NWCDN Members regularly post articles and summary judgements in workers’ compensations law in your state.
Select a state from the dropdown menu below to scroll through the state specific archives for updates and opinions on various workers’ compensation laws in your state.
Contact information for NWCDN members is also located on the state specific links in the event you have additional questions or your company is seeking a workers’ compensation lawyer in your state.
Ohio Bureau of Workers’ Compensation Update
BWC Actions
The Board of the Ohio Bureau of Workers’ Compensation (“BWC”) met in January 2025to discuss another potential rate reduction for Ohio’s private employers. The proposed rate reduction would be 6% which would amount to almost $60 million less in premiums paid by Ohio private employers. It would apply to the next fiscal year effective July 1, 2025. If approved at the Board’s next meeting on February 28, 2025, this reduction would be the sixth straight reduction since Governor DeWine took office and the 16th rate decrease in the last 17 years going back to 2008. Overall, the average rate levels for the 257,000 private and public Ohio employers are at their lowest in over 60 years.
The proposed 6% rate cut represents an average statewide premium change, including administrative costs. The actual premium paid by individual private employers depends on several factors, including the expected future claims costs in their industry, their company’s recent claims history, and their participation in various BWC programs.
Ohio Judicial Decisions
Temporary Total Compensation
State ex rel. Ohio State Univ. v. Pratt, 169 Ohio St.3d 527, 2022-Ohio-4111, 206 N.E.3d 708
On June 20, 2017, the claimant, a food and beverage manager for OSU at the Blackwell Inn, submitted her two-week notice, to resign on July 5, 2017. She had an offer of employment from a different employer. Four days later, on June 24, 2017, the claimant sustained a trip and fall injury. The claimant’s claim was allowed, and she underwent surgeries on June 27, 2017, and May 29, 2018, and was paid TTD compensation. The employer moved to terminate TTD. The commission’s SHO determined TTD was payable because the claimant did not voluntarily abandon the workforce as she was leaving her position at OSU for another position. The commission voted not to exercise continuing jurisdiction, but, in the dissent, one commissioner asserted the majority misinterpreted and misapplied State ex rel. Klein v. Precision Excavating & Grading Co., 155 Ohio St.3d 1446, 2018-Ohio-3890, 119 N.E.3d 386, by evaluating whether the claimant intended to abandon the workforce instead of whether the claimant intended to abandon her former position of employment.
The Court of Appeals granted the employer’s requested writ of mandamus and ordered the commission to vacate the award of TTD after July 5, 2017. The commission’s order was issued after the decision in Klein but before the effective date of the amendment to R.C. 4123.56(F). The Court found that, under Klein, the commission is to consider only whether the claimant has voluntarily abandoned her former position of employment and not whether she has removed herself from the workforce generally.
The Ohio Supreme Court reversed the decision of the Court of Appeals and found that the commission did not abuse its discretion by determining that, but for the injury, the claimant would have remained in the workforce. The Supreme Court explained that while Klein referenced whether the claimant “voluntarily removes himself from his former position of employment,” the analysis was specific to the facts of the case and that “Klein’s abandonment of his former position was therefore equivalent to abandonment of the workforce during the period for which he sought TTD compensation.” Thus, the Supreme Court concluded, “The question is whether those circumstances demonstrate a voluntary abandonment of the workforce – permanent or temporary – such that the injured worker’s wage loss is not the result of the work injury. In other words, do the circumstances indicate that the injured worker would be working – somewhere – but for the injury?”
Permanent Partial Disability
State ex rel. Hobbs v. Indus. Comm., 10th Dist. Franklin No. 22AP-308, 2023-Ohio-1759
Tenth District Court of Appeals found the commission did not abuse its discretion in denying the claimant’s application for another increase in his percentage of permanent partial disability under R.C. 4123.57(A). The commission found the request was not supported with “substantial evidence of new and changed circumstances developing since the time of the hearing on the original or last determination,” as required by R.C. 4123.57(A). The record did not show the clamant underwent any medical treatment since 2002, that his condition became disabling following his last treatment, or that the claim was amended to include an additional medical condition, nor does the record support employee's contention that he testified that his medical condition was worsening since no such testimony appears in the record. The Tenth District Court of Appeals found the claimant failed to meet the burden in mandamus to demonstrate a clear right to relief, and denied the claimant’s requested writ of mandamus. Following this decision, the claimant filed a Notice of Appeal to the Ohio Supreme Court, which is currently pending.
Scheduled Loss
State ex rel. Harris v. Indus. Comm., Supreme Court of Ohio, Slip Opinion No. 2023-Ohio-3081. The claimant sustained a head injury that impacted his vision. The commission denied his motion for scheduled loss of vision compensation pursuant to R.C. 4123.57(B), relying on a physician’s medical opinion that the claimant’s vision impairment was not due to an actual injury to the eyes. The Tenth District Court of Appeals found the commission did not abuse its discretion and denied the requested writ, finding there was some evidence in the record that established the claimant’s loss of vision was not attributable to damage to the structure or function of the claimant’s eye, but was due to the loss of brain function. R.C. 4123.57(B) did not authorize loss of use compensation when the loss of brain function was the cause of the vision loss rather than actual damage to the eye structure itself. The Supreme Court affirmed the Court of Appeals’ decision and denied the writ of mandamus, albeit on different grounds. The Supreme Court determined the commission’s order, which was based upon “the absence of a credible assessment” of loss of vision, was based upon some evidence. The Supreme Court declined to address the Smith case, finding the commission’s order did not deny compensation in reliance upon that case.
Substantial Aggravation of a Preexisting Condition
Dunn v. Devco Holdings, Inc., 3d Dist. Union No. 14-22-18, 2023-Ohio-680
The claimant suffered a workplace injury to her hip, and she later filed for additional psychological conditions in her workers’ compensation claim. The commission additionally allowed the claim for “substantial aggravation of persistent depressive disorder, with anxious distress, late onset, with persistent major depressive disorder, moderate.” The employer appealed to common pleas court under R.C. 4123.512. The trial court found in favor of the claimant, finding the testimony of Dr. Black to be persuasive in that her diagnosis is based upon objective diagnostic findings, objective clinical findings, or objective test results as required by R.C. 4123.01(C), and that the psychiatric condition arose from the injury.
The employer appealed, arguing the claimant did not present evidence of objective diagnostic findings, objective clinical findings, or objective test results that demonstrated a substantial aggravation of her psychological condition. Specifically, the employer argued the MMPI-2 test that Dr. Black had administered to the claimant is not an objective test and did not show substantial aggravation. The Third District Court of Appeals found Dr. Black testified at trial that the MMPI-2 is a standardized objective test. It gives you the idea of the person’s personality characteristics and helps with your diagnosis formulation. It has 567 true and false questions and the responses are combined together and scored to give you kind of a concrete and quantifiable results. She added that the MMPI-2 was developed out of standardized testing and provides a concrete and quantifiable result. She explained that although the person’s answers are subjective, the actual results and scoring of it makes it objective. The appellate court affirmed the trial court’s decision, finding the Dr. Black’s testimony showed that the MMPI-2 test provided objective results, and her testimony that the claimant’s injury substantially aggravated a pre-existing condition was based on objective findings, as required by R.C. 4123.01(C).
© Copyright 2025 by Christopher Ward and Raymond Tarasuck Calfee, Halter & Griswold, LLP. All rights reserved. Reprinted with permission.
BWC Actions
The Board of the Ohio Bureau of Workers’ Compensation (“BWC”) met in April 2024 and did the following actions:
- Allowed the “lapse free” rebate program to sunset effective 7/1/2024. This automatic 2% rebate was paid to employers who submitted timely premium installment payments.
- Allowed the Transitional Work Performance Bonus to sunset effective 7/1/2024. The program, compatible with group experience rating, awarded employers up to 10% of premium rebates for returning injured employees back to light duty work.
- The BWC has started to issue 2024 (7/1/2024 to 6/30/2025) coverage certificates and installment plans. Employers are recommended to review the estimated payment set by the BWC to ensure accurate premiums. This is also the first look at the new premium calculation which combines the state base rate with the BWC’s administrative costs.
Citing enhanced workplace safety measures and decreased BWC expenses have led Governor Mike DeWine to propose a 7% reduction in workers’ compensation premium rates for private employers. The BWC Board approved the reduction in February, which will amount to approximately $67 million in savings for the fiscal period July 2024 to June 2025.
Ohio Senate Bill 106 was passed by the Ohio General Assembly and signed by the Governor, with an effective date of Jun 12, 2024. This new regulation requires, under certain circumstances, that the BWC or self-insuring employer pay for services used to determine whether a health care professional servicing air ambulance patients sustained an injury or occupational diseases after exposure to blood or bodily fluids or a drug or other chemical substance. It also allows a workers’ compensation claimant to provide a signed medical release form that is equivalent to the release form prepared by the BWC under a continuing law or adopted by the BWC under the Act.
Marijuana
Ohioans voted to pass Issue 2 in the November 2023 election which legalized recreational marijuana in the state, expanding access to employees and potentially raising workplace safety issues for employers. The new law does provide businesses with the right to maintain their current drug-free workplace policies.
Regulatory Actions (New Rules)
4123-3-35 Employer Handicap Reimbursement: Substitutes the words “disability” or “condition” for the word “handicap” and corrects typographical errors. Effective April 1, 2024.
4123-6-02.2 Provider Access to the HPP – Provider Certification Criteria.
- Removes, for all providers, the requirement of an unrestricted drug enforcement agency registration.
- Removes the mandate to require providers to submit proof of workers’ compensation coverage, and require providers to provide proof upon request.
- Corrects name of Ohio board that licenses ambulance, ambulette and air ambulance services.
- Corrects name of board certifying or accrediting certified shoe retailers.
- Adds language requiring Ohio Department of Health licensure for home health agencies.
- Adds language requiring Ohio Department of Health licensure for hospitals on or after September 30, 2024.
- Clarifies language regarding the requirement of Medicare approval for various provider types,
- Effective April 15, 2024.
4123-6-31: Payment for Miscellaneous Medical Services and Supplies.
- Clarifies language for the prior approval of acupuncture
- Clarifies reimbursement eligibility for orthotic devices and services by supplier-orthotist.
- Adds payment for diagnostic testing and nerve injections in addition to imaging.
- Expands approval of payment for diagnostic testing and nerve injections when its it medically necessary either to develop a plan of treatment for, or to pursue more specific diagnoses reasonably related to the allowed conditions in a claim.
- Clarifies when payment for services for non-allowed conditions will be denied.
- Adds requirement that requests for payment for duplicative diagnostic testing or imaging will be denied absent evidence of new or changed medical circumstances or other medical evidence supporting the request.
- Clarifies that up to three spinal levels unilaterally, bilaterally, or contiguously to the level of the allowed condition may be approved.
- Clarifies that one repeat diagnostic injection to confirm pain relief response may be approved. Public hearing held on March 7, 2024.
4123-17-14 Reporting of Payroll and Reconciliation of Premium Due.
This rule contains provisions governing the payroll reporting and premium payment requirements for employers. The primary proposed substantive change to the rule would allow the Administrator to waive reconciliation of payroll reports for clients of alternate employer organizations (“AEOs”) and professional employer organizations (“PEOs”), who are reporting all of their payroll through the AEO or the PEO and are a client employer of the AEO or the PEO for the entire policy year. Since the complete payroll of the client employer is reported under the AEO or the PEO policy, there is no business reason for the Administrator to require these employers to reconcile their payroll. This proposed change is the new paragraph (E)(4) in the proposed rule. Public hearing scheduled for May 16, 2024.
Ohio Judicial Decisions
Supreme Court of Ohio
Temporary Total Compensation – State ex re. Dillon v. Indus. Comm., 2024-Ohio-744 (March 5, 2024).
On March 5, 2024, The Ohio Supreme Court issued a significant decision in State ex rel. Dillon v, Industrial Commission (Slip opinion No. 2024-Ohio-744) by ruling that any Temporary Total Disability Benefits (TTD) received by a Claimant subsequent to achieving Maximum Medical Improvement (MMI) can be recouped by Employers. While on its face this may not seem like a major change in the current law, this landmark decision overrules prior case law and sets the stage for potential widescale determination of overpayments in many of Ohio Workers’ Compensation claims.
For almost twenty-six years, the termination of TTD by way of a finding of MMI was governed by the Supreme Court’s decision in State ex rel. Russell v. Indu. Comm., 82 Ohio Std.3d 516, (1998). In Russell the Court determined that a Claimant’s TTD benefits may not be terminated prior to a hearing before an Industrial Commission hearing officer so long as the Claimant’s attending physician continues to certify TTD, and that a hearing officer may not terminate a Claimant’s TTD benefits retroactive to a date prior to the date of hearing. Moreover, the Russell Court further stated that a Claimant is entitled to all compensation paid up to the date of the hearing. The Russell Court then summarily concluded that “…the appropriate date on which to terminate disputed TTD compensation on the basis of maximum medical improvement is the date of the termination hearing and the commission may not declare an overpayment for the payments received by the claimant before that date.” Id at 519. This is no longer the case.
In Dillon, the Bureau of Workers’ Compensation (BWC) allowed Dillon’s claim for “lumbar strain.” On appeal, a District Hearing Officer once again allowed Dillon’s claim for only the “lumbar strain” but granted TTD compensation for that condition. Dillon subsequently appealed the denial of her additional requested conditions to the Staff Hearing Officer (SHO) level, and her employer obtained an Independent Medical Examination (IME). The employer’s IME concluded that Dillon had reached MMI as of August 8, 2019. The SHO hearing was held on October 28, 2019, at which time the SHO affirmed the disallowance of Dillon’s addition requests and also found Dillon to be MMI as of August 8, 2019, the date of the Employer’s IME. However, between August 8, 2019, and the time of the October 28, 2019, SHO hearing, Dillon had received TTD payments totaling $5,549.40. The BWC issued an Order attempting to recoup these funds. The Ohio Industrial Commission found that recoupment was appropriate which gave rise to Dillon seeking a writ of mandamus from the Tenth District Court of Appeals. The court of appeals denied the writ which gave rise to this matter before the Ohio Supreme Court.
The Ohio Supreme Court in Dillon denied the requested writ but took a de novo review of the issue since the court of appeals decision involved an issue of statutory interpretation. The Dillon Court concluded that Claimants are not entitled to receive payments after attaining MMI pursuant to ORC 4123.56(A), and that if the Claimant is not entitled to those payments, ORC 4123.511(K) requires that those payments be recouped. The Dillon Court concluded that the reasoning by the Russell Court ran counter to the plain language of those statutes and therefor overruled Russell.
So, where do we go from here? The practical effect of Dillon is that Employers will now argue at hearings that a Claimant should be determined MMI as of the date of the Employer’s IME.
Loss of Use – State ex rel. Walters v. Indus. Comm., 2024-Ohio-553 (Feb. 16, 2024)
Mr. Walters (Decedent) was employed as a mechanic by Paradise Lawn Care. On May 16, 2018, the Decedent was pinned under the bucket while repairing a bucket loader, sustaining blunt trauma to his chest. The injury caused traumatic asphyxiation leading to cardiac arrest and ultimately severe anoxic brain injury. The Decedent died the next day. The Ohio BWC allowed the claim for dependent death benefits to his surviving spouse Mrs. Walters (Walters).
In addition to the award of dependent death benefits, Walters also requested a scheduled loss of use award claiming that that prior to her husband’s death that he suffered the loss of use of both arms and legs, loss of sight in both eyes and loss of hearing in both ears. Hospital records indicate that there were no injuries to the Decedent’s arms, legs, eyes or ears. In support of her claim, Walters submitted a letter from the Decedent’s trauma surgeon in which he opined that by the very nature of the anoxic brain injury the Decedent was left without the use of his arms and legs and likely without his vison or hearing from the time of the injury until his death the next day. The Claimant also obtained a medical opinion from a neuro-ophthalmologist who opined that the Decedent had suffered a total loss of vision and hearing as a result of the traumatic injuries.
The BWC obtained a file review in which he State doctor opined that the Decedent was unresponsive and had no neurologic function from the time of the blunt trauma until his death and that there was no evidence or trauma to the extremities or any compromise to the vascular or neurologic structures that support the extremities. The opinion was that had the Decedent survived he would have retained the use of his arm and legs.
The DHO granted the request for scheduled loss of use and the Employer and BWC obtained another report in which the physician opined that the Decedent was dead prior to the loss of use of his arms, legs, vision and hearing. Walters also obtained two additional medical opinions one stating that while it was not possible to perform tests of brain function it was still their opinion that the Decedent spent the last day of his life without hearing or vision. Yet another opinion obtained by Walters found that the decedent was never “brain dead” because he never underwent testing to confirm brain death and that until his death the decedent had lost use of his vision, hearing, arms and legs.
The SHO vacated the DHO Order found that the medical evidence did not substantiate the request for scheduled-loss compensation as set forth by the Supreme Court’s decision in State ex rel. Smith v. Indus. Comm., 138 Ohio St. 3d 312. Walters then filed a writ of mandamus to the Tenth District Court of appeals which denied the writ finding that where there is only a loss of brain function and no other injury to the body that Commission does not abuse its discretion in failing to award loss of use compensation. Walters then appealed to the Ohio Supreme Court.
The Ohio Supreme Court upheld the Court of Appeals decision with an analysis that revolved around the basic premise of the Smith case. The crux of the holding in Smith is that in the absence of an injury to the eyes and ears, evidence of a brain injury that precludes definitive visual and auditory testing is insufficient to support an award for loss of sight and hearing. In the Smith case no test could be performed to determine whether there was an actual loss of hearing or sight and the medical evidence there showed that Smith was unable to process sights and sounds because of damage to his brain not to because of an injury to his eyes or ears. The Court found that the instant matter involving Walters was like that in Smith.
However, although the Court also upheld the Tenth Districts ruling as it applies to the denial of the request for the loss of limbs, it did not go as far as to say that the same loss of use analysis the Court used in Smith for loss of sight and hearing is applicable for the loss of limbs request. The Court rather stated that apart from the Smith analysis there was some evidence to in the Walters case to support the SHO’s finding that an award for the loss of arms and legs was not substantiated.
Violation of Specific Safety Requirement (“VSSR”) – State ex rel. Cassens Corp. v. Indus. Comm., 2024-Ohio-526 (February 14, 2024).
Mr. Ybarra worked for Cassens Corp, an automobile transportation company. He was moving newly manufactured cars by driving them to a staging area in the outdoor lot of an automobile manufacturer for eventual delivery to auto dealerships. The outdoor lot was enclosed by a fence with a gate and not accessible to the public. While walking in the lot, Mr. Ybarra was hit from behind by a coworker who was driving a newly manufactured car to the staging area. The coworker did not see Mr. Ybarra because the car’s windshield was covered with snow. Following allowance of his workers’ compensation claim, Mr. Ybarra filed an application for a violation of a specific safety requirement (“VSSR”) award alleging Administrative Code Chapter 4123:1-5 applied to Cassens Corp because the enclosed outdoor lot qualified as a “workshop” and Cassens Corp violated Administrative Code Section 4123:1-5-13(C)(4) which required all motor vehicles to have cab glass with the vision “unimpaired by its condition.” The Industrial Commission granted Mr. Ybarra’s VSSR application finding that the outdoor yard constituted a “workshop” because the perimeter of the outdoor lot was fenced with gates for entry and exit, which were guarded and not open to unauthorized people and that Cassens Corp’s business operations were always conducted outside in the lot. The Commission further found that the newly manufactured vehicle constituted a “motor vehicle,” and that the accumulated snow violated Administrative Code Section 4123:1-5-13(C)(4). Cassens Corp appealed to the Tenth District Court of Appeals.
The Tenth District Court of Appeals overturned the Commission’s decision finding that the commission abused its discretion regarding whether the outdoor lot constituted a “workshop.” The Court determined that, although the outdoor lot was enclosed by a perimeter fence, the area did not meet the definition of a “workshop” as it was nothing more than a very large parking lot. The outdoor lot was not “a room or place wherein power-driven machinery is employed and manual labor is exercised by way of trade for gain or otherwise.” There was no manufacturing or vehicle assembly in the lot and driving the vehicles to a staging area for delivery to dealerships was not part of the manufacturing process.
The Industrial Commission appealed to the Supreme Court of Ohio arguing that an enclosed, restricted, and fenced-in area, where motor vehicles are used as an integral and primary part of the Employer’s work process, constitutes a workshop or factory, and that the outdoor lot where Mr. Ybarra did his manual labor of moving motor vehicles was “a room or place wherein power-driven machinery is employed and manual labor is exercised by way of trade for gain or otherwise.”
The Supreme Court noted that the term “workshop” is defined as “a small establishment where manufacturing or handicrafts are carried on. Or similarly, as “a small establishment where manufacturing or craftwork is carried on by a proprietor with or without helpers and often without power machinery.” The Supreme Court agreed with the Tenth District Court of Appeals that there was not some evidence to support the commission’s finding that the purpose of the outdoor yard was conducting the type of work that would classify the outdoor yard as a workshop and that the commission placed too much emphasis on the presence of a perimeter fence. The Supreme Court stated that the mere presence of a guarded and gated perimeter fence, in and of itself, is not sufficient to classify the enclosure as a “workshop.” There was no evidence that Cassens Corp’s business was one of craftwork, trade, or manufacturing, with or without power machinery. Cassens Corp did not manufacture the vehicles. It only drove them from the manufacturing plant to the outdoor lot. The Supreme Court concluded that, because Mr. Ybarra was not injured in a “workshop,” Administrative Code Chapter 4123:1-5 did not apply to Cassens Corp and, therefore, Cassens Corp was not liable for the alleged VSSR.
Tenth District Court of Appeals
Temporary Total Compensation – State ex rel. Michell Brown v. Indus. Comm., 2024-Ohio-797 (March 5, 2024).
In September 2017, Ms. Brown was injured when she slipped and fell on a wet floor. Her workers’ compensation claim was allowed, she underwent two surgeries, and she received temporary total compensation. On November 4, 2019, Ms. Brown returned to work on light duty with restrictions to wear a knee brace and take seated breaks. Ms. Brown continued to experience significant symptoms but was able to work through May 23, 2020, when the employer laid her off work due to the COVID-19 pandemic. On December 9, 2020, Ms. Brown requested temporary total compensation from May 23, 2020, through March 1, 2021, based on her treating physician’s opinion that Ms. Brown was unable to return to her former position of employment due to the allowed conditions in her claim. On December 9, 2020, Dr. David Dunkin reviewed the medical file at the request of the BWC and opined that there was no objective medical evidence supporting any substantial change in circumstances in Ms. Brown’s condition since she last worked on May 23, 2020, or that Ms. Brown is unable to work at her former position of employment.
The Industrial Commission denied Ms. Brown’s request for temporary total compensation under R.C. 4123.56(F) finding that Ms. Brown was not working as of May 23, 2020, for reasons unrelated to the allowed conditions in the claim, and that her request was unsupported by the medical evidence based on the opinion of Dr. Dunkin. Ms. Brown appealed to the Tenth District Court of Appeals.
Ms. Brown argued that R.C. 4123.56(F), which was effective as of September 15, 2020, did not apply to her request for compensation because her right to compensation accrued on May 23, 2020, even though she filed her request for compensation on December 9, 2020, after R.C. 4123.56(F) went into effect. Ms. Brown also argued that even if R.C. 4123.56(F) applied, she was eligible to receive temporary total compensation because she was working light duty when she was laid off on May 23, 2020, and her subsequent requests for compensation included additional limitations preventing her from working full duty.
The Court noted that R.C. 4123.56(F) applied to claims pending on or arising after the September 15, 2020 effective date of the legislation and because Ms. Brown’s claim “arose” on May 23, 2020, and was filed on December 9, 2020, Ms. Dillon’s request for compensation was pending on or after September 15, 2020.
The Court also noted that R.C. 4123.56(A) states that temporary total compensation will not be paid for the period when work within the physical capabilities of the employee is made available by the employer or another employer. The Court stated that when a claimant takes work with provided restrictions and then is terminated for reasons unrelated to the allowed conditions, the claimant is not eligible for temporary total compensation. The Court referred to Dr. Dunkin’s report wherein he opined that the medical evidence was insufficient to establish that Ms. Brown was not capable of performing the sedentary duties of her job with employer accommodations. The Court further noted that, although Ms. Brown was not required to prove that she was unable to work solely due to an impairment arising from the allowed conditions in her claim, she was required to establish that the allowed conditions in her claim were a reason she was not working. However, the Industrial Commission determined that Ms. Brown was capable of working on May 23, 2020, based on Dr. Dunkin’s opinion. Lastly, the Court determined that Dr. Dunkin’s report was not internally inconsistent, applied the correct standard, and was some evidence upon which the Industrial Commission could rely to deny Ms. Brown’s request for temporary total compensation.
Temporary Total Compensation – State ex rel. Ruffin v. Indus. Comm., 2024-Ohio-799 (March 5, 2024).
In September 2008, Ms. Ruffin was injured her lower back when she was pushing boxes through a machine. Ms. Ruffin was restricted from work and received temporary total compensation until she returned to work with light duty restrictions on September 4, 2012. Ms. Ruffin worked light duty with restrictions until July 17, 2013. On July 19, 2013, Ms. Ruffin presented to the emergency department with complaints of right-sided hip and back pain. She was diagnosed with non-allowed conditions of lumbar radiculopathy and osteoarthritis, provided steroids, and discharged home.
Ms. Ruffin retired on January 13, 2014. On February 12, 2014, Ms. Ruffin’s doctor submitted a letter to Ms. Ruffin’s attorney stating that Ms. Ruffin was 66 years old and suffering from chronic conditions as a result of her work injury. The work that she does aggravates her symptoms and she probably won’t feel better until she leaves that employment.
In September 2015, Ms. Ruffin’s was diagnosed with major depressive disorder, single episode, moderate and restricted from all work from September 17, 2015 through March 17, 2016. The BWC subsequently allowed the condition of major depressive disorder, single episode, moderate in Ms. Ruffin’s BWC claim. In January 2016, Ms. Ruffin filed a C-84 request for temporary total compensation indicating she was not presently working in any capacity and was receiving social security retirement benefits. She also filed a request for temporary total compensation from September 17, 2015, through March 17, 2016, and to continue.
In April 2016, the Industrial Commission denied her request for temporary total compensation finding that Ms. Ruffin had voluntarily abandoned her employment when she retired on January 31, 2014, for reasons unrelated to her industrial injury. The Commission found that although, Ms. Ruffin testified that she retired because her doctor told her that she would not get better until she stopped working, there were no retirement or resignation papers in the claim file certifying that Ms. Ruffin retired for reasons related to her industrial injury. Further, the last physical restrictions in the claim file certified restrictions through October 31, 2012, only. There were no documented restrictions in the claim file from October 31, 2012, through January 31, 2014.
Additionally, the letter from her doctor was issued approximately two weeks after Ms. Ruffin resigned and stated that Ms. Ruffin would not feel better until she leaves “that” employment – not all employment. Further, Ms. Ruffin testified that she had not looked for any other employment and had been receiving social security retirement since she retired on January 31, 2014. Accordingly, Ms. Ruffin failed to show that she was disabled from all employment at the time of her retirement and therefore she did not have any wages to replace. In November 2022, (over six years later) Ms. Ruffin appealed to the Tenth District Court of Appeals.
The court noted that R.C. 4123.56(F) did not apply to Ms. Ruffin’s case because the Industrial Commission had resolved Ms. Ruffin’s claim prior to the statute’s effective date of September 15, 2020. Therefore, the judicially created doctrine of voluntary abandonment was applicable. Voluntary abandonment exists “when a workers’ compensation claimant voluntarily removes [themselves] from [their] former position of employment for reasons unrelated to a workplace injury, [the claimant] is no longer eligible for [TTD] compensation, even if the claimant remains disabled at the time of [their] separation from employment.” The court noted that when determining whether an employee’s retirement bars a subsequent request for temporary total compensation, two considerations predominate: Was the retirement precipitated by the workplace injury, and did the claimant remain in the workforce after retiring?
The court found that Ms. Ruffin was not under any work restrictions related to the allowed conditions in the claim at the time of her retirement as she retired over a year after her work restrictions were no longer in effect. The court also found that Ms. Ruffin’s doctor did not issue his letter recommending Ms. Ruffin leave “that” employment until two weeks after she had retired. There was no evidence to indicate that Ms. Ruffin’s doctor had communicated his opinion to her prior to her retirement. Further, Ms. Ruffin’s doctor did not recommend Ms. Ruffin retire from all employment. He merely advised that Ms. Ruffin should retire from her current job. Lastly, it was undisputed that Ms. Ruffin had retired from all employment, received social security retirement benefits, and had not sought any work after January 31, 2014. Therefore, the court concluded that there was some evidence to support the Commission’s determination that Ms. Ruffin had voluntarily abandoned her employment and its denial of her request for temporary total compensation.
© Copyright 2024 by Christopher Ward and Raymond Tarasuck Calfee, Halter & Griswold, LLP. All rights reserved. Reprinted with permission.
2023 Budget
The two-year operating budget for the Ohio Bureau of Workers’ Compensation (“BWC”) was signed prior to the June 30th deadline (House Bill 31). It included a slight increase in appropriations for the agency, but no new policy initiatives included in the final version. The BWC had proposed to rename the BWC as the “Department of Workforce Insurance and Safety,” but this was removed by the legislature prior to passage and the BWC’s name remains the same.
Amendments related to requirements for the BWC to provide PTSD benefits without accompanying injury and a loss of use proposal that would have exposed self-insured employers to major liability were defeated during the BWC budget process.
Marijuana
An attempt to add a proposal to modify the state’s medical marijuana program was unsuccessful in 2023. However, in the November elections, Ohio citizens Issue 2 ballot initiative to legalize recreational marijuana.
Regulatory Actions (New Rules)
Ohio Administrative Code (“OAC”) sections 4123:1-5-01 through 4123:1-5-16: Specific Safety Requirements Applicable to “Workshops” and “Factories.” Replaces “shall” with “will”; “requirement” with “specification,”; “required” with “needed”; and “requiring” with “involving.” Change was effective June 30, 2023. Similar changes made to OAC 4123:1-5-17 through 4123:1-5-29 and 4123:1-5-99 with regard to other sections applicable to “Workshops” and “Factories.” Change effective September 1, 2023.
OAC 4121-3-09: Hearings before the Commission and its Staff and District Hearing Officers: Adds language that parties and representatives may attend a hearing in person by telephone or through Industrial Commission authorized web-based technology. This eliminates the requirement for the filing of a notice of waiver to appears in person when attending a hearing virtually. Change effective July 20, 2023.
OAC 4123-17-02: Successorship: Changes the criteria the BWC uses to determine the rate of successor entity that wholly succeeds one or more legal entities when at least one of the entities involved has a merit rating experience. The proposed change will permit the BWC to combine the experience of all of the involved entities to establish the rate of the successor entity without regard to whether one of the entities involves has a merit rating experience. States that the BWC will consider, but is not bound by, language in a purchase agreement between the parties regarding non-assumed liabilities when determining experience transfers. Change effective July 1, 2023.
Ohio Judicial Decisions
Temporary Total Compensation - State ex rel. Quest Diagnostics, Inc. v. Indus. Comm., 2023-Ohio-2213. (July 5, 2023)
In early 2018, Quintina Stone, a phlebotomist with Quest Diagnostics, Inc., notified her supervisor that she would be relocating to California due to her husband’s employment. Ms. Stone expressed her desire to transfer her employment within the company and was told that she would be permitted to do so. On October 3rd, Ms. Stone learned that her husband would start his new position on October 29th and submitted multiple transfer requests with Quest in California which were signed and dated by her supervisor. On October 6th, Ms. Stone was injured at work when she fell from a stepladder. Her workers’ compensation claim was allowed for various shoulder injuries. Her doctor ordered work restrictions that were to expire on October 31st. Ms. Stone was off work for four days due to her injury and then took a previously scheduled five-day vacation. Ms. Stone’s physician released her to work with temporary restrictions and she returned to work with light-duty restrictions on October 22nd.
On October 24th, Ms. Stone further discussed with Quest about transferring to one of Quest’s California locations. Upon contacting the California recruiter, Ms. Stone learned that a certification was required in California which she did not have. On October 28th, Ms. Stone resigned from Quest indicating her move to California as the reason. In March 2019, Ms. Stone received her California phlebotomist certification. In June 2019, Ms. Stone filed for temporary total disability (“TTD”) compensation dating back to October 27, 2018, to continue until she was medically able to return to work.
The District Hearing Officer (“DHO”) found that Ms. Stone did not qualify for TTD compensation because (1) She voluntarily removed herself from her position; (2) her transfer was not approved by Quest and she relocated to be with her spouse; (3) Ms. Stone knew she lacked the certification to do the job she sought before moving; (4) Ms. Stone chose to resign and relocate; (5) Ms. Stone may not have known about the certification until right before her move, but she should have known she had not been approved to formally relocate; (6) Ms. Stone chose to resign and relocate, even given that it “seemed fairly” certain that she would not be able to keep working for Quest; and (7) Ms. Stone’s decision to resign was hers alone.
On appeal, the Staff Hearing Officer (“SHO”) also denied her request for TTD, compensation ordering that (1) Ms. Stone voluntarily resigned; (2) There was no job offer or guarantee with Quest; (3) Ms. Stone’s options at the time of her resignation included either to stay behind and work towards her California certification or resign from her position; (4) Ms. Stone resigned for personal reasons; and (5) Ms. Stone’s resignation was a personal choice.
On appeal, the Industrial Commission found that the SHO had misapplied State ex rel. Klein v. Precision Excavating & Grading. The Commission vacated the SHO’s order and granted Ms. Stone’s request for TTD compensation. The Commission reasoned that Klein was different from Ms. Stone’s claim because Ms. Stone “had expressed her desire to transfer within the company and received reassurances from her supervisor that a transfer was possible prior to sustaining her injury.” And Ms. Stone had submitted her forms for transfer prior to her injury, to only later find out that a separate certification was necessary for transfer. This created justifiable reliance that Ms. Stone would be able to transfer, and she “reasonably expected” she would be able to transfer, but for her injury.
The Commission further explained that voluntarily abandonment hinges on intent which is “inferred from words spoken, acts alone, other objective facts, and all relevant circumstances existing at the time of the alleged abandonment.” Because Ms. Stone’s intent was to remain employed with Quest, and her words and actions showed that she did not plan to abandon her position, she did not voluntarily remove herself from her position with Quest and was entitled to TTD compensation.
Quest appealed to the Tenth District Court of Appeals asking to vacate the Commission’s award of TTD compensation and to reinstate the SHO’s order. The Tenth District concluded that the Commission had misinterpreted and misapplied the law of voluntary abandonment. The Court pointed to Klein’s reassertion of ineligibility for TTD compensation if a claimant’s workplace injury did not cause the loss of earnings. Essentially, if a claimant resigns “for reasons unrelated to her workplace injury she is no longer eligible for TTD.” Because Ms. Stone resigned for reasons not related to her October 2018 injury, she was not eligible for TTD compensation. Contrary to Ms. Stone’s objection, Ms. Stone’s intent/reason(s) for resigning were not related to her injuries. Because there was no relationship between Ms. Stone resigning to move to California with her spouse and her sustained injuries, there was an absence of a “causal connection.” The Court ordered the Commission to vacate its order and to enter an order denying Ms. Stone’s request for TTD compensation. Both Ms. Stone and the Commission appealed.
In July 2023, the Ohio Supreme Court affirmed the decision of the Tenth District Court of Appeals stating that in Klein, we held that “when a workers’ compensation claimant voluntarily removes himself from his former position of employment for reasons unrelated to a workplace injury, he is no longer eligible for TTD compensation, even if the claimant remains disabled at the time of his separation from employment. Klein overruled precedent, returning to the fundamental tenet of TTD compensation: that the industrial injury must cause the worker’s loss of earnings. The key question is whether an injured worker who is no longer in the former position has abandoned the workforce, either temporarily or permanently, not merely abandoned the former position. In other words, it must appear that, but for the industrial injury, the claimant would be gainfully employed. The Supreme Court concluded that, had Ms. Stone not been injured, she would have experienced the same wage loss upon relocating to California without the proper certification. And had Ms. Stone remained employed by Quest in Ohio, she would not have experienced any wage loss. Accordingly, the undisputed facts demonstrate that Ms. Stone’s industrial injury was not the “but for” cause of her lost earnings. Ms. Stone’s reasons for abandoning the workforce and experiencing lost wages lack the necessary causal relationship to her industrial injury.
Voluntary Abandonment Defense – State ex rel. AutoZone Stories, Inc. v. Indus. Comm., 2023-Ohio-633 (March 2, 2023).
In State ex rel. AutoZone Stores, Inc. v. Industrial Commission, the Tenth District Court of Appeals issued Ohio’s first appellate review of R.C. 4123.56(F), which deals with temporary total benefits (“TTD”) and went into effect in 2020. R.C. 4123.56(F) states, in part:
If an employee is unable to work or suffers a wage loss as the direct result of an impairment arising from an injury or occupational disease, the employee is entitled to receive compensation under this section, provided the employee is otherwise qualified. If an employee is not working or has suffered a wage loss as the direct result of reasons unrelated to the allowed injury or occupational disease, the employee is not eligible to receive compensation under this section.
R.C. 4123.56(F) supersedes any previous Ohio court cases establishing the doctrine of “voluntary abandonment,” which blocked disability benefits for claimants who voluntarily removed themselves from the workforce or were terminated for violation of work rules. In AutoZone, the claimant was injured on June 15, 2020 but worked light duty until his termination for cause in September 2020, following an argument with a coworker. The claimant requested TTD benefits in October 2020 and underwent an approved shoulder surgery in November 2020.
The Industrial Commission granted the claimant’s request for TTD beginning the date of his surgery. His employer brought a mandamus action before the Tenth District, arguing he was not entitled to TTD pursuant to R.C. 4123.56(F). The Tenth District affirmed the Commission’s decision and rejected the employer’s arguments. The employer argued that under the last sentence of 4123.56(F) outlined above, the claimant was not entitled to TTD because the surgery was not the reason he was off work—rather it was his prior termination for cause. Therefore, the claimant was off work “as the direct result of reasons unrelated to his injury.” The employer further argued that the claimant had no “wage loss” because he had already been terminated before he underwent the surgery. The Tenth District disagreed, stating:
Overall, we find the text of R.C. 4123.56(F) to be unambiguous. If a claimant is unable to work, R.C. 4123.56(F) sets forth two operative questions to be eligible for TTD compensation: (1) whether he or she is unable to work as the direct result of an impairment arising from an injury or occupational disease; and (2) whether he or she is otherwise qualified to receive TTD compensation. R.C. 4123.56(F) does not impose an additional requirement on a claimant to prove he or she is unable to work solely due to an impairment arising from an injury or occupational disease. Only when an otherwise qualified claimant is not working as a direct result of reasons unrelated to the allowed injury or occupational disease is the claimant ineligible to receive TTD compensation.
The court also directly addressed the prior voluntary abandonment doctrine from Ohio case law used before the enactment of R.C. 4123.56(F):
Although the employer implies we should analyze the effect of the termination and whether evidence exists that claimant had abandoned the workforce prior to his approved surgery, this is exactly the analysis the legislature expressly superseded by enacting R.C. 4123.56(F). Contrary to the employer's position, R.C. 4123.56(F) requires us to review only whether the claimant in this case was unable to work as the direct result of an impairment arising from an injury or occupational disease to support the grant of TTD for the period specified.
The development of Ohio case law on the interpretation of R.C. 4123.56(F) will provide further clarity for Ohio employers on this issue. As for now, arguments on limiting AutoZone to its specific facts may be an avenue for employers in defeating these requests for TTD – such as that despite an internal investigation prior to the claimant’s termination, he received unemployment compensation because his termination was found to be “without just cause” by the Ohio Department of Jobs and Family Services; and that the claimant was on light duty at the time of his termination and waited only two months to undergo surgery, showing intention to “abandon” the workforce may have been more evident if he had been working full duty at the time of termination but subsequently waited six months or more to undergo surgery.
State ex rel. Butler Vill. v. Indus. Comm., 2023-Ohio-3774 (10th District, October 17, 2023)
The Tenth District Court of Appeals held that an employee who voluntarily resigned their employment is entitled to temporary total disability compensation. In March 2021, a Butler Village employee was injured at work and thereafter worked in a light duty capacity. In April 2021, the employer reorganized and the injured worker’s job duties changed. In May 2021, the injured worker voluntarily resigned her position. In her resignation letter, she wrote, “I do not feel I can accomplish this newly reorganized position effectively. Therefore, please accept my resignation effective immediately.” Notably, she did not cite her injury as a reason for her resignation.
The injured worker first applied for temporary total disability compensation in September 2021, four months after she resigned. During the Staff Hearing Officer (SHO) hearing, the injured worker testified that her injuries prevented her from performing her job “effectively.” She testified that she needed assistance from a co-worker to perform some of her job duties, and she did not want to perform below standards. Therefore, she resigned her employment. During the hearing, the employer testified that the injured worker was successfully working at the time of her resignation. Additionally, the injured worker did not cite her industrial injury as a contributing factor in her resignation letter. The Staff Hearing Officer found, however, that the injured worker’s testimony outweighed this contrary evidence. The Staff Hearing Officer concluded that the industrial injury caused the injured worker to resign and granted temporary total disability.
The employer appealed the Industrial Commission decision to the Tenth District Court of Appeals, arguing that it abused its discretion and made a mistake of law under R.C. 4123.56(F). The employer argued the injured worker’s unemployment was solely the result of her voluntary resignation rather than reasons related to her allowed injury. The court rejected the employer’s argument. In reaching its decision, the court noted that the injured worker was working light duty at the time of her resignation. The injured worker could initially perform most job duties with one arm. When the employer reorganized and eliminated two of her roles, the injured worker alleged her job duties became more physically demanding than she could accomplish working light duty. Only after her job duties changed did the injured worker resign her position.
In granting temporary total disability compensation, the court reasoned: “while [the employee] may have had other reasons or motivations, there is some evidence in the record supporting the finding that she was unable to work as the direct result of an impairment arising from her allowed injury.”
Permanent Total Disability - State ex rel. Kidd v. Indus. Comm. 2023-Ohio-2975. (August 29, 2023)
Donna Kidd injured her back in 2013 while working as a warehouse and production employee at Tronair, Inc. Ms. Kidd’s workers’ compensation claim was allowed for various lumbar-spine conditions. Ms. Kidd returned to work for approximately 6 months and then left work due to increasing pain. In 2015, Ms. Kidd underwent a spinal surgery which did not relieve her pain symptoms. Ms. Kidd completed 27 weeks of vocational rehabilitation, and the BWC determined that she demonstrated the ability to independently continue her job search. In 2017, Ms. Kidd obtained part-time employment as a school-cafeteria server but ended her employment approximately eight months later due to increasing pain in her lower back and legs and increased difficulty with standing, bending, and lifting.
In 2018, Ms. Kidd filed for Permanent Total Disability (“PTD”) compensation. In support of her application for PTD, Ms. Kidd submitted a report from her chiropractor who reported that Ms. Kidd required the ability to change her position on a frequent basis, that she was unable to sit or stand for periods between 10 to 20 minutes without having to change positions due to increasing left leg pain. The chiropractor further noted that Ms. Kidd was unable to return to gainful employment “due to worsening of her lumbar disc condition and radicular leg complaints” and that Ms. Kidd “would be considered permanently and totally disabled due to her allowed conditions.”
The Industrial Commission’s examining doctor, Dr. Shah, concluded that Ms. Kidd could work at a sedentary level with the additional restrictions of no bending, twisting, or squatting, avoiding overhead activities, and avoiding activities that require increased balance, including using ladders. Ms. Kidd was limited to standing for approximately 20 minutes, sitting for 20 to 30 minutes with changes in position, and walking up to 1/2 mile. She required rest periods every 15-20 minutes for 1-2 minutes as needed during standing, sitting, or walking, and had difficulty lifting due to her low back pain Ms. Kidd was also evaluated by a vocational consultant who disagreed with Dr. Shah’s opinion that Ms. Kidd could work at a sedentary level. She stated that Ms. Kidd was 100% totally unemployable and does not retain the capacity to engage in sustained, remunerative employment. She stated that Dr. Shah’s list of restrictions was less than a sedentary level; that no employer will accommodate a break every 15 minutes due to being non-productive and inefficient for most job tasks; and the restrictions are so limiting that Ms. Kidd would find it very difficult to find an employer willing to accommodate such requirements. While sitting in this position for 15 minutes, Ms. Kidd is in pain and this affects her concentration. At home, she is able to change positions frequently. At a job, she would not have this opportunity because alternating between sitting, standing, and walking around would impact her ability to complete job tasks in a timely manner. Additionally, she participated in vocational rehabilitation that included job seeking skills training, job development, job coaching and working with an employment specialist but finding an employer who would accommodate her restrictions could not be identified.
The Commission denied Ms. Kidd’s application for PTD compensation based on her testimony and Dr. Shah’s opinion that she was capable of sustained remunerative employment at a sedentary level. The Commission found that Dr. Shah’s restrictions were consistent with the definition of sedentary work in Ohio Administrative Code Section 4121-3-34(B)(2)(a), and that “modern innovations in office equipment, such as sit/stand desks and wireless telephone technology, as well as work-from-home options, offer workers the ability to change positions at their convenience.” Ms. Kidd appealed to the Tenth District Court of Appeals.
On appeal, Ms. Kidd argued that the Commission had abused its discretion by relying on Dr. Shah’s report because his restrictions were less than sedentary work and therefore inconsistent with the definition of sedentary work in Ohio Administrative Code Section 4121-3-34(B)(2)(a). Ms. Kidd also argued that the Commission’s analysis of the nonmedical factors relating to her alleged disability status was flawed and that the Commission failed to consider how Ms. Kidd’s need to telework or utilize modern office innovations would hinder her ability to find employment.
The Tenth District Court of Appeals agreed with Ms. Kidd and held that the Commission’s reliance on Dr. Shah’s opinion constituted an abuse of discretion because his restrictions were “seemingly inconsistent” with the definition of “sedentary work” in Ohio Administrative Code Section 4121-3-34(B)(2)(a). The Court further determined that advancements in workplace technology and Ms. Kidd’s potential proficiency in that regard do not address Ms. Kidd’s apparent impediment to sedentary work as that term is defined in the Ohio Administrative Code.” The Commission appealed to the Supreme Court of Ohio.
On appeal, the Commission argued that its decision was not an abuse of discretion because Dr. Shah’s work restrictions were consistent the definition of sedentary work and that the Commission’s acknowledgment of advances in workplace accommodations further supported its decision. Ms. Kidd reiterated her argument that Dr, Shah’s medical restrictions were inconsistent with the definition of sedentary work and maintained that her need to take rest periods every 15 to 20 minutes limited her ability to function such that she was incapable of engaging in sustained remunerative employment.
The Supreme Court found the restrictions in Dr. Shah’s report consistent with the definitions of PTD and sedentary work. The Court specifically noted that the definition of sedentary work does not address “rest periods” so Dr. Shah’s imposition of rest periods with his restrictions is not inconsistent with the definition of sedentary work. Regarding the Commission’s reliance on advances in workplace technology, the Supreme Court reasoned that in making a PTD determination, the Commission must consider the doctors’ reports and opinions; a claimant’s age, education, and work record; factors of a psychological, psychiatric, and sociological nature; and “any other factors” that might be important to its determination of whether this specific claimant may return to the job market by utilizing past employment skills, or those skills which may be reasonably developed.” Because the Commission can consider any other factors it is not precluded from considering advances in workplace technology in determining whether jobs exist that are reasonably likely to accommodate a claimant’s medical restrictions.
The Court also noted that the evaluation of the weight and credibility of the evidence is left to the discretion of the Commission within the context of each case. And because workers’ compensation cases are largely fact-specific, no one test or analysis can be said to apply to each and every factual possibility. Therefore, we prefer a flexible and analytically sound approach that eschews hard-and-fast rules. Prohibiting consideration of prevalent workplace accommodations and technology would be antithetical to this flexible approach and to the Commission’s exercise of discretion within its field of expertise. The Court concluded that Dr. Shah’s report constituted some evidence, the Commission did not abuse its discretion in denying Kidd’s application for PTD compensation, and reversed the Tenth District Court of Appeals’ decision.
Loss of Use - State ex rel. Ottinger v. B&B Wrecking & Excavating, Inc., 2023-Ohio-1758 (May 25, 2023)
In 2018, claimant was injured when he fell from a roof and sustained multiple injuries and his claim was allowed for various conditions including “paraplegia, incomplete.” In 2019, he filed a motion for compensation for functional loss of use of both of his legs. His motion stated: “In support of this motion, please consider that the medical on file and the fact that his claim is allowed fo[r] ‘paraplegia.’” A BWC nurse reviewed the motion and stated that the medical evidence and the allowed condition of “paraplegia” support the request for compensation of the functional loss of use of both of his legs. However, the claim was allowed for the condition of “paraplegia, incomplete” not “paraplegia” and claimant’s medical records indicated that he could walk for 200 feet, used a walker and wheelchair for mobilization, and is continuing physical therapy on his legs with a goal of returning to work.
The BWC initially granted his request for loss of use compensation. Approximately six weeks later, the BWC filed a motion requesting the Industrial Commission to exercise its continuing jurisdiction arguing there were clear mistakes of law and fact in the BWC’s order granting claimant’s loss of use award. The Industrial Commission granted the BWC’s motion finding continuing jurisdiction was warranted based on the mistake of fact that his claim was allowed for “paraplegia, incomplete” not “paraplegia” and that the medical evidence in the file demonstrated that he had not lost the use of his legs. The Industrial Commission also found that the BWC had made a mistake of law by issuing the loss of use award based on the incorrect allowed condition and the medical evidence that he retained some use of his legs.
Upon appeal before the 10th District, the magistrate found that the commission did not abuse its discretion and the commission’s order was supported by some evidence. The commission identified the following two mistakes of fact by the BWC: (1) the incorrect diagnoses of paraplegia instead of paraplegia, incomplete; and (2) there was evidence on file prior to and subsequent to the issuance of the order of claimant’s ability to stand and ambulate independently with a wheeled walker, which was inconsistent with a loss of use award.
The Court concluded that the commission found at least one clear mistake of fact that was supported by some evidence and therefore did not abuse its discretion in its exercise of continuing jurisdiction. The Court noted that a single mistake of fact or mistake of law was all that was needed to justify the commission’s exercise of continuing jurisdiction. As long as some medical evidence supports the commission’s findings, those findings will not be disturbed. In this case, the commission had ample. evidence in the record which supported the commission’s finding that the BWC granted claimant’s motion based on the factual mistake that his claim had been allowed for “paraplegia,” not “paraplegia, incomplete,” in order to properly exercise continuing jurisdiction.
Classification of Workers - State ex rel. Friendship Supported Living, Inc. v. Ohio Bur. of Workers’ Comp., 2023-Ohio-957. (March 28, 2023).
Friendship Supported Living, Inc., (“Friendship”), provided in-home direct-care services to developmentally disabled persons. In addition to its regular W-2 employees, Friendship classified individuals who provided home health care services as independent contractors. In 2008, the BWC conducted an audit of Friendship and determined the workers were independent contractors. In 2017, the BWC conducted a second audit of Friendship and determined the workers were employees, not independent contractors. The BWC supported its decision by finding that Friendship also had W-2 employees who visited the same consumers as the workers to perform related services. The workers were interviewed, hired, and paid set wages. Friendship assigned schedules and work hours to the workers. Friendship made decisions about care, medication, exercise, etc., and the worker followed a plan developed by a healthcare provider and overseen by a case manager or RN. The contract stated that after 24 months the workers could apply to be employees of Friendship. Friendship performed all scheduling of days and times when the worker was to work. Friendship monitored the workers’ activities for compliance and quality. A worker could not hire someone to cover the worker’s services – the services must be performed by the individual worker. The workers submitted timesheets, were paid by the hour, and did not invoice for services. Friendship carried liability insurance.
Friendship appealed the BWC’s decision to the Tenth District Appellate Court. The Court determined that the BWC had abused its discretion and ordered the BWC to vacate its order. The BWC appealed to the Supreme Court of Ohio arguing that the court committed error by reweighing the evidence and that the BWC’s decision was based on reasoning that was fully supported by evidence in the record.
The Ohio Supreme Court noted the key determination for determining whether an individual is an employee or an independent contractor is who has the right to control the manner or means of doing the work. The Court stated that the right-to-control test is not marked by a bright-line rule but rather a set of non-exhaustive factors such as: the existence of a contract for the performance by an individual of a certain piece or kind of work at a fixed price; the independent nature of the individual’s business or the individual’s distinct calling; the individual’s employment of assistants with the right to supervise their activities; the individual’s obligation to furnish necessary tools, supplies, and materials; the individual’s right to control the progress of the work except as to final results; the time for which the individual is employed; whether the method of payment is by time or by job; whether the work is part of the regular business of the employer; who controls the details and quality of the work; who controls the hours worked; who selects the routes travelled; what is the length of employment; the type of business; and any pertinent agreements or contracts.
The Court reviewed the factors and found that the Ohio Department of Developmental Disability’s regulation of Friendship was not evidence that supported the BWC’s classification of Friendship’s workers as employees. The Court also concluded that Friendship did not exert control over a facet of the work relationship with the workers by requiring that the workers carry their own automobile insurance, because even if the direct-care workers were not involved with Friendship, they would still be required by law to maintain insurance coverage per state-law requirements. The Court noted that Friendship paid the workers hourly but also issued 1099’s to the workers. Because the bureau’s analysis regarding these two aspects of how Friendship paid the workers was supported by some evidence in the record, the Court concluded that these findings effectively canceled each other out.
Instead of determining whether the BWC’s weighing of the factors in the right-to-control test was supported by some evidence, the Supreme Court determined that the BWC failed to consider the totality of the circumstances and remanded the issue back to the BWC for the BWC to provide specific evidence whether Friendship’s monitoring for quality and compliance demonstrated Friendship’s control over the workers or whether it was merely confirming compliance with the terms of the independent contractor agreement. The Court also ordered the BWC to address whether the workers were free to work for other companies including Friendship’s competitors, and to address the previously omitted factors regarding the workers’ routes.
Death Benefits - State ex rel. McDonald v. Indus. Comm., 2023-Ohio-1620. (May 17, 2023).
Mr. McDonald died in a ditch collapse while working for the employer. Amanda Carpenter was Mr. McDonald’s fiancée and the mother of Mr. McDonald’s two minor children. She filed a claim with the BWC for death benefits for her and their two minor children. The Industrial Commission granted death benefits to their two minor children but denied death benefits to Ms. Carpenter. The commission found that she was not dependent on Mr. McDonald as a surviving spouse because they were never married, common-law marriage was abolished in Ohio since 1991, case law did not extend R.C. 4123.59(D)(2) to an unmarried person in a relationship with a decedent worker, and for over 80 years the commission had required that a legal marriage exist.
Ms. Carpenter appealed to the Tenth District Court of Appeals. The Tenth District concluded that because the last paragraph of R.C. 4123.59(D) says that a dependent can be “a member of the family of the deceased employee” or a person that “bears to the deceased employee the relation of surviving spouse, lineal descendant, ancestor, or brother or sister,” Ms. Carpenter could potentially qualify for death benefits as a member of McDonald’s family, even though she was not his surviving spouse.
On appeal before the Ohio Supreme Court reviewed R.C. 4123.59(D) and noted that the statute is divided into two sections. The Court noted that the first section stated that “no person shall be considered a prospective dependent unless such person is a member of the family of the deceased employee and bears to the deceased employee the relation of surviving spouse, lineal descendant, ancestor, or brother or sister.” While the second section stated “in all other cases, the question of dependency, in whole or in part, shall be determined in accordance with the facts in each particular case existing at the time of the injury resulting in the death of such employee, but no person shall be considered as dependent unless such person is a member of the family of the deceased employee, or bears to the deceased employee the relation of surviving spouse, lineal descendant, ancestor, or brother or sister.”
The Court reasoned that because the second section used the word “or” instead of the word “and” as used in first section, the second section in R.C. 4123.59(D) created two categories of potential dependents: (1) “a member of the family of the deceased employee” or (2) a person who “bears to the deceased employee the relation of surviving spouse, lineal descendent, ancestor, or brother or sister.” Therefore, the Court concluded that marital status was not determinative of whether a person is eligible to receive death benefits under the last paragraph of R.C. 4123.59(D). In other words, any person may be eligible for death benefits if it is determined that the person is “a member of the family of the deceased employee” under the facts of the particular case.
The Court concluded that the Industrial Commission failed to further consider or determine whether Ms. Carpenter was a member of Mr. McDonald’s family, even though she was not married to Mr. McDonald, pursuant to the second section of 4123.59(D). And, the commission could determine that an unmarried person who was in a relationship with a deceased employee was “a member of the family of the deceased employee,” depending on the facts of that particular case. The Court remanded the matter back to the commission to determine whether Ms. Carpenter was a member of Mr. McDonald’s family at the time of the injury that resulted in his death.
State ex rel. Heilman v. Indus. Comm., 2023-Ohio-3073. (August 31, 2023).
Arthur Heilman was injured on April 4, 2019, while working for Riverside Maine Industries, Inc., (“Riverside”) when he was struck in the head by a piece of metal from a machine that failed. Mr. Heiman died on April 6, 2019, as a result of his work-related injuries. Patricia Heilman filed a death claim and a loss of use application for the total loss of use of both arms and legs, total loss of vision in both eyes, and total loss of hearing in both ears on behalf of her deceased husband. Riverside certified Ms. Heilman’s claim, and her request for death benefits was paid on October 15, 2019. The Commission denied her application for payment of loss-of-use-compensation, pursuant to R.C. 4123.57(B). Ms. Heilman appealed to the Tenth District Court of Appeals.
The Court concluded that certain medical reports cannot constitute “some evidence” to support the Commission’s order denying Ms. Heilman’s motion for loss-of-use compensation because it did not comply with the holding in State ex rel. Wallace v. Indus. Comm., 57 Ohio St. 2d 55, 386 N.E.2d 1109 (1979) inasmuch as the reviewing physician, when rendering his opinion, did not accept the objective findings of the coroner who was an examining physician.
Accordingly, the Court directed the Commission to vacate its order denying Ms. Heilman’s application, determine, without reliance on the reviewing physician’s reports, whether Ms. Heilman had established Mr. Heilman’s loss of use of both arms and legs, loss of vision in both eyes, and loss of hearing in both ears, and enter an order granting or denying compensation accordingly. On October 5, 2023, the Industrial Commission filed an appeal to the Ohio Supreme Court. On October 16, 2023, Ms. Heilman filed a cross-appeal to the Ohio Supreme Court.
State ex rel. Kenneth Cogan v. Indus. Comm., 2022-Ohio-3748 (October 5, 2023)
Mr. Cogan did not have a lens in his right eye as a result of a childhood injury involving a BB pellet. With the use of a hard contact lens, his vision was restored to 20/40. Without a hard contact lens, his vision was “count fingers at two feet.” However, Mr. Cogan never underwent corrective surgery prior to his work injury. Several decades later, Mr. Cogan was injured at work when a ratchet struck his right eye. Mr. Cogan underwent three corrective surgeries. Following the second surgery, Mr. Cogan’s corrected vision in his right eye was measured at “count fingers at two feet.” After the third surgery, Mr. Cogan’s vision was 20/400 and his doctor opined he did not have usable vision in his right eye due to refractive error. Mr. Cogan filed an application for total vision loss in his right eye. Relying on the report of Dr. Raffoul, the Industrial Commission denied his application determining that Mr. Cogan could not show that he suffered any loss of vision due to the industrial injury when comparing his pre-injury uncorrected vision without the hard contact lens of “count fingers at two feet” to his post-injury uncorrected vision of “count fingers at two feet.” Mr. Cogan appealed to the Tenth District Court of Appeals.
The Tenth District Court of Appeals found that the Commission applied the incorrect standard to determine Mr. Cogan’s preinjury visual baseline. The Court stated that the Commission should not have strictly adhered to the standard of comparing Mr. Cogan’s uncorrected pre-injury vision without a hard contact lens to Mr. Cogan’s uncorrected post-injury vision. In doing so, the Commission predetermined that Mr. Cogan did not suffer vision loss because Mr. Cogan’s uncorrected vision remained at “count fingers at two feet.” Instead, the Commission should have construed the statute liberally in favor of Mr. Cogan, exercised its discretion, and taken into account the unique circumstances of Mr. Cogan’s medical history regarding his right eye. The Commission should have compared Mr. Cogan’s pre-injury, corrected, usable vision of 20/40 to his post-injury, uncorrected, unusable vision of 20/400. Note that, instead of finding Mr. Cogan had lost 100% of his vision in his right eye, the Court remanded the matter back to the Commission to apply the correct standard to determine Mr. Cogan’s pre-injury visual baseline and determine whether the medical evidence supports an award for loss of vision. The Commission appealed to the Supreme Court of Ohio.
The issue before the Ohio Supreme Court was whether the Commission had discretion to use Mr. Cogan’s vision as corrected by a hard contact lens as Mr. Cogan’s preinjury visual baseline. The Commission argued that Mr. Cogan’s use of a hard contact lens to correct his vision was distinguishable from someone who had surgery to correct their vision prior to their work injury. As a result, the Commission argued it was required to use Mr. Cogan’s pre-injury, uncorrected vision as a baseline. The Court noted that R.C. 4123.57(B) states that the standard for post-injury vision is the claimant’s uncorrected vision without consideration of surgical procedures, contact lenses, or glasses. However, R.C. 4123.57(B) does not address the standard for measuring pre-injury vision.
On October 5, 2023, the Supreme Court rejected the Commission’s argument finding no distinction between surgical procedures and optical prostheses as both are considered a correction to vision, not a restoration of vision. The Court found that whether a claimant has had a preinjury surgical correction is not determinative under R.C. 4123.57 or case law, therefore, the Commission abused its discretion by using Mr. Cogan’s pre-injury, uncorrected vision as a baseline. The Court affirmed the decision of the Tenth District Court of Appeals and remanded the matter to the Commission for further proceedings.
State ex rel. Levitin v. Indus. Comm., 2022-Ohio-2750 (October 4, 2023)
Rimmia Levitin was injured when her right hand was caught in the rollers of a flatbed die-cutter machine. Approximately ten months prior to her injury, the Employer renovated the machine and modified a guard by increasing its weight to prevent it from bowing and accidentally shutting down the machine. In addition to her BWC claim, Ms. Levitin filed an application for a VSSR award alleging the Employer violated two sections of the Administrative Code. The Industrial Commission denied Ms. Levitin’s VSSR application stating that the first code section was not violated because it applied to a single function machine and the machine in this case was a multifunction machine. And, the second code section was not violated because a safety device need not be foolproof. The purpose of a specific safety requirement is to provide reasonable but not absolute safety for employees. The increased weight of the guard may have made the guard less effective, but not useless. Lastly, there was no evidence that the Employer had been forewarned of the malfunction by a prior malfunction of the guard under the “one-time malfunction” rule. Ms. Levitin appealed to the Tenth District Court of Appeals.
The Tenth District Court of Appeals found that the Industrial Commission decision was based on “some evidence” and was not an abuse of discretion. The Court also noted that safety regulations do not impose strict liability on employers whenever a safety device fails. The Court referenced the “one-time malfunction” exception which provides that the fact that a safety device that otherwise complies with the safety regulations failed on a single occasion is not alone sufficient to find that the safety regulation was violated. Under this exception, the question becomes whether the Employer had ever been forewarned of the malfunction on the date of injury by a prior malfunction of the safety device. In this case, the modified safety guard had not malfunctioned prior to Ms. Levitin’s injury. Ms. Levitin appealed to the Supreme Court of Ohio.
On appeal Ms. Levitin argued that because the employer intentionally modified the guard, the guard did not provide reasonable safety from accidental injury and the employer cannot claim a lack of forewarning under the one-time malfunction rule. On October 4, 2023, the Supreme Court affirmed the Tenth District Court of Appeals’ decision finding that the Commission’s decision was supported by “some evidence.” The Court noted that the employer did not modify the guard to disable it. Instead, the employer modified the guard because it was malfunctioning and accidentally actuating a shutdown. The employer may have provided a less-effective means of protection, but that is not the same as an employer providing no guard at all. As to the one-time malfunction rule, the Court noted that the Commission’s decision was supported by witness testimony and maintenance logs that the type of failure had never occurred before. The Court refused to reweigh the evidence, even if contrary witness statements existed. Ms. Levitin also tried to argue that where a corporate party denies knowledge of a fact, a court should determine whether any evidence demonstrates knowledge of that fact by any employee. The Court rejected Ms. Levitin’s argument as an inversion of the “some evidence” rule and an attempt to get the Court to reweigh the evidence.
State ex rel. Spotleson v. Medlab Ohio Inc., 2023-Ohio-2464. (July 18, 2023).
On October 13, 2010, Susan Spotleson sustained an injury while employed at Medlab Ohio, Inc., when a vehicle she was driving was struck by another vehicle. Her workers’ compensation claim was allowed for “left shoulder sprain”; “neck sprain”; “head injury with no loss of consciousness”; ”disc protrusion C6-C7 level”; “substantial aggravation of pre-existing disc protrusion C5-C6”; “reflex sympathetic dystrophy bilateral upper arms”; “left neoplasm uncertain behavior lower neck from previous cervical surgery”; “complex regional pain syndrome of left lower limb”; “chronic regional pain syndrome of the face”; “myelomalacia C3-C4 and C7”; and “cervical disorder with myelopathy C3-C4 and C7.”
In March 2012, the BWC issued an order granting temporary total disability (“TTD”) compensation beginning on February 22, 2012, and to continue based on the submission of medical evidence. The BWC paid TTD compensation through February 27, 2017. Ms. Spotleson submitted C-84 forms dated February 25, March 25, April 25, and May 25, 2017. In addition to the C-84 forms, Ms. Spotleson submitted a January 31, 2017, physician report of work ability MEDCO-14 estimating a potential return to work date of February 28, 2017. The BWC issued a letter informing Ms. Spotleson that she had not submitted a physician report of work ability MEDCO-14 or any other medical evidence to support the most recent period of TTD compensation. The letter also indicated that if the requested documentation was not submitted, TTD compensation would end on February 27, 2017. Ms. Spotleson submitted C-84 forms dated June 25 and July 25, 2017. TTD compensation was granted, and the BWC appealed. In July 2021, the order was vacated, and TTD compensation was denied on the basis that TTD was not payable from two years prior to the date that the motion was filed pursuant to R.C. 4123.52. Ms. Spotleson appealed to the Tenth District Court of Appeals.
The Court upheld the BWC’s denial of TTD compensation finding that there was “some evidence” in the record to support the order denying TTD compensation for the period of February 28, 2017, through February 26, 2018. Because the only application for compensation before the SHO was the February 27, 2020, C-86 motion, the two-year limitation in R.C. 4123.52 prohibited the SHO from granting TTD compensation from February 17, 2017, through February 26, 2018. The Court noted that the language in R.C. 4123.52 barring the Commission from awarding compensation beyond two years prior to the date of the filing of the application is explicit and mandatory. On August 29, 2023, Ms. Spotleson filed an appeal to the Ohio Supreme Court which is pending.
State ex rel. Jeld-Wen, Inc. v. Indus. Comm., 2023-Ohio-2593. (July 27, 2023).
On May 13, 2019, Steven Totten’s right hand was caught between a conveyor and outfeed table on a patio door cleaner while working for Jeld-Wen, Inc., a self-insured employer. Jeld-Wen recognized Mr. Totten’s claim for his injuries.
After an absence, Mr. Totten returned to work on August 11, 2019, and was assigned light-duty work. After working less than one week, Mr. Totten was experiencing pain in his right fourth finger and was examined by a doctor who initially removed him from work entirely but then allowed him to return on August 15, 2019, “with a complete restriction from using his right hand.” This restriction was continued until October 2019, at which time Mr. Totten stopped working because “the offered employment required him to use his right hand which was contrary to the doctor’s restrictions.” Mr. Totten was subsequently examined by a new physician, who completely removed Mr. Totten from work from October 4, 2019, through January 15, 2020, based on Mr. Totten’s inability to perform the light-duty work that had been offered. In January 2020, Mr. Totten was examined by a third doctor, who concluded that Mr. Totten could have performed the light-duty work as of October 4, 2019, in part because Mr. Totten had been performing that work between August 15th and October 4th. Subsequently, Mr. Totten sought TTD compensation benefits from October 4, 2019, onward. The Commission granted Mr. Totten’s temporary total benefits. Jeld-Wen appealed to the Tenth District Court of Appeals. Jeld-Winn argued that it had offered a light-duty job to Mr. Totten and therefore the Commission should have denied his request for TTD compensation. The Court determined that Jeld-Wen did not provide any evidence—such as testimony from an occupational specialist—that its light-duty work could be performed with a single hand, and it was undisputed that Mr. Totten testified that the light-duty work required him to use his right hand. Although two of the doctor’s disagreed over the “no use of right hand” restriction, the record was clear that both doctors believed that the restriction was appropriate. In light of this other evidence, the Commission was free to give the opinion that Mr. Totten could perform light-duty work appropriate weight in view of Mr. Totten’s testimony and the other evidence in the record.
The Court upheld the Commission’s decision because there was “some evidence” in the record to support the Commission’s orders. No appeal was filed to the Ohio Supreme Court.
State ex rel. Moore v. Indus. Comm., 2023-Ohio-3075. (August 31, 2023).
On November 26, 1991, Tamara Moore sustained an injury to her right shoulder while picking up a small motor during her employment for Gemi Holdings, Inc. Her workers' compensation claim was allowed for “right shoulder sprain,” “myoneural disorder of long thoracic nerve,” “joint derangement right shoulder,” and “depressive disorder.” She received temporary total disability compensation. She never underwent any surgeries for her injury.
Moore attempted to participate in rehabilitation, but in June 1992, was informed that she was not medically stable for participation in rehabilitation, and her rehabilitation file was closed in January 1993. Without rehabilitation, she returned to restricted-duty work with Gemi in February 1993, and continued working there for approximately 28 years. However, she continued to have pain in her right shoulder and continued to receive medical treatment periodically.
In August 2019, Ms. Moore was laid off due to the Gemi’s relocation of the workforce to Mexico. In February 2021, Ms. Moore filed for Permanent Total Disability (“PTD”). Ms. Moore was examined by four doctors in 2021. Ms. Moore’s doctor, Dr. Hurst, opined Ms. Moore had no capacity for sustained remunerative employment due to the allowed physical conditions in the claim. Ms. Moore’s psychologist, Dr. Lyall, opined Ms. Moore was PTD for the allowed psychological conditions in the claim. The BWC doctor, Dr. Scheatzle, opined Ms. Moore could perform light-duty work with restrictions. The BWC psychologist, Dr. Pawlarczyck, opined that Ms. Moore’s psychological condition resulted in a 24% whole-person impairment and caused her to experience significant social withdrawal, and be irritable and pessimistic which would affect her ability to work with others. She would be unable to tolerate stress encountered at work, and there was the potential to engage in some suicidal behavior.
A Staff Hearing Officer (“SHO”) denied Ms. Moore’s application for PTD based on Dr. Scheatzle’s and report, finding that among other things: Ms. Moore was able to perform light-duty work for the employer for 28 years; Ms. Moore was laid off only due to the employer’s moving its workforce to Mexico; following her layoff, Ms. Moore did not seek vocational rehabilitation; Ms. Moore’s lack of sleep has been a chronic problem for a number of years, but she was still capable of working; Ms. Moore was capable of performing light work, and can sit, stand, walk, and lift with her right arm to shoulder height; Ms. Moore did not take any pain medications; Ms. Moore did not pursue any vocational rehabilitation; Ms. Moore performed activities of daily living inconsistent with being unable to perform all sustained remunerative employment; and Ms. Moore
refused psychotherapy treatment despite feeling stressed. The SHO rejected Dr. Pawlarczyk’s report as internally inconsistent and Dr. Lyall’s report because he stated Ms. Moore had only worked for Gemi for 11/2 years.
Ms. Moore appealed to the Tenth District Court of Appeals arguing the SHO failed to provide a reason why it rejected Ms. Moore’s reports, and improperly considered her percentage of partial impairment in violation of Ohio Administrative Code 4121-3-34(D)(3)(f).
The Court noted that the Commission was the exclusive evaluator of weight and credibility of the evidence and it would be improper for the Court to evaluate the propriety of the Commission’s finding that a doctor’s report was persuasive. The Court further noted that the Commission was not required to identify the evidence it finds unpersuasive or the reason for rejecting it, because “[l]ogic dictates that if the identity of rejected evidence is irrelevant, so is the reason for the rejection.” Accordingly, the Commission did not need to state why it found one doctor’s report more persuasive than that of another doctor. The Commission may not state an arbitrarily reason for rejecting a report but the Commission must have “some reasonable basis for the rejection of a physician’s finding.” The Court noted that, contrary to Ms. Moore’s argument, the SHO provided two reasons for rejecting the reports as some evidence: (1) the doctor failed to explain how Ms. Moore was unable to return to sustained remunerative employment yet worked for 28 years after her injury in a light-duty capacity; and (2) the doctor indicated in his report that Ms. Moore had been diagnosed with an unspecified anxiety disorder, a condition not allowed in Ms. Moore’s claim.
The Court stated that OAC section 4121-3-34(D)(3)(f) provides that an “adjudicator shall not consider the injured worker's percentage of permanent partial impairment as the sole basis for adjudicating an application for compensation for permanent total disability. However, contrary to Ms. Moore’s argument, the SHO did not consider Ms. Moore’s percentage of impairment as the sole basis for denying her PTD application as the SHO denied Ms. Moore’s application for the numerous other reasons as indicated in its order. Therefore, because the SHO did not consider Moore’s percentage of impairment as the sole basis for denying Ms. Moore PTD compensation, the SHO’s decision did not violate OAC 4121-3-34(D)(3)(f).
The Court held that because the SHO’s order was based on “some evidence” and did not violate OAC 4121-3-34(D)(3)(f) the Commission did not abuse discretion when it denied Ms. Moore’s PTD compensation. No appeal has been filed with the Ohio Supreme Court as of October 16, 2023.
State ex rel. Cincinnati v. Indus. Comm., 2023-Ohio-3638 (October 5, 2023)
Joseph Conley was diagnosed with thyroid cancer while working as a firefighter for the City of Cincinnati. Mr. Conley’s claim was initially denied by the Industrial Commission. Upon Mr. Conley’s request for reconsideration, the Commission invoked its continuing jurisdiction based on “a clear mistake of law” and found that the expert reports relied on by the hearing officers to deny Mr. Conley’s claim were insufficient as a matter of law to rebut the presumption under R.C. 4123.68(X)(1). Specifically, the Commission found that the reports did not show, by a preponderance of competent scientific evidence, that exposure to the type of carcinogen alleged did not or could not have caused Mr. Conley’s cancer. After reconsideration, the Commission allowed Mr. Conley’s claim. The City of Cincinnati appealed to the Tenth District Court of Appeals arguing that a clear mistake of law did not exist, instead the Commission was improperly reweighing the evidence.
The Court noted that R.C. 4123.68(X) sets forth a rebuttable presumption that cancer contracted by firefighter who has been assigned to at least six year of hazardous duty as a firefighter constitutes a presumption that the cancer was contracted in the course of and arising out of that firefighter’s employment if the firefighter was exposed to certain carcinogens. An employer can rebut the presumption through evidence that shows, by a preponderance of competent scientific evidence, that exposure to the type of carcinogen alleged did not or could not have caused the cancer being alleged.
The Court reviewed Cincinnati’s expert reports and determined that the medical literature the city’s expert relied on did not establish that the exposure to the pertinent carcinogens did not or could not have caused Mr. Conley’s cancer. Therefore, the City’s expert report did not show by a preponderance of competent scientific evidence that Mr. Conley’s exposure to the carcinogens did not or could not have caused Mr. Conley’s cancer. The Court stated that the misapplication of the rebuttable presumption was a clear mistake of law, and concluded that the Commission properly identified the mistake of law in that the medical evidence cited the hearing officers was not legally sufficient to rebut the statutory presumption in R.C. 4123.68(X). No appeal has been filed with the Ohio Supreme Court as of October 16, 2023
© Copyright 2024 by Christopher M. Ward, Calfee, Halter & Griswold, LLP. All rights reserved. Reprinted with permission.
REGULATORY ACTIONS (New Rules)
4123-6-36 Enhanced care program
(Effective January 1, 2023)
The proposed new rule would permit an MCO to authorize medical treatment reimbursement requests for any conditions within the same knee as the conditions initially allowed in the claim and presumed to be causally related to the industrial injury during such time as the conditions are being considered for allowance or being adjudicated. If the injured worker or employer appeal a claim, additional allowance, or medical treatment reimbursement request, the claim will be removed from the enhanced care program. Applies to knee only claims. Treatment limited to first sixty days from date of initial allowance. State fund claims, only.
4123-3-37 Lump Sum Advancements
Eliminates the requirement that a Lump Sum Advancement application be notarized. In response to the BWC’s request for comments, on September 26, 2022, the OMA submitted a comment to the BWC in support of the proposed change.
4123 Successorship
Changes the criteria the BWC uses to determine the rate of a successor entity that wholly succeeds one or more legal entities when at least one of the entities involved has a merit rating experience. The proposed change will permit the BWC to combine the experience of all of the involved entities to establish the rate of the successor entity without regard to whether one of the entities involved has a merit rating experience. Eliminates the requirement that a legal entity be assigned only one risk pursuant to O.A.C.
4123-17-13 Employer Application for Workers’ Compensation Coverage
Permits the BWC to deny or rescind an employer’s application for coverage when the BWC determines the employer that has submitted an application for coverage is essentially the same employer for which the BWC has previously provided coverage. Upon denial or rescission of the employer’s application, the BWC will have the option to maintain the applying employer’s prior or existing policy, in addition to the BWC’s current authority to transfer a prior policy to the applying employer or reactivate a previously cancelled policy of the applying employer.
Modifies the start date of Employer’s coverage so that it begins upon the BWC’s receipt of the employer’s coverage application fee, instead of the BWC’s receipt of the employer’s first estimated premium payment, as long as the employer makes the first estimated premium payment.
JUDICIAL DECISIONS
State ex rel. Ohio State Univ. v. Pratt, 2022-Ohio-4111 (November 18, 2022)
On June 20, 2017, Ms. Pratt submitted a two-week letter of resignation stating her last day of work at OSU would by July 5th. On June 24th she sustained a work-related injury and on June 27th she had surgery. On June 28th, she accepted a new job with Sweet Carrot to begin in the fall after she recovered from her surgery. She requested temporary total compensation. OSU objected based on her resignation letter arguing Ms. Pratt was ineligible for temporary total compensation because she voluntarily abandoned her previous position of employment prior to her work injury. OSU relied on the Supreme Court’s 2018 decision in Klein v. Precision Excavating & Grading Co., 155, Ohio St.3de 78, 2018-Ohio-3890. In Klein, the Court held that when a workers’ compensation claimant voluntarily removes himself from his former position of employment for reasons unrelated to a workplace injury, he is no longer eligible for temporary total compensation, even if the claimant remains disabled at the time of his separation from employment. The Industrial Commission granted Ms. Pratt’s request for temporary total compensation and OSU appealed.
The Supreme Court acknowledged that its decision in Klein created some confusion because the Court interchangeably referred to both abandonment of the claimant’s former “position of employment” and abandonment of “employment” generally. And, the Court noted that its holding in Klein focused on an injured worker who voluntarily removes himself from his former position of employment for reasons unrelated to a workplace injury.
The Court clarified its prior decision in Klein and found in favor of Ms. Pratt stating that the test for temporary total compensation is not whether the injured worker has abandoned the former position of employment but whether the injured worker has abandoned the workforce. The Court ruled that a determination of voluntary abandonment requires consideration of all relevant circumstances existing at the time of the alleged abandonment. The Court also noted that, in contrast to Ms. Pratt’s case, in Klein, the injured worker resigned his employment to look for another job and did not have another job to go to during his period of disability.
Note that the Court determined that the current version of R.C. 4123.56 did not apply as it became effective September 15, 2020, after the Industrial Commission issued its final order in Ms. Pratt’s workers’ compensation claim.
R.C. 4123.56(F) current states:
If an employee is unable to work or suffers a wage loss as the direct result of an impairment arising from an injury or occupational disease, the
employee is entitled to receive compensation under this section, provided the employee is otherwise qualified. If an employee is not working or has suffered a wage loss as the direct result of reasons unrelated to the allowed injury or occupational disease, the employee is not eligible to receive compensation under this section. It is the intent of the general assembly to supersede any previous judicial decision that applied the doctrine of voluntary abandonment to a claim brought under this section.
State ex rel. Walmart, Inc. v. Hixson, 2022-Ohio-4187 (November 30, 2022)
Ms. Hixson sustained injuries when she fell while working for Walmart in 2017. Ms. Hixson received temporary total compensation. On March 6, 2018, Ms. Hixson notified Walmart of her age-related retirement and Walmart moved to terminate her temporary total compensation based on her voluntary abandonment of employment. The Industrial Commission denied Walmart’s motion, relying on State ex rel. Pretty Prods. Inc., v. Indus. Comm. 77 Ohio St.3d 5, (1976) which held that a claimant who voluntarily abandons his employment is entitled to temporary total compensation if he is medically incapable of returning to work at the time of the abandonment. In other words, a claimant can abandon a former position only if he has the physical capacity for employment at the time of the abandonment.
The Industrial Commission concluded that Ms. Hixson did not voluntarily abandon her employment when she retired because she was temporarily and totally disabled from her position with Walmart on the date of her retirement.
The Ohio Supreme Court subsequently decided State ex rel. Klein v. Precision Excavating & Grading Co., overruling State ex rel. Pretty Prods. Inc., holding that when a workers’ compensation claimant voluntarily removes himself from his former position of employment for reasons unrelated to a workplace injury, he is no longer eligible for temporary total compensation, even if the claimant remains disabled at the time of his separation from employment.
After the Ohio Supreme Court issued its decision in Klein, Walmart appealed the Industrial Commission’s 2018 denial of its motion to terminate temporary total compensation and asked the Court to retroactively apply the new rule in Klein to Ms. Hixson’s claim.
The 10th District Court of Appeals agreed and terminated Ms. Hixson’s temporary total compensation based on a retroactive application of the Ohio Supreme Court’s ruling in Klein. The 10th District Court of Appeals noted that decisions of the Ohio Supreme Court are generally applied retroactively unless the Supreme Court states otherwise, and the Supreme Court did not state the Klein decision did not apply retroactively. Ms. Hixson appealed.
The Ohio Supreme Court reversed the 10th District Court of Appeals decision and reinstated Ms. Hixson’s temporary total compensation. The Supreme Court stated that its decision in Klein applied prospectively only. The Court noted that, although it did not explicitly say it in its decision, the language of its decision in Klein implies that it should be applied prospectively, only. The Court held that its decision in Klein established a new principle of law that was not foreshadowed in prior decisions and that retroactive application of the Klein decision would cause and inequitable result to injured workers who were not part of the case.
State ex rel. Waste Mgt. of Ohio, Inc. v. Indus. Comm., 2022-Ohio 4581 (December 22, 2022)
Travis Gelhausen lost control of a truck he was driving for Waste Management of Ohio which flipped on its side pinning him in the wreckage. Jolene Szapowal was driving behind Mr. Gelhausen and stopped to help. She later testified via affidavit that when she approached the wreckage, she could see Mr. Gelhausen from his ribs to his knees and that he was breathing for approximately three minutes before he passed. She did not see Mr. Gelhausen move his arms or legs.
Mr. Gelhausen’s dependents filed for compensation under R.C. 4123.57(B) for Mr. Gelhausen’s loss of use of both arms and legs during the three minutes he survived prior to his death. The expert witnesses for the dependents and Waste Management offered contrasting opinions as to the medical conclusions to be drawn from the nature of Mr. Gelhausen’s post-accident breathing. However, both experts agreed that, based on Ms. Szapowal’s non-medical testimony, Mr. Gelhausen initially survived the accident before he died.
A Staff Hearing Officer for the Industrial Commission initially denied the dependents’ request for loss of use compensation finding that Mr. Gelhausen did not survive the accident for a discernible period of time after his injury. On reconsideration, the Industrial Commission exercised its continuing jurisdiction finding that the Staff Hearing Officer’s Order contained a clear mistake of fact as it was uncontroverted that Mr. Gelhausen had survived the accident for approximately three minutes. The
Industrial Commission further determined that Mr. Gelhausen lost the use of his bilateral arms and legs during the time between the accident and his death and awarded the dependents 850 weeks of compensation.
Waste Management appealed. The Tenth District Court of Appeals found that there was a mistake of fact therefore the commission did not abuse its discretion when it invoked its continuing jurisdiction. Waste Management appealed to the Supreme Court of Ohio.
The Ohio Supreme Court upheld the Industrial Commission’s decision to grant
850 weeks of loss of use benefits to the dependents of a deceased worker who survived for three minutes before dying from his injuries.
The Supreme Court also upheld the commission’s decision to invoke continuing jurisdiction. The Court noted that, contrary to the Staff Hearing Officer’s conclusion that Mr. Gelhausen did not survive the accident, both experts agreed that Mr. Gelhausen initially survived the accident. The Court reiterated that Ohio law does not require a specific length of time for survival or that the injured worker be aware of his loss of use in order to qualify for scheduled loss of use benefits. The Court also upheld the commission’s award of a lump sum payment of 850 weeks of compensation. The Court stated that, if Mr. Gelhausen had survived, Ohio law would have permitted him to request the BWC to commute his weekly installments to a lump sum payment. Further, Ohio law permits the dependents to receive an award up to the amount Mr. Gelhausen would have been entitled to receive had he survived. Therefore, the commission did not abuse its discretion when it awarded the dependents 850 weeks of compensation in a lump sum amount.
Note that an interesting evidentiary issue lingers within the Industrial Commission’s decision to award loss of use benefits to the dependents. The only evidence that Mr. Gelhausen survived the accident was the non-medical testimony of Ms. Szapowal. And, although, Ms. Szapowal testified that she did not see Mr. Gehausen move his arms or legs, there was no objective medical evidence that Mr. Gelhausen could not move his arms or legs. However, the Ohio Supreme Court determined this point was irrelevant. Instead, the Court focused solely on the commission’s finding of a mistake of fact regarding Mr. Gelhausen surviving the accident to justify the commission’s invoking its continuing jurisdiction.
10th District Court of Appeals
State ex rel. Block v. Indus. Comm., 2022-Ohio-4474 (December 13, 2022)
On December 12, 2012, Michael Block was injured while working as a roofer when he fell from a residential roof onto a concrete walkway. He suffered a number of injuries, most prominently to the right wrist. After surgery and years of treatment, he filed a claim for the total loss of use of the right hand. The Industrial Commission denied Mr. Block’s motion and he appealed.
The Court upheld the commission’s decision based on the abuse of discretion standard stating that the Court will not determine that the commission abused its discretion when there is some evidence in the record to support the commission’s finding.
The Court noted that R.C. 4123.57(B) authorizes scheduled compensation to a claimant for the total loss of a body part, such as the total loss of an arm or leg. “Loss” includes not only amputation, but also the loss of use of the affected body part. To qualify for compensation under R.C. 4123.57(B), the loss of use need not be absolute if the claimant has “suffered the permanent loss of use of the injured bodily member for all practical intents and purposes.”
The Court noted that Mr. Block relied heavily on the rebuttal report of his expert
witness, Dr. George, to support permanency, pointing to Dr. George’s findings that there was total ankyl
fingers extending all the way up throughout the hand to the wrist. However, the Court stated that these findings did not mandate a conclusion that Mr. Block suffered a total loss of use of the right hand. Ankylosis of the wrist and loss of sensation in two fingers did not inevitably equate to total loss of use of the right hand. Mr. Block's allowed conditions and ankylosis were in his wrist, not his hand, and a loss of use of two or more fingers by amputation or ankylosis is required to constitute a loss of the use of the hand per R.C. 4123.57(B). Even if Dr. George opined Mr. Block had a loss of sensation in two fingers, Mr. Block did not show the loss of use of two or more fingers.
The Court deferred to the commission’s conclusion that Dr. George's rebuttal report was insufficient to support a finding that there was a total loss of use and that any loss of use was permanent. In contrast, the commission relied on Dr. Pellegrino’s report providing some evidence to support the commission’s decision that Mr. Block retained some function of the right hand therefore the allowed injury did not result in a total permanent loss of use of the right hand. Dr. Pellegrino explained that Mr. Block's primary functional limitation of the right arm was due to the fusion of his right wrist, and Mr. Block suffered some subjective decreased sensation in the right hand, he indicated that the right hand neurological function remained functionally intact to allow full range of motion without increased pain, and grasping, pincher grasp, and fine-motor movement.
State ex rel. Walters v. Indus. Comm., 2022-Ohio-4587 (December 20, 2022)
On May 16, 2018, Timothy Walters was employed as a mechanic with Paradise Lawn Care, Inc. Mr. Walters was working on a small bucket loader that was used to load mulch onto company trucks. The bucket loader moved from its upright position toward the ground, landing on Mr. Walters’ chest. Mr. Walter’s was found pinned under the bucket loader and was unconscious. The next day, Mr. Walters died from a sustained a traumatic cardiac arrest as a result of traumatic asphyxiation caused by his work injury.
Laurie Walters, Mr. Walters’ surviving spouse, filed a motion for a scheduled loss of use award. The Industrial Commission denied Ms. Walters’ motion stating that the medical evidence did not substantiate that a loss of use award was warranted where, as a result of this anoxic brain injury, decedent was left without function of his arms and legs and without the ability to hear or see. Relying on State ex rel. Smith v. Indus. Comm., 138 Ohio St.3d 312, 2014-Ohio-513, the Industrial Commission stated that this type of injury does not satisfy the requirements for the requested loss of use award as the losses of function due to a brain injury do not qualify for the losses enumerated in R.C. 4123.57(B).
The 10th District Court of Appeals affirmed the Industrial Commission’s decision to deny the loss of use award stating that the loss of use of vision and hearing caused by anoxic brain injury that prevents the processing and visual and auditory signals by functioning eyes and ears is not compensable under R.C. 4123.57. The 10th District Court
brain injury when the Ohio Supreme Court has not allowed the loss of use of eyes and ears due to anoxic brain injury, and specifically stated in Smith that the General Assembly had not included loss of brainstem functioning in the schedule for compensation set forth in R.C. 4123.57.
The Court noted that, as with the worker's eyes and ears in Smith, in the present case, there was no evidence that Mr. Walters’ legs and arms were not functionable. Instead, the expert medical report relied on by the commission showed that Mr. Walters was left without function of his arms and legs due to anoxic brain injury. There was no conclusive evidence from any medical professional that Mr. Walters suffered injuries directly to the eyes and ears, and there was no evidence of trauma to the eyes or ears.
State ex rel. AutoZone Stores, Inc. v. Indus. Comm., 2023-Ohio-644 (March 2, 2023)
On June 15, 2020, Jason Schomaker sustained an injury when he was moving batteries while working for AutoZone. On September 5, 2020, Mr. Schomaker was involved in an argument with another employee. AutoZone conducted an investigation and terminated Mr. Schomaker on September 16, 2020. On November 16, 2020, Mr. Schomaker underwent surgery and filed a request for temporary total compensation.
AutoZone argued that Mr. Schomaker was not eligible for temporary total compensation pursuant to R.C. 4123.56(F) because he was terminated from employment prior to his surgery. The Industrial Commission rejected AutoZone’s argument and granted Mr. Schomaker’s request for compensation beginning on the date of his surgery as he was unable to return to and perform his former position of employment due to the allowed conditions in his claim. AutoZone appealed.
The Court noted that when a claimant removes himself from employment for reasons unrelated to the work-related injury, he is no longer eligible for temporary-total-disability compensation since the voluntary abandonment—and not the injury—causes the loss of wages. Amended R.C. 4123.56(F) contains two distinct sections for determining whether an employee is entitled to TTD compensation based upon wage loss. Pursuant to the first section, an employee is entitled to receive compensation if the employee is unable to work or suffers a wage loss as the direct result of an impairment arising from an injury or occupational disease. Pursuant to the second section of R.C. 4123.56(F), if an employee is not working or has suffered a wage loss as the direct result of reasons unrelated to the allowed injury or occupational disease, the employee is not eligible to receive wage-loss compensation.
The Court concluded that the first section applied to Mr. Schomaker. He was entitled to receive compensation because he underwent an authorized surgery to treat the allowed conditions on November 16, 2020. Mr. Schomaker was unable to work as of the date of his surgery as the direct result of an impairment arising from an injury. At that point, his failure to work was not “a direct result of reasons unrelated to the allowed injury” as stated in the second section. The Court noted that contrary to the employer's argument, as of November 16, 2020, Mr. Schomaker was unable to work regardless of the reason for or cause of his termination on September 16, 2020. His reason for not working up until the date of surgery was irrelevant for purposes of determining his eligibility for wage-loss compensation after the surgery due to the allowed conditions.