Crocetto v. Lynn Development Corp.

612 A.2d 1212, 223 Conn. 376, 1992 Conn. LEXIS 259
CourtSupreme Court of Connecticut
DecidedAugust 11, 1992
Docket14475
StatusPublished
Cited by10 cases

This text of 612 A.2d 1212 (Crocetto v. Lynn Development Corp.) is published on Counsel Stack Legal Research, covering Supreme Court of Connecticut primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Crocetto v. Lynn Development Corp., 612 A.2d 1212, 223 Conn. 376, 1992 Conn. LEXIS 259 (Colo. 1992).

Opinion

Berdon, J.

The sole issue in this appeal is whether a “subsistence allowance” provided to a former employee while enrolled in a workers’ rehabilitation program constitutes “workers’ compensation payments” within the meaning of General Statutes § 31-284b (a)1 so as to trigger mandatory health insurance coverage. In this case, the plaintiff, Frank Crocetto, who had been injured during the course of his employment with the defendant, Lynn Development Corporation, continued to receive health insurance coverage under the defendant’s group plan until he exhausted his permanent partial disability benefits under General Statutes § 31-308.2 Subsequently, the plaintiff received a weekly subsistence allowance when he enrolled in a workers’ rehabilita[378]*378tion program established under General Statutes § 31-283a.3 While receiving the weekly subsistence allowance, he sought to have his health insurance coverage reinstated. The workers’ compensation commissioner (commissioner) concluded that the plaintiff and his family had been entitled to insurance coverage from the time the coverage had been terminated to the time the plaintiff’s participation in the rehabilitation program had ended. The commissioner, therefore, ordered the defendant to reimburse the plaintiff for medical expenses incurred during that period. The compensation review division (CRD) affirmed the commissioner’s decision. The defendant appealed,4 and we now reverse.

Although the parties dispute several factual allegations, the following facts are not contested. In November, 1984, during the course of his employment with [379]*379the defendant, the plaintiff injured his back. The injury resulted in a 10 percent permanent partial disability of the back. At the time of the injury, the defendant supplied Blue Cross/Blue Shield health insurance to the plaintiff and his family. Following the injury, the plaintiff was no longer able to work for the defendant.

The plaintiff received temporary total disability benefits from November 30, 1984, until October 21, 1985, under the Workers’ Compensation Act (act). Thereafter, he received permanent partial disability benefits under the act. During the period in which these temporary and permanent benefits were paid under § 33-308, the defendant continued to provide health insurance coverage to the plaintiff and his family pursuant to § 31-284b. When the plaintiff exhausted his permanent partial disability benefits in October, 1986, the defendant terminated the plaintiff’s health insurance coverage.

Sometime after October, 1986,5 the plaintiff received eight or nine weeks of supplemental partial permanent disability payments pursuant to General Statutes § 31-308a.6 In September, 1987, the plaintiff enrolled [380]*380in the vocational rehabilitation training program under § 31-283a. From September, 1987, to August 25,1989, the period during which the plaintiff had attended the program, the CRD found that the plaintiff had received a weekly subsistence vocational rehabilitation allowance,7 from the division of workers’ rehabilitation, which was purportedly established under § 31-283a.

Because the plaintiff was receiving this subsistence allowance, he sought to reinstate his health insurance coverage in accordance with § 31-284b (a). The commissioner concluded that the plaintiff’s receipt of the subsistence allowance triggered the statutory mandate for the defendant to provide health insurance coverage to the plaintiff and his family. Accordingly, the commissioner determined that the plaintiff should have been covered from October, 1986, when the health insurance coverage had been terminated, to August 25, 1989, when the plaintiff finished his vocational rehabilitation training and the subsistence allowance was terminated. He ordered the defendant to reimburse the plaintiff for any medical expenses that Blue Cross/Blue Shield would have covered during that period. Pursuant to the defendant’s motion for articulation, the commissioner clarified his opinion and held that the plaintiff’s family was also entitled to health insurance coverage. The defendant appealed to the CRD, which affirmed the decision of the commissioner.

[381]*381In this appeal, the defendant argues that § 31-284b (a) does not require an employer to provide health insurance coverage to an employee receiving a subsistence allowance and that the CRD, therefore, improperly affirmed the commissioner’s conclusion that it was obligated to provide health insurance coverage to the plaintiff and his family. We agree.

Section 31-284b (a) mandates that an employer provide an injured employee with the same health insurance coverage that the employee had on the date of injury during the period in which the employee is “eligible to receive or is receiving workers’ compensation payments” pursuant to the act. The issue, therefore, is whether a subsistence allowance is such a payment under the act. We normally accord great deference to the construction of a statute by the agency charged with its enforcement and only reverse when the agency has acted unreasonably, arbitrarily, illegally or in an abuse of its discretion. Griffin Hospital v. Commission on Hospitals & Health Care, 200 Conn. 489, 496, 512 A.2d 199, appeal dismissed, 479 U.S. 1023, 107 S. Ct. 781, 93 L. Ed. 2d 819 (1986). We conclude, however, that a subsistence allowance is not a payment authorized by the act and, therefore, health insurance coverage should not be reinstated because of the award of such an allowance.

The plaintiff conceded at oral argument that a subsistence allowance is not authorized by statute or by administrative regulations. Instead, the plaintiff maintains that the first director of the workers’ rehabilitation division initiated the distribution of the subsistence allowance in 1972 by drawing upon funds that were created under General Statutes § 31-283b8 to finance [382]*382the workers’ rehabilitation division. Although the record is silent with respect to the workers’ rehabilitation division’s authority to award a subsistence allowance, we do not dispute that this may very well be the policy of the division.9 The mere fact that a practice may exist to award subsistence allowances to participants in the rehabilitation program, however, does not persuade us that the receipt of such an allowance triggers an employer’s obligation to provide health insurance coverage to an injured employee and his or her family. To constitute the basis for triggering the obligation to provide health insurance coverage, the subsistence allowance must have been required either by statute or by regulation authorized by the legislature and promulgated in accordance with the procedure outlined in the Uniform Administrative Procedure Act, General Statutes § 4-166 et seq. Salmon Brook Convalescent Home v. Commission on Hospitals & Health Care, 177 Conn. [383]*383356, 417 A.2d 358 (1979). We conclude that the ad hoc award of subsistence allowances does not qualify as “workers’ compensation payments” under § 31-284b. Accordingly, we reverse the decision of the CRD.

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Bluebook (online)
612 A.2d 1212, 223 Conn. 376, 1992 Conn. LEXIS 259, Counsel Stack Legal Research, https://law.counselstack.com/opinion/crocetto-v-lynn-development-corp-conn-1992.