Case Title: Thomas v. Logue

Citation: 2023-Ohio-3522

Docket Number: 

State: ohio

Court: Ohio Supreme Court

Date: 2023-10-03T00:00:00Z

Document:
[Until this opinion appears in the Ohio Official Reports advance sheets, it may be cited as 
Thomas v. Logue, Slip Opinion No. 2023-Ohio-3522.] 
 
 
NOTICE 
This slip opinion is subject to formal revision before it is published in an 
advance sheet of the Ohio Official Reports.  Readers are requested to 
promptly notify the Reporter of Decisions, Supreme Court of Ohio, 65 
South Front Street, Columbus, Ohio 43215, of any typographical or other 
formal errors in the opinion, in order that corrections may be made before 
the opinion is published. 
 
SLIP OPINION NO. 2023-OHIO-3522 
THOMAS, APPELLEE, v. LOGUE, ADMR., OHIO BUREAU OF WORKERS’ 
COMPENSATION, APPELLANT. 
[Until this opinion appears in the Ohio Official Reports advance sheets, it 
may be cited as Thomas v. Logue, Slip Opinion No. 2023-Ohio-3522.] 
Workers’ compensation—Subrogation—R.C. 4123.93(D)—Costs expended by 
Bureau of Workers’ Compensation for a medical review that is used to deny 
a workers’ compensation claimant’s application for workers’ compensation 
benefits are not recoverable in subrogation from an award workers’ 
compensation claimant receives from a third-party tortfeasor for the same 
injury, because the costs expended for the medical review were not paid “on 
behalf of the claimant” under R.C. 4123.93(D)—Court of appeals’ 
judgment affirmed and cause remanded to Court of Claims. 
(No. 2022-0787—Submitted May 16, 2023—Decided October 3, 2023.) 
APPEAL from the Court of Appeals for Franklin County, No. 21AP-385, 
2022-Ohio-1603. 
__________________ 
 
 
SUPREME COURT OF OHIO 
 
2 
BRUNNER, J. 
INTRODUCTION 
{¶ 1} Appellee, Lamar Thomas, was working in waste management when 
he was injured in a vehicle collision caused by a third party.  The Bureau of 
Workers’ Compensation (“BWC”) allowed his workers’ compensation claim for 
some conditions, but when Thomas’s treating physician linked other conditions to 
the workplace accident and Thomas asserted a claim for those conditions, the BWC 
sought and paid for a medical review.  On the basis of the second opinion rendered 
during the medical review, the BWC challenged, and the Industrial Commission 
ultimately disallowed, the additional claim.  Then, when Thomas settled his 
personal-injury case against the third-party tortfeasor, the BWC recouped through 
subrogation the cost of the medical review it had used to deny Thomas’s additional 
workers’ compensation claim.  Thomas sued appellant, John Logue, administrator 
of the BWC, in the Ohio Court of Claims, seeking to recover the portion of the 
BWC’s subrogated award relating to its medical review.  His case against the BWC 
in the Court of Claims was denied via judgment on the pleadings, and Thomas 
appealed.  The Tenth District Court of Appeals reversed the Court of Claims’ 
decision, and we accepted jurisdiction over the BWC’s appeal to determine whether 
the medical review it obtained was an expense recoverable in subrogation.  We 
agree with the Tenth District in concluding that it was not; thus, we affirm the court 
of appeals’ judgment and remand this cause to the Court of Claims for further 
proceedings. 
FACTS AND PROCEDURAL HISTORY 
{¶ 2} According to the allegations in his complaint against the BWC, 
Thomas was an employee of a waste-management company when he was injured 
in the course of his employment in a vehicle collision caused by a third party.  The 
BWC allowed Thomas’s initial claim for workers’ compensation coverage.  
However, based on a causal-relation opinion from his treating physician, Thomas 
January Term, 2023 
3 
 
sought additional workers’ compensation coverage, claiming that his allowed 
conditions 
aggravated 
his 
preexisting 
degenerative-disc 
disease 
and 
spondylolisthesis.  Rather than allow the additional claim based on the opinion of 
the treating physician, the BWC hired Dr. Gerald Yosowitz to review Thomas’s 
medical records.  In his report, Dr. Yosowitz opined that the conditions for which 
Thomas sought additional workers’ compensation coverage were degenerative and 
unrelated to the injury he had sustained in the vehicle collision.  The BWC used 
this report to successfully argue against Thomas’s additional claim with the result 
that it was disallowed. 
{¶ 3} When Thomas pursued a personal-injury claim against the third-party 
tortfeasor, the BWC asserted a right of subrogation.  Following Thomas’s 
settlement with and recovery from the third party, the BWC made its claim for and 
obtained subrogation.  The subrogated amount sought and obtained by the BWC 
from Thomas’s tort-action recovery included the fees it had paid to Dr. Yosowitz 
for the medical review that it had used to dispute the opinion by Thomas’s treating 
physician, which resulted in the Industrial Commission’s disallowing Thomas’s 
additional claim.  Thomas took the position that according to the law and multiple 
publications of the BWC and the Industrial Commission, the BWC’s subrogation 
interest extends only to costs that the BWC incurred on behalf of the injured worker.  
He asserted that costs incurred by the BWC to dispute his additional workers’ 
compensation claim were not incurred on his behalf and therefore were not 
recoverable through subrogation. 
{¶ 4} Thomas subsequently filed a class-action lawsuit against the BWC in 
the Ohio Court of Claims.  He sought a declaration that the subrogation-recovery 
practices described in his case (and common to the alleged class) are unlawful; he 
alleged that the practices unjustly enriched the BWC, that they violated equal 
protection, and that he was therefore entitled to restitution and injunctive relief. 
SUPREME COURT OF OHIO 
 
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{¶ 5} The BWC moved for judgment on the pleadings, arguing that the costs 
and expenses it incurs in connection with a medical review are incurred “on behalf 
of” the workers’ compensation claimant and are therefore included in the definition 
of “subrogation interest” under R.C. 4123.93(D).  In support of this view, the BWC 
asserted in its motion that  
 
the text of R.C. 4123.93(D) provides that BWC’s subrogation 
interest “includes past, present, and estimated future payments of 
compensation, medical benefits, rehabilitation costs, or death 
benefits, and any other costs or expenses paid to or on behalf of 
the claimant by the statutory subrogee pursuant to this chapter or 
Chapter 4121., 4127., or 4131. of the Revised Code.” 
 
(Emphasis, boldface, and underlining added by the BWC.)  The BWC argued that 
Dr. Yosowitz’s independent medical review was necessary “to evaluate whether 
Thomas was entitled to participate in the workers’ compensation fund for the 
additional allowances” and consequently, that its cost was expended on Thomas’s 
behalf, notwithstanding the fact that its conclusions were, in the end, not beneficial 
to his claim.  In response, Thomas pointed out that the medical review was neither 
treatment nor care provided to him, that it was performed at the request of the BWC 
to defend against his claim for additional workers’ compensation allowances, and 
that it was not an expense that he had claimed or recovered in his action against the 
third-party tortfeasor. 
{¶ 6} The Court of Claims granted the BWC’s motion for judgment on the 
pleadings.  It reasoned: 
 
When the terms “costs or expenses” and “on behalf of” in 
R.C. 4123.93(D) are considered according to the rules of grammar 
January Term, 2023 
5 
 
and common usage, the Court determines that these terms pertain to 
an amount paid by BWC or expenditure paid by BWC in the name 
of, on the part of, or as the agent or representative of a claimant.  In 
the Court’s view, the costs and expenses incurred by BWC in 
connection with an injured worker’s medical review—in this case 
Lamar Thomas—are included within the statutory definition of 
“subrogation interest” under R.C. 4123.93(D) because it is an 
expenditure paid by BWC on the part of a claimant. 
 
Thomas v. Ohio Bur. of Workers’ Comp., Ct. of Cl. No. 2021-00112JD, 2021 WL 
3124286, *4 (June 28, 2021).1 
{¶ 7} The Tenth District reversed the Court of Claims, finding that the 
medical review was not conducted “on behalf of” Thomas and therefore was not an 
expense for subrogation purposes.  2022-Ohio-1603, 191 N.E.3d 1155, ¶ 11-30.  
The appellate court reasoned: 
 
BWC states that in ordering Dr. Yosowitz’s record review and 
report, it was acting “to determine the propriety of [Thomas’s] 
request.”  (Emphasis added.)  (BWC’s Brief at 24.)  BWC states that 
Dr. Yosowitz’s medical review “was necessary to evaluate whether 
[Thomas] was entitled to participate in the workers’ compensation 
 
1. The Court of Claims also noted that both the Cuyahoga County and Franklin County Courts of 
Common Pleas had declined to grant the BWC’s motions for judgment on the pleadings in a prior 
class-action lawsuit filed by Thomas on the subrogation issue.  See Thomas v. Buehrer, Cuyahoga 
C.P. No. CV-16-859245 (Mar. 23, 2017), id., Cuyahoga C.P. No. CV-16-859245 (Sept. 13, 2018) 
(transferring venue to Franklin County), and Thomas v. Morrison, Franklin C.P. No. 18 CV 8643 
(Jan. 31, 2019).  The parties stipulated to a voluntary dismissal of that action before a decision was 
rendered on the merits, see Thomas v. McCloud, Franklin C.P. No. 18 CV 8643 (Mar. 18, 2020).  
Thomas subsequently initiated this suit in the Court of Claims. 
SUPREME COURT OF OHIO 
 
6 
fund for the additional allowances.”  (Emphasis added.)  (BWC’s 
Brief at 22.)  In order “[t]o assist in this determination,” BWC relied 
on its authority under Ohio Adm.Code 4123-3-09(C)(4) to “ ‘at any 
point in the processing of an application for benefits, require the 
employee to submit to a physical examination or * * * refer a claim 
for investigation.’ ”  (Emphasis added.)  (BWC’s Brief at 22, 
quoting Ohio Adm.Code 4123-3-09(C)(4).)  See R.C. 4123.53(A) 
(providing that BWC “may require any employee claiming the right 
to receive compensation to submit to a medical examination”).  By 
these statements, it is clear that BWC was not ordering the record 
review in the interest of or as the representative of [Thomas], but, 
rather, to fulfill its ministerial purpose of administering the workers’ 
compensation system.  See State ex rel. Crabtree v. Bur. of Workers’ 
Comp., 71 Ohio St.3d 504, 507, 1994-Ohio-474, 644 N.E.2d 361 
(1994) (stating that the statutory framework of Ohio’s workers’ 
compensation system “consistently reflected” that the BWC’s “role 
is ministerial”); Greene v. Conrad, 10th Dist. No. 96APE12-1780 
(Aug. 21, 1997); Broyles v. Conrad, 2d Dist. No. 20670, 2005-Ohio-
2233, ¶ 12.  See also Willitzer v. McCloud, 6 Ohio St.3d 447, 449, 6 
[OBR] 489, 453 N.E.2d 693 (1983) (stating, under a prior version 
of workers’ compensation scheme that an independent physician 
examining workers’ compensation claimants, at the request of the 
commission for the purpose of reporting their medical conditions 
was performing an “investigative-medical fact-finding function”). 
BWC states that its “mission” is “to ensure that a claimant is 
fully and fairly compensated to the extent he or she is entitled to 
be—no more and no less.”  (Emphasis sic.)  (BWC’s Brief at 27.)  
Citing another provision of Ohio’s workers’ compensation statutes, 
January Term, 2023 
7 
 
BWC acknowledges that its “role” in this process is to serve “as 
steward and fiduciary of the State Insurance Fund.”  (BWC’s Brief 
at 25, citing R.C. 4123.32(B).)  See State ex rel. Daily Servs., L.L.C. 
v. Morrison, 154 Ohio St.3d 498, 2018-Ohio-2151, 116 N.E.3d 112, 
¶ 25 (stating that BWC “has a fiduciary responsibility to safeguard 
the Workers’ Compensation Fund”); State ex rel. Harry Wolsky 
Stair Builder, Inc. v. Indus. Comm., 58 Ohio St.3d 222, 224, 569 
N.E.2d 900 (1991) (stating that BWC’s “sole fiduciary 
responsibility is to the State Insurance Fund”).  Contrary to BWC’s 
contentions, these statements of its purpose do not demonstrate that 
BWC is acting as the representative of or in the interest of claimants.  
Instead, they provide more support for BWC’s ministerial role in 
fairly administering the claims presented to it by claimants. 
 
2022-Ohio-1603 at ¶ 19-20. 
{¶ 8} The BWC appealed, and we accepted a single proposition of law for 
review: 
 
The cost of an independent medical review, which the 
[BWC] pays in order to complete the record, is a cost paid “on behalf 
of the claimant” and thus subject to subrogation. 
 
See 168 Ohio St.3d 1414, 2022-Ohio-3636, 196 N.E.3d 846. 
DISCUSSION 
{¶ 9} Our review of a lower court’s decision granting judgment on the 
pleadings under Civ.R. 12(C) is de novo.  New Riegel Local School Dist. Bd. of 
Edn. v. Buehrer Group Architecture & Eng., Inc., 157 Ohio St.3d 164, 2019-Ohio-
2851, 133 N.E.3d 482, ¶ 8.  Granting judgment on the pleadings, especially when 
SUPREME COURT OF OHIO 
 
8 
filed by a defendant, generally results in dismissal.  See, e.g., State ex rel. Fire Rock, 
Ltd. v. Ohio Dept. of Commerce, 163 Ohio St.3d 277, 2021-Ohio-673, 169 N.E.3d 
665, ¶ 6, quoting State ex. rel. Midwest Pride, IV, Inc. v. Pontious, 75 Ohio St.3d 
565, 569, 664 N.E.2d 931 (1996) (“A court should grant the motion [for judgment 
on the pleadings] and dismiss the complaint when it determines that ‘no material 
factual issues exist and that the movant is entitled to judgment as a matter of law’ ”); 
State ex rel. Mancino v. Tuscarawas Cty. Ct. of Common Pleas, 151 Ohio St.3d 35, 
2017-Ohio-7528, 85 N.E.3d 713, ¶ 8, fn. 2 (a lower court’s ruling on a motion to 
dismiss filed after the complaint and answer were filed is properly viewed as a 
ruling on a motion for judgment on the pleadings under Civ.R. 12(C)). 
 
“Dismissal is appropriate under Civ.R. 12(C) when (1) the court 
construes as true, and in favor of the nonmoving party, the material 
allegations in the complaint and all reasonable inferences to be 
drawn from those allegations and (2) it appears beyond doubt that 
the plaintiff can prove no set of facts that would entitle him or her 
to relief.” 
 
Maternal Grandmother, ADMR v. Hamilton Cty. Dept. of Job & Family Servs., 167 
Ohio St.3d 390, 2021-Ohio-4096, 193 N.E.3d 536, ¶ 13, quoting Reister v. 
Gardner, 164 Ohio St.3d 546, 2020-Ohio-5484, 174 N.E.3d 713, ¶ 17, citing 
Pontious at 570. 
{¶ 10} As both parties in this case observe, the workers’ compensation 
scheme enacted in R.C. Chapter 4123 is a grand bargain between workers (who 
need to be compensated for their injuries with a minimum of fuss) and employers 
(who would prefer not to be subjected to the difficulties of trial and the danger of 
unpredictable jury awards).  See Ohio Constitution, Article II, Section 35; R.C. 
4123.54 and 4123.74; Holeton v. Crouse Cartage Co., 92 Ohio St.3d 115, 119, 748 
January Term, 2023 
9 
 
N.E.2d 1111 (2001).  The statutory scheme also makes clear who bears the burden 
of maintaining the administrative structure of the workers’ compensation program: 
 
The administrative costs of the industrial commission, the 
bureau of workers’ compensation board of directors, and the bureau 
of workers’ compensation shall be those costs and expenses that are 
incident to the discharge of the duties and performance of the 
activities of the industrial commission, the board, and the [BWC] 
under * * * Chapters 4121., [4123.,] 4125., 4127., 4133., and 4167. 
of the Revised Code, and all such costs shall be borne by the state 
and by other employers amenable to [R.C. Chapter 4123] * * *. 
 
R.C. 4123.341; see also R.C. 4123.342; Cirino v. Ohio Bur. of Workers’ Comp., 
153 Ohio St.3d 333, 2018-Ohio-2665, 106 N.E.3d 41, ¶ 4, quoting R.C. 4123.341 
(noting, in case in which fees were assessed against claimants accessing workers’ 
compensation funds with debit cards, that the BWC “is required to ensure that all 
‘administrative costs’—that is, all costs that are ‘incident to the discharge of the 
duties and performance of the activities of the * * * [BWC]’—are borne by the state 
and employers” [ellipsis added in Cirino]).  It is likewise clear that when an injured 
worker makes a claim and the employer or the BWC has doubts about the claim, 
the employee may be required to submit to examinations regarding the employee’s 
health and ability to work.  See R.C. 4123.53 and 4123.651.  In the case of BWC-
initiated examinations, the BWC must pay the cost of the examination.  R.C. 
4123.53(A).  In the case of employer-initiated examinations, the employer must 
pay for the examination.  R.C. 4123.651(A).  Were it not for the question of 
subrogation, the cost of Dr. Yosowitz’s medical review would clearly have been 
required to be borne by the BWC. 
{¶ 11} R.C. 4123.931(A) provides BWC’s right to subrogation: 
SUPREME COURT OF OHIO 
 
10 
 
The payment of compensation or benefits pursuant to * * * 
Chapter 4121., [4123.,] 4127., or 4131., of the Revised Code creates 
a right of recovery in favor of a statutory subrogee against a third 
party, and the statutory subrogee is subrogated to the rights of a 
claimant against that third party.  The net amount recovered is 
subject to a statutory subrogee’s right of recovery. 
 
The “statutory subrogee” is “the administrator of workers’ compensation, a self-
insuring employer, or an employer that contracts for the direct payment of medical 
services pursuant to division (P) of section 4121.44 of the Revised Code.”  R.C. 
4123.93(B).  In this case, the statutory subrogee is the BWC. 
{¶ 12} In subrogation cases such as this, in which the injured worker’s 
personal-injury claim against a third-party tortfeasor has been settled (rather than 
tried), 
 
the claimant shall receive an amount equal to the uncompensated 
damages divided by the sum of the subrogation interest plus the 
uncompensated damages, multiplied by the net amount recovered, 
and the statutory subrogee shall receive an amount equal to the 
subrogation interest divided by the sum of the subrogation interest 
plus the uncompensated damages, multiplied by the net amount 
recovered, except that the net amount recovered may instead be 
divided and paid on a more fair and reasonable basis that is agreed 
to by the claimant and statutory subrogee. 
 
R.C. 4123.931(B).  The “claimant” is a “person who is eligible to receive 
compensation, medical benefits, or death benefits under * * * Chapter 4121., 
January Term, 2023 
11 
 
[4123.,] 4127., or 4131. of the Revised Code,” R.C. 4123.93(A), and in this case, 
the claimant is Thomas.  “ ‘Uncompensated damages’ means the claimant’s 
demonstrated or proven damages minus the statutory subrogee’s subrogation 
interest.”  R.C. 4123.93(F).  “ ‘Net amount recovered’ means the amount of any 
award, settlement, compromise, or recovery by a claimant against a third party, 
minus the attorney’s fees, costs, or other expenses incurred by the claimant in 
securing the award, settlement, compromise, or recovery” but it “does not include 
any punitive damages.”  R.C. 4123.93(E).  And finally, “subrogation interest” is 
defined as “past, present, and estimated future payments of compensation, medical 
benefits, rehabilitation costs, or death benefits, and any other costs or expenses paid 
to or on behalf of the claimant by the statutory subrogee pursuant to * * * Chapter 
4121., [4123.,] 4127., or 4131. of the Revised Code.”  R.C. 4123.93(D). 
{¶ 13} Determining the amount dictated by the formula in R.C. 
4123.931(B) is not possible on the record before this court, but neither is it 
necessary.  The record before us does not include an accounting of Thomas’s total 
recovery from his settlement with the third-party tortfeasor or the expenses he 
incurred in securing the settlement.  What we can discern, however, from the 
allegations in Thomas’s complaint against the BWC and the exhibits to the 
pleadings is that the cost of Dr. Yosowitz’s medical review was included in the 
“subrogation interest” asserted by the BWC and recovered from Thomas’s 
settlement.  The question is whether that was permissible. 
{¶ 14} The statutes set out above make clear that the answer for Thomas 
and those similarly situated in the alleged class is no.  The payment that the BWC 
made to Dr. Yosowitz for providing the medical review and any other similar 
payment it made in relation to persons in the alleged class should not have been 
included in the BWC’s subrogation recovery.  First, examinations are generally to 
be paid for by the party that orders them, see R.C. 4123.53(A) and 4123.651(A), 
and there is no doubt in this case that the medical review in question was ordered 
SUPREME COURT OF OHIO 
 
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by the BWC.  Taking the allegations in the complaint at face value (as we are 
required to do when reviewing a judgment-on-the-pleadings decision, see Maternal 
Grandmother, 167 Ohio St.3d 390, 2021-Ohio-4096, 193 N.E.3d 536, at ¶ 13), we 
accept as true that the treating physician’s report established that the workplace 
accident “substantially aggravated [Thomas’s] pre-existing degenerative disc 
disease at L3-L4 and L4-L5 as well as [his] pre-existing spondylothesis [sic] at L5.”  
There are no equivocations to or evident insufficiencies in that alleged fact, and the 
BWC has not pointed to any.  Rather, as alleged in the complaint, the BWC was 
“[u]nwilling to grant the request” to allow Thomas’s additional workers’ 
compensation claim and for that reason alone, it referred the matter to Dr. Yosowitz 
for a medical review.  In short, according to the complaint, the BWC sought a 
medical review before allowing the claim for Thomas’s additional conditions—
something it was statutorily entitled to do but for which it was also statutorily 
required to bear the cost.  See R.C. 4123.53(A).  The BWC now takes the position 
that even though the statute requires it to bear the cost of the medical review it 
sought with Dr. Yosowitz, R.C. 4123.931 entitles it to recoup that cost from 
Thomas’s third-party tort-claim settlement.  That is incorrect—logically, 
statutorily, and constitutionally. 
{¶ 15} Let’s get logic out of the way first.  In Thomas’s tort action against 
the third party that caused the vehicle collision, he could not have sought to recover 
as damages the cost of the BWC’s medical review by Dr. Yosowitz.  That expense 
was borne by the BWC in its attempt to avoid providing coverage for what it 
believed were preexisting conditions that were not exacerbated by the allowed 
injuries in Thomas’s workers’ compensation case.  That expense was not for 
medical treatment, nor was it any other form of cognizable compensatory expense 
that Thomas could have presented in his third-party tort case to recover as damages.  
See, e.g., Rieger v. Giant Eagle, Inc., 157 Ohio St.3d 512, 2019-Ohio-3745, 138 
N.E.3d 1121, ¶ 10 (“In order to establish an actionable claim of negligence, a 
January Term, 2023 
13 
 
plaintiff must show the existence of a duty, a breach of that duty, and an injury that 
was proximately caused by the breach”).  Since Thomas could not have recovered 
for that expense from the third party, it is illogical to conclude that the amount 
Thomas did recover from the third party by way of settlement should be diminished 
by a subrogation claim for that expense. 
{¶ 16} R.C. 4123.93(D) makes clear that any subrogation “includes past, 
present, and estimated future payments of compensation, medical benefits, 
rehabilitation costs, or death benefits, and any other costs or expenses paid to or on 
behalf of the claimant by the statutory subrogee pursuant to * * * Chapter 4121., 
[4123.,] 4127., or 4131. of the Revised Code.”  (Emphasis added.)  While payments 
to Dr. Yosowitz were “costs or expenses,” they were not payments made “to” 
Thomas.  Nor does logic support that the payments were made “on behalf” of 
Thomas.  The payments were made to Dr. Yosowitz because the BWC was 
attempting to deny coverage for Thomas’s additional workers’ compensation claim.  
The BWC argues that Dr. Yosowitz’s medical review was to fill “gaps” in 
Thomas’s claim and could well have inured to Thomas’s benefit.  However, the 
BWC has never specified what these “gaps” were, and our standard of review 
leaves no room for supplying evidence for the BWC or doubting the sufficiency of 
Thomas’s allegations as the complaining party regarding his treating physician’s 
opinion.  Moreover, the statutory scheme shows that the BWC is a steward of the 
workers’ compensation fund. See R.C. 4123.32(B).  As such, the BWC acts in the 
interest of both employers and workers when it seeks a second opinion to avoid 
paying for false claims.  While that may remotely inure to the benefit of Thomas 
and similarly situated workers in the alleged class, the aim of the BWC’s securing 
a second opinion is more so for the solvency of the workers’ compensation system 
than for the benefit of any individual worker. 
{¶ 17} The cost of Dr. Yosowitz’s medical review is not contained within 
the statutory definition of “subrogation interest.”  See R.C. 4123.93(D).  To the 
SUPREME COURT OF OHIO 
 
14 
extent there is any ambiguity in that conclusion, R.C. 4123.95 instructs that 
“Sections 4123.01 to 4123.94, inclusive, of the Revised Code shall be liberally 
construed in favor of employees and the dependents of deceased employees.”  
Permitting the BWC to recoup from an employee the cost of a medical review that 
it sought and used to deny a claim by the employee would not be in keeping with 
the required “liberal” construction of the Revised Code in favor of the employee—
to the contrary, it would be a construction in favor of employers and the BWC. 
{¶ 18} Finally, we have explained that subrogation is constitutional in this 
context insofar as it prevents a double recovery: 
 
In dealing with the constitutionality of various collateral-
benefits-offset statutes under Section 16, Article I [of the Ohio 
Constitution], this court has recognized that the state has a legitimate 
interest in preventing double recoveries.  Thus, it is constitutionally 
permissible for the state to prevent a tort victim from recovering 
twice for the same item of loss or type of damage, once from the 
collateral source and again from the tortfeasor.  However, we have 
also recognized that these kinds of statutes are not rationally related 
to their purpose where they operate to reduce a plaintiff’s tort 
recovery irrespective of whether a double recovery has actually 
occurred.  Thus, we have consistently and repeatedly held that due 
process permits deductions for collateral benefits only to the extent 
that the loss for which the collateral benefit compensates is actually 
included in the award.  McMullen v. Ohio State Univ. Hosp. (2000), 
88 Ohio St.3d 332, 341-344, 725 N.E.2d 1117, 1125-1127; State ex 
rel. Ohio Academy of Trial Lawyers v. Sheward (1999), 86 Ohio 
St.3d 451, 479-482, 715 N.E.2d 1062, 1088-1090; Buchman v. 
Wayne Trace Local School Dist. Bd. of Edn. (1995), 73 Ohio St.3d 
January Term, 2023 
15 
 
260, 652 N.E.2d 952; Sorrell v. Thevenir (1994), 69 Ohio St.3d 415, 
633 N.E.2d 504. 
There is no valid justification for dispensing with these 
principles in determining the constitutionality of R.C. 4123.931.  
Like the collateral-benefits-offset statutes, the subrogation statute is 
aimed at preventing the tort victim from keeping a double recovery, 
the only conceptual difference being that the intended beneficiary is 
the statutory subrogee (i.e., the collateral payor) rather than the 
tortfeasor.  Thus, R.C. 4123.931 must also satisfy the constitutional 
requirement that deductible or, in this case, subrogable or 
recoupable items be matched to those losses or types of damages 
that the claimant actually recovered from the tortfeasor. 
We are now confronted with similar determinative issues 
under Sections 16 and 19, Article I of the Ohio Constitution.  
Whether expressed in terms of the right to private property, remedy, 
or due process, the claimant-plaintiff has a constitutionally protected 
interest in his or her tort recovery to the extent that it does not 
duplicate the employer’s or [BWC’s] compensation outlay.  Thus, if 
R.C. 4123.931 operates to take more of the claimant’s tort recovery 
than is duplicative of the statutory subrogee’s workers’ 
compensation expenditures, then it is at once unreasonable, 
oppressive upon the claimant, partial, and unrelated to its own 
purpose. 
 
(Emphasis added.)  Holeton, 92 Ohio St.3d at 121-122, 748 N.E.2d 111; see also 
Groch v. GMC, 117 Ohio St.3d 192, 2008-Ohio-546, 883 N.E.2d 377, ¶ 39, 77-80 
(adhering to the double-recovery principle set forth in Holeton but noting that in 
cases in which a tort recovery undercompensates the injured worker, both the BWC 
SUPREME COURT OF OHIO 
 
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and the injured worker share the burden of the undercompensation).  In short, the 
BWC’s subrogation rights do not extend to expenses it incurred for things like the 
medical review that it obtained from Dr. Yosowitz—i.e., expenses that were not 
recoverable by Thomas from the third-party tortfeasor. 
CONCLUSION 
{¶ 19} Dr. Yosowitz’s medical review was not obtained on behalf of 
Thomas or for his benefit but as a second opinion whether Thomas’s workplace 
accident aggravated his preexisting degenerative-spine conditions.  While 
obtaining that review may have been a reasonable thing for the BWC to have done 
to protect the solvency of the workers’ compensation system, it was plainly, under 
the allegations in the pleadings, not done for Thomas’s benefit or on his behalf.  
Moreover, the cost of that medical review was not recoverable by Thomas in his 
personal-injury claim against the third-party tortfeasor.  Thus, in shifting the cost 
of the medical review to Thomas through subrogation, the BWC has attempted to 
avoid responsibility for the costs statutorily assigned to it—costs that were not paid 
for the benefit of or on behalf of a claimant and which the claimant could not have 
recovered from the third-party tortfeasor.  The BWC’s attempted expansion of 
subrogation in this context is unlawful. 
{¶ 20} We therefore affirm the Tenth District Court of Appeals’ judgment 
and remand this cause to the Court of Claims for further proceedings. 
Judgment affirmed 
and cause remanded to the Court of Claims. 
FISCHER, DONNELLY, and STEWART, JJ., concur. 
KENNEDY, C.J., dissents, with an opinion joined by DEWINE and DETERS, 
JJ. 
__________________ 
KENNEDY, C.J., dissenting. 
January Term, 2023 
17 
 
{¶ 21} R.C. 4123.931 gives the Bureau of Workers’ Compensation 
(“BWC”) a right of subrogation when a workers’ compensation claimant receives 
a damages award from a third party for the same workplace injury.  The subrogation 
amount depends in part on the amount of the “subrogation interest,” which R.C. 
4123.93(D) defines as “includ[ing] past, present, and estimated future payments of 
compensation, medical benefits, rehabilitation costs, or death benefits, and any 
other costs or expenses paid to or on behalf of the claimant by the statutory 
subrogee.” 
{¶ 22} We are asked to decide whether the costs incurred by the BWC for 
an independent medical review to evaluate a claimant’s entitlement to additional 
workers’ compensation benefits are paid on behalf of the claimant.  Under the plain 
language of R.C. 4123.93(D), they are.  For this reason, I dissent and would reverse 
the judgment of the Tenth District Court of Appeals. 
{¶ 23} In appellee Lamar Thomas’s complaint against appellant, John 
Logue, administrator of the BWC, Thomas alleged that he was injured in the course 
and scope of his employment when he was involved in an automobile accident 
caused by the negligence of a third party.  The BWC allowed Thomas’s initial claim 
for workers’ compensation benefits, but he subsequently sought additional 
compensation for the aggravation of a preexisting injury.  According to Thomas, 
the BWC was “[u]nwilling” to allow the additional claim, and it ordered an 
independent medical review.  The physician who performed the independent 
medical review determined that the workplace injury had not aggravated Thomas’s 
preexisting condition.  Based on the independent medical review, the Industrial 
Commission denied Thomas the additional compensation that he sought. 
{¶ 24} In the meantime, Thomas sued the third-party tortfeasor who 
precipitated the automobile accident in which he had been injured.  After Thomas 
settled his lawsuit against the third-party tortfeasor, the BWC asserted its 
SUPREME COURT OF OHIO 
 
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subrogation interest, which included the costs it had paid for the independent 
medical review. 
{¶ 25} Thomas brought this putative class action in the Court of Claims on 
behalf of himself and similarly situated claimants, alleging that the BWC has been 
unjustly enriched when it recovered through subrogation the costs of independent 
medical reviews that it has obtained in workers’ compensation cases.  The Court of 
Claims granted the BWC’s motion for judgment on the pleadings, but the Tenth 
District reversed, holding that Thomas had stated a claim for unjust enrichment 
because the cost of the independent medical review that the BWC had obtained in 
Thomas’s workers’ compensation case was not incurred on behalf of Thomas but 
rather was an administrative cost that R.C. 4123.341 requires the BWC to bear.  
2022-Ohio-1603, 191 N.E.3d 1155, ¶ 24, 28-29. 
{¶ 26} Our review of the court of appeals’ decision involves a question of 
statutory interpretation, so our review is de novo.  See Ceccarelli v. Levin, 127 Ohio 
St.3d 231, 2010-Ohio-5681, 938 N.E.2d 342, ¶ 8.  “The question is not what did 
the general assembly intend to enact, but what is the meaning of that which it did 
enact.”  Slingluff v. Weaver, 66 Ohio St. 621, 64 N.E. 574 (1902), paragraph two of 
the syllabus.  “When the statutory language is plain and unambiguous, and conveys 
a clear and definite meaning, we must rely on what the General Assembly has said,” 
Jones v. Action Coupling & Equip., Inc., 98 Ohio St.3d 330, 2003-Ohio-1099, 784 
N.E.2d 1172, ¶ 12, and apply it as written, Summerville v. Forest Park, 128 Ohio 
St.3d 221, 2010-Ohio-6280, 943 N.E.2d 522, ¶ 18. 
{¶ 27} The phrase “on behalf of” is not defined by R.C. 4123.93.  “When a 
term is undefined, we give the term its ‘plain and ordinary meaning.’ ”  Great Lakes 
Bar Control, Inc. v. Testa, 156 Ohio St.3d 199, 2018-Ohio-5207, 124 N.E.3d 803, 
¶ 8, quoting Rhodes v. New Philadelphia, 129 Ohio St.3d 304, 2011-Ohio-3279, 
951 N.E.2d 782, ¶ 17.  The plain and ordinary meaning of “on behalf of” is “in the 
January Term, 2023 
19 
 
interest of : as the representative of : for the benefit of.”  Webster’s Third New 
International Dictionary 198 (1993). 
{¶ 28} By Thomas’s own admission, the BWC was “[u]nwilling” to allow 
his additional workers’ compensation claim, notwithstanding his attending 
physician’s opinion that the workplace injury aggravated a preexisting condition.  
But rather than deny Thomas’s additional claim outright under Ohio Amin.Code 
4123-3-09(B), the BWC spent money on an independent medical review.  By 
having his medical file reviewed by an independent physician, Thomas received a 
second chance to persuade the BWC that the workplace injury did in fact aggravate 
his preexisting condition and support his claim for additional compensation.  
Because the BWC was unwilling to grant Thomas additional benefits without the 
independent medical review, that review could only benefit him.  The BWC’s 
payment for the independent medical review was therefore for Thomas’s benefit 
and in his interest, and for this reason, that cost was paid “on behalf of” Thomas. 
{¶ 29} However, this class action was not brought solely in Thomas’s name; 
it also involves the rights of other injured workers who have received independent 
medical reviews that were paid for by the BWC.  For those claimants who have 
obtained a diagnosis from their attending physicians, as Thomas did in this case, an 
independent medical review could provide additional credible evidence supporting 
their claims for compensation.  But as amici curiae Ohio Chamber of Commerce, 
Ohio Manufacturers’ Association, and National Federation of Independent 
Business/Ohio point out, independent medical reviews are completed for “injured 
workers who do, or do not, have evidence relating medical conditions to a 
workplace injury.”  For some claimants, an independent medical review may 
furnish the only evidence proving that the workplace injury caused their losses.  
Without that evidence, a claim for workers’ compensation benefits would be 
denied.  See R.C. 4123.54(A) (allowing “compensation for loss sustained on 
account of the injury”).  An independent medical review is plainly beneficial to 
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20 
those claimants.  For claimants like Thomas, whose claims are ultimately denied, 
they are still granted the benefit of further review. 
{¶ 30} Importantly, the workers’ compensation system is designed to be 
nonadversarial.  See State ex rel. Ohio AFL-CIO v. Ohio Bur. of Workers’ Comp., 
97 Ohio St.3d 504, 2002-Ohio-6717, 780 N.E.2d 981, ¶ 49.  The BWC’s purpose 
in obtaining an independent medical review is not to build a record against the 
claimant; rather, its administrative rules require it to make “every effort * * * to 
complete the record,” (emphasis added) Ohio Adm.Code 4123-3-09(B)(1).  That is, 
the BWC must ensure that qualified claimants do not have their claims disallowed 
simply because they were unable to muster sufficient credible evidence to support 
their claims on initial review.  Therefore, the BWC’s obtaining an independent 
medical review is in the interest of all claimants—if the BWC does not fill in the 
gaps of the injured workers’ claims, those claimants might not receive the medical 
treatment, paid time off, or other compensation and benefits that they deserve. 
{¶ 31} Other provisions support the conclusion that the costs incurred by 
the BWC for an independent medical review may be recovered through 
subrogation.  R.C. 4123.931(A) provides that the right of recovery through 
subrogation applies to compensation and benefits paid “pursuant to [R.C. Chapter 
4123],” and R.C. 4123.30 permits the BWC to pay for an injured worker’s 
“compensation, 
medical 
services, 
examinations, 
recommendations 
and 
determinations, nursing and hospital services, medicine, rehabilitation, death 
benefits, funeral expenses, and like benefits for loss sustained on account of injury, 
disease, or death.”  (Emphasis added.) 
{¶ 32} Independent medical reviewers conduct an examination when they 
review an injured worker’s medical records.  See Webster’s Third New 
International Dictionary at 790 (defining “examine” as “to inspect or test for 
evidence of disease or abnormality” and defining “examination” as “the act or 
process of examining”).  And following that examination, they make a 
January Term, 2023 
21 
 
determination whether the workplace injury caused the injured worker’s condition.  
See id. at 616 (defining “determination” as “conclusion [or] decision” 
[capitalization deleted]).  R.C. 4123.30 therefore permits the BWC to pay the costs 
of an independent medical review from the state fund, and R.C. 4123.931(A) 
creates a right for the BWC to recover those costs from a damages award that the 
claimant receives from a third-party tortfeasor. 
{¶ 33} Because R.C. 4123.931(A) permits the BWC to recover the costs of 
an independent medical review that it ordered to evaluate a claimant’s application 
for workers’ compensation benefits, the Court of Claims properly granted the 
BWC’s motion for judgment on the pleadings.  The Tenth District Court of Appeals 
erred in construing the relevant statutes, and its judgment should be reversed.  The 
majority does not do that, so I dissent. 
DEWINE and DETERS, JJ., concur in the foregoing opinion. 
__________________ 
Flowers & Grube, Paul W. Flowers, Louis E. Grube, and Melissa A. Ghrist; 
Garson Johnson, L.L.C, James A. DeRoche, and Jeffrey D. Johnson; Weisman, 
Kennedy & Berris Co., R. Eric Kennedy, and Daniel P. Goetz; Ciano Goldwasser, 
L.L.P., and Andrew S. Goldwasser, for appellee. 
Dave Yost, Attorney General, Benjamin M. Flowers, Solicitor General, 
Zachery P. Keller, Deputy Solicitor General, and Timothy Miller, Assistant 
Attorney General, for appellant. 
Elk & Elk Co., Ltd., and Curtis M. Fifner, urging affirmance for amicus 
curiae Ohio Association for Justice. 
Garvin & Hickey, L.L.C., Preston J. Garvin, Michael J. Hickey, and Nathan 
P. Frazen, in support of appellant, for amici curiae Ohio Chamber of Commerce 
and Ohio Manufacturers’ Association. 
Bricker & Eckler, Sue A. Roudebush, and Anne Marie Sferra, in support of 
appellant, for amicus curiae National Federation of Independent Business/Ohio. 
SUPREME COURT OF OHIO 
 
22 
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