit more complex, because
the nexus between the late claimed condition and the
initial incident is not the original condition for which the
employer provided medical treatment, but the incident
itself. The board’s decision in Landrette v. Bristol, 11
Conn. Workers’ Comp. Rev. Op. 149 (1993), illustrates
this manner of proof. In Landrette, the claimant police
officer injured his ankle during an altercation with a
suspect and gave notice of claim to his employer on
the same day. Id., 150. The claimant alleged that he had
provided oral notice of claim with respect to a mouth
injury he received during the altercation, and the
employer disputed that notice of claim had been provided or that any treatment had been furnished by the
employer within the one year period. Id. Without referring to or relying on any resolution of these factual
disputes between the parties by the commissioner, the
board concluded that, regardless of whether the claimant had provided notice or the employer had provided
treatment within the one year limit for the mouth injury,
it was compensable because it was causally related
to the incident for which the employer had furnished
medical care. Id., 151–52. In so concluding, the board
relied on one of its earlier decisions, Hebert v. New
Departure Hyatt Bearings, 4 Conn. Workers’ Comp.
Rev. Op. 94 (1987), in which it had allowed benefits for
a late claimed injury, a herniated disc at the L1-2 level of
his spine, because the employer had furnished medical
treatment for a timely noticed injury, a herniated disc
at the C5-6 level of his spine, because both injuries were
causally related to the original incident. Id., 95. The
board subsequently relied on Landrette in Scott v.
Bridgeport, No. 4637, CRB-4-03-2 (February 24, 2004),
which involved a dispute between the claimant and his
employer regarding the compensability of a late claimed
brain injury, where the claimant had alleged that the
brain injury arose from the same work-related fall that
had caused a timely noticed leg injury. Consistent with
Landrette and Hebert, the board remanded the case to
the commissioner to allow the claimant ‘‘the opportunity to demonstrate the causal link between a compensable accident and the head/traumatic brain injury.’’ Id.
The board’s decision in the present case is consistent
with its precedent spanning almost twenty years, as
well as the principles we set forth in Gesmundo v. Bush,
supra, 133 Conn. 607. We conclude, therefore, that the
interpretation is both time-tested and reasonable and
should be accorded deference. See, e.g., Hartford v.
Hartford Municipal Employees Assn., 259 Conn. 251,
270, 788 A.2d 60 (2002) (deference given to administrative board’s reasonable ‘‘time-tested interpretation’’ of
statutory terms).
Applying the rule to the present case, we conclude
that the plaintiff has failed to demonstrate that he falls
under the medical care exception. As to the first method
of proof, the plaintiff did not attempt to demonstrate
that the defendant had furnished medical care for his
heart disease following the October 2, 1996 incident.
In fact, his argument is inconsistent with that theory,
since his starting point is his claim that he was misdiagnosed at the time. The plaintiff instead relied on the
second method of proof, attempting to demonstrate a
link between his April 6, 2000 myocardial infarction
and the October 2, 1996 incident. The commissioner’s
findings, however, are fatal to the plaintiff’s argument.
First, the commissioner found that there was ‘‘insufficient evidence to support the [plaintiff’s] allegation that
his myocardial infarction on April 6, 2000, was causally
related to his lifting incident on October 2, 1996.’’ As
the board observed, the commissioner’s denial of the
plaintiff’s motion to correct the findings clarified that
the commissioner found no connection between the
lifting incident and the plaintiff’s heart disease. Specifically, the commissioner rejected the plaintiff’s motion
to correct the findings to state that the plaintiff had
‘‘reported symptoms of heart disease on October 2,
1996, which were misdiagnosed as solely orthopedic
problems but because the [defendant] provided medical
care for the symptoms . . . the claim is timely brought
. . . .’’ The commissioner, therefore, did not find that
there had been a misdiagnosis or that the defendant
had provided treatment to the plaintiff for symptoms
of heart disease. Additionally, the plaintiff had
requested that the findings be corrected to state: ‘‘The
[plaintiff] suffered pain on October 2, 1996, which was
reported to his employer and for which medical treatment was provided. It was discovered that this pain
was both orthopedic and anginal in nature on April 6,
2000.’’ The commissioner’s denial of these requested
corrections demonstrates that he found no connection
whatsoever between the October 2, 1996 incident and
the plaintiff’s heart disease. Given these findings, which
the plaintiff has not successfully challenged, the board
properly affirmed the decision of the commissioner.
The plaintiff’s arguments to the contrary are unpersuasive. First, he claims that he is not required to demonstrate that the October 2, 1996 incident caused his
heart disease, because § 7-433c does not require a claimant to prove a causal connection to employment. Ciarlelli v. Hamden, supra, 299 Conn. 276. The plaintiff
misses the point of the medical care exception—
although he would not need to show a causal connection to his employment to qualify for benefits pursuant
to § 7-433c, he still must meet the requirements of § 31294c, which, because he seeks to benefit from the medical care exception provision, require that he prove
either: (1) that his employer previously furnished medical care for the specific condition at issue in the late
claim; or (2) that a late claimed condition was causally
related to a timely reported incident for which the
employer furnished medical care. The plaintiff argued
that his heart disease was related to the October 2, 1996
incident, so he was required to show that the incident
caused his late claimed condition, the heart disease.
The plaintiff also contends that, in order to toll the
statute of limitations, he merely needed to demonstrate
that he reported symptoms that were consistent with
angina, and was not required to prove that the lifting
incident caused his heart disease. As we already have
explained, however, the commissioner’s findings do not
support the conclusion that the plaintiff reported symptoms that were consistent with angina. Finally, even if
we agreed with the plaintiff’s additional contention that
the defendant at one point conceded the existence of
coronary artery disease, which we do not, that argument
would be unavailing. The commissioner’s factual finding that the plaintiff failed to prove a connection
between the October 2, 1996 incident and his heart
disease is dispositive of the appeal.
The decision of the compensation review board is
affirmed.
In this opinion the other justices concurred.
1
General Statutes § 31-294c provides in relevant part: ‘‘(a) No proceedings
for compensation under the provisions of this chapter shall be maintained
unless a written notice of claim for compensation is given within one year
from the date of the accident or within three years from the first manifestation of a symptom of the occupational disease, as the case may be, which
caused the personal injury . . . .
‘‘(c) Failure to provide a notice of claim under subsection (a) of this
section shall not bar maintenance of the proceedings if . . . within the
applicable period an employee has been furnished, for the injury with respect
to which compensation is claimed, with medical or surgical care as provided
in section 31-294d. . . .’’
2
The plaintiff appealed from the decision of the compensation review
board to the Appellate Court, and this court transferred the appeal to itself
pursuant to General Statutes § 51-199 (c) and Practice Book § 65-1.
3
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 employment, no proof or record of such examination shall be required as evidence
in the maintenance of a claim under this section or under such municipal
or state retirement systems. The benefits provided by this section shall be
in lieu of any other benefits which such policeman or fireman or his dependents may be entitled to receive from his municipal employer under the
provisions of chapter 568 or the municipal or state retirement system under
which he is covered, except as provided by this section, as a result of 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. As used in this section, the term ‘municipal employer’ shall have the
same meaning and shall be defined as said term is defined in section 7-467.’’
4
‘‘A form 30C is the form prescribed by the workers’ compensation commission . . . for use in filing a notice of claim under the [Workers’ Compensation Act] . . . .’’ (Internal quotation marks omitted.) Del Toro v. Stamford,
270 Conn. 532, 536 n.4, 853 A.2d 95 (2004).
5
The board observed that, ‘‘[t]he question of timely notice aside, claims
for § 7-433c benefits are not recognized unless the condition of hypertension
or heart disease and the death or disability resulting from such condition
are suffered while the claimant is a regular member of the police or fire
department.’’ See General Statutes § 7-433c (a).
6
The plaintiff does not claim to establish jurisdiction under § 31-294c (a),
and indeed would be unable to do so. The commissioner included in his
findings that the plaintiff was diagnosed with acute myocardial infarction
on April 5, 2000. The commissioner also found that the plaintiff filed a form
30C, notice of claim on June 20, 2001, more than one year after he was
diagnosed with heart disease.
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