Opinion
CASE NO. 946 CRD-3-89-11
APRIL 16, 1991
The claimant was represented [by] Karen Fox Tross, Esq. and Steven D. Ecker both at the time of representation of Jacobs, Grudberg, Belt Dow, P.C.
The respondents were represented by Lucas Strunk, Esq., and James L. Pomeranz both of Pomeranz, Drayton Stabnick and Howard Wilgoren, Esq.
This Petition for Review from the November 2, 1989 Finding and Award of the Commissioner at Large acting for the Third District was heard October 26, 1990 before a Compensation. Review Division panel consisting of the Commission Chairman, John Arcudi, and Commissioners Robin Waller and James Metro.
OPINION
Whether or not an employer was obligated to continue to pay group medical insurance premium for its injured employee was the issue for determination below. The commissioner ruled the employer was obligated and the employer has appealed. Claimant suffered a compensable injury August 7, 1981. By a Stipulation approved in the Third District January 5, 1985 the parties settled all unresolved claims arising out of that injury.
Paragraph #4 of the Stipulation stated, "Employer-Respondent shall remain liable for any and all medical, surgical, hospital, nursing and incidental expenses within the purview of chapter 568." Sec. 31-294 in chapter 568 obligates the employer to pay all medical expenses arising from the compensable injury. On the date of injury, August 7, 1981 there existed in Title 31 but not in chapter 568, Sec. 31-51h. Sec. 31-51h obligated the employer to continue in force group medical policies for employees who had suffered compensable injuries. That statute was declared unconstitutional, Stone Webster Engineering Corp. v. Ilsley, 518 F. Sup. 1297 (D. Conn. 1981), aff'd 690 F.2d 323 (1982), Aff'd sub nom, Arcudi v. Stone Webster Engineering Corp. 463 U.S. 1220, (1983)[.]
Sec. 31-51h provided in pertinent part:
No employer, private, municipal or state, shall cancel or withhold accident and health insurance or life insurance coverage of any employee or his dependents or cease to make payments or contributions at the regular hourly or weekly rate for full-time employees for each week of disability to an employee's welfare fund as defined in subsection (h) of section 31-53 while the employee is eligible to receive or receiving workers' compensation payments pursuant to chapter 568 or is receiving a continuation of salary or wages under a provision for sick leave payments for time lost for on-the-job injury . . . .
Shortly after the U.S. Court of Appeals' affirmance of Stone Webster, the Connecticut General Assembly enacted 31-284b as part of chapter 568 with an October 1, 1982 effective date. Sec. 31-284b has been declared constitutional, R. R. Donnelly v. Prevost, 915 F.2d 789 (1990), cert denied 59 U.S.L.W. 3565 (April 1, 1991). As of January 5, 1985, the date when the Third District approved the parties' Stipulation, Sec. 31-284b had been in effect for more than two years. Sec. 31-284b, although couched in different language guaranteed to employees rights similar to those contained in Sec. 31-51h. Meanwhile the employer, probably because of ignorance of the Stone Webster decision, continued to pay premiums to keep the claimant's group health insurance in force from the 1981 date of injury until early 1986.
Sec. 31-284b states in part:
any employer, as defined in section 31-275, 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 fund, as defined in section 31-53, shall provide to such employee equivalent insurance coverage or welfare fund payments or contributions while the employee is eligible to receive or is receiving workers' compensation payments.
The claimant argues that the language in the January 5, 1985 Stipulation "liable for any and all medical, surgical, hospital, nursing and incidental expenses within the purview of chapter 568" includes Sec. 31-284b obligations since 31-284b was in chapter 568 at the time the Stipulation was entered into by the parties and approved by the Third District. The commissioner below ruled that the claimant entered into the Stipulation in reliance on that understanding of the Stipulation language. Therefore he ruled that this was part of the consideration flowing from the employer to secure the employee's agreement in the Stipulation.
It is true, as the commissioner indicated in paragraph #10 of his Finding, that the Workers' Compensation law makes the commissioner the "sole arbiter" of the fairness and appropriateness of any Stipulation arrived at by the parties. However, can the commissioner be arbiter of matters over which he has no jurisdiction? On August 7, 1981, the date of claimant's injury, Stone Webster tells us that Sec. 31-51h which then purported to obligate the employer for group health insurance plans was invalid. Therefore, because the commissioner's jurisdiction was limited to the powers granted in the law itself, Castro v. Viera, 207 Conn. 420 (1988), there then existed no jurisdiction for the commissioner to order the employer to continue paying medical insurance premiums.
If the January, 1985 Stipulation was entered into because (1) claimant mistakenly thought that chapter 568 medical obligations encompassed Sec. 31-284b enacted more than a year after the date of injury or (2) both parties by mutual mistake considered the employer had a legal obligation to continue paying group medical insurance premiums, then the Stipulation should have been set aside, and any disputed claims between employer and employee would need to be adjudicated in further proceedings. We agree that would be an unfortunate result, especially since at the time of the commissioner's decision the claimant was hospitalized due to psychiatric disabilities. However, we cannot agree that the commissioner without jurisdiction to enforce an alleged employer obligation flowing from an employee's 1981 injury becomes empowered to do so because of unclear language in a Stipulation.
The appeal is sustained, and the matter is remanded to the Third District for further proceedings consistent with this opinion.
Commissioner Robin Waller and James Metro Concur.