OHIO SUPREME COURT OVERRULES RUSSELL V. INDUS. COMM.
Since 1998, the Industrial Commission through R98-1-04 based upon State ex rel. Russell v. Indus. Comm. 82 Ohio St. 3d 516, 696 N.E. 1069(1998) has consistently ruled that when temporary total compensation is terminated based upon a finding of maximum medical improvement the appropriate termination date is the date of the termination hearing. Thereafter, Employers have the right to recoup any overpaid amounts paid after that date.
On March 6, 2024 the Supreme Court in State ex rel. Dillon v. Indus. Comm., Slip Opinion No. 2024-744 overturned Russell, ruling that pursuant to statute, an injured worker is not entitled to temporary total compensation between the time they are found to have reached maximum medical improvement and the date of the termination hearing.
Dillon, the injured worker, filed a mandamus action asserting that the overpayment caused by her temporary total compensation being terminated two months prior to the SHO hearing should be vacated. Dillon relied on Russell to argue that a finding of maximum medical improvement can only be made at the termination hearing.
The Court specifically noted that R.C. 4123.56(A) provides a prohibition on injured worker’s receiving payment after attaining maximum medical improvement. If TTD payments are made after the claimant reaches maximum medical improvement, then the claimant is not entitled to them.
Practical Application:
Under Dillon, Employers should be arguing termination of temporary total compensation as of the date of the report of maximum medical improvement. Payments of TTD through the date of the termination hearing would be subject to overpayment and recoupment provided by R.C. 4123.511(K). From a practical standpoint Dillon has insured that overpayments will likely be larger with the earlier termination date.
While it is impossible to know the practical effects of this case, it will arguably have an impact on termination of light duty and the subsequent payment of TTD. In relying on Dillon, it is conceivable that an MMI examination prior to termination of light duty would limit the subsequent request for temporary total compensation or have it denied in its entirety.
This again underscores the necessity of prompt extent of disability examinations to limit the length of temporary total compensation.
Lisa Patterson: Super Lawyer 2024
Lisa Patterson has once again been selected as Super Lawyer for the year of 2024. Lisa has been selected as a Super Lawyer every year from 2013-2024. She joins a select group of only 5% of the top attorneys who have attained a high-degree of peer recognition and professional achievement in their field.
Congratulations Lisa!
Where is the winning for Employers in Ohio workers’ compensation?
ANSWER: For an Employer, having a worker injured on the job is an immediate loss to both the Injured Worker and the Employer. The Employers I represent are not in the business to injure workers, and understand that when the system is working as it is intended the Injured worker receives the treatment they require, they heal and they return to work.
QUESTION: But what about those contested claims?
ANSWER: As an attorney, I have one job when involved in a claim:
1) get it denied, 2) get it settled and 3) get it closed.
My focus is always bringing a claim to its conclusion quickly. The longer the claim continues, the more treatment, the more compensation, and more importantly the more litigation costs can result in an unmanageable claim. If an outright denial cannot be secured it’s important that defense strategies are put in place to limit treatment/compensation.
All attorneys get unfavorable decisions, but it’s a challenge to continue to work through one in a creative way to achieve the goal. The focus in defending workers’ compensation claims should not be on a single issue or single hearing, but on the projected mapping of the life of the claim; what happens between and after hearings is every bit as important as what takes place at the hearings.
Find an attorney that’s more focused on concluding the war, rather than winning the battle.
Legislative News: Senate Bill 106
Senate Bill 106 was introduced on April 11, 2023 for consideration. This Bill would add physicians and registered nurses as qualifying professions under the state’s existing law providing testing for first responders exposed to chemicals or bodily fluids who are provided “post-exposure medical diagnostic services, consistent with the standards of medical care existing at the time of the exposure, to investigate whether an injury or 16 occupational disease was sustained.”
State ex Rel Friendship Supported Living, Inc. v. Ohio Bur. Of Workers’ Comp., Slip Opinion No. 2023-Ohio-957.
The Supreme Court found in this case that the BWC had abused its discretion by failing to sufficiently account for the factors required in determining whether in-home direct-care workers were employees rather than independent contractors. The Appellee Friendship Supported Living Inc. underwent a premium audit in 2008 and the BWC classified their workers as independent contractors. An audit in 2017 yielded the exact opposite result, the BWC classifying their direct-care workers as employees, and not independent contractors.
Friendship Supported Living Inc. protested the BWC’s audit findings to the Adjudicating Committee who determined that they had the “right to control the workers.” They appealed further the Administrator’s Designee who again cited “sufficient control” over the workers to classify them as employees. Friendship Supported Living Inc. filed a complaint for a writ of mandamus requesting that the workers be classified as independent contractors and reimburse them for the premiums it had incurred as the result of the BWC’s classification. The Court of Appeals granted the writ and ordered that BWC to vacate its order classifying the workers as employees and ordered the BWC to return any premium payments paid on that classification. Rather than adopt the Court of Appeals decision, the Supreme Court noted that the BWC orders’ were not sufficient because they did not consider the totality of circumstances in the light of the relevant factors and order a limited writ to return to the issue to the BWC to specifically, address compliance and quality, workers’ freedom to work for other entities, and routes traveled and length of employment factors.