O'Connor v. Med-Center Home Health Care, Inc.
The Appellate Court explained in the 2011 case of Bode v. Connecticut Mason Contractors, The Learning Corridor, that a medical determination of total disability is merely one way a claimant can establish total incapacity to work, and one of many types of evidence the commissioner may consider in making this finding. While working as a nurse for Med-Center Home Health Care, Inc., Jean O'Connor fell on ice in a patient's driveway, sustaining knee and other injuries, which Med-Center accepted. Eventually, O'Connor requested coverage for a partial knee replacement. Orthopedic physicians, Steven Selden and Aris Yannopoulos, conducted independent medical examinations and reported that O'Connor was capable of sedentary work. Med-Center and its insurer, AIG Claims Services, Inc., filed a notice of intention to discontinue or reduce payments. During hearings, the trial commissioner received medical reports including from O'Connor's treating physician, Michael Kaplan, opining that she was "functionally disabled" and "capable of only the most sedentary of duties" and from Dr. Philip Mongeluzzo, Jr., describing O'Connor's Coumadin therapy. O'Connor testified to not being able to perform a "desk job" because she was unable to sit for extended periods and could not get there. She testified to restrictions including not being able to drive. The commissioner concluded that Kaplan and Mongeluzzo were of the opinion that O'Connor was totally disabled, found the plaintiff credible and awarded temporary total disability benefits. The Compensation Review Board affirmed the decision. The defendants appealed claiming that the board erred in upholding the finding and award of total disability made without direct medical evidence of total disability. The Appellate Court affirmed the board's decision. The commissioner's factual finding that Kaplan and Mongeluzzo were of the opinion that the plaintiff was totally disabled was clearly erroneous. However, the Appellate Court rejected the defendant's contention that without direct medical evidence the commissioner could not properly find the plaintiff totally disabled. Bode highlighted that the evaluation of whether a claimant is totally disabled is a holistic determination of work capacity, rather than a medical determination. The commissioner did not apply an improper legal standard to the underlying facts when, by evaluating all of the evidence, he found that the plaintiff met her evidentiary burden without requiring direct medical evidence of total disability. The commissioner reasonably could have found as he did.