JOSEPH R. KREVIS CLAIMANT-APPELLANT
v.
CITY OF BRIDGEPORT EMPLOYER SELF-INSURED
and
PMA MANAGEMENT CORPORATION OF NEW ENGLAND THIRD-PARTY ADMINISTRATOR RESPONDENTS-APPELLEES
No. 6321 CRB-4-19-4
Connecticut Workers Compensation
Compensation Review Board Workers Compensation Commission
May 28, 2020
This
Petition for Review from the April 15, 2019 Finding and
Denial by Jodi Murray Gregg, the Commissioner acting for the
Fourth District, was heard December 20, 2019 before a
Compensation Review Board panel consisting of Commission
Chairman Stephen M. Morelli and Commissioners Peter C.
Mlynarczyk and David W. Schoolcraft.
[1]
The
claimant appeared at oral argument before the board as a
self-represented party.
The
respondents were represented by Joseph J. Passaretti, Jr.,
Esq., Montstream & May, L.L.P.
OPINION
STEPHEN M. MORELLI, CHAIRMAN.
The
claimant has appealed from a Finding and Denial (finding)
issued by Commissioner Jodi Murray Gregg (commissioner) which
determined that the claimant’s pacemaker operation was
not compensable pursuant to General Statutes §
7-433c.
[2] The claimant argues that this
decision was contrary to law and the evidence, which he
believes established that this ailment was compensable and
the treatment for the ailment should have been paid for under
this statute. The respondents argue that the claimant’s
compensable hypertension is a distinct ailment from the
condition that required him to obtain a pacemaker and the
medical evidence credited by the commissioner was that the
compensable hypertension was not a substantial factor behind
the claimant’s need for surgery. We are satisfied that
the commissioner’s decision herein is consistent with
the evidence and the law. Therefore, we affirm the Finding
and Denial.
The
commissioner reached the following factual findings at the
conclusion of the formal hearing. She noted that the claimant
had a compensable § 7-433c claim for hypertension and
had received a Finding and Award in 1989 for an 18.3 percent
permanent partial disability rating for his heart. In 2006, a
subsequent Finding and Award raised this disability level to
28.75 percent and in 2012, this disability level was raised
in another Finding and Award to 35 percent. Now retired, the
claimant sustained a complete heart block with unstable
ventricular response on April 11, 2014. This incident caused
a dual-chamber pacemaker to be implanted. After this
procedure, the claimant’s treating physician, Craig
Werner, M.D., rated him on December 29, 2014, with a 30
percent impairment rating due to hypertension, a 30 percent
impairment due to peripheral arterial disease, and a 5
percent whole person rating to the heart block. See Findings,
¶ 6, citing Claimant’s Exhibit L. However, the
commissioner cited Werner’s July 18, 2015 report
discounting the claimant’s compensable injury as the
cause of the 2014 procedure; “although Mr. Krevis has a
history of long standing hypertension as well as peripheral
arterial disease I do not believe that his hypertension or
his peripheral arterial disease was a substantial
contributing factor in his complete heart block.”
Findings, ¶ 7, quoting Claimant’s Exhibit N.
The
commissioner also considered evidence presented from the
cardiologist who performed the 2014 implant surgery on the
claimant, Joseph J. Tiano, M.D. Tiano opined on December 1,
2015, that in regard to the claimant’s “AV
conduction disease status post dual-chamber pacemaker, the
likely etiology is underlying senile conduction disease which
is age appropriate given his age of 75. His underlying
comorbities of diabetes and hypertension are also
contributing factors. I can’t fully assess the exact
percentage of HTN contributing to his conduction disease but
could guess it contributed about 10%.” Findings, ¶
8, quoting Claimant’s Exhibit M.
The
respondents presented evidence from their expert witness
Martin Krauthamer, M.D., which the commissioner considered.
Krauthamer held a respondent’s examination on March 30,
2016 and after the examination opined that he did not feel
that “the hypertension in any way contributed to his
conduction system disease…accordingly, I do not feel
that the hypertension was a significant contributing factor
in his development of complete heart block and requiring a
pacemaker.” Findings, ¶ 9, quoting
Claimant’s Exhibit N. Krauthamer was deposed on July 5,
2016 and testified that that he is of the opinion that
hypertension is not a significant or probable cause of heart
block and that there is no interrelationship between
hypertension and conduction system disease. Findings, ¶
10, citing Claimant’s Exhibit A.
[3] He said that the
claimant’s long history of hypertension was not a
significant factor in the development of his heart block.
Findings, ¶ 11. He also testified as to the mechanism of
a heart block, which included this testimony:
But when the
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