Opinion

State ex rel. Brown v. Indus. Comm.

  • 2016 Ohio 7007
Court
Ohio Court of Appeals
Filed
Sep 27, 2016
Status
Published
On the bench
Luper Schuster
Cited by
1 cases
Authority
More cited than 45.6%

The opinion

[Cite as State ex rel. Brown v. Indus. Comm., 2016-Ohio-7007.]

IN THE COURT OF APPEALS OF OHIO

TENTH APPELLATE DISTRICT

State of Ohio ex rel. Michael L. Brown, :

Relator, :

v. : No. 15AP-909

Industrial Commission of Ohio and : (REGULAR CALENDAR)

ABC Chiropractic,

:

Respondents.

:

D E C I S I O N

Rendered on September 27, 2016

On brief: Knisley Law Offices, Dylan O. Knisley, and

Kurt A. Knisley, for relator.

On brief: Michael DeWine, Attorney General, and Natalie J.

Tackett, for respondent Industrial Commission of Ohio.

IN MANDAMUS

LUPER SCHUSTER, J.

{¶ 1} Relator, Michael L. Brown, commenced this original action requesting that

this court issue a writ of mandamus ordering respondent Industrial Commission of Ohio

("commission") to vacate its order denying Brown's application for temporary total

disability ("TTD") compensation and ordering the commission to find Brown is entitled to

TTD compensation.

{¶ 2} Pursuant to Civ.R. 53(C) and Loc.R. 13(M) of the Tenth District Court of

Appeals, this court referred the matter to a magistrate. The magistrate issued the

appended decision, including findings of fact and conclusions of law, recommending this

court deny relator's request for a writ of mandamus.

No. 15AP-909 2

{¶ 3} On May 27, 2016, relator filed with this court a document captioned

"Objection to Magistrate's Decision Dated May 20, 2016." Civ.R. 53(D)(3)(b)(ii) requires

that "[a]n objection to a magistrate's decision shall be specific and state with particularity

all grounds for objection." Relator did not give any specific grounds for his objection to

the magistrate's decision. Instead, the body of the document purporting to be relator's

objections states in its entirety, "Relator, Michael L. Brown, hereby gives notice of

objection to the Tenth District Appellate Court of Ohio from the Magistrate's decision

rendered on May 20, 2016," and, following the signature page, relator requested this court

schedule an oral argument. (Relator's Objs. at 1-3.) Because relator does not include any

argument or any grounds for an objection, we cannot construe relator's filing on May 27,

2016 as objections. Accordingly, no objections having been filed, we review this case

under Civ.R.53(D)(4)(c).

{¶ 4} Finding no error of law or other defect on the face of the magistrate's

decision, this court adopts the magistrate's decision as our own, including the findings of

fact and conclusions of law. In accordance with the magistrate's decision, we deny

relator's requested writ of mandamus.

Writ of mandamus denied.

DORRIAN, P.J., and BRUNNER, J., concur.

No. 15AP-909 3

APPENDIX

IN THE COURT OF APPEALS OF OHIO

TENTH APPELLATE DISTRICT

State of Ohio ex rel. Michael L. Brown, :

Relator, :

v. : No. 15AP-909

Industrial Commission of Ohio and : (REGULAR CALENDAR)

ABC Chiropractic,

:

Respondents.

:

MAGISTRATE'S DECISION

Rendered on May 20, 2016

Knisley Law Offices, Dylan Knisley, and Kurt Knisley, for

relator.

Michael DeWine, Attorney General, and Natalie J. Tackett,

for respondent Industrial Commission of Ohio.

IN MANDAMUS

{¶ 5} Relator, Michael L. Brown, has filed this original action requesting that

this court issue a writ of mandamus ordering respondent, Industrial Commission of

Ohio ("commission"), to vacate its order which denied relator's application for

temporary total disability ("TTD") compensation, and ordering the commission to find

that he is entitled to that compensation.

No. 15AP-909 4

Findings of Fact:

{¶ 6} 1. Relator was working as a chiropractor on July 2, 2014, when he alleged

that he sustained a work-related injury to his neck, right shoulder, and right knee when

he caught a patient who fell.

{¶ 7} 2. Relator's FROI-1 filed July 28, 2014, was initially disallowed by the

Ohio Bureau of Workers' Compensation ("BWC") based upon a finding that relator was

not covered under workers' compensation because he was a sole proprietor/partner who

had not elected to have coverage for himself on the date of injury.

{¶ 8} 3. Following a hearing on December 10, 2014, a district hearing officer

("DHO") allowed relator's claim for the following conditions: "cervical sprain; right

shoulder sprain; right knee medial meniscus tear; and right knee sprain." The DHO also

awarded relator TTD compensation from July 3 through September 12, 2014, and

indicated that such compensation may continue based upon submission of appropriate

proof.

{¶ 9} 4. The BWC appealed and the matter was heard before a staff hearing

officer ("SHO") on February 10, 2015. Based on evidence that relator had prior

extensive right shoulder problems and that Robert J. Nowinski, D.O., opined that he

needed right shoulder replacement surgery for end-stage glenohurmeral arthritis, the

SHO specifically disallowed relator's claim for "cervical sprain; right shoulder sprain."

{¶ 10} The SHO determined that relator's claim should be allowed for "right knee

medial meniscus tear; right knee sprain," and determined that relator had presented

sufficient evidence entitling him to an award of TTD compensation for the closed period

of July 18 through August 31, 2014. The SHO specifically relied on the

September 25, 2014 C-30 request for medical information completed by Mark

D'Onofrio, M.D., who indicated that he first saw relator for right knee pain on July 9,

2014, and diagnosed relator as having a right knee tear medial meniscus. Dr. D'Onofrio

indicated that relator underwent a right knee arthroscopy and that he was disabled from

employment from July 18 to August 31, 2014.

{¶ 11} 5. Relator's appeal was refused by order of the commission mailed

March 4, 2015.

No. 15AP-909 5

{¶ 12} 6. Relator treated exclusively with Mark Drake, D.C. Relator first saw Dr.

Drake on July 11, 2014 for evaluation and treatment of his cervical, right shoulder, and

right knee conditions. Dr. Drake's report indicates that relator's primary reason for

treatment with him was for cervical and thoracic complaints and that relator intended to

pursue orthopedic evaluation of both his shoulder and knee. Dr. Drake only treated

relator's cervical and thoracic spine and shoulder. Dr. Drake recommended further

treatment for his spine and recommended that his shoulder and knee be evaluated by an

orthopedist.

{¶ 13} In his August 20, 2014 report, Dr. Drake indicated that relator presented

for continued treatment of cervical and right upper extremity complaints and that he

was awaiting approval of post-surgical rehabilitation for his knee. On examination, Dr.

Drake noted that his cervical range of motion was substantially reduced and that he had

diminished range of motion with report of pain in flexion, extension, abduction, internal

rotation, and external rotation of his right shoulder. Dr. Drake noted that relator was

able to actively flex his right knee to 90 degrees, noted some crepitus, but no obvious

click as would be associated with a torn meniscus. Treatment included chiropractic

adjustments of relator's thoracic and cervical regions, as well as adjustment and

therapeutic ultra sound to his right shoulder.

{¶ 14} Dr. Drake completed a Medco-14 dated August 25, 2014 indicating that

relator was temporarily unable to return to his former position of employment from

July 2 through September 12, 2014. Dr. Drake noted that both relator's right shoulder

sprain and his right knee sprain were the conditions causing his temporary disability

and that he was awaiting approval for right shoulder rehabilitation, right knee post-

surgical rehabilitation, and a cervical sprain MRI.

{¶ 15} The record also contains the October 11, 2014 report of Dr. Drake

indicating that relator presented for continued treatment and evaluation of job injuries

involving his cervical spine and right shoulder. This report specifically indicates that the

additional injury affecting relator's right knee was not the primary focus of the visit, but

that he did continue to have pain. Dr. Drake adjusted relator's upper thoracic and

cervical regions, and applied electrical stimulation and therapeutic ultrasound to his

shoulder. Dr. Drake indicated that he would again request authorization for a cervical

No. 15AP-909 6

spine MRI and continued chiropractic care. Dr. Drake also recommended an orthopedic

consultation to evaluate relator's right shoulder and indicated that he would complete a

Medco-14 noting substantial limitations in relator's right shoulder function that limit his

ability to function within his profession as a chiropractor. Dr. Drake did complete a

Medco-14 indicating that relator was temporarily and totally disabled from

October 11, 2014 through January 13, 2015, noting that the conditions causing this

disability were his right shoulder sprain with possible internal joint derangement and

right knee sprain with torn meniscus.

{¶ 16} The record also contains a January 12, 2015 report of Dr. Drake indicating

that relator presented for evaluation of right shoulder, cervical spine, and right knee

injuries. Dr. Drake noted that relator reported pain of 8/10 in his shoulder and 6/10 in

his right knee. Dr. Drake noted that relator's range of motion of his right shoulder was

still significantly affected and that he had active range of motion of his right knee to full

extension without additional pain. Dr. Drake again recommended a cervical MRI, a

medical evaluation for an EMG study of relator's right upper extremity, an orthopedic

consultation for relator's right knee and right shoulder, and rehabilitation for relator's

right knee. Dr. Drake completed another Medco-14 indicating that relator was

temporarily and totally disabled from January 16 through March 15, 2015, and again

listed relator's right shoulder sprain with suspected joint derangement and right knee

sprain with torn meniscus as the conditions causing relator's disability.

{¶ 17} 7. In an order mailed March 13, 2015, the BWC determined that relator

had been overpaid TTD compensation in the amount of $21,225 and ordered that the

overpayment be recouped from future awards of compensation to which relator may

become entitled.

{¶ 18} 8. Relator appealed and the matter was heard before a DHO on April 15,

2015. The DHO modified the prior BWC order finding an overpayment and stating:

The Hearing Officer finds that the Injured Worker was paid

temporary total disability compensation from 07/03/2014 to

02/07/2015. However, Staff Hearing Officer order dated

02/10/2015 only granted temporary total disability

compensation from 07/18/2014 to 08/31/2014, a closed

period. It is therefore the order of the Hearing Officer that

the Injured Worker was overpaid temporary total disability

No. 15AP-909 7

compensation from 07/03/2014 to 07/17/2014 and from

09/01/2014 to 02/07/2015. It is therefore the order of the

Hearing Officer that the total amount of the overpayment is

$21,225. The BWC is to recoup the overpayment pursuant to

R.C. 4123.511(K).

This order is based on the Staff Hearing Officer order dated

02/10/2015.

{¶ 19} 9. Relator's appeal was heard before an SHO on May 26, 2015. The SHO

affirmed the prior DHO order finding an overpayment, stating:

The order of the District Hearing Officer, issued 04/17/2015,

is affirmed.

The Staff Hearing Officer affirms the District Hearing

Officer's finding that the Bureau of Workers' Compensation

correctly calculated the overpaid periods of temporary total

disability compensation in this claim between 07/03/2014

and 02/07/2015. Specifically, the Staff Hearing Officer notes

the Injured Worker was awarded a discreet and closed period

of temporary total disability compensation pursuant to Staff

Hearing Officer order, dated 02/10/2015. Temporary total

disability compensation was awarded from 07/18/2014

through 08/31/2014, closed period. Accordingly, the Staff

Hearing Officer finds the Injured Worker was erroneously

paid temporary total disability compensation by the Bureau

of Workers' Compensation from 07/03/2014 to 07/17/2014

and again from 09/01/2014 to 02/07/2015. The Staff

Hearing Officer affirms the Bureau of Workers'

Compensation's calculation of these overpaid benefits to

total $21,225.00 and orders that a recoupment be made

pursuant to the non-fraud provisions of R.C. 4123.511(K).

This decision is based on the Staff Hearing Officer's decision,

dated 02/10/2015 and the overpayment calculation included

in the Bureau of Workers' Compensation administrative

order, dated 03/13/2015.

All of the evidence available to the Industrial Commission

was reviewed and considered in rendering this decision.

{¶ 20} 10. In an order mailed June 18, 2015, relator's appeal from the

determination of an overpayment was refused.

No. 15AP-909 8

{¶ 21} 11. On May 26, 2015, (the same day the SHO upheld the determination of

an overpayment), a DHO heard relator's new application for TTD compensation. The

DHO specifically denied relator's request for TTD compensation from August 31, 2014

through May 6, 2015 finding that relator failed to establish by a preponderance of the

evidence that he was temporarily and totally disabled based independently on the

allowed conditions in his claim. Specifically, the DHO order provides:

Temporary total disability compensation requested from

08/31/2014 through 05/06/2015 is denied. The Staff [sic]

Hearing Officer finds the Injured Worker has failed to

establish by a preponderance of the evidence in file that he

was temporarily and totally disabled based independently on

the allowed conditions in this claim during this period.

Specifically, the Staff [sic] Hearing Officer finds the serial

MEDCO-14s Physician's Reports of Work Ability covering

this period and completed by Mark Drake, D.C. all indicate

that in Dr. Drake's opinion the Injured Worker's temporary

total disability is attributable, at least in part, to conditions

specifically disallowed in this claim. The Staff [sic] Hearing

Officer cites the MEDCO-14 signed by Dr. Drake on

10/27/2014 in which Dr. Drake opines the Injured Worker is

temporarily and totally disabled as a result of a right

shoulder sprain and notes in his corresponding office note,

dated 10/11/2014, that the Injured Worker was there for

continuing treatment and evaluation involving the cervical

spine and right shoulder and that the right knee was

specifically not the focus of the visit. Similarly, the Staff [sic]

Hearing Officer cites the MEDCO-14, signed by Dr. Drake on

09/20/2014 which cites the disallowed right shoulder sprain

as a disabling condition; the MEDCO-14 completed on

08/20/2014 citing both the disallowed cervical and right

upper extremity conditions and the previously cited

MEDCO-14, signed 10/27/2014.

{¶ 22} Thereafter, the DHO stated that, if relator presented sufficient medical

evidence, the commission would consider whether he was entitled to an award of TTD

compensation from May 7 through May 19, 2015, stating:

The Staff [sic] Hearing Officer notes the Injured Worker

returned to his surgeon, Mark D'Onofrio, M.D. on

05/17/2015. On this visit Dr. D'Onofrio noted that physical

therapy had just been approved and indicated that the

Injured Worker needed to complete this physical therapy

No. 15AP-909 9

with the possibility of vocational rehabilitation at that time

and went on to note the Injured Worker was not able to work

as he had not had appropriate physical therapy to address

his right knee medial meniscal tear. Accordingly, and based

on this office note, the Staff [sic] Hearing Officer finds that

consideration of payment of temporary total disability

compensation from 05/07/2015 through 05/19/2015 shall

be considered upon submission of appropriate certification

of disability stemming from the allowed conditions in this

claim during this period.

{¶ 23} Thereafter, the DHO determined that TTD compensation was appropriate

from May 20 through May 26, 2015, stating:

Temporary total disability compensation is awarded from

05/20/2015 through 05/26/2015 and shall continue to be

paid upon submission of appropriate certification and proof

of disability stemming from the allowed conditions in this

claim. This period of temporary total disability compensation

is based on the MEDCO-14 completed by Dr. Drake on

05/20/2015 which predicates disability based solely on the

allowed conditions in this claim.

{¶ 24} 12. Relator's appeal was heard before an SHO on July 7, 2015. The SHO

affirmed the prior DHO order finding that relator was not entitled to an award of TTD

compensation from August 31 through May 6, 2015, stating:

Temporary total disability compensation remains denied for

the closed period 08/31/2014 through 05/06/2014 [sic], on

a finding that the Injured Worker has not satisfied his

burden of proving that he was temporarily and totally

disabled independently by the allowed conditions in the

claim. It is particularly noted that the allowed conditions in

the claim are limited to right knee medial meniscus tear and

right knee sprain, and that the claim has been explicitly

disallowed for cervical sprain and right shoulder sprain. The

medical records in the file clearly show that the Injured

Worker was being treated for all of these conditions

throughout the period in question. The Injured Worker's

obligation is to demonstrate to [sic] that he was

independently disabled by the allowed conditions in the

claim, without consideration being given to the conditions

which have been disallowed. The records over the period for

which compensation is denied do not demonstrate that the

No. 15AP-909 10

Injured Worker was independently disabled by the allowed

conditions.

The Injured Worker submits several MEDCO-14 Physician's

Reports of Work Ability from Mark Drake, D.C. Dr. Drake

lists both allowed and non allowed conditions, and when

asked the question, "Is this condition causing temporary

disability?" in each of the cases of MEDCO-14s covering the

period which has been denied indicates for some or all of the

non allowed conditions that they are causing temporary

disability. Typical of this, is the 10/27/2014 MEDCO-14 and

the corresponding office note of 10/11/2014.

Counsel for the Injured Worker argued that the certification

on the MEDCO-14 of a condition with a box checked

indicating that it is temporarily and totally disabled is a

statement that that condition, operating separately and

without consideration of the other conditions listed, causes a

temporary and total disability, for each one of the conditions

so marked on the form. This is not consistent with the design

of the form itself, and is not an unambiguous statement. This

is particularly true since the form itself, as a separate section

of the same question, asks the treating physician to list all

other conditions being treated.

{¶ 25} Thereafter, as the DHO found, the SHO concluded that relator may be

entitled to TTD compensation from May 7 through May 19, 2015, and specifically

awarded him TTD compensation from May 20 through May 26, 2015 and continuing

upon submission of appropriate proof:

The Injured Worker was seen by his surgeon, Mark

D'Onofrio, M.D., on 05/17/2015. Dr. D'Onofrio's note from

that date of treatment states that the Injured Worker was not

able to work because he had not completed an adequate

course of physical therapy with regard to his right knee

medial meniscus tear, consequently, for the period

05/07/2015 through 05/19/2015, temporary total may be

considered upon presentation of appropriate proof.

Finally, the temporary total disability compensation is

awarded from 05/20/2015 through 05/26/2015, to continue

upon presentation of appropriate proof. This award is based

upon the 05/20/2015 MEDCO-14 from Dr. Drake, which

does state the Injured Worker was independently disabled

solely by the allowed conditions in the claim.

No. 15AP-909 11

{¶ 26} 13. Relator's further appeal was refused by order of the commission

mailed July 28, 2015.

{¶ 27} 14. Thereafter, relator filed the instant mandamus action in this court.

Conclusions of Law:

{¶ 28} For the reasons that follow, it is this magistrate's decision that this court

should deny relator's request for a writ of mandamus.

{¶ 29} The Supreme Court of Ohio has set forth three requirements which must

be met in establishing a right to a writ of mandamus: (1) that relator has a clear legal

right to the relief prayed for; (2) that respondent is under a clear legal duty to perform

the act requested; and (3) that relator has no plain and adequate remedy in the ordinary

course of the law. State ex rel. Berger v. McMonagle, 6 Ohio St.3d 28 (1983).

{¶ 30} In order for this court to issue a writ of mandamus as a remedy from a

determination of the commission, relator must show a clear legal right to the relief

sought and that the commission has a clear legal duty to provide such relief. State ex

rel. Pressley v. Indus. Comm., 11 Ohio St.2d 141 (1967). A clear legal right to a writ of

mandamus exists where the relator shows that the commission abused its discretion by

entering an order which is not supported by any evidence in the record. State ex rel.

Elliott v. Indus. Comm., 26 Ohio St.3d 76 (1986). On the other hand, where the record

contains some evidence to support the commission's findings, there has been no abuse

of discretion and mandamus is not appropriate. State ex rel. Lewis v. Diamond

Foundry Co., 29 Ohio St.3d 56 (1987). Furthermore, questions of credibility and the

weight to be given evidence are clearly within the discretion of the commission as fact

finder. State ex rel. Teece v. Indus. Comm., 68 Ohio St.2d 165 (1981).

{¶ 31} TTD compensation awarded pursuant to R.C. 4123.56 has been defined as

compensation for wages lost where a claimant's injury prevents a return to the former

position of employment. Upon that predicate, TTD compensation shall be paid to a

claimant until one of four things occurs: (1) claimant has returned to work; (2)

claimant's treating physician has made a written statement that claimant is able to

return to the former position of employment; (3) when work within the physical

capabilities of claimant is made available by the employer or another employer; or (4)

No. 15AP-909 12

claimant has reached MMI. See R.C. 4123.56(A); State ex rel. Ramirez v. Indus.

Comm., 69 Ohio St.2d 630 (1982).

{¶ 32} Relator asserts that the commission abused its discretion arguing that all

of the relevant medical evidence clearly demonstrates that he was temporarily and

totally disabled during the relevant time periods as a result of the allowed conditions in

his claim. Relator argues that Dr. Drake repeatedly opined that post-surgical therapy

for his knee was necessary and that the Medco-14s completed by Dr. Drake support a

finding that the allowed conditions for his right knee disabled him independently of any

disability which was caused by the non-allowed right shoulder condition.

{¶ 33} It is undisputed that an award of TTD compensation cannot be based on

non-allowed conditions. See State ex rel. Chrysler Corp. v. Indus. Comm., 81 Ohio

St.3d 158 (1998). Where a claimant has both allowed and non-allowed conditions, the

commission must determine to what extent, if any, the non-allowed or disallowed

conditions contribute to a claimant's disability under State ex rel. Waddle v. Indus.

Comm., 67 Ohio St.3d 452 (1993).

{¶ 34} As noted in the findings of fact, Dr. Drake submitted several Medco-14s

certifying that relator was temporarily and totally disabled. On each of those forms, Dr.

Drake was asked to list all the conditions being treated which were caused by the work-

related injury. On each form, Dr. Drake specifically indicated that he was treating

relator for injuries to his neck, right shoulder, and right knee. Further, on each Medco-

14, Dr. Drake noted that the conditions affecting relator's neck were not causing

temporary total disability. However, on each Medco-14, Dr. Drake specifically noted

that relator's right shoulder and right knee were conditions causing him to be

temporarily and totally disabled. Additionally, as noted in the findings of fact, each

report/office note which accompanies Dr. Drake's Medco-14s begins with a discussion of

relator's cervical spine and his right shoulder. The right knee condition is always the

last condition discussed by Dr. Drake and he does not provide treatment. In the

October 11, 2014 report, Dr. Drake specifically notes that the additional injury affecting

relator's right knee was not the primary focus of his visit.

{¶ 35} Although relator asserts that the Medco-14s indicate that each of the

conditions (right shoulder and right knee) independently rendered him temporarily and

No. 15AP-909 13

totally disabled, the commission did not find this evidence to be persuasive. Instead, the

commission rejected relator's argument because the Medco-14 provides a space for the

treating physician to indicate what work-related injuries were being treated, whether or

not they were disabling, and provides a separate section for the treating physician to list

all other conditions being treated.

{¶ 36} It is undisputed that relator's claim was specifically disallowed for both

cervical and right shoulder conditions. As such, neither of those two conditions are, for

purposes of his workers' compensation claim, being treated due to his work-related

injury. Instead, those two conditions are not allowed in the claim and should be listed

under the section of the form asking the treating physician to list all other conditions

being treated. The magistrate finds that the commission's interpretation and analysis of

the form is reasonable and does not constitute an abuse of discretion. There simply is

no indication on the forms or in Dr. Drake's reports from which one could conclude that

the allowed right knee condition independently rendered relator temporarily and totally

disabled.

{¶ 37} Based on the foregoing, it is this magistrate's decision that relator has not

demonstrated that the commission abused its discretion when it denied his request for

temporary total disability compensation and this court should deny his request for a

writ of mandamus.

/S/ MAGISTRATE

STEPHANIE BISCA

NOTICE TO THE PARTIES

Civ.R. 53(D)(3)(a)(iii) provides that a party shall not assign as

error on appeal the court's adoption of any factual finding or

legal conclusion, whether or not specifically designated as a

finding of fact or conclusion of law under Civ.R.

53(D)(3)(a)(ii), unless the party timely and specifically objects

to that factual finding or legal conclusion as required by Civ.R.

53(D)(3)(b).

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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