Summary
In Skorupski v. Commercial Union Insurance Co., 2 Conn. Workers' Comp. Rev. Op. 133, 338 CRD-3-84 (1985) we held that the filing must be in accordance with Sec. 31-321 C.G.S., "service personally or by registered or certified mail addressed to the person upon whom it is to be served."
Summary of this case from Ebrech v. Cadbury Schweppes, Inc.Opinion
CASE NO. 338-CRD-3-84
APRIL 1, 1985
The claimant was represented by Bruce L. Levin, Esq. of the law firm of Mihaly and Mihaly.
The respondent was represented by Paul A. Scholder, Esq.
This Petition for Review from the July 11, 1984 Decision granting a Motion to Preclude Defenses of the Commissioner at Large, acting for the Third District, was argued on March 1, 1985 before a Compensation Review Division panel consisting of Chairman John Arcudi and Commissioners Andrew P. Denuzze and Frank J. Verrilli.
OPINION
This appeal arises from a Sec. 31-297(b) issue. The Commissioner below granted a Motion to Preclude presentation of any defenses, because the Respondents had failed to file a disclaimer within twenty days of a written notice of claim served pursuant to Sec. 31-321, C.G.S. The District file reveals that claimant had filed a Group Health Plan Statement of Claim early in May, 1983. Respondents filed a Form 43, Notice to Compensation Commissioner and Employee of Intention to Contest Liability to Pay Compensation May 26, 1983 within twenty days of the Group Health Plan filing. Neither of these May, 1983 documents was served in compliance with the Sec. 31-321 procedure. On December 1, 1983 the claimant filed a formal 30 C Notice of Claim for Compensation by certified mail as Sec. 31-321 prescribes. Respondents, apparently relying on their May 26 disclaimer, failed to serve any disclaimer to this second notice of claim.
Sec. 31-297(b) Whenever liability to pay compensation is contested by the employer, he shall file with the compensation commissioner, on or before the twentieth day after he has received a written notice of claim, a notice in accord with a form prescribed by the commissioners stating that the right to compensation is contested, the name of the claimant, the name of the employer, the date of the alleged injury or death and the specific grounds on which the right to compensation is contested and a copy thereof shall be sent to the employee. If the employer or his legal representative fails to file the notice contesting liability within the time prescribed herein the employer shall be conclusively presumed to have accepted the compensability of such alleged injury or death and shall have no right thereafter to contest the employee's right to receive compensation on any grounds or the extent of his disability.
Sec. 31-321. Manner of serving notices. Unless otherwise specifically provided, or unless the circumstances of the case or the rules of the commission direct otherwise, any notice required under this chapter to be served upon an employer, employee or commissioner shall be by written or printed notice, service personally or by registered or certified mail addressed to the person upon whom it is to be served at his last-known residence or place of business. Notices in behalf of a minor shall be given by or to his parent or guardian or, if there is no parent or guardian, then by or to such minor.
The trial Commissioner ruled that the disclaimer filed earlier was a nullity, because it was not filed by certified or registered mail or personal presentation. He further ruled that the Group Health Plan Statement of Claim mailed via regular mail to the Respondent Employer did not constitute a proper notice of a workers' compensation claim and therefore the employer was not compelled to disclaim the earlier notice within twenty days. However, the trial Commissioner continued, the December notice of claim served with the formality required by Sec. 31-321 was a proper notice of claim necessitating the filing of a Sec. 31-297b disclaimer if Respondent wished to contest liability.
Actually, the Group Health Plan Statement of Claim filed in May did constitute a notice that the employee was asserting a claim for a condition related to the employment. This assertion arose from answers to questions 6 and 10 of the form. The other answers on the form gave the name of the employee, her address, the name of the treating doctor, the date of first disability from work and a description of the disabling condition. The disabling condition was described as DSM III-300.02. The letters refer to the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Third Edition. The numbers after the letters refer to one of the conditions described in the manual, i.e. "generalized anxiety disorder." Thus the information given substantially complies with the provisions of Sec. 31-294. Had this notice been served in person or by registered or certified mail, we do not doubt that it would have given rise to an obligation on the part of the Respondent Employer to file a disclaimer if, in fact, compensability were to be contested. De La Torre v. State of Conn. 148-CRD-1-82, 2 Conn. Workers' Comp. Rev. Op. 95 (1984), Timothy v. Upjohn Co. 150-CRD-3-82, 2 Conn. Workers' Comp. Op. 1 (1983), appeal dismissed because not final judgmt., 3 Conn. App. 162 (1985), Bush v. Quality Bakers of America, 2 Conn. App. 363, cert. denied, 194 Conn. 804 (1984) affirming 2 Conn. Workers' Comp. Rev. Op. 36, DeLeon v. Jacobs Brothers, Inc. 38 Conn. Sup. 331, (1981) affirming 1 Conn. Workers' Comp. Rev. Op. 18.
Sec. 31-294. Such notice may be given to the employer or the commissioner and shall state, in simple language, the date and place of the accident and the nature of the injury resulting therefrom, or the date of the first manifestation of a symptom of the occupational disease and address of the employee and of the person in whose interest compensation is claimed . . ."
The Appellants argue that even if this May notice of claim did not satisfy the Timothy v. Upjohn test, it was a sufficient notice to trigger their responsive pleading, a Sec. 31-297(b) disclaimer. They as Respondents could not rely on the technical defect in the manner of serving the notice, and so they filed their May 26, 1983 Form 43. The filing of that form, they maintain, gave notice to the employee that liability was being contested, and the filing of a further disclaimer after the more formally served December notice of claim would be superfluous. This issue was not decided by us in De La Torre as that disclaimer was not served on the dependent claimant but on the estate of the decedent employee.
Is not a disclaimer conforming to Menzies v. Fisher, 165 Conn. 338 (1973) specificity requirements filed within twenty days after some notice of claim and giving actual notice to a claimant that liability is being contested sufficient to satisfy Sec. 31-297(b)? Possibly, but Section 31-321 defines the statutory method by which actual notice is to be achieved, and this disclaimer did not conform to that statutory procedure. Moreover, Menzies v. Fisher, supra, emphasizes the law's requirement that the disclaimer must state "specific grounds on which the right to compensation is contested." The May 26, 1983 disclaimer here only stated, "Doubtful that disability occupationally related. Pending investigation." Menzies found disclaimer language stating "(w)e deny a compensable accident or injury" to be insufficient because not specific enough. The three member court majority held that an employer using such unspecific "grounds of contest . . . leaves the claimant as much in the dark with regard to the nature of the contest as does a categorical denial or mere silence from the employer," Menzies v. Fisher, supra, 347. That judicial declaration applies equally to the unspecific language of the Respondents Appellants here. The disclaimer on which they attempt to rely fails to state the specific grounds on which compensation is contested.
If the May 1983 disclaimer had stated specific grounds and if it had been served pursuant to Sec. 31-321 procedure, then on some equitable theory it may very well have been sufficient to estop preclusion. But we need not decide that issue here. The Commissioner's decision granting preclusion is affirmed, and the appeal is dismissed.
Commissioners Denuzze and Verrilli concur in this opinion.