Connecticut’s workers’ compensation system covers most, but not all employers and employees in the state. All businesses with at least one employee must carry workers’ compensation insurance, and generally, all full- and part-time employees are covered.
However, there are some exceptions. Sometimes the exact number of hours a part-time employee works can become an issue in workers’ compensation coverage. For instance, an employee who works in a private home for less than 26 hours a week is generally not eligible for workers’ compensation.
A recent Connecticut Supreme Court case highlights how the fine print can sometimes leave workers out in the cold after they have been hurt on the job. It also shows how the appeals process can work.
Firefighter’s case
The case involved a man who worked for many years as a firefighter for the town of Waterford. He was hired on a part-time basis in 1992 and was made full-time in 1997. Ten years later, he suffered heart trouble and required quadruple bypass surgery.
The firefighter submitted a claim for workers’ compensation benefits because of his heart disease, but Waterford declined his claim. According to the town, the man worked for less than 20 hours a week when he was a part-time employee, and therefore was not eligible for the type of benefits he sought.
At issue was a part of workers’ compensation law that applies to firefighters. It provides that certain benefits are available only to a “uniformed member of a paid municipal fire department” hired before 1996. The town argued that the term “member” in this context applies only to firefighters who worked at least 20 hours per week before 1996. The man provided no evidence that he had worked more than 20 hours a week during his years as a part-time employee, and so the town argued he was ineligible.
The man took the case to the Workers’ Compensation Commission, which ruled that he should be eligible for the benefits. The commissioner did not make any findings about how many hours the man had worked. The town took the case to the Workers’ Compensation Review Board, which upheld the commissioner’s findings.
The town then took the case to the state court of appeals, which upheld the board’s decision. Next, the town took the case to the state supreme court, which reversed the decision. The high court found that the man must prove he worked at least 20 hours a week as a part-time worker in order to meet the definition of a “member of a paid municipal fire department” under the meaning of the workers’ compensation law. It sent the case back to lower courts to determine how many hours the man worked.
Fighting for your benefits
The case above is unusual in many respects, but it illustrates some important issues.
First, when employers and their insurance carriers can find a way to deny an expensive claim, or to pay less than the worker deserves, they will use it. When that happens, workers need to go through the appeals process. Workers’ compensation disputes don’t usually go all the way to the Connecticut Supreme Court, but they can be long and technically challenging. It’s important for injured workers and their families to learn about their legal options to fight for their benefits.