Fieldhouse v. Regency Coachworks, Inc. ( 2022 )


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    FIELDHOUSE v. REGENCY
    COACHWORKS, INC., ET AL.
    (AC 44225)
    Bright, C. J., and Alvord and DiPentima, Js.*
    Syllabus
    Pursuant to statute (§ 31-294c (a)), no proceedings for workers’ compensa-
    tion shall be maintained unless a written notice of claim for compensa-
    tion is given, inter alia, within one year of the date of the accident that
    caused the personal injury.
    The defendant employer appealed to this court from the decision of the
    Compensation Review Board reversing the decision of the Workers’
    Compensation Commissioner denying and dismissing, for lack of subject
    matter jurisdiction, the plaintiff employee’s claim for workers’ compen-
    sation benefits. During the course of her employment with the defendant,
    the plaintiff was injured, and, thereafter, the plaintiff’s direct supervisor
    advised the plaintiff to submit a workers’ compensation claim when her
    pain did not resolve. Subsequently, the plaintiff visited the defendant’s
    workers’ compensation insurance agency, P Co., in person, after it failed
    to return her calls requesting to file a claim. At P Co., the plaintiff stated
    that she wanted to file a claim and a P Co. employee, F, told her not
    to worry because she had two years to file a claim. F assisted the plaintiff
    with completing a first report of injury and told the plaintiff that she
    would file the claim for the plaintiff. The plaintiff thereafter received a
    phone call from the defendant’s workers’ compensation insurer, B Co.,
    and the plaintiff provided a recorded statement about the incident and
    the treatment she had received. Shortly thereafter, the plaintiff received
    correspondence from B Co. indicating that the insurer had opened a
    claim and assigned a claim number for the plaintiff’s date of injury. B Co.
    also enclosed in that correspondence a pharmacy card. The defendant
    subsequently filed a form 43 contesting both the jurisdiction and compen-
    sability of the plaintiff’s claim. The plaintiff did not file a form 30C
    notice of claim or request a hearing within one year of the injuries she
    had sustained, as required by § 31-294c. The commissioner determined
    that, because the plaintiff failed to meet the statutory notice requirement
    for filing a claim for workers’ compensation benefits set forth in § 31-
    294c (a) and failed to satisfy an exception to the notice requirement set
    forth in § 31-294c (c), the Workers’ Compensation Commission lacked
    subject matter jurisdiction. On appeal, the board, inter alia, reversed
    the commissioner’s decision, concluding that the commissioner misap-
    plied the totality of the circumstances standard and that the plaintiff
    substantially complied with the statutory notice provisions such that
    the defendant was provided with constructive notice of the claim. On
    the defendant’s appeal to this court, held that the board properly reversed
    the commissioner’s decision, the board having properly determined that
    the totality of the circumstances indicated that the plaintiff substantially
    complied with the statutory notice provisions of § 31-294c (a): the defen-
    dant had sufficient notice that the plaintiff was pursuing or intended to
    pursue a workers’ compensation claim and the prerequisites for estab-
    lishing the commission’s subject matter jurisdiction over a claim were
    met as the plaintiff had filed a first report of injury form, provided a
    recorded statement to B Co., and received correspondence from B Co.
    regarding her claim within one year of the date of injury, which indicated
    that it had opened a claim and assigned a claim number for the plaintiff.
    Argued November 10, 2021–officially released July 12, 2022
    Procedural History
    Appeal from the decision of the Workers’ Compensa-
    tion Commissioner for the Second District denying and
    dismissing the plaintiff’s claim for workers’ compensa-
    tion benefits for lack of subject matter jurisdiction,
    brought to the Compensation Review Board, which
    reversed the commissioner’s decision, from which the
    named defendant appealed to this court. Affirmed.
    David C. Davis, for the appellant (named defendant).
    Lawrence C. Sgrignari, for the appellee (plaintiff).
    Opinion
    ALVORD, J. The defendant Regency Coachworks,
    Inc.,1 appeals from the decision of the Compensation
    Review Board (board) reversing the decision of the
    Workers’ Compensation Commissioner for the Second
    District (commissioner) determining that the plaintiff,
    Linda Fieldhouse, failed to satisfy the notice require-
    ment set forth in General Statutes § 31-294c and that
    her claim for workers’ compensation benefits failed to
    satisfy an exception to the notice requirement as set
    forth in § 31-294c (c). On appeal, the defendant claims
    that the board erred, as a matter of law, in concluding
    that the commissioner misapplied the totality of the
    circumstances standard and that the plaintiff had sub-
    stantially complied with the notice requirements such
    that the defendant was provided with constructive
    notice of the claim. We affirm the decision of the board.
    The following facts, as found by the commissioner,
    and procedural history are relevant to our resolution
    of this appeal. On November 27, 2015, in the course of
    her employment for the defendant, the plaintiff fell
    down several stairs. The fall caused her to hit her head
    on the door at the bottom of the stairs, hit her knee on
    something, and bend her foot. She was unable to get
    up from the floor on her own, and her direct supervisor
    on that date, Robert Charland, had to help her. He
    assisted her up the stairs to her office where she sat
    down at her desk; however, after a few hours, she real-
    ized that the pain was not receding. After she informed
    Charland about her pain, he gave her permission to
    leave. The plaintiff left the office and drove herself to
    an urgent care clinic in Enfield.
    At some point following the incident, the plaintiff
    told Charland that, because she was not getting any
    better, she was considering filing a workers’ compensa-
    tion claim, and he advised her to do so. Thereafter, she
    called the defendant’s workers’ compensation insur-
    ance agency, Paradiso Insurance Agency (agency), and
    told a representative that she needed to file a claim.
    On November 16, 2016, after previously leaving several
    messages in an attempt to make an appointment, the
    plaintiff visited the agency in person as its office is
    located just one street over from the defendant’s office.
    At the agency, the plaintiff specifically stated that she
    wanted to file a workers’ compensation claim, but an
    agency employee, Stephanie Fanelli, told her not to
    worry because she had two years to file a claim. Fanelli
    also helped her to complete a first report of injury and
    told the plaintiff that she would file the claim for her.
    Because the plaintiff was unaware of the specific
    time frame for filing a workers’ compensation claim,
    she relied on Fanelli’s statement that she had two years
    to file a claim and that Fanelli would file the claim. The
    plaintiff believed that the first report of injury that she
    had completed with Fanelli initiated her claim. After
    that report was completed, she received a number of
    communications from the defendant’s workers’ com-
    pensation insurer, BerkleyNet Underwriters, LLC
    (BerkleyNet), which she thought meant that her claim
    had been opened. First, on November 22, 2016, the
    plaintiff received a telephone call from a BerkleyNet
    representative, to whom she gave an approximately
    twenty-five minute long recorded statement. The plain-
    tiff believed that her recorded statement provided Berk-
    leyNet with information about the incident and the
    treatment she had received, allowing her to continue
    her claim. Shortly thereafter, the plaintiff also received
    correspondence from BerkleyNet, dated November 22,
    2016, indicating that the insurer had opened a claim
    and assigned a claim number for a date of injury of
    November 27, 2015, and enclosed a pharmacy card. The
    plaintiff then received a letter, dated March 27, 2017,
    stating in relevant part: ‘‘In accordance with your
    [w]orkers’ [c]ompensation claim from Friday, Novem-
    ber 27, 2015, BerkleyNet . . . has arranged for you to
    be examined . . . .’’ The wording of this letter solidi-
    fied the plaintiff’s belief that she had a pending workers’
    compensation claim that had been commenced on
    November 16, 2016. Moreover, on May 4, 2017, the plain-
    tiff received correspondence welcoming her to the
    BerkleyNet pharmacy program, along with a second
    pharmacy card. As of the date of the formal hearing
    on November 20, 2018, however, the plaintiff had not
    received any workers’ compensation benefits.
    At trial, the defendant did not dispute that an incident
    occurred at the workplace on November 27, 2015. It
    argued, however, that the Workers’ Compensation Com-
    mission (commission) was deprived of subject matter
    jurisdiction because (1) the plaintiff did not file a notice
    of claim (form 30C)2 within one year from the date of
    injury and (2) none of the statutory exceptions to that
    requirement were satisfied. In opposition, the plaintiff
    asserted that, under the totality of the circumstances,
    the defendant was aware of her claim within one year
    of her date of injury.
    The commissioner took administrative notice of a
    form 30C dated June 29, 2017, which was received by
    the commission on July 3, 2017, and a second copy of
    the same form 30C, which was received by the commis-
    sion on July 26, 2017. The commissioner also took
    administrative notice of a denial of claim (form 43)3
    that was received by the commission on July 26, 2017,
    in which the defendant challenged both jurisdiction and
    compensability. Additionally, the commissioner took
    administrative notice of the fact that the first hearing
    request was received from the plaintiff on July 28, 2017,
    and that the first hearing was held on August 21, 2017.
    The commissioner then made the following findings:
    the plaintiff failed to file a form 30C within one year
    of November 27, 2015, her date of injury; no hearing
    was requested and none was held within one year of
    November 27, 2015; no voluntary agreement was ever
    issued; and the defendant and BerkleyNet did not pro-
    vide the plaintiff with any medical or surgical care.
    Ultimately, the commissioner determined that,
    because the plaintiff failed to meet the statutory notice
    requirements for filing a claim for workers’ compensa-
    tion benefits set forth in § 31-294c, the commission
    lacked subject matter jurisdiction. Therefore, the com-
    missioner denied and dismissed the plaintiff’s claim.
    Subsequently, on appeal, the board concluded that the
    commissioner misapplied ‘‘the totality of circumstances
    standard’’ and that ‘‘[t]he actions taken by [BerkleyNet]
    on and after November 22, 2016, serve[d] to demon-
    strate that the claimant’s interactions with her immedi-
    ate supervisor, coupled with her personal appearance
    at the workers’ compensation insurance agency with
    the express intention of filing a workers’ compensation
    claim, reflect that the claimant substantially complied
    with the statutory notice provisions such that the
    [defendant was] provided with constructive notice of
    this claim.’’
    On appeal to this court, the defendant asserts that
    the board erred, as a matter of law, in reversing the
    commissioner’s decision because ‘‘ ‘totality of circum-
    stances’ or ‘substantial compliance’ are not statutory
    exceptions to the notice requirement as set forth in the
    plain language of the [Workers’ Compensation Act (act),
    General Statutes § 31-275 et seq.].’’ More specifically,
    the defendant contends that the commission is a body
    created by statute, whose jurisdiction is outlined by the
    legislature, and it is legal error to carve out another
    exception to the notice of claim requirements of § 31-
    294c (a). Thus, the defendant argues that, without
    proper notice, the commission lacked subject matter
    jurisdiction. We disagree.
    We first set forth our standard of review and the
    general principles applicable to workers’ compensation
    appeals. ‘‘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. . . . Neither the . . . board nor
    this court has the power to retry [the] facts. 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. . . . The commissioner has the power and duty,
    as the trier of fact, to determine the facts. . . . Our
    scope of review of the actions of the board is similarly
    limited. . . . The role of this court is to determine
    whether the review [board’s] decision results from an
    incorrect application of the law to the subordinate facts
    or from an inference illegally or unreasonably drawn
    from them. . . .
    ‘‘Cases that present pure questions of law, however,
    invoke a broader standard of review than is ordinarily
    involved in deciding whether, in light of the evidence,
    the agency has acted unreasonably, arbitrarily, illegally
    or in abuse of its discretion. . . . Because the filing of
    a notice of claim implicates the [commission’s] subject
    matter jurisdiction . . . we review this determination
    applying a plenary standard of review.’’ (Citation omit-
    ted; internal quotation marks omitted.) Izikson v. Pro-
    tein Science Corp., 
    156 Conn. App. 700
    , 707, 
    115 A.3d 55
     (2015).
    Section 31-294c (a) provides in relevant part: ‘‘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 . . . .’’ Our Supreme Court
    has explained that ‘‘[f]iling a notice of claim or . . .
    satisfaction of one of the . . . exceptions [contained
    in § 31-294c (c)] is a prerequisite that conditions whether
    the [commission] has subject matter jurisdiction under
    the [act].’’ (Internal quotation marks omitted.) Veilleux
    v. Complete Interior Systems, Inc., 
    296 Conn. 463
    , 468,
    
    994 A.2d 1279
     (2010).
    ‘‘Furthermore, [i]t is well established that, in resolv-
    ing issues of statutory construction under the [act], we
    are mindful that the act indisputably is a remedial stat-
    ute that should be construed generously to accomplish
    its purpose. . . . The humanitarian and remedial pur-
    poses of the act counsel against an overly narrow con-
    struction that unduly limits eligibility for workers’ com-
    pensation. . . . Accordingly, [i]n construing workers’
    compensation law, we must resolve statutory ambigu-
    ities or lacunae in a manner that will further the reme-
    dial purpose of the act. . . . [T]he purposes of the act
    itself are best served by allowing the remedial legisla-
    tion a reasonable sphere of operation considering those
    purposes.’’ (Citation omitted; internal quotation marks
    omitted.) DeJesus v. R.P.M. Enterprises, Inc., 
    204 Conn. App. 665
    , 677–78, 
    255 A.3d 885
     (2021).
    ‘‘Administrative agencies [such as the commission]
    are tribunals of limited jurisdiction and their jurisdic-
    tion is dependent entirely upon the validity of the stat-
    utes vesting them with power and they cannot confer
    jurisdiction upon themselves. . . . The plain language
    of the [act] . . . requires one of four possible prerequi-
    sites to establish the [commission’s] subject matter
    jurisdiction over a claim: (1) a timely written notice of
    claim; General Statutes § 31-294c (a); (2) a timely hear-
    ing or a written request for a hearing or an assignment
    for a hearing; General Statutes § 31-294c (c); (3) the
    timely submission of a voluntary agreement; General
    Statutes § 31-294c (c); or (4) the furnishing of appro-
    priate medical care by the employer to the employee for
    the respective work-related injury.’’ (Citation omitted;
    internal quotation marks omitted.) Izikson v. Protein
    Science Corp., supra, 
    156 Conn. App. 708
    .
    We begin our analysis with § 31-294c, which estab-
    lishes the filing periods for notices of claim with respect
    to workers’ compensation injuries. As stated previously,
    for the commission to have jurisdiction over a claim for
    workers’ compensation benefits, § 31-294c (a) requires
    a claimant to file a ‘‘written notice of claim for compen-
    sation . . . within one year from the date of the acci-
    dent or within three years from the first manifestation
    of a symptom of the occupational disease, as the case
    may be . . . .’’
    ‘‘Although a form 30C is the standard form used to
    provide notice of an employee’s intent to pursue a work-
    ers’ compensation claim, § 31-294c (a) does not require
    a plaintiff to draft his or her written notice of claim
    with absolute precision. . . . The legislature designed
    the [act] to further a remedial purpose. . . . The act’s
    provisions, therefore, should be broadly construed to
    accomplish its humanitarian purpose. . . . The pur-
    pose of [§ 31-294c], in particular, is to alert the employer
    to the fact that a person has sustained an injury that
    may be compensable . . . and that such person is
    claiming or proposes to claim compensation under the
    [a]ct. . . . Furthermore, the statute’s requirement that
    the plaintiffs use simple language when issuing a notice
    of claim indicates that the legislature intended to facili-
    tate lay persons who pursue their claims without the
    advice of counsel. . . .
    ‘‘In light of the foregoing principles, our case law has
    recognized that an employee satisfies the notice of claim
    requirement of § 31-294c (a) if, under the totality of the
    circumstances, he or she provides written notice that is
    in substantial compliance with the notice content require-
    ments of [§ 31-294c (a)].’’ (Citations omitted; internal
    quotation marks omitted.) Izikson v. Protein Science
    Corp., supra, 
    156 Conn. App. 708
    –709.
    For example, in Funaioli v. New London, 
    52 Conn. App. 194
    , 195, 
    726 A.2d 626
     (1999), the plaintiff attended
    a routine physical examination in March, 1987, during
    which he was diagnosed with hypertension. One year
    later, the plaintiff hired a law firm to represent him;
    id.; and the plaintiff’s attorney ‘‘sent a letter to the
    second district workers’ compensation commissioner
    and to the chairman of the workers’ compensation com-
    mission that stated: ‘Enclosed you will find a [first
    report of occupational injury or disease] with reference
    to the above-named Claimant. We are not requesting a
    hearing at this time.’ ’’ Id., 196. Notably, ‘‘[t]he plaintiff
    did not file a form 30C notice of claim until 1992 through
    a new attorney . . . .’’ Id. This court, however, held
    that the letter from the plaintiff’s attorney stating that
    the claimant was not requesting a hearing ‘‘at this time’’
    along with the first report of injury, were sufficient to
    satisfy the notice requirement of § 31-294c. Id., 196, 198.
    Conversely, in Izikson, after the plaintiff was injured
    in the course of his employment with the defendant,
    he notified his supervisor, who filled out a first report
    of injury form and transmitted it to the employer’s insur-
    ance provider. Izikson v. Protein Science Corp., supra,
    
    156 Conn. App. 702
    . The supervisor then informed the
    plaintiff that the insurance provider wanted to speak
    with him and that the plaintiff should contact the insur-
    ance provider directly to learn more about the process
    of pursuing a workers’ compensation claim. 
    Id.,
     702–
    703. The plaintiff received a prescription card in the
    mail from the insurance provider, but the accompanying
    letter did not indicate that it had accepted any claim.
    
    Id., 703
    . A form 30C was never filed, and the plaintiff
    never requested a hearing within one year of his injury.
    
    Id.
     Subsequently, more than one year after the injury
    occurred, the plaintiff filed a claim for workers’ com-
    pensation benefits. 
    Id., 704
    . His claim was dismissed
    as untimely by the commissioner and that dismissal
    subsequently was affirmed by the board. 
    Id., 705
    . This
    court held that the board properly affirmed the commis-
    sioner’s determination because the plaintiff failed to
    comply with the notice of claim requirement of § 31-
    294c (a), as he ‘‘failed to provide any sort of written
    notice informing the defendants that he was pursuing
    or intended to pursue a workers’ compensation claim.’’
    Id., 712. Most notably, this court found the following
    facts, among others, to be determinative: the supervisor,
    not the plaintiff, filed the first report of injury form; the
    plaintiff never sent any e-mail or other correspondence
    mentioning an intent to file a claim; and the plaintiff
    never contacted the insurance provider, even after his
    supervisor suggested that he do so. Id.
    In the present case, unlike in Izikson, when Charland
    told the plaintiff to go ahead and file a claim with the
    agency, the plaintiff, after many unsuccessful attempts
    to contact the agency, visited the agency in person and,
    at that time, was able to file her first report of injury
    form. Similar to the plaintiff in Izikson, however, the
    plaintiff in the present case believed that a claim had
    been opened when she received a letter and pharmacy
    card from BerkleyNet, dated November 22, 2016.4 But,
    unlike in Izikson, in the present case, the plaintiff
    received the letter and pharmacy card from BerkleyNet
    as a direct result of her efforts to initiate and pursue her
    workers’ compensation claim. Specifically, the plaintiff
    initiated the claims process by filing a first injury report
    with Fanelli. Subsequently, on November 22, 2016, she
    gave a recorded statement to a representative from
    BerkleyNet that lasted roughly twenty-five minutes.
    Notably, the plaintiff filed her first injury report, pro-
    vided her recorded statement, and received the letter
    with the pharmacy card in response to her statement
    all within one year of the date of injury. Finally, a few
    months after she had provided the recorded statement,
    the plaintiff received a letter stating that ‘‘[i]n accor-
    dance with your [w]orkers’ [c]ompensation claim from
    Friday, November 27, 2015, [BerkleyNet] has arranged
    for you to be examined . . . .’’
    Accordingly, given that the plaintiff had filed a first
    report of injury form, provided a recorded statement
    to BerkleyNet, and received multiple pieces of corre-
    spondence in the mail regarding her ‘‘[w]orkers’ [c]om-
    pensation claim from Friday, November 27, 2015,’’ and
    indicating that BerkleyNet had opened a claim and
    assigned a claim number for the plaintiff, we conclude
    that the board properly determined that, based on the
    totality of the circumstances, the plaintiff substantially
    complied with the statutory notice provisions of § 31-
    294c (a).
    To be clear, in reaching this conclusion, we are not
    carving out a new exception to the notice requirements
    of § 31-294c (a). We reiterate that ‘‘[i]t is not the court’s
    role to acknowledge an exclusion when the legislature
    painstakingly has created such a complete statute. We
    consistently have acknowledged that the act is an intri-
    cate and comprehensive statutory scheme. . . . The
    complex nature of the workers’ compensation system
    requires that policy determinations should be left to
    the legislature, not the judiciary.’’ (Internal quotation
    marks omitted.) Salerno v. Lowe’s Home Improvement
    Center, 
    198 Conn. App. 879
    , 884, 
    235 A.3d 537
     (2020);
    see also Wiblyi v. McDonald’s Corp., 
    168 Conn. App. 92
    , 107, 
    144 A.3d 530
     (2016) (‘‘we will not recognize, in
    the absence of legislative action,’’ time limitation not
    set forth in statute); Izikson v. Protein Science Corp.,
    supra, 
    156 Conn. App. 713
     (expressly declining ‘‘to carve
    out another exception’’ to notice of claim requirement
    in § 31-294c (a) because ‘‘the legislature, rather than
    this court, is the proper forum through which to create’’
    additional exceptions to that statute). We simply con-
    clude that the plaintiff, in filing her first report of injury
    with BerkleyNet and supplementing it with a recorded
    statement, substantially complied with the written
    notice requirement § 31-294c (a).
    The decision of the Compensation Review Board is
    affirmed.
    In this opinion the other judges concurred.
    * This appeal originally was argued before a panel of this court consisting
    of Chief Judge Bright, Judge Alvord, and former Justice Sullivan. Thereafter,
    Judge DiPentima replaced former Justice Sullivan. Judge DiPentima has
    read the briefs and appendices and listened to a recording of the oral
    argument prior to participating in this decision.
    1
    BerkleyNet Underwriters, LLC, the workers’ compensation insurer for
    Regency Coachworks, Inc., was also named as a defendant in this action
    but is not a party to this appeal. We therefore refer in this opinion to Regency
    Coachworks, Inc., as the defendant.
    2
    ‘‘A form 30C is the form prescribed by the workers’ compensation com-
    mission of Connecticut for use in filing a notice of [a workers’ compensation]
    claim . . . .’’ (Internal quotation marks omitted.) Reid v. Speer, 
    209 Conn. App. 540
    , 543 n.3, 
    267 A.3d 986
     (2021), cert. denied, 
    342 Conn. 908
    , 
    271 A.3d 136
     (2022).
    3
    ‘‘A form 43 is a disclaimer that notifies a claimant who seeks workers’
    compensation benefits that the employer intends to contest liability to pay
    compensation.’’ (Internal quotation marks omitted.) Woodbury-Correa v.
    Reflexite Corp., 
    190 Conn. App. 623
    , 626 n.3, 
    212 A.3d 252
     (2019).
    4
    The letter dated November 22, 2016, states that it was sent in regard to
    the status of her claim for her injury suffered on November 27, 2015. The
    letter provides in relevant part: ‘‘BerkleyNet is the workers compensation
    carrier for your [e]mployer . . . . We have received a First Report of Injury
    and have opened a claim for the date of injury above. . . . If you need
    medical treatment, please ask your employer for the name of an approved
    provider on your company’s panel of network doctors. If you need to fill a
    prescription related to your injury at work, please use the enclosed Instant
    Access Pharmacy Card at a participating network pharmacy to avoid paying
    out-of-pocket for your medication.’’
    

Document Info

Docket Number: AC44225

Filed Date: 7/12/2022

Precedential Status: Precedential

Modified Date: 7/11/2022