Rivera v. Veterans Memorial Med. Ctr., No. X03 Cv98 0503569s (Aug. 14, 2001)

2001 Conn. Super. Ct. 11015, 30 Conn. L. Rptr. 273
CourtConnecticut Superior Court
DecidedAugust 14, 2001
DocketNo. X03 CV98 0503569S CT Page 11016
StatusUnpublished

This text of 2001 Conn. Super. Ct. 11015 (Rivera v. Veterans Memorial Med. Ctr., No. X03 Cv98 0503569s (Aug. 14, 2001)) is published on Counsel Stack Legal Research, covering Connecticut Superior Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Rivera v. Veterans Memorial Med. Ctr., No. X03 Cv98 0503569s (Aug. 14, 2001), 2001 Conn. Super. Ct. 11015, 30 Conn. L. Rptr. 273 (Colo. Ct. App. 2001).

Opinion

[EDITOR'S NOTE: This case is unpublished as indicated by the issuing court.]

MEMORANDUM OF DECISION REGARDING CLASS CERTIFICATION
This is a purported class action brought by former patients who received treatment at the defendant Veterans Memorial Medical Center (the "Hospital"). The Second Amended Complaint of April 17, 1998 contains eleven counts, including a count for abuse of process, violation of the Connecticut Unfair Trade Practices Act, Connecticut General Statutes § 42-110a et seq. (CUTPA), intentional infliction of emotional distress, violation of worker's compensation regulations and statutes, breach of covenant of good faith and fair dealing and other claims. By Memorandum of Decision dated June 2, 1998 this court, Levine, J. certified the class.

Discovery in the case is not yet completed. The pleadings are not closed, there is no trial date assigned, and no class notice has been filed. During the course of a discovery conference with counsel concerning the identity of members of the purported class, the court became concerned that the class may have been improvidently certified.

Even after class certification, the court retains a duty to monitor continually whether the requirements of certification remain satisfied.See e.g., Richardson v. Byrd, 709 F.2d 1016, 1019 (5th Cir. 1983) (the court ". . . is charged with the duty of monitoring its class decisions in light of the evidentiary development of the case"). If the facts and evidence revealed and developed pre-trial no longer support the maintenance of a class action, this court must decertify the case. SeeMarr v. WMX Technologies, Inc., No. 960071542, 1996 WL 694634, *9 (Conn.Super. 1996) (". . . certification may be vacated as the case progresses toward resolution on the merits . . .); Sessum v. Houston CommunityCollege, 94 F.R.D. 316, 318 (D.Tex. June 7, 1982).

Based on the foregoing another hearing took place on December 7 and 8, 2000 and January 3, 2001 to determine whether or not to decertify the class which is defined as follows:

All persons with accepted workers' compensation claims, as that term is defined in the worker's compensation statutes and relevant caselaw, against whom the hospital brought suit for unpaid medical CT Page 11017 bills incurred in the treatment of work related injuries or diseases at a time when the hospital knew or should have known of the existence of the accepted workers' compensation claim.1

Legal Framework

Connecticut General Statutes § 31-294d provides that "[a]ll disputes concerning liability for hospital services in workers' compensation cases shall be settled by the commissioner in accordance with this chapter." Connecticut State Regulation 31-279-9 (e) provides that "[a]ll charges for medical, surgical, hospital and nursing services [rendered in an accepted worker's compensation case], except those for expert testimony, shall be solely the responsibility of the employer or carrier, and no claim will be made against the injured employee for all or part of a fee."

Based on the foregoing it is clear that a medical provider cannot sue an employee to recover its fees rendered in an accepted workers' compensation case, but, instead must recover from the employer, or the employer's worker's compensation insurance carrier. If the employer or the insurance carrier does not pay voluntarily, then the medical provider must seek payment through the Worker's Compensation Commissioner and not through the courts.

Many patients who report that their medical condition is work-related do not have an accepted worker's compensation case. A problem which medical providers such as the defendant Hospital often encounter in the worker's compensation context is an inability to determine whether a patient who reports that his injury is work related actually has an accepted worker's compensation case. If the patient does not, then the provider can sue the patient to recover its fees.

At the hearing on this matter Jesse Frankl, a Workers' Compensation Commissioner, testified that sometimes people go to a hospital for treatment and tell the hospital, incorrectly, that their medical problem is work related so that they don't have to pay any deductible under their group health insurance coverage. In addition, some people may tell the health care provider that their medical problem is work related, but may chose not to report it to their employer. Such people would not have an accepted worker's compensation claim and could be sued by the medical provider for payment. Figueroa v. C and S Ball Bearing, 237 Conn. 1, 9,675 A.2d 845 (1996).

John Mastropietro, Chairman of Workers' Compensation Commission, testified that there are three ways in which a worker's compensation case CT Page 11018 becomes an "accepted case:" 1) The employee files a notice of claim, known as a Form 30C, and the employer makes payments pursuant to the claim; 2) The employer and the employee enter into a Voluntary Agreement whereby the employer acknowledges that the employee's injuries or disease is related to her employment; or 3)In the absence of a Form C or Voluntary Agreement, the employer or its insurer pays the employee's medical bills without reservation.

Chairman Mastropietro further testified that every year approximately 40, 000 accepted claims exist as to which the Commission has no record because the employer or its insurer has payed medical bills without filing anything with the Worker's Compensation Commission. This creates a big problem for a medical provider seeking payment because unless it receives independent information supplied by the employee/patient about the existence of an accepted worker's compensation case, it has no ability to discover for itself whether there is such a case, and often no recourse but to bring suit against the employee for payment.

Both Commissioner Frankl and Commissioner Mastropietro testified that as between the hospital and the patient, it is the patient who has the duty to provide the hospital with sufficient information concerning the worker's compensation case to enable the hospital to obtain payment from the employer. If the employee/patient fails to provide such information and the hospital cannot otherwise determine whether an accepted worker's compensation case exists, then even if the case exists but is not on record with the Worker's Compensation Commission, the employee runs the risk of being personally sued by the hospital. See Figueroa v. C and SBall Bearing, 237 Conn. 1, 9, 675 A.2d 845 (1996) ("If an employee decides not to utilize the act, however, he exposes himself to liability for the services performed by a medical provider. A medical provider, however, does not have standing to invoke the jurisdiction of the commission by giving notice on behalf of the employee or by independently filing a claim).

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Walsh v. National Safety Associates, Inc.
695 A.2d 1095 (Connecticut Superior Court, 1996)
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675 A.2d 845 (Supreme Court of Connecticut, 1996)
Walsh v. National Safety Associates, Inc.
694 A.2d 795 (Supreme Court of Connecticut, 1997)
Marr v. WMX Technologies, Inc.
711 A.2d 700 (Supreme Court of Connecticut, 1998)
Arduini v. Automobile Insurance
583 A.2d 152 (Connecticut Appellate Court, 1990)
Honan v. Dimyan
726 A.2d 613 (Connecticut Appellate Court, 1999)
Sessum v. Houston Community College
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Richardson v. Byrd
709 F.2d 1016 (Fifth Circuit, 1983)

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Bluebook (online)
2001 Conn. Super. Ct. 11015, 30 Conn. L. Rptr. 273, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rivera-v-veterans-memorial-med-ctr-no-x03-cv98-0503569s-aug-14-connsuperct-2001.