In the case of D’Amico v. ACE Financial Solutions, the Appellate Court of Connecticut recently further clarified scope of the workers’ compensation exclusive remedy doctrine. The exclusive remedy doctrine, at its most basic, says that an employee gives up his right to sue his employer in exchange for specific benefits, such as medical treatment for job-related injuries.
The plaintiff in this case, a former correctional officer, sustained numerous injuries while attempting to restrain an inmate. The plaintiff suffered injuries to his neck, back, shoulder, arm and hand, as well as suffering post-traumatic stress disorder (PTSD), depression, fibromyalgia, hypertension among other problems. The plaintiff then filed a claim under the Workers’ Compensation Act.
Pursuant to state law and general practices, the claim was eventually transferred from the state of Connecticut to ACE Financial Solutions, who had Berkley Administrators of Connecticut administer the claim.
Eventually, the plaintiff was informed that his claims for psychiatric medication and treatment and fibromyalgia would no longer be covered, as they were deemed palliative.
DeOliveira and the Law in Connecticut
The Workers’ Compensation Act specifically states that employers fall under the exclusive remedy provision – so once employees start receiving medical treatment and/or payment for their work injuries, they cannot sue their employer for further compensation. The Connecticut courts, under DeOliveira v. Liberty Mutual and other related cases, have extended the provision to cover insurers and third party administrators as well as injuries resulting or exacerbated by the claims process.
The plaintiff claimed that ACE fell outside of the scope of DeOliveira because ACE was an “independent third party” and not an employer, insurer or third party administrator.
Citing DeOliveira, the court stated that the exclusive remedy provision covers the workers’ compensation claims process, including any “independent third parties” involved in the claims process.
Through the D’Amico decision the Appellate Court of Connecticut reaffirmed the DeOliveira decision and further defined what it means to be in the context of the workers’ compensation claims process, by including “independent third parties” to those already protected by the exclusive remedy provision.
Workers’ compensation is a complex issue; for questions or concerns about a workers’ compensation claim speak with an experienced workers’ compensation attorney.