Byrd v. Bechtel/Fusco

878 A.2d 1162, 90 Conn. App. 641, 2005 Conn. App. LEXIS 338
CourtConnecticut Appellate Court
DecidedAugust 9, 2005
DocketAC 25686
StatusPublished
Cited by2 cases

This text of 878 A.2d 1162 (Byrd v. Bechtel/Fusco) is published on Counsel Stack Legal Research, covering Connecticut Appellate Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Byrd v. Bechtel/Fusco, 878 A.2d 1162, 90 Conn. App. 641, 2005 Conn. App. LEXIS 338 (Colo. Ct. App. 2005).

Opinion

Opinion

BISHOP, J.

The pro se plaintiff, Leonard W. Byrd, appeals from the decision of the workers’ compensation review board (board) affirming the decision of the workers’ compensation commissioner (commissioner) in favor of the defendants.1 On appeal, the plaintiff [643]*643claims that he was improperly denied a hearing on claims he made to the commissioner regarding the managed care plan administered by the defendant Concentra Integrated Services, Inc. (Concentra).2

The following facts and procedural history are relevant to our discussion of the plaintiffs claims. On February 7, 2000, the plaintiff sustained a compensable injury to his right ankle while working for the defendant Bechtel/Fusco on site at a construction project at the University of Connecticut. Over the next several months, the plaintiff received treatment for his ankle, including three surgeries. In August, 2000, the plaintiff began experiencing pain in his back. After the plaintiff received physical therapy for his back, Sterling Administrative Services, Inc. (Sterling), the third party administrator, inquired as to whether the back pain was related to the covered ankle injury. On January 3, 2001, Sterling contacted the plaintiffs physical therapist and instructed the therapist to continue to care for the plaintiffs ankle injury and to cease care for his back. The plaintiff sought review of the denial of the care to his back. Concentra, which at that time was serving as the administrator of the managed care plan, determined that physical therapy for the plaintiffs back was not related to his injured ankle. The record reflects that the plaintiff thereafter wrote to the chairman of the workers’ compensation commission on February 22, March 20 and May 4,2001, requesting that the chairman review the managed care plan. The chairman denied the plaintiffs request on each occasion.

On February 19, 2003, the commissioner, Donald H. Doyle, Jr., conducted a formal hearing regarding the plaintiffs claims. At the hearing, the plaintiff sought a [644]*644review of the entire utilization review process of the managed care plan administered by Concentra. On the basis of the plaintiffs allegations, the commissioner ordered the parties to submit briefs on the question of whether he had jurisdiction to conduct the inquiry requested by the plaintiff. The commissioner then bifurcated the hearing to consider separately whether the plaintiffs back injury was compensable and whether the commissioner had jurisdiction to investigate the managed care plan.3 After the parties submitted briefs on the jurisdiction issues in April, 2003, the commissioner determined that he did not have jurisdiction to adjudicate the plaintiffs claims regarding the managed care plan. The plaintiff then appealed to the board, which affirmed the decision of the commissioner. This appeal followed.

On appeal, the plaintiff claims that the commissioner improperly ruled that he did not have jurisdiction over his allegations regarding the managed care plan. Essentially, the plaintiff claims that the commissioner had jurisdiction to assess the plan’s utilization review process and that by declining to provide the plaintiff a hearing on his allegations regarding the plan, the commissioner denied him due process of law.

Initially, we review whether the commissioner had jurisdiction over the plaintiffs claims. “We have previously observed that the workers’ compensation commission, like any administrative body, must act strictly within its statutory authority .... It cannot modify, abridge, or otherwise change the statutory provisions under which it acquires authority unless the statutes expressly grant it that power. . . . [I]t is settled law that the commissioner’s jurisdiction is confined by the [Workers’ Compensation Act (act), General Statutes [645]*645§ 31-275 et seq.] and limited by its provisions. . . . The commissioner exercises jurisdiction only under the precise circumstances and in the manner particularly prescribed by the enabling legislation. . . . The parties cannot confer jurisdiction upon the commissioner by agreement, waiver or conduct. . . . The [act] is not triggered by a claimant until he brings himself within its statutory ambit. . . . Although the [act] should be broadly construed to accomplish its humanitarian purpose ... its remedial purpose cannot transcend its statutorily defined jurisdictional boundaries.” (Internal quotation marks omitted.) Nationwide Mutual Ins. Co. v. Allen, 83 Conn. App. 526, 532, 850 A.2d 1047, cert. denied, 271 Conn. 907, 859 A.2d 562 (2004).

If jurisdiction exists for the commissioner to review the managed care plan, such authority must be found within the act. Consequently, our review is plenary. In order to determine whether the commissioner had jurisdiction, we analyze the legislation, particularly General Statutes § 31-278,4 which outlines the authority of the commissioner. “It is well established that [although not dispositive, we accord great weight to the construction given to the workers’ compensation statutes by the commissioner and [the compensation] review board. . . . However, [w]e have determined . . . that the traditional deference accorded to an agency’s interpretation of a statutory term is unwarranted when the construction of a statute . . . has not previously been subjected to judicial scrutiny [or to] ... a governmental agency’s time-tested interpretation . . . .” (Citation omitted; internal quotation marks omitted.) Donahue v. Southington, 259 Conn. 783, 787, [646]*646792 A.2d 76 (2002). Because we agree with the board that the plaintiffs claim presents an issue of first impression, we do not grant the deference ordinarily afforded to the commission’s determination.

In his memorandum of decision dated April 3, 2002, the commissioner ruled that he did not have jurisdiction to hear the plaintiffs claims regarding the managed care plan. The commissioner held that the chairman had the authority to approve or disapprove the medical care plans and that this power equates to a license under General Statutes § 4-166 (6) of the Uniform Administrative Procedure Act (UAPA), General Statutes § 4-166 et seq. Additionally, the commissioner urged the plaintiff to petition the chairman to review his claims. After the commissioner’s ruling, the plaintiff appealed the decision to the board, which affirmed the commissioner’s decision. The board held that the chairman’s powers to review and approve medical care plans under General Statutes §§ 31-279 (d)5 and 31-280 (12)6 [647]*647necessarily provided the chairman with exclusive review over the manner in which medical care plans are operated.7 Additionally, in affirming the commission’s decision, the board noted the absence of any specific provision granting commissioners the right to review medical care plans.

On appeal, the plaintiff relies on the language found in § 31-278 that “[e]ach commissioner shall hear all claims and questions arising under this chapter . . . .” The plaintiffs reliance is misplaced. In reviewing the language of the statute, we follow our Supreme Court’s interpretation of the statute in Stickney v. Sunlight Construction, Inc., 248 Conn.

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Related

DeJesus v. R.P.M. Enterprises, Inc.
204 Conn. App. 665 (Connecticut Appellate Court, 2021)
Byrd v. Bechtel/Fusco
888 A.2d 87 (Supreme Court of Connecticut, 2005)

Cite This Page — Counsel Stack

Bluebook (online)
878 A.2d 1162, 90 Conn. App. 641, 2005 Conn. App. LEXIS 338, Counsel Stack Legal Research, https://law.counselstack.com/opinion/byrd-v-bechtelfusco-connappct-2005.