workers' compensation

Subscribe to workers' compensation

The Ohio Supreme Court has definitively decided that an employee cannot unilaterally dismiss an employer-initiated appeal in a workers’ compensation case; rather, the employer must consent to the dismissal.

After a workers’ compensation claim proceeds administratively before the Industrial Commission, any party may appeal the Commission’s decision to permit the employee to participate in the workers’ compensation system to the Court of Common Pleas. After an appeal is filed, the employee must file a petition/complaint within 30 days.

Regardless of which party files the appeal, the employee is the plaintiff in the workers’ compensation case. While the court case is proceeding on an employer-initiated appeal, the employee continues to receive workers’ compensation benefits. However, should the court reverse the Industrial Commission’s decision and deny the claim, the employer receives a refund of costs previously paid to the employee.
Continue Reading Workers’ compensation law aiming to reduce appeal time is constitutional

Recently, Gov. Kasich signed into law the workers’ compensation budget. In addition to funding the Ohio Bureau of Workers’ Compensation (BWC), the bill enacted a number of substantive changes to the law. These changes are effective Sept. 29, 2017. Below are some of the significant amendments impacting Ohio employers:

  • Decreases statute of limitations: For claims

…

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.…

Continue Reading Some clarity: The Supreme Court of Ohio definitively decides procedure for abatement of substantial aggravation conditions

A recent case highlights the intersection of FMLA and workers’ compensation laws. Angela Samuel (Samuel) was employed by Progressive Casualty Insurance Co. (Progressive) as a retention specialist and primarily worked out of her home. While on a leave of absence covered by the Family Medical Leave Act (FMLA), Progressive notified Samuel that she needed to submit documentation in support of her FMLA request. Previously, Samuel’s documents in support of her FMLA leave were either never received or misplaced by Progressive.

On a Sunday evening, Samuel hand-delivered the paperwork to an unattended reception desk outside of a human resources department at a building on Progressive’s campus. As she was leaving, she slipped in a stairway and fell onto her right side.…

Continue Reading Sunday deliveries of FMLA paperwork: A recipe for disaster

Ohio Senators have introduced a bill to change Ohio workers’ compensation laws to permit claimants who are peace officers, firefighters or emergency medical personnel diagnosed with post-traumatic stress disorder (“PTSD”) to obtain workers’ compensation benefits.

Presently, Ohio law only recognizes claims for psychological conditions if the psychological condition arises out of an injury or occupational…

As we have explained before, one of an employer’s main defenses in a workers’ compensation claim is that the employee’s own actions – rather than the work-related injuries — have led to the employee being off work. The Ohio Supreme Court recently revisited the analysis of when an employee’s actions constitute a voluntary abandonment of employment thereby precluding receipt of temporary total disability compensation.

In State ex. rel. Robinson v. Indus. Comm., Parma Care Nursing and Rehabilitation hired Shelby Robinson in 1995, and at that time, provided her with a written job description that established her job duties and responsibilities. Further, Parma Care provided her with a copy of an employee handbook detailing Parma Care’s policies and procedures. Over the years, Parma Care disciplined Robinson for violating work rules. In a written warning on February 29, 2008, Robinson acknowledged that she had been warned that any future violations would result in her termination from employment.

On April 10, 2008, Robinson was injured at work and subsequently filed a workers’ compensation claim, which was recognized for multiple low back conditions. As a result, she returned to work in a light duty capacity. On April 15, 2008, a state surveyor reported to Parma Care that Robinson had violated state rules. Based on this infraction, Parma Care terminated Robinson’s employment.

Subsequently, Robinson’s physician certified that Robinson was temporarily and totally disabled from all employment beginning on the date of her injury. The Industrial Commission determined that Robinson’s termination amounted to a voluntary abandonment of her employment and she therefore was ineligible for temporary total compensation. Robinson appealed and the Court of Appeals upheld the Industrial Commission’s decision. Robinson appealed to the Ohio Supreme Court, which affirmed the decision and held that Robinson voluntarily abandoned her employment as a result of her termination for violating a written work rule and was not entitled to receive temporary total disability compensation. …
Continue Reading Detailed, written job descriptions are vital to employer’s defense in workers’ compensation claim

Every once in a while – okay maybe more frequently than that – I realize that I have missed a court decision on an issue I have been following. Most recently, I had been intrigued by the Sixth Circuit panel decisions in Brown v. Cassens Transport Co. (Brown II) and Jackson v. Sedgwick Claims Management Services, Inc. that had upheld Michigan workers’ compensation claimants’ rights to file federal RICO claims against their employers, their employers’ third party administrators and physicians who had conducted independent medical examinations on the theory that the defendants had conspired to unlawfully deny or terminate their workers’ compensation benefits. I had also noted that at least one other such case had been filed in federal court in Arizona.

My initial reaction was that these were terrible decisions that would enable any workers’ compensation claimant who was dissatisfied with a decision relating to his claim to challenge that decision in federal court. That reaction was further intensified when it occurred to me that the shoe could just as easily go on the other foot – that employers could file similar actions against an employee, his doctor and his representative, based on theories claiming that they conspired with each other to create or perpetuate a fraudulent claim. I wondered whether such a lawsuit could be viable in Ohio, which also is situated in the Sixth Circuit. What a horrible intrusion into a state’s workers’ compensation system this would create….

Fortunately, the Sixth Circuit’s September 24, 2013, en banc decision in the Jackson case relieves my concerns for the time being. In Jackson, two Coca-Cola Enterprises, Inc., employees sued their employer, Sedgwick (its workers’ compensation third-party administrator), and a physician who had examined them both, claiming that they had “engaged in a fraudulent scheme involving the mail . . . to avoid paying benefits to injured employees” in violation of the Racketeer Influenced and Corrupt Organization Act (“RICO”). In short, both plaintiffs claimed that Sedgwick, on behalf of Coca-Cola, scheduled them for examinations with a physician who they claimed was a “a doctor ‘who could be relied upon to lie for defendants and write a report stating a claimant did not have a work related disability regardless of the true facts.’” Then, the plaintiffs’ complaint alleges that Coca-Cola and Sedgwick relied on the physician’s reports to either deny or terminate benefits in their claims.
Continue Reading Sixth Circuit En Banc Decision Rejects RICO Claim for Alleged Workers’ Compensation Fraud

In August 2009, Shaun Armstrong sustained minor physical injuries in a motor vehicle accident while in the scope of his employment. The other driver, who plowed into the back of Armstrong’s truck, was killed.

Armstrong’s workers’ compensation claim was allowed for neck and back injuries. He also sought an allowance for PTSD, which the Industrial…

Until the Ohio legislature enacted R.C. 2745.01 in 2005, the employer intentional tort exception to workers’ compensation immunity exasperated Ohio employers. Under the exception as interpreted by the Ohio Supreme Court, employers could be held liable for an intentional tort (with the accompanying tort damages such as punitive damages) so long as they had knowledge of a dangerous condition in its workplace that was substantially certain to cause injury and nevertheless required its employee to work under that condition. This was a very relaxed standard for an “intentional” tort and one that was made even more relaxed by increasingly liberal interpretations from Ohio appellate courts.

R.C. 2745.01 was designed to raise the standard by requiring employees to prove that the employer acted with “deliberate intent” to cause an employee to suffer an injury, a disease, a condition, or death. The statute created only two presumptions of a deliberate intent to injure: (a) if an employer deliberately lied to an employee about whether a substance was toxic or hazardous and as a result that substance injured the employee, or (b) if an employer deliberately removed an “equipment safety guard” and as a result of the removal the employee was injured. In those two circumstances, specific intent would be presumed.

Once the Ohio Supreme Court upheld the constitutionality of R.C. 2745.01 the plaintiffs’ bar attempted to find ways around the statute to once again open up the lucrative business of employer intentional torts. However, one-by-one early successes by the plaintiffs’ bar in the appellate courts have been overturned in the Ohio Supreme Court.

For example, in Houdek v. ThyssenKrupp Materials N.A., Inc., the Ohio Supreme Court rejected the Eighth Appellate District’s finding that R.C. 2745.01 did not really require deliberate intent to injure in order to establish an employer intentional tort. Similarly, in Hewitt v. L.E. Myers Co., the Ohio Supreme Court rejected the Sixth Appellate District’s broad interpretation of an “equipment safety guard” to include personal protective equipment (rather than a guard attached to a piece of a equipment) Had it been upheld, the lower court decision in Hewitt in effect would have imposed an affirmative duty on employers to make available personal protective equipment at the risk of being found liable for an employer intentional tort. In reaching its decision, the Ohio Supreme Court in Hewitt defined an equipment safety guard as “a device designed to shield the operator from exposure to or injury by a dangerous aspect of the equipment.”

Despite the Ohio Supreme Court’s rejection of expansive interpretations of employer intentional torts from the intermediate courts of appeal, the Sixth Appellate District again has attempted to find a way around the statute. Specifically, in Pixley v. Pro-Pak Industries, Inc., the Sixth District concluded, contrary to the Supreme Court’s Hewitt decision, that for purposes of interpreting R.C. 2745 an equipment safety guard need not be a device “designed to shield the operator [of the equipment] from injury.” Therefore, according to the Sixth District non-operators injured by removal of such a device from a piece of equipment could obtain a presumption of specific intent and proceed to a jury on an employer intentional tort claim. This interpretation by the Sixth District, if upheld by the Ohio Supreme Court, would substantially expand the scope of the intentional tort exception by expanding the types of devices that can constitute equipment safety guards as well as expanding the types of employees who could argue for the exception.…

Continue Reading Ohio’s Sixth District Court of Appeals Finds a New Way to Expand Scope of the Employer Intentional Tort Statute

As we have previously discussed, the Bureau of Workers’ Compensation (BWC) has traditionally taken an aggressive position in finding that a business purchasing all or part of another business is responsible for the predecessor entity’s workers’ compensation risk, frequently resulting in an increase in premiums and penalties for the purchasing entity.
Continue Reading Ohio Supreme Court Again Reins In BWC On Successor Liability