Case Title: State ex rel. Dayton Foods Ltd. Partnership v. Unger

Citation: 2004-Ohio-6556

Docket Number: 20040290

State: ohio

Court: Ohio Supreme Court

Date: 2004-12-15T00:00:00Z

Document:
[Cite as State ex rel. Dayton Foods Ltd. Partnership v. Unger, 104 Ohio St.3d 299, 2004-Ohio-
6556.] 
 
 
THE STATE EX REL. DAYTON FOODS LIMITED PARTNERSHIP, APPELLANT, v. 
UNGER ET AL., APPELLEES. 
[Cite as State ex rel. Dayton Foods Ltd. Partnership v. Unger, 104 Ohio St.3d 
299, 2004-Ohio-6556.] 
Workers’ compensation — Doctor’s failure to respond to employer’s request 
that he approve employer’s proposed light-duty position does not satisfy 
the criteria set forth in R.C. 4123.56(A) for terminating a claimant’s 
temporary-total-disability 
compensation 
— 
Doctor’s 
method 
of 
prospectively certifying a claimant’s disability does not invalidate the 
disability certification — Commission did not abuse its discretion in 
authorizing surgery when some evidence existed relating need for 
surgery to injury — Court of appeals’ judgment affirmed. 
(No. 2004-0290 — Submitted October 12, 2004 — Decided December 15, 2004.) 
APPEAL from the Court of Appeals for Franklin County, No. 02AP-1076, 2003-
Ohio-7228. 
____________________ 
 
Per Curiam. 
{¶1} 
Appellee-claimant, Joseph Unger, was the bakery manager for a 
store owned by appellant, Dayton Foods Limited Partnership, a self-insured 
employer.  He was hurt on June 7, 2000, when a cabinet weighing over 100 
pounds fell on him.  Dayton Foods unsuccessfully contested the resulting 
workers’ compensation claim, which was ultimately allowed for “left 
shoulder/arm sprain, left shoulder AC arthralgia with evidence of rotator cuff 
tendonitis and impingement syndrome.”  Since that time, Dayton Foods has 
contested surgical treatment and temporary total disability compensation (“TCC”) 
at almost every turn.  Facts relating to Unger’s attempts to get surgical treatment 
SUPREME COURT OF OHIO 
2 
and TCC overlap, making a strictly chronological recitation of the facts 
impractical.  Instead, we will set forth the facts relating to each issue separately, 
bringing them together only as they merge administratively and judicially. 
Surgical-Treatment Authorization 
{¶2} 
On December 7, 2000, Unger was examined, at Dayton Foods’ 
request, by Dr. Jose Chavez.  Confining his exam to what was then the only 
allowed condition – left shoulder/arm sprain – Dr. Chavez did not comment on 
Unger’s rotator cuff.  He felt that Unger’s allowed condition had reached  
maximum medical improvement (“MMI”) and attributed Unger’s continuing left-
arm difficulties to a cervical disc condition. 
{¶3} 
Dr. Chavez’s determination that Unger’s left shoulder sprain had 
reached MMI was apparently the impetus for Dayton Foods’ refusal thereafter to 
authorize further treatment.  From at least February 2001, Unger’s physician, Dr. 
Kevin Paley, suspected that Unger’s rotator cuff had also been injured and made 
repeated requests for authorization of an MRI.  Dayton Foods denied those 
requests. 
{¶4} 
On June 19, 2001, Unger was examined by Dr. Wayne C. 
Woodard.  Dr. Woodard also suspected a rotator-cuff injury and recommended an 
MRI.  He also believed that Unger had not reached MMI. 
{¶5} 
On June 28, 2001, appellee Industrial Commission of Ohio held a 
hearing.  Authorization for an MRI followed those proceedings, and the procedure 
was performed on August 14, 2001.  The administering doctor concluded: 
{¶6} 
“A small subchondral cyst is seen in the posterior humeral head.  
No bone marrow edema is seen to suggest bone contusion or fracture.  No 
significant joint effusion is noted.  A type I acromion process is present.  No 
significant left acromioclavicular joint hypertrophy is seen.  The tendon of the 
long head of the biceps muscle is in its expected location, in the bicipital groove.  
The glenoid labrum is grossly intact.  No rotator cuff tear is identified.  There is a 
January Term, 2004 
3 
9.0 x 7.0 x 5.0 millimeter object noted along the anterior aspect of the humeral 
head, the signal characteristics of which follow those of bone, possibly 
representing a loose body.” 
{¶7} 
On October 18, 2001, the administering doctor submitted this 
addendum to the MRI report:   
{¶8} 
“I have been asked by Dr. Paley to review this examination with 
specific attention to the possibility of rotator cuff tendonitis rather than a tear.  On 
further review of the examination, there is some minimal low-grade signal 
abnormality seen in the mid-fibers of the supraspinatus tendon consistent with 
tendonosis.  This could represent mild tendonitis or tendon degeneration.” 
{¶9} 
This addendum later triggered Dayton Foods’ assertion that Dr. 
Paley had pressured the MRI radiologist into finding some evidence of rotator-
cuff injury. 
{¶10} Dr. Paley’s office notes from autumn 2001 recommend an 
arthroscopic evaluation of the shoulder, a surgical decompression, and removal of 
the loose body shown on the MRI.  On October 29, 2001, Dr. Paley asked Dayton 
Foods to authorize these procedures. 
{¶11} In response, Dayton Foods had Unger examined by Dr. Steven 
Wunder on November 6, 2001.  Dr. Wunder believed that surgery was 
unnecessary, writing: 
{¶12} “It is my understanding this claim has been recognized and 
allowed for a left shoulder strain, left shoulder rotator cuff tendonitis, and left 
shoulder rotator cuff tear.  I believe these conditions from the industrial injury 
have resolved.  The MRI scan was unremarkable for a rotator cuff tear.  There 
was no evidence of impingement on the MRI, and there was a type I acromion 
and no AC joint hypertrophy.  Furthermore, I do not believe that the loose body 
was related to the industrial injury.  Quite clearly, there was no evidence of a bone 
SUPREME COURT OF OHIO 
4 
contusion, fracture or joint effusion to suggest trauma as the cause of the loose 
body.” 
{¶13} From that point, dueling medical reports came to the forefront.  On 
December 21, Dr. Paley responded to Dr. Wunder’s report: 
{¶14} “In reviewing Dr. Wunder’s medical report, I do not follow his line 
of reasoning.  Dr. Wunder accurately describes the history of the injury as well as 
the subsequent care.  On the evaluation by Dr. Wunder, Mr. Unger clearly 
continues to be quite symptomatic.  According to Dr. Wunder’s physical 
examination, Mr. Unger has rotator cuff impingement signs.  He also has painful 
range of motion of the left shoulder.  Dr. Wunder does not adequately assess the 
integrity of the rotator cuff with resisted testing. 
{¶15} “It is obvious based on the examination by Dr. Wunder that Mr. 
Unger continues to be quite symptomatic with evidence clinically of rotator cuff 
tendonitis.  This corresponds well with the MRI findings that were previously 
obtained on Mr. Unger’s left shoulder.  His examination also corresponds well 
with multiple other physical examinations including that of myself and Dr. 
Woodard who like myself is a Board Certified Orthopedic Surgeon with great 
expertise in the examination of shoulder injuries.  I do not understand how Dr. 
Wunder can state that Mr. Unger’s conditions from the industrial injury have 
resolved when he has such continued clinical findings of left shoulder pain, 
weakness, and impingement signs. 
{¶16} “ * * *  
{¶17} “I also take exception with Dr. Wunder’s assessment that the MRI 
does not show any evidence of a bone contusion, joint effusion, or evidence of 
acute trauma.  The MRI was obtained on August 14, 2001, which is 
approximately 14 months after the injury.  Anybody with any reasonable medical 
training should know that an MRI obtained 14 months after an acute injury will 
not show acute evidence of an injury to the bone such as a bone contusion, 
January Term, 2004 
5 
fracture, or joint effusion.  Mr. Unger was found to have a large loose body within 
the shoulder joint on the MRI of August 14, 2001.  Individuals do not just have 
loose bodies within the shoulder.  A specific injury must occur to cause a loose 
body to form.  Mr. Unger has no past history of problems with the left shoulder 
prior to the accident of June 7, 2000.  The mechanism of injury of a large shipping 
cabinet falling on him could, in my opinion, be the source of this loose body in 
addition to the injury to the rotator cuff. 
{¶18} “I am quite concerned, having reviewed many of Dr. Wunder’s 
independent medical examinations over the year, about the accuracy of his 
assessment with regard to the injured worker.  I have not had the pleasure of 
reviewing an independent medical examination by Dr. Wunder where he does not 
come to the conclusion where the patient has reached maximum medical 
improvement.  Mr. Unger categorically has not reached maximum medical 
improvement because he continues to be quite symptomatic and has not 
completed care.  He has failed extensive conservative treatment and requires a 
surgical procedure in order to be maximally medically improved.  Dr. Wunder’s 
own physical examination findings support this conclusion.” 
{¶19} Dr. Wunder answered on February 5, 2002: 
{¶20} “Dr. Paley appears to express hostility towards anyone that 
disagrees with his opinions.  Relative to Mr. Unger or any other workers’ 
compensation claimant that I see, we try to follow evidence-based medicine.  The 
physicians that saw him at or near the time of injury felt that his condition was 
coming from the cervical spine.  There was no rotator cuff tear noted on his MRI.  
Dr. Paley apparently requested the radiologist to re-read the MRI and they [sic] 
indicated that there was only a minimum low-grade signal abnormality in the mid 
fibers of the supraspinatus tendon compatible with tendinosis or degeneration.  
This is not an unusual finding in a 47-year-old male and would not be considered 
SUPREME COURT OF OHIO 
6 
traumatic.  His MRI scan showed no evidence of impingement nor did it 
document a rotator cuff tear. 
{¶21} “My opinion is unchanged after reviewing Dr. Paley’s December 
21, 2001, report.  The rotator cuff was intact with resisted testing.  Dr. Paley 
obviously did not read my report as I noted normal strength around the shoulder 
girdle region on several occasions.  He indicated surgery was needed so that he 
could return to work and be a productive member of society.  He has been able to 
continue to work.  In fact he worked for a year until he saw Dr. Paley. 
{¶22} “I don’t believe an arthroscopic exploration would be indicated or 
necessary for the patient’s industrial injury.  A subacromial decompression would 
not be indicated or necessary for the allowed conditions or his industrial injury.” 
{¶23} On March 8, 2002, Dr. Paley followed up: 
{¶24} “I have reviewed for a second time Dr. Wunder’s physical 
examination and conclusions on Mr. Unger dated November 6, 2001.  Within his 
physical examination Dr. Wunder does indicate that there are  impingement signs 
about Mr. Unger’s left shoulder.  He also states that he has pain with resisted 
strength testing about the left shoulder.  Both of these are indicative of an injury 
to the rotator cuff.  I do not see how Dr. Wunder can, therefore, conclude that the 
patient has a normal rotator cuff. 
{¶25} “It is still my opinion as a Board certified orthopedic surgeon with 
Fellowship training in shoulder surgery that Mr. Unger has an injury to the rotator 
cuff consisting of left shoulder rotator cuff tendonitis.  This was seen on the MRI.  
This should not be considered age-related changes as discussed in Dr. Wunder’s 
letter.  Certainly MRI findings in conjunction with clinical findings seen on Mr. 
Unger’s examination should lead to the conclusion that Mr. Unger has sustained 
an injury to the rotator cuff and requires the previously-requested surgery. 
{¶26} “I would like you to know that I have no hostility towards Dr. 
Wunder as alluded to in his letter.  I am, however, obligated to be my patient’s 
January Term, 2004 
7 
advocate; and I do not appreciate the significant delay in treatment for Mr. Unger 
based on what I feel are inaccurate conclusions by Dr. Wunder.” 
{¶27} Dayton Foods had by this time denied surgical-treatment 
authorization, prompting Unger to move the commission for a hearing.  The 
procedural course before the commission and court of appeals will be set forth 
shortly. 
The TTC Controversy 
{¶28} While Dr. Paley was attempting to secure approval for an MRI, 
Unger was receiving TTC.  On April 26, 2001, Unger submitted a C-84 form on 
which Dr. Paley had certified that Unger’s temporary total disability would last 
through June 26, 2001.  The next day, Dayton Foods faxed a letter to the doctor: 
{¶29} “This letter is in response to the disability slip that Joseph Unger 
submitted on April 26, 2001. 
{¶30} “We have an aggressive return to work policy and actively attempt 
to return individuals to work within the work restrictions placed upon them.  It is 
our belief that this policy is in the best interest of the employee as it allows them 
to return to work that is within their restrictions without losing any compensation. 
{¶31} “As such, we are requesting that you complete and return the 
attached Attending Physician Report as soon as possible. 
{¶32} “I believe we have a great opportunity to return Joseph to work, 
when considering he is in a manager’s position and we have many options to 
consider in adapting any restrictions.” 
{¶33} Just seven days later, on May 3, 2001, Dayton Foods sent a second 
fax: 
{¶34} “I am sending you this letter to once again request that you 
complete the Attending Physician Report for Joseph Unger that was faxed to you 
on April 27, 2001 * * *.  Your delay in responding to this request is directly 
impacting Mr. Unger’s compensation. 
SUPREME COURT OF OHIO 
8 
{¶35} “I want to again emphasize that we have an aggressive return to 
work policy and actively attempt to return individuals to work within the work 
restrictions placed upon them.  It is our belief that this policy is in the best interest 
of the employee as it allows them to return to work that is within their restrictions 
without losing any compensation. 
{¶36} “When you take into consideration that his allowed condition 
and/or your request for additional conditions, all involve his left shoulder, I am 
certain that Mr. Unger can return to work as a manager with restrictions that allow 
for these conditions.” 
{¶37} On May 7, 2001, Dr. Paley faxed two documents to Dayton Foods.  
The first was a copy of Dayton Foods’ May 3rd fax, upon which Dr. Paley had 
written the following: 
{¶38} “You are the one delaying compensation and treatment for Mr. 
Unger – NOT ME.  Kindly approve the previously requested treatment plan.  Mr. 
Unger probably would have returned to work by now if you would approve 
treatment.”  (Emphasis sic.) 
{¶39} The second document was the completed “Attending Physician’s 
Report of Injury/Status”  that Dayton Foods had requested.  It restricted Unger to 
sedentary work but also contained the notation “off work through 6/26 until 
treatment approved.” 
{¶40} Dayton Foods responded the next day: 
{¶41} “This letter is in response to your fax of May 7, 2001. 
{¶42} “First, we are not denying treatment to Mr. Unger.  The treatment 
that you are referring to can proceed and be submitted for approval through our 
medical insurance plan, Anthem. 
{¶43} “At this time, further treatment under the workers’ compensation 
claim cannot be approved.  This is based on the determination that Mr. Unger was 
January Term, 2004 
9 
at maximum medical improvement as of the independent medical examination of 
December 7, 2000. 
{¶44} “Second, Mr. Unger can return to work as the Bakery Manager 
under the restrictions you placed on the Attending Physician’s Report, faxed on 
May 7, 2001. 
{¶45} “This work would require him to sit at his desk working with his 
computer.  His job duties while at his desk would consist of:   
{¶46} “1.  Completion of the action plan projects given to him on April 
26, 2001 
{¶47} “2.  He would also be responsible for completing the weekly work 
schedules of all the bakery employees   
{¶48} “3.  He would also be responsible for scheduling all store orders in 
the production schedule per order delivery requirements. 
{¶49} “He would also need to attend management meetings as scheduled. 
{¶50} “These job requirements comply with all the restrictions that you 
indicated on the 5/7/01 report.  The company will comply and will require Mr. 
Unger to comply with the restrictions contained within the 5/7/01 report. 
{¶51} “Please respond back to me by Friday, May 11, 2001, indicating 
your acceptance of the job modifications as outlined above.” (Emphasis sic.) 
{¶52} There is no evidence that Dr. Paley responded to this letter. 
{¶53} Unger saw Dr. Paley on May 24.  Dr. Paley’s notes from that visit 
indicate the following: 
{¶54} “The patient continues to require an arthroscopic subacromial 
decompression.  The patient’s caseworker refuses to allow an MRI of the 
shoulder.  I will submit another request for the arthroscopic subacromial 
decompression and hopefully with the independent medical examination findings 
we can proceed with appropriate treatment for the patient.  The patient cannot 
work at this time due to his symptoms and I will extend his disability through 
SUPREME COURT OF OHIO 
10 
June 26, 2001.  I am quite frustrated with the delay inappropriate [sic] treatment 
for this patient.  The patient could have return[ed] to work at this time if his 
treatment had been approved [in] a timely fashion.  I will reassess the patient in 
three weeks time.” 
{¶55} That same day, Dr. Paley wrote to Dayton Foods: 
{¶56} “I’ve had the pleasure of evaluating Mr. Joseph Unger for his 
injured left shoulder.  He continues to be symptomatic and requires an 
arthroscopic subacromial decompression of the shoulder.  As you know, 
numerous attempts have been made to proceed with an MRI of the shoulder in 
order to amend his claim to the correct diagnosis of left shoulder rotator cuff 
tendinitis.  To date, all request[s] have been denied.  Until appropriate treatment is 
allowed for Mr. Unger I will keep him off work.  He is not able to perform light-
duty of any kind.  Kindly approv[e] treatment for Mr. Unger.  As I previously 
discussed with you, Mr. Unger could have return[ed] to work full duty if his 
treatment plan had not unnecessarily been delayed.” 
{¶57} Despite Dr. Paley’s indication that he would not release Unger to 
work until an MRI and other treatment was authorized, Dayton Foods focused on 
Dr. Paley’s April 26, 2001 C-84 form that listed an estimated return-to-work date 
of June 26, 2001.  Unger – following Dr. Paley’s instructions – did not return to 
work on that date, and Dayton Foods sent the following letter to him the next day: 
{¶58} “This letter is to notify you that you have failed to return to work 
after a leave of absence (return to work date of June 27, 2001). 
{¶59} “Company policy states that failure to return to work after a leave 
of absence is considered a voluntary quit. 
{¶60} “Also, company policy states that being absent without reporting 
for three (3) consecutive workdays is considered an automatic quit. 
{¶61} “You must contact me by 8 AM, Eastern Standard Time, Friday, 
June 29th, 2001, or you will be subject to these policies.” 
January Term, 2004 
11 
{¶62} Unger was not terminated on the 29th.  Perhaps the reason was that 
a commission hearing was held the previous day, at which an MRI was authorized 
based on Dr. Paley’s reports and reports by Dr. Woodard, who concurred in Dr. 
Paley’s findings. 
{¶63} On July 6, 2001 – before Unger had had an MRI – a Dayton Foods 
representative sent another letter to Dr. Paley: 
{¶64} “I am sending you this letter per the results of the hearing of June 
28, 2001. 
{¶65} “First, the request for the MRI is approved.  * * *  
{¶66} “Second, the offer to return Mr. Unger to work as the Bakery 
Manager per the restrictions you placed on the Attending Physician’s Report, 
faxed on May 7, 2001 is still available. 
{¶67} “Again, this work would require him to sit at his desk working 
with his computer.  His job duties while at his desk would consist of: 
{¶68} “1.  Completion of the action plan projects given to him on April 
24, 2001. 
{¶69} “2.  He would also be responsible for completing the weekly work 
schedules of all of the bakery employees. 
{¶70} “3.  He would also be responsible for scheduling all store orders in 
the production schedule per order delivery requirements. 
{¶71} “He would also need to attend management meetings as scheduled. 
{¶72} “These job requirements comply with all of the restrictions that 
you indicated on the 5/7/01 report.  The company will comply and will require 
Mr. Unger to comply with the restrictions contained within the 5/7/01 report. 
{¶73} “If Mr. Unger’s restrictions have changed, please forward the new 
restrictions to me as soon as possible.  I have attached a new Attending 
Physician’s Report for your convenience if it is needed. 
SUPREME COURT OF OHIO 
12 
{¶74} “I want to again emphasize that we have an aggressive return to 
work policy and actively attempt to return individuals to work within the work 
restrictions placed upon them. 
{¶75} “Your help in this matter is deeply appreciated.  Please respond by 
Friday, July 13, 2001.” (Emphasis sic.) 
{¶76} It is unclear whether Unger was receiving TTC at the time Dayton 
Foods sent this letter, and it is also unclear whether Unger knew that he still had a 
job to return to after Dayton Foods’ June 29, 2001 deadline had passed.  In any 
event, by July 11, 2001, he was living in another state.  On July 11, 2001, he 
reported to Dr. Paley for reevaluation.  Office notes from that visit reflect the 
following:   
{¶77} “HISTORY OF PRESENT ILLNESS:  Joseph is here for 
evaluation of his left shoulder.  He has been approved for a left shoulder MRI.  He 
is currently living in St. Louis, Missouri due to his financial situation.  He 
continues to be symptomatic with complaints of left shoulder pain.  He is unable 
to relocate back to Dayton at this time because of his financial situation.  He is 
currently living with family.  He has not received any disability or back pay. 
{¶78} “PHYSICAL EXAMINATION:  Examination shows good 
shoulder range of motion but pain at the extremes.  He has positive impingement 
signs.  He has moderate rotator cuff weakness.  He is neurologically intact in the 
upper extremity and cervical neck examination was unremarkable.  He has no 
instability about the shoulder.  There is no evidence of infection.  There is no 
tenderness about the acromioclavicular joint biceps tendon. 
{¶79} “ * * * 
{¶80} “DISPOSITION AND PLAN:  I would like to proceed with MRI 
of the left shoulder.  At this time Joseph is unable to return to work at his former 
place of employment in Dayton, Ohio due to his financial situation.  I would like 
January Term, 2004 
13 
to reassess the patient in three weeks time after the MRI when he will be back in 
town.” 
{¶81} Dayton Foods apparently read those notes to mean that Dr. Paley 
was attributing Unger’s inability to work to Unger’s relocation, rather than his 
injury.  Dayton Foods sent claimant this letter: 
{¶82} “Based upon Dr. Paley’s office notes of July 11th, 2001, you are 
required to report to work and perform the duties of Bakery Director. 
{¶83} “It is clear from Dr. Paley’s office notes that you are now 
physically able to perform the duties of Bakery Director, as outlined in the May 8, 
2001 letter to yourself and Dr. Paley. 
{¶84} “Joe, if you do not return to work by 8 AM on Monday, August 
6th, 2001, then it shall be determined that you voluntarily quit your position and 
your employment will be terminated.” 
{¶85} Unger did not respond, and on August 8, Dayton Foods made good 
on its threat to terminate his employment. 
Commission and Court of Appeals Proceedings 
{¶86} On July 23, 2001, Dayton Foods moved to terminate TTC “due to 
the treating physician’s failure to respond to light duty job offer.”  A district 
hearing officer (“DHO”) denied Dayton Foods’ motion on October 10, 2001: 
{¶87} “The employer argued that temporary total disability compensation 
should be terminated because the physician of record had not responded to the 
employer’s request to certify light duty employment.  The employer further 
argued that the claimant voluntarily terminated his employment on 08/06/2001 
and that the claimant is currently receiving treatment for unallowed conditions. 
{¶88} “The physician of record’s failure to adequately respond to the 
self-insured employer does not constitute a basis to terminate temporary total 
disability compensation.  The District Hearing Officer notes that Dr. Paley, the 
physician of record, stated that claimant could not perform any work until an MRI 
SUPREME COURT OF OHIO 
14 
is performed.  An MRI was not obtained until 08/14/2001.  The District Hearing 
Officer further notes that on C-84s dated 06/14/2001 and 08/12/2001 Dr. Paley 
indicated that claimant could not perform any light duty employment.  Thus, even 
though the employer may be able to adhere to any medical restrictions, there is 
simply no evidence from a medical provider that the claimant can return to such 
work. 
{¶89} “Next, the employer argued that they offered employment to the 
claimant on 07/26/2001 and that claimant’s failure to respond resulted in his 
voluntary termination on 08/06/2001.  The District Hearing Officer disagrees.  
Again, the medical documentation does not indicate that the claimant can return 
to restricted work.  As such, the claimant’s absence from the work force is not 
voluntary, but due to the allowed conditions in the claim. 
{¶90} “Finally, the employer argued that claimant is receiving treatment 
for conditions not allowed in the claim.  The medical documentation that the 
employer apparently relies upon was not supplied to the claim.  The District 
Hearing Officer has no medical documentation to make such a conclusion.  
Neither the  08/14/2001 MRI nor any office notes from Dr. Paley beyond 
07/11/2001 are on file. 
{¶91} “Accordingly, the District Hearing Officer orders the continued 
payment of temporary total disability compensation upon the further submission 
of appropriate medical evidence.” 
{¶92} A staff hearing officer (“SHO”) affirmed the DHO’s ruling after a  
November 30, 2001 hearing, with the following entry: 
{¶93} “The employer’s C-86 filed 07/25/2001 is denied.  It is the finding 
of the Staff Hearing Officer that [Dr. Paley’s] failure to respond to the employer’s 
light duty job offer does not constitute a basis for termination of the claimant’s 
temporary total disability compensation benefits, especially when medical 
January Term, 2004 
15 
evidence on file continues to clearly document the continued temporary disability 
of the claimant due to the 06/07/2000 industrial injury. 
{¶94} “This order is based upon the medical reports of Dr. Paley 
04/26/2001, 07/11/2001, 06/14/2001, 08/12/2001, and the evidence adduced at the 
hearing.” 
{¶95} Dayton Foods appealed.  While that matter was pending, two more 
motions were filed:  Unger moved for surgical-treatment authorization, and  
Dayton Foods filed another motion to terminate TCC, this time asserting MMI.  
This motion to terminate was based on the November 6, 2001 report by Dr. 
Wunder discussed earlier. 
{¶96} On January 25, 2002, the commission refused to consider Dayton 
Foods’ appeal of the SHO order denying Dayton Foods’ first motion to terminate.  
On April 19, a DHO ruled on Unger’s motion for authorization of surgery and 
Dayton Foods’ motion to terminate TCC based on MMI.  Relying on Dr. 
Wunder’s February 5, 2002 and November 6, 2001 reports, respectively, the DHO 
denied surgical-treatment authorization and granted Dayton Foods’ motion to 
terminate TTC. 
{¶97} An SHO reversed both findings, relying on Dr. Paley’s findings: 
{¶98} “It is the finding of the Staff Hearing Officer that the claimant’s 
request for authorization for further treatment with Dr. Paley and for orthoscopic 
[sic] surgery is granted.  The Staff Hearing Officer finds the reports of Dr. Paley, 
dated 12/21/01 and 3/8/02 to be persuasive in both the claimant’s need for surgery 
and its causal relationship to the 6/7/00 industrial injury. 
{¶99} “Temporary total disability compensation is to continue from the 
date of last payment to 7/4/02, based on the C-84 from Dr. Paley dated 2/11/02 
and 4/30/02.” 
{¶100} Dayton Foods’ appeal of the SHO’s order was refused, and 
Dayton Foods initiated an action in mandamus in the Court of Appeals for 
SUPREME COURT OF OHIO 
16 
Franklin County.  The court of appeals held that Dr. Paley’s December 21, 2001 
report was “some evidence” relating the loose body in Unger’s shoulder to his 
industrial injury and that the commission, therefore, did not abuse its discretion in 
authorizing the operation. 
{¶101} Addressing TTC, the court relied on R.C. 4123.56(A) and Ohio 
Adm.Code 4121-3-32(A) and stressed that it is a claimant’s refusal of an offer of 
suitable employment, not a doctor’s, that is needed to satisfy the statute’s 
termination criteria.  It also rejected Dayton Foods’ assertion that Dr. Paley’s C-
84 forms were flawed because they prospectively certified temporary total 
disability. 
{¶102} This cause is now before this court on an appeal as of right. 
{¶103} Dayton Foods’ objection to surgery has been the same 
throughout – lack of causal relationship between the need for surgery and the 
industrial injury.  Its challenge to TTC, on the other hand, has alternated between 
three different theories.  The court of appeals, through its magistrate, has done an 
exemplary job assembling the relevant facts and addressing the arguments 
accurately and succinctly.  We affirm its judgment. 
{¶104} On the issue of surgery, Dayton Foods implies that Dr. Paley is 
being deceptive.  It accuses the doctor of requesting surgery for an allowed 
condition — tendonitis — when he really seeks to repair a nonallowed condition 
— a loose body in Unger’s shoulder.  This argument ignores the SHO’s 
conclusion that the need for surgery – even if a loose body is involved – is related 
to the industrial injury.  Dr. Paley’s December 21, 2001 report states: 
{¶105} “Mr. Unger was found to have a large loose body within the 
shoulder joint on the MRI of August 14, 2001.  Individuals do not just have loose 
bodies within the shoulder.  A specific injury must occur to cause a loose body to 
form.  Mr. Unger has no past history of problems with the left shoulder prior to 
the accident of June 7, 2000.  The mechanism of injury of a large shipping cabinet 
January Term, 2004 
17 
falling on him could, in my opinion, be the source of this loose body in addition to 
the injury to the rotator cuff.” 
{¶106} This contradicts Dayton Foods’ assertion that there is no 
evidence causally relating the loose body to the industrial injury.  Accordingly, its 
argument is rejected. 
{¶107} Turning to TTC, Dayton Foods accuses Dr. Paley of being 
uncooperative in Dayton Foods’ efforts to return Unger to light-duty work and 
claims that under R.C. 4123.56(A) this warrants termination of TCC.  This 
proposition fails. 
{¶108} R.C. 4123.56(A) provides that TTC payments “shall not be made 
for the period when any employee has returned to work, when an employee’s 
treating physician has made a written statement that the employee is capable of 
returning to the employee’s former position of employment, when work within 
the physical capabilities of the employee is made available by the employer or 
another employer, or when the employee has reached the maximum medical 
improvement.” 
{¶109} Ohio Adm.Code 4121-3-32(B)(2)(d) supplements the statute, 
allowing termination “[u]pon the finding of a district hearing officer that the 
employee has received a written job offer of suitable employment.”  “Suitable 
employment” is “work which is within the employee’s physical capabilities.”  
Ohio Adm.Code 4121-3-32(A)(3).  “Job offer” is a “proposal, made in good faith, 
of suitable employment within a reasonable proximity of the injured worker’s 
residence.”  Ohio Adm.Code 4121-3-32(A)(6). 
{¶110} Dayton Foods never extended a light-duty job offer to Unger, nor 
did it seek termination for his failure to accept such an offer, rendering Ohio 
Adm.Code 4121-3-32(B)(2)(d) inapplicable.  It instead maintains that it was 
foreclosed from extending a job offer by Dr. Paley’s failure to respond to its 
proposed light-duty position.  This assertion has three flaws. 
SUPREME COURT OF OHIO 
18 
{¶111} First, neither the Revised Code nor the Administrative Code lists 
a doctor’s response to a proposed job offer as a termination criterion.  Second, 
Dayton Foods’ description of Dr. Paley as unresponsive is tenuous.  On April 26, 
2001, Unger submitted to Dayton Foods a C-84 form in which Dr. Paley 
prohibited Unger from working through June 26.  Dayton Foods refused to accept 
that medical opinion and instead faxed Dr. Paley a form asking him to list 
Unger’s medical restrictions.  When Dr. Paley did not respond within one week, 
Dayton Foods again faxed the request.  This time, Dr. Paley indicated that Unger 
could do sedentary work but also wrote that Unger was “off work through 6/26 
until treatment approved.” 
{¶112} Dayton Foods seized upon the possibility of sedentary work and 
immediately wrote to the doctor and informed him that in the opinion of the 
Human Resources Director, Unger was medically capable of the light-duty job 
that Dayton Foods had proposed.  Notwithstanding Dr. Paley’s C-84 form and the 
handwritten notation, Dayton Foods requested that Dr. Paley – within the next 
three days – accept the Human Resources Director’s medical assessment and 
release Unger to the light-duty job.  Dr. Paley, understandably, did not answer. 
{¶113} Contrary to Dayton Foods’ representation, Dr. Paley answered 
Dayton Foods’ requests promptly.  He simply refused to allow himself to be 
bullied into forcing Unger back to work prematurely.  Again, Dr. Paley had stated 
from the beginning that Unger was medically incapable of any work  through 
June 26.  The alleged factual basis for Dayton Foods’ legal position does not, 
therefore, withstand scrutiny. 
{¶114} Third, Dayton Foods’ position would penalize Unger, by 
terminating his TTC, for a dispute over which he has no control.  The quarrel here 
is between Dr. Paley and Dayton Foods.  Unger should not be put in the crossfire 
merely because he heeded his doctor’s instructions. 
January Term, 2004 
19 
{¶115} Last, Dayton Foods mounts a technical challenge to Dr. Paley’s 
C-84 forms, criticizing his prospective certification of disability.  C-84 forms, of 
course, are designed to accommodate prospective certification and are often used 
this way, particularly where TTC is ongoing. 
{¶116} Dayton Foods’ complaint appears to be with Dr. Paley’s practice 
of certifying disability for a two-month period, with a doctor’s examination 
scheduled in the middle.  For example, Dr. Paley saw Unger on April 16, 2001.  
He prepared the C-84 form on April 26, reporting that Unger was unable to work 
from that date through June 26.  The C-84 form also indicated that Unger’s next 
scheduled appointment was May 16.  Dayton Foods apparently believes that the 
disability should only have been certified through May 15 with any disability 
finding thereafter contingent on the results of the May 16 visit. 
{¶117} Dayton Foods’ plan, however, could interrupt what should be 
continuous compensation.  Using the dates in the example, Dayton Foods’ 
proposed method would allow Dr. Paley to verify disability only through May 15.  
Then, presumably after the May 16 exam, the doctor – if Unger was still disabled 
– would file a new C-84 form extending the date of disability.  Unfortunately, this 
scheme does not factor in form-preparation and processing time, which could 
result in a break in compensation.  This explains why many doctors do exactly as 
Dr. Paley does:  estimate a period of disability and schedule an interim visit to 
estimate further extension.  Dayton Foods has cited no legal authority to support 
changing this traditional method of completing C-84 forms.  We therefore decline 
Dayton Foods’ invitation to change it. 
{¶118} We affirm the judgment of the court of appeals. 
Judgment affirmed. 
 
MOYER, C.J., RESNICK, F.E. SWEENEY, PFEIFER, O’CONNOR and 
O’DONNELL, JJ., concur. 
 
LUNDBERG STRATTON, J., concurs in judgment only. 
SUPREME COURT OF OHIO 
20 
__________________ 
 
Pickrel, Schaeffer & Ebeling, David C. Korte, Michelle D. Bach and 
Salvatore A. Gilene, for appellant. 
 
Jim Petro, Attorney General, and Erica L. Bass, Assistant Attorney 
General, for appellee Industrial Commission. 
 
Casper & Casper and Megan Richards, for appellee Joseph Unger. 
__________________