Opinion
CASE NO. 4550 CRB-1-02-7, CLAIM NO. 100034862
APRIL 3, 2003
The claimant was represented by Donald Leis, Jr., Esq., Bromson Reiner, 546 Halfway House Road, Windsor Locks, CT 06096-1599.
The respondents were represented by Michael J. McAuliffe, Esq., Pomeranz, Drayton Stabnick, 95 Glastonbury Road, Glastonbury, CT 06033.
This Petition for Review from the July 2, 2002 Finding and Dismissal of the Commissioner acting for the First District was heard February 21, 2003 before a Compensation Review Board panel consisting of the Commission Chairman John A. Mastropietro and Commissioners Nancy A. Brouillet and Howard M. Belkin.
OPINION
The claimant has petitioned for review from the July 2, 2002 Finding and Dismissal of the Commissioner acting for the First District. She contends on appeal that the trial commissioner erred by ruling that she was not entitled to continued health insurance benefits pursuant to § 31-284b C.G.S. following the death of her husband, Carl Weymouth. We find error, and reverse the trial commissioner's decision.
The decedent was a 25-year employee of the respondent town of East Windsor. He had been collecting benefits pursuant to § 7-433c C.G.S. at the time of his death on February 17, 1998, and had also been provided with group health insurance benefits for himself and his wife. Upon his death, the respondents contended that they were no longer responsible for continuing this health insurance for the benefit of his dependent widow pursuant to § 31-306 C.G.S. The trial commissioner agreed with that argument. Though this very issue had been decided by this board inSansone v. Enfield, 3885 CRB-1-98-9 (Nov. 18, 1999), where we held that a dependent widow (or widower) is entitled to continued health insurance coverage under § 31-284b as part of her compensation under § 31-306, the trier explained, "I still feel that the dissenting opinion in that case correctly interpreted the two statutes, Section 31-284b and 31-306. . . . Section 31-306 clearly states that employers are required to pay "compensation' to surviving dependents. There is no reference to payment of health insurance. Since the statutory language is clear and unambiguous, there is no room for construction." Accordingly, the trier dismissed the widow's claim for benefits. The claimant has filed an appeal from that ruling.
We begin with a discussion of Sansone, supra, whose material facts are substantially identical to the facts of this case. There, the decedent was a police officer for the town of Enfield prior to suffering a fatal myocardial infarction on July 7, 1986. His job had entitled him and his spouse to health insurance benefits. Upon his death, his widow, a presumptive dependent under § 31-306, attempted to avail herself of health insurance benefits. The respondent declined to provide such coverage. The trial commissioner ruled that the combination of §§ 31-284b (a), 31-306, 7-433b and 7-433c entitled her to continued medical insurance coverage.
In affirming that decision on appeal, we observed that § 31-284b (a) provides:
In order to maintain, as nearly as possible, the income of employees who suffer employment-related injuries, any employer who provides accident and health insurance or life insurance coverage for any employee or makes payments or contributions at the regular hourly or weekly rate for full-time employees to an employee welfare plan, shall provide to the employee equivalent insurance coverage or welfare plan payments or contributions while the employee is eligible to receive or is receiving compensation pursuant to this chapter, or while the employee is receiving wages under a provision for sick leave payments for time lost due to an employment-related injury. As used in this section, "income" means all forms of remuneration to an individual from his employment, including wages, accident and health insurance coverage, life insurance coverage and employee welfare plan contributions and "employee welfare plan" means any plan established or maintained for employees or their families or dependents, or for both, for medical, surgical or hospital care benefits.
This statute applies to employees of the state of Connecticut and its municipalities, as it has been declared unconstitutional as applied to private employers in light of the preemptive effect of the federal Employee Retirement Income Security Act. Civardi v. Norwich, 231 Conn. 287, 298-99 n. 14 (1994), citing District of Columbia v. Greater Washington Board of Trade, 506 U.S. 125 (1992); Luis v. Frito-Lay, Inc., Supreme Court, Docket No. SC 14536 (Order, April 27, 1993). Thus, employees of towns such as Enfield and East Windsor may continue to receive health insurance coverage for themselves and their families while receiving compensation benefits, including § 7-433c benefits. Deschnow v. Stamford, 214 Conn. 394, 398 (1990).
Section 31-306 (a), meanwhile, conclusively presumes a widow such as the claimant in Sansone (or in the instant case) to be a dependent of the deceased employee, and thus entitled to "compensation" under the statute. In general, the term compensation" is currently defined by § 31-275 (4) to include all benefits mandated by the Workers' Compensation Act, including payments made under the provisions of § 31-284b. Section 31-306 (a) prescribes payment of "compensation . . . as follows," and then mentions two specific types: first, $4000 in burial expenses ($3000 at the time of the claimant's death in Sansone), and second, a weekly compensation benefit equal to three-fourths of the after-tax weekly earnings of the deceased employee, along with cost-of living adjustments (two-thirds of the before-tax earnings at the time of the claimant's death in Sansone).
In Sansone, we noted that the absence of references to further benefits in § 31-306 has not stopped courts from authorizing dependent survivors of deceased workers from recovering other types of benefits, such as specific indemnity awards. Cappellino v. Cheshire, 226 Conn. 569, 575 (1993). We then cited the purpose of§ 31-284b, which is to protect injured employees by maintaining as much of their income as is possible, including health insurance benefits. "In order to keep these dependents in the same financial position that they were when the decedent was still living, their "compensation' would necessarily have to include a maintenance of health and life insurance benefits under § 31-284b. It would be inconsistent with the benevolent spirit of the Act to hold that a dependent spouse whose husband survived his compensable injury would normally be entitled to continue her insurance coverage under § 31-284b, but that a dependent widow would not qualify for such compensation even though she is eligible for other economic loss' benefits under chapter 568." Sansone, supra. Accordingly, we held that the "ambiguous interplay of § 31-284b and § 31-306 should be construed to allow the claimant to receive accident, life and health insurance coverage as part of her survivor's benefits." One commissioner dissented, opining that the definition of "compensation" in § 31-306 is restricted to the items specifically listed therein, which do not include § 31-284b benefits.
The facts of the instant case are functionally identical to those in Sansone. One would expect, therefore, that the principle of stare decisis would have led the trier to follow the Sansone decision here. The stare decisis doctrine "counsels that a court should not overrule its earlier decisions unless the most cogent reasons and inescapable logic require it." George v. Ericson, 250 Conn. 312, 318 (1999), quoting Hall v. Gilbert Bennett Mfg. Co., 241 Conn. 282, 296 (1997). "Stare decisis is justified because it allows for predictability in the ordering of conduct, it promotes the necessary perception that the law is relatively unchanging, it saves resources and it promotes judicial efficiency." George, supra, citing Conway v. Wilton, 238 Conn. 653, 658-59 (1996). As an appellate body, we are faithful to the stare decisis doctrine. Without it, there would be no guarantee of decisionmaking consistency in our legal culture, and the elimination of that normative influence would diminish the value of the law in general. Naturally, exceptions to the rule are necessary, and principles of law that are initially valuable may become detrimental to the operation of the law at a later time, thereupon requiring modification. George, supra, citing Jolly, Inc. v. Zoning Board of Appeals, 237 Conn. 184, 196 (1996). We also value the ability of judges and commissioners to think independently. However, a court, agency or tribunal should not break from precedent unless there is an inescapable and crucial need to do so in the interests of justice. George, supra, 319; Conway, supra, 660.
At the time of the trier's decision, this board's ruling in Sansone was less than three years old. The legislature has not since acted to contravene the effects of that holding, nor has our system since changed in such a way that there is cause to consider modifying our decision. We do not believe there was cause for the trier to ignore this board's pronouncement in Sansone under these circumstances. In doing so, he risked fostering an impression that the precedents set by this board of appeal are routinely open to question, with a litigant's chances of success being primarily dependent on the personal views of a given commissioner as to the correct interpretation of the law. Whether or not our decision is eventually upheld on further appeal, it presently holds precedential weight and should be followed accordingly until an appeals tribunal, if an appeal is taken, advises otherwise.
Furthermore, this appeal has given us occasion to further consider the merits of this issue. After reviewing our reasoning in Sansone, and considering the respondents' arguments, we are even more firmly convinced that our prior ruling was correct, and emphatically endorse the majority opinion in that decision. We also wish to make one or two additional points. When we state that our legislature has not acted to overturn the effects of Sansone, we are also recognizing our Appellate Court's 1991 decision in Tufaro v. Pepperidge Farm, Inc., 24 Conn. App. 234 (1991). There, the court held that § 31-284b applies not only to an injured employee who is unable to return to work following the termination of her job, but also to her dependents. The court held that, despite the absence of a specific reference to dependents in § 31-284b, the legislative intent to cover such dependents could be inferred from the express objective of the statute, which was to maintain the income of employees who suffer employment-related injuries. "Because the underlying purpose of the act is to provide not only for the worker but also for her dependents, . . . the compensation review division reasonably and correctly construed General Statutes § 31-284b to include the dependents' benefits as a part of that [employee's] income." Id., 239. No voice of disapproval for this holding has emerged from our legislature, and it has become commonly accepted in this system that health insurance for dependents is included in the protections of § 31-284b.
Pepperidge Farm, Inc., is, of course, a private-sector company. At the time Tufaro was decided, the federal preemption question regarding § 31-284b's applicability to private employers had not yet been fully resolved. The most recent court decision from the Second Circuit Court of Appeals had affirmed a holding that § 31-284b was not preempted by ERISA, and the court considered the matter so settled. Tufaro, supra, 237, citing R.R. Donnelley Sons Co. v. Prevost, 915 F.2d 787 (2d. Cir. 1990).
The trial commissioner below stated that death benefits for survivors, though derivative from an injured employee's claim, are prescribed separately by § 31-306 and are not identical to those received by an injured employee during his lifetime. This is quite true, insofar as an injured employee is entitled to reasonable medical care for his compensable injuries pursuant to § 31-294d, and intrinsically personalized benefits like the § 31-283a rehabilitation program. Still, the availability of survivorship benefits is "inextricably linked to, and wholly dependent on, the existence of a compensable injury or illness suffered by the employee. . . . A dependent has no compensation rights unless and until the employee dies as a result of the occupational injury or disease. Further, the calculation of the amount of survivor's benefits to which a dependent may be entitled is determined as of the date of the employee's injury and not as of the date on which the dependent becomes eligible to receive such benefits." Duni v. United Technologies Corp./Pratt Whitney Aircraft Division, 239 Conn. 19, 25 (1996). The classes of compensation awarded to an employee and his or her dependents may be separate and independent of each other, but they both arise out of the same incident. "If the employee is awarded compensation for an injury, and in consequence of it, subsequently dies, the injury preceding the death and the death arose out of the one injury, compensation for the latter is payable to and belongs to the dependent, while the compensation awarded to the living employee is payable to and belongs to him [or her]." Duni, supra, 26 n. 8, quotingBiederzycki v. Farrel Foundry Machine Co., 103 Conn. 701, 704-705 (1926).
Looking at the essence of group health insurance benefits that are continued under § 31-284b, which coverage under Tufaro, supra, must be maintained on behalf of both an employee and his dependents, we cannot ignore the fact that these benefits directly impinge upon the welfare of both the employee and each one of the dependents covered under the policy. If we allow ourselves to characterize this benefit as "compensation" for a moment, we see that it is "compensation" with aspects that simultaneously and directly benefit both the living employee and his dependents. If that employee should die, it would disserve the remedial purpose of the act and the stated intent of § 31-284b to characterize this benefit as one that was redeemed solely by the living employee, with no concurrent or residual "payability" to that employee's dependents (to solecize the term "payable" as used in Duni, supra, n. 8). In that sense, the derivative nature of survivor's benefits is important and instructive. A key benefit that is payable to dependents during the lifetime of the employee would suddenly evaporate at the moment of his death, even though their adjunctive death benefit claim would originate from the same compensable injury. We would strongly disfavor such a result, as it would create an additional hardship for the dependents of deceased employees — individuals who would already be struggling to adjust to the recent demise of a family member and financial provider. Health insurance is too important a benefit to exclude in this manner.
As such, we reverse the trial commissioner's decision. The respondents are ordered to reimburse the claimant for the cost of maintaining equivalent health insurance benefits under § 31-284b. and to assume liability for that insurance as long as she continues to receive weekly benefit payments under § 31-306.
Commissioners Nancy A. Brouillet and Howard M. Belkin concur.
CERTIFICATION
THIS IS TO CERTIFY THAT a copy of the foregoing was mailed this 3rd day of April 2003 to the following parties:
GLORIA WEYMOUTH
DONALD LEIS, YR., ESQ. 7099 3400 0008 5540 6613
TOWN OF EAST WINDSOR POLICE DEPARTMENT
MICHAEL J. McAULIFFE, ESQ. 7099 3400 0008 5540 6606
PENNY, BOTTICELLO, O'BRIEN HIGGINS P.C.
___________________ Lorraine Lockery Administrative Hearings Lead Specialist Compensation Review Board Workers' Compensation Commission