Dominguez v. New York Sports Club

198 Conn. App. 854
CourtConnecticut Appellate Court
DecidedJuly 14, 2020
DocketAC42089
StatusPublished
Cited by3 cases

This text of 198 Conn. App. 854 (Dominguez v. New York Sports Club) 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
Dominguez v. New York Sports Club, 198 Conn. App. 854 (Colo. Ct. App. 2020).

Opinion

*********************************************** The “officially released” date that appears near the be- ginning of each opinion is the date the opinion will be pub- lished in the Connecticut Law Journal or the date it was released as a slip opinion. The operative date for the be- ginning of all time periods for filing postopinion motions and petitions for certification is the “officially released” date appearing in the opinion.

All opinions are subject to modification and technical correction prior to official publication in the Connecticut Reports and Connecticut Appellate Reports. In the event of discrepancies between the advance release version of an opinion and the latest version appearing in the Connecticut Law Journal and subsequently in the Connecticut Reports or Connecticut Appellate Reports, the latest version is to be considered authoritative.

The syllabus and procedural history accompanying the opinion as it appears in the Connecticut Law Journal and bound volumes of official reports are copyrighted by the Secretary of the State, State of Connecticut, and may not be reproduced and distributed without the express written permission of the Commission on Official Legal Publica- tions, Judicial Branch, State of Connecticut. *********************************************** JOSEPH DOMINGUEZ v. NEW YORK SPORTS CLUB ET AL. (AC 42089) Alvord, Elgo and Eveleigh, Js.

Syllabus

The defendant employer and its workers’ compensation insurer appealed to this court from the decision of the Compensation Review Board, which reversed in part the decision of the Workers’ Compensation Com- missioner granting in part the plaintiff employee’s motion to preclude the defendants from contesting the compensability of his injuries pursuant to statute (§ 31-294c (b)). The defendants did not file a form 43 to contest liability for the plaintiff’s injuries within the twenty-eight day time period mandated by § 31-294c (b) but, rather, filed that form seventy-five days after they received the plaintiff’s form 30C notice of claim. The defen- dants’ form 43 stated that no medical records supporting the plaintiff’s claim and no request for medical or indemnity benefits had been pre- sented to them. The commissioner determined that, because the defen- dants had not timely filed a form 43, they were precluded from contesting the compensability of the plaintiff’s claim but that, under the limited exception to the preclusion provision of § 31-294c (b) articulated in Dubrosky v. Boehringer Ingelheim Corp. (145 Conn. App. 261), the defendants could contest the extent of the plaintiff’s injuries due to their inability to pay indemnity benefits or medical payments within the twenty-eight day time period mandated by § 31-294c (b). The board reversed the commissioner’s decision in part, concluding that the com- missioner improperly applied the Dubrosky exception to the preclusion provision of § 31-294c (b) and directed that the defendants were to be precluded from presenting a defense to the plaintiff’s claim for benefits. On appeal, the defendants claimed that it had been impossible to comply with the mandate of § 31-294c (b) that they commence payment to the plaintiff on or before the twenty-eighth day after receiving written notice of his claim because he failed to furnish them with medical bills or a separate request for payment within that twenty-eight day period. Held: 1. The defendants could not prevail on their claim that the board improperly precluded them from contesting the extent of the plaintiff’s injuries: because the plaintiff complied with the notice of claim requirements in § 31-294c (a) and the defendants did not file a responsive answer of any kind within the twenty-eight day period mandated by § 31-294c (b) to indicate their intention to contest liability or to commence payment, the conclusive presumption of compensability in § 31-294c (b) barred them from contesting the extent of the plaintiff’s disability or his right to receive compensation, and this court concluded that, although the mechanics of the commence payment predicate in § 31-294c (b) were ambiguous, the initial burden with respect to the commence payment predicate rested with the employer, which was consistent with the legislative policies and purposes embodied in § 31-294c (b), the broad remedial purposes of the Workers’ Compensation Act (§ 31-275 et seq.) and the statutory (§ 31-294d) requirement of an immediate response from employers with respect to medical expenses, and the placing of the initial burden on the employer comported with a primary purpose of § 31-294c (b), which is to keep the process of initiating a claim for compensation simple and accessible for laypersons, as § 31-294c (b) does not require the claimant to furnish medical bills or a separate request for payment within twenty-eight days after commencing a claim; furthermore, it was entirely consonant with the legislative history and policies embodied in § 31-294c (b) that an employer be required to provide notice to a claimant within the twenty-eight day period when the employer seeks to avail itself of the one year safe harbor provision in § 31-294c (b) that permits an employer to make payments on a claim instead of filing a notice that it is contesting the claim. 2. This court declined to extend the limited exception in Dubrosky to the preclusion provision of § 31-294c (b) in situations in which employers dispute liability and the extent of a claimant’s injuries, and fail to make payments for a claimant’s medical care; the defendants did not accept liability for the plaintiff’s injuries or make any payments for his medical care, and the complex nature of the workers’ compensation scheme required that policy determinations and the creation of exceptions to § 31-294c (b) be left to the legislature. Argued January 13—officially released July 14, 2020

Procedural History

Appeal from the decision of the Workers’ Compensa- tion Commissioner for the Seventh District granting in part the plaintiff’s motion to preclude the defendants from contesting liability as to his claim for certain work- ers’ compensation benefits, brought to the Compensa- tion Review Board, which reversed the commissioner’s decision in part, and the defendants appealed to this court; thereafter, Walter Dominguez, administrator of the plaintiff’s estate, was substituted as the plaintiff. Affirmed. James T. Baldwin, for the appellants (defendants). John J. Morgan, for the appellee (substitute plaintiff). Opinion

ELGO, J. This case concerns the mandate of General Statutes § 31-294c (b), which obligates an employer pre- sented with proper notice of a workers’ compensation claim to respond within twenty-eight days by either filing a notice contesting liability or commencing pay- ment on the claim. The employer in the present case did neither, which led the Compensation Review Board (board) to conclude that the employer was precluded under § 31-294c (b) from contesting both liability for, and the extent of, injuries allegedly sustained by the plaintiff, Joseph Dominguez.1 On appeal, the defendant New York Sports Club2 asks us to extend the narrow exception to the preclusion provision of § 31-294c (b) recognized by this court in Dubrosky v. Boehringer Ingelheim Corp., 145 Conn. App. 261, 76 A.3d 657, cert. denied, 310 Conn. 935, 78 A.3d 859 (2013), to cases in which an employer (1) provides no response to a prop- erly filed claim for compensation within the twenty- eight day statutory period, (2) makes no payments on the claim, (3) files an untimely notice contesting liability for the claimant’s injuries, and (4) alleges in subsequent administrative proceedings before the Workers’ Com- pensation Commission that it was impossible to com- mence payment due to the claimant’s failure to submit medical bills within the twenty-eight day statutory period. We decline to do so and, accordingly, affirm the decision of the board.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Mention v. Kensington Square Apartments
214 Conn. App. 720 (Connecticut Appellate Court, 2022)
Reid v. Speer
209 Conn. App. 540 (Connecticut Appellate Court, 2021)
Salerno v. Lowe's Home Improvement Center
Connecticut Appellate Court, 2020

Cite This Page — Counsel Stack

Bluebook (online)
198 Conn. App. 854, Counsel Stack Legal Research, https://law.counselstack.com/opinion/dominguez-v-new-york-sports-club-connappct-2020.