In its recent decision, Clendenin v. Girl Scouts of W. Ohio, the Supreme Court of Ohio definitively decided that an Industrial Commission order determining that a pre-existing condition that was substantially aggravated by a work-related incident has returned to the pre-injury level is an issue that may not be appealed to a court of common pleas.
While working for the Girl Scouts of Western Ohio, Audrey Clendenin (Clendenin) was injured on Oct. 21, 2008. Her claim was recognized for multiple right shoulder conditions as well as substantial aggravation of pre-existing dermatomyositis, a rare inflammatory disease. In March 2013, the Ohio Bureau of Workers’ Compensation (BWC) filed a motion to abate the claim for the substantial aggravation condition. The Industrial Commission granted the motion, finding that compensation and medical benefits were no longer to be paid in the claim for the allowed substantial aggravation condition.
Clendenin filed an appeal to the Hamilton County Court of Common Pleas, alleging that her condition had not returned to its pre-injury status and that compensation and medical benefits should continue to be paid in the claim. The BWC moved to dismiss the complaint on the basis that the abatement of a substantial aggravation condition is an extent of disability issue which statutorily is not appealable to court. The trial court agreed and granted the motion. Clendenin appealed to the 1st District Court of Appeals, which reversed the trial court decision and concluded that the abatement decision addressed an injured worker’s right to participate in the workers’ compensation system and was appealable to the court of common pleas. The BWC appealed to the Supreme Court of Ohio.
In Ohio, the state workers’ compensation system is the exclusive remedy for work-related injuries. The Industrial Commission of Ohio adjudicates issues that arise in workers’ compensation claims.
Ohio law permits a claimant to appeal an Industrial Commission final decision to the court of common pleas in “an injury or occupational disease case, other than a decision as to the extent of disability.” Courts of common pleas have jurisdiction to review Industrial Commission decisions involving a claimant’s right to participate or to continue to participate in the Ohio workers’ compensation fund. A right to participate issue involves determining whether the claimant’s injury occurred in the course of and arising out of the claimant’s employment. In most cases, this involves whether a claim should initially be recognized or whether the claim should be additionally allowed for another medical condition.
Appeals to the court of common pleas cannot involve the extent of a claimant’s disability. An Industrial Commission order involving the extent of a claimant’s disability determines the amount and/or type of benefits payable under the workers’ compensation system for the allowed conditions in the claim to a claimant. A claimant’s only remedy to contest the Commission’s extent of disability decision is to file a mandamus complaint in the Franklin County Court of Appeals asking the court to issue an order requiring the Commission to vacate its order.
The distinction between decisions on the right to participate versus the extent of disability is important because a common pleas court appeal on an issue addressing the right to participate entitles the injured worker to a jury trial on the merits. In a mandamus action, the appellate court will only review the record before the Commission to determine if there is some evidence to support the Commission’s order. This is a very low standard and frequently results in upholding the Commission’s order.
Clendenin’s claim was additionally allowed for a substantial aggravation condition. Hence, the Industrial Commission had already allowed her claim for this condition and she was granted the right to participate in the fund for this condition.
In finding that Clendenin’s substantial aggravation condition had abated, the Industrial Commission determined that Clendenin’s allowed substantial aggravation condition had returned to a level that would have existed but for her work related incident, and therefore she was no longer entitled to benefits and compensation for that condition. The Supreme Court determined that the Industrial Commission’s decision solely addressed the extent of Clendenin’s disability and therefore was not appealable to the court of common pleas. Notably, the Court indicated that had the Industrial Commission found that the substantial aggravation condition was not aggravated and therefore disallowed in the claim, then the issue would have been appealable to the court of common pleas.
In Clendenin, the Supreme Court held that an Industrial Commission decision involving whether or not a claimant’s pre-existing condition that was substantially aggravated by a work related incident has returned to a level that would have existed absent the work injury involves the extent of a claimant’s disability that may only be challenged by a mandamus action.
The Supreme Court has eliminated the uncertainty surrounding whether the abatement of a substantial aggravation condition is a right to participate issue or an extent of disability issue. Although this may sound like legal semantics, this decision provides clarity and reduces the number of lawsuits that may be filed against an employer arising out of a work related incident. Overall, this is good news for employers. In addition, now employers may be more likely to file motions to abate substantial aggravation conditions as a means to reduce claim costs without incurring more litigation costs.