Case Title: State ex rel. Jordan v. Indus. Comm.

Citation: 2008-Ohio-6137

Docket Number: 20071901

State: ohio

Court: Ohio Supreme Court

Date: 2008-12-03T00:00:00Z

Document:
[Cite as State ex rel. Jordan v. Indus. Comm, 120 Ohio St.3d 412, 2008-Ohio-6137.] 
 
 
 
THE STATE EX REL. JORDAN, APPELLANT, v. INDUSTRIAL  
COMMISSION OF OHIO ET AL., APPELLEES. 
[Cite as State ex rel. Jordan v. Indus. Comm., 
 120 Ohio St.3d 412, 2008-Ohio-6137.] 
Workers’ compensation — Injured worker has no vested right to payment for 
brand name drugs — Judgment affirmed. 
(No. 2007-1901 – Submitted September 30, 2008 – Decided December 3, 2008.) 
APPEAL from the Court of Appeals for Franklin County, 
No. 06AP-908, 2007-Ohio-5157. 
__________________ 
Per Curiam. 
{¶ 1} This is a direct appeal by Karen S. Jordan, who asserts the right to 
continue to receive full payment for brand name drugs for an industrial injury she 
suffered in 1984.  She asserts that she has been prescribed many different 
medications since her claim was allowed and has always taken brand name 
medication, which was paid in full until Ohio Adm.Code 4123-6-21(I) took effect.  
She argues that appellee Industrial Commission of Ohio has applied this 
administrative rule retroactively to deprive her of the right to full payment.  The 
commission denied the existence of such a right.  Jordan then filed a petition for a 
writ of mandamus compelling the commission to vacate its order denying her 
request for brand name medication.  The court of appeals denied the writ.  State 
ex rel. Jordan v. Indus. Comm., Franklin App. No. 06AP-908, 2007-Ohio-5157.  
We affirm that judgment. 
{¶ 2} The Ohio Bureau of Workers’ Compensation was ordered to create 
and administer a healthcare partnership program to “provide medical, surgical, 
nursing, drug, hospital, and rehabilitation services and supplies” to injured 
SUPREME COURT OF OHIO 
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workers when R.C. 4121.441 was enacted in 1993.  Former R.C. 4121.441(A), 
Am.Sub.H.B. No. 107, 145 Ohio Laws, Part II, 2990, 3092.  Among other things, 
the partnership was to incorporate “appropriate financial incentives to reduce 
service cost and insure proper system utilization without sacrificing the quality of 
service.”  Former R.C. 4121.441(B)(4). 
{¶ 3} In 1997, an administrative rule, Ohio Adm.Code 4123-6-21, 
former section (E), authorized the bureau to establish a “maximum allowable cost  
* * * for medications which are pharmaceutically and therapeutically equivalent.”  
1996-1997 Ohio Monthly Record 1380.  The practical effect was that the 
“maximum allowable cost” would henceforth correspond to the price of the 
generic equivalent if one existed. 
{¶ 4} There was, however, one exception.  4123-6-21(F) provided: 
{¶ 5} “Claimants who request a brand name drug or whose physician 
specifies a brand name drug designated by ‘dispense as written’ on the 
prescription for a medication which has an applicable maximum allowable cost 
price shall be liable for the product cost difference between the established 
maximum allowable cost price of the drug product and the average wholesale 
price plus or minus the bureau established percentage of the dispensed brand 
name drug, if prior authorization for the brand name drug is not obtained by the 
prescriber.”  (Emphasis added.)  1996-1997 Ohio Monthly Record 1381.  
{¶ 6} The italicized language was removed from the provision by 
amendments to the Administrative Code that took effect in October 2005.  
Renumbered Ohio Adm.Code 4123-6-21(I), the amendment left intact the balance 
of the earlier provision.  The removal of the “prior authorization” clause meant 
that without exception, the bureau would no longer cover the full price of a brand 
name prescription when there was a generic substitute. 
{¶ 7} Jordan argues that appellee has deprived her of the right to full 
payment by applying the administrative rule retroactively. 
January Term, 2008 
3 
{¶ 8} Common to every allegation of unlawful retroactivity is a claim 
that a right is being abridged.  But as we observed in Bielat v. Bielat (2000), 87 
Ohio St.3d 350, 357, 721 N.E.2d 28, “not just any asserted ‘right’ will suffice.”  It 
must be a “vested right,” because a retroactive law is defined as one that “ ‘takes 
away or impairs vested rights acquired under existing laws, or creates a new 
obligation, imposes a new duty, or attaches a new disability, in respect to 
transactions or considerations already past.’ ”  Van Fossen v. Babcock & Wilcox 
Co. (1988), 36 Ohio St.3d 100, 106, 522 N.E.2d 489, quoting Cincinnati v. 
Seasongood (1889), 46 Ohio St. 296, 303, 21 N.E. 630. 
{¶ 9} A “vested right” can “be created by common law or statute and is 
generally understood to be the power to lawfully do certain actions or possess 
certain things; in essence, it is a property right.”  Washington Cty. Taxpayers 
Assn. v. Peppel (1992), 78 Ohio App.3d 146, 155, 604 N.E.2d 181.  It has been 
described as a right “which it is proper for the state to recognize and protect, and 
which an individual cannot be deprived of arbitrarily without injustice.”  State v. 
Muqdady (2000), 110 Ohio Misc.2d 51, 55, 744 N.E.2d 278.  A vested right is 
one that “ ‘so completely and definitely belongs to a person that it cannot be 
impaired or taken away without the person’s consent.’ ”  Harden v. Ohio Atty. 
Gen., 101 Ohio St.3d 137, 2004-Ohio-382, 802 N.E.2d 1112, ¶ 9, quoting Black’s 
Law Dictionary (7th Ed.1999) 1324.  A right also cannot be characterized as 
vested “unless it constitutes more than a ‘mere expectation or interest based upon 
an anticipated continuance of existing laws.’ ”  Roberts v. Treasurer (2001), 147 
Ohio App.3d 403, 411, 770 N.E.2d 1085, quoting In re Emery (1978), 59 Ohio 
App.2d 7, 11, 13 O.O.3d 44, 391 N.E.2d 746. 
{¶ 10} Jordan maintains that she has a vested right to full payment for 
brand name drugs.  It is impossible, however, to reconcile that assertion with the 
vested-right characteristics that were just articulated.  Jordan’s insistence, 
moreover, that we look at the law in effect on her date of injury does not advance 
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her cause.  R.C. 4123.54, which authorizes compensation for occupational 
injuries, disease, and death, has consistently given claimants the right to treatment 
for their allowed conditions.  It has never given them the right to dictate the terms 
of that treatment or the conditions of payment.  R.C. 4123.66 has always given 
that right to the administrative agency. 
{¶ 11} Jordan argues that nothing in the Revised Code or the 
Administrative Code in effect in 1984 prohibited full reimbursement.  It is equally 
true, however, that these codes did not mandate full payment.  The right to make 
these types of financial decisions has always resided with the administrative 
agency. 
{¶ 12} Jordan is not helped by former Ohio Adm.Code 4123-6-21(F), 
1996-1997 Ohio Monthly Record 1381.  Effective from 1997 to 2005, the 
provision limited brand name reimbursement to the price of the generic equivalent 
unless the commission had authorized coverage of a brand name medication.  
Jordan proposes that this requirement was satisfied by an August 18, 2005 staff 
hearing officer order that “specifically authorize[d] the following medications, 
pursuant to Bureau of Workers’ Compensation rules and regulation:  Roxicodone; 
Soma; Sinequan; Klonopin; Lidoderm; Buspar.” 
{¶ 13} Jordan’s assertion that this order established that she had a vested 
right to brand name medications is unpersuasive.  The order prefaced its 
authorization as “pursuant to Bureau of Workers’ Compensation rules and 
regulation,” and those rules and regulations later changed.  As noted earlier, a 
vested right entails “more than a mere expectation of future benefit or interest 
founded upon an anticipated continuance of existing laws,” in this case, former 
Ohio Adm.Code 4123-6-21(F).  Roberts, 147 Ohio App.3d at 411, 770 N.E.2d 
1085. 
{¶ 14} The court of appeals correctly held that Jordan has no vested right 
to full payment for brand name medication.  Without such a right, there can be no 
January Term, 2008 
5 
credible claim of impermissible retroactivity.  The judgment of the court of 
appeals is hereby affirmed. 
Judgment affirmed. 
MOYER, 
C.J., 
and 
PFEIFER, 
LUNDBERG 
STRATTON, 
O’CONNOR, 
O’DONNELL, LANZINGER, and CUPP, JJ., concur. 
__________________ 
Heinzerling, Goodman & Reinhard, L.L.C., and Jonathan H. Goodman, 
for appellant. 
Nancy Hardin Rogers, Attorney General, and Stephen D. Plymale, 
Assistant Attorney General, for appellee. 
______________________