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

Citation: 2001-Ohio-292

Docket Number: 19990912

State: ohio

Court: Ohio Supreme Court

Date: 2001-03-07T00:00:00Z

Document:
[Cite as State ex rel. Welker v. Indus. Comm., 91 Ohio St.3d 98, 2001-Ohio-292.] 
 
 
 
THE STATE EX REL. WELKER, APPELLANT AND CROSS-APPELLEE, v. 
INDUSTRIAL COMMISSION OF OHIO ET AL., APPELLEES AND CROSS-
APPELLANTS. 
[Cite as State ex rel. Welker v. Indus. Comm. (2001), 91 Ohio St.3d 98.] 
Workers’ compensation — Application for scheduled loss compensation under 
R.C. 4123.57(B) based on amputation of entire left thumb — Court of 
appeals’ judgment affirming Industrial Commission’s denial of 
amputation benefits affirmed — Successful reattachment of thumb 
precludes any award for amputation — Court of appeals’ judgment that 
Industrial Commission had not adequately addressed the loss-of-use issue 
reversed, when. 
 (No. 99-912 — Submitted November 14, 2000 — Decided March 7, 2001.) 
APPEAL and CROSS-APPEAL from the Court of Appeals for Franklin County, No. 
98AP-136. 
__________________ 
 
Per Curiam.  Appellant-claimant Randall A. Welker suffered a serious 
industrial injury to his left thumb.  When he was transported initially to the closest 
emergency room, claimant’s thumb hung by only a sliver of skin and muscle.  
After transfer to another facility, two surgeries were performed to reattach the 
digit. 
 
The procedure was successful.  Three months after the surgery, one of the 
surgeons, Dr. John Biondi, reported: 
 
“His thumb looks excellent without any signs of infection. * * * X-Rays 
taken on 7/1/93 show excellent consolidation.  He has no pain in the thumb and I 
am going to send him to therapy for ROM [range of motion] exercises and 
strengthening.” 
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One month later he wrote: 
 
“X-rays show complete consolidation, his thumb looks quite good and he 
has good motion at the MP joint although it is fairly stiff out at the IP joint.  He 
has excellent sensation and at this point I want to see him back for a final check in 
six months.” 
 
Claimant eventually returned to his former position of employment.  An 
examination by Dr. Mark E. Weaver in July 1995 assessed an eight percent 
permanent partial impairment.  That November, Dr. Kenneth M. Cardlin 
described claimant’s thumb as “very functional” and having “remarkably 
preserved function.”  He reported that “[t]he patient states he is performing most 
usual activities, although [he] avoids the heaviest of lifting due to uncertainty as 
to prolonged gripping.” 
 
Claimant applied to appellee Industrial Commission of Ohio for scheduled 
loss compensation under R.C. 4123.57(B) based on “the amputation of the total 
left thumb.” 
 
In a lengthy order, the commission denied an award because (1) the thumb 
had been successfully reattached and (2) there was no evidence of a permanent 
and total loss of use of the digit. 
 
The Court of Appeals for Franklin County, in mandamus, upheld the 
commission’s denial of amputation benefits.  It held, however, that the 
commission had not adequately addressed the loss-of-use issue and ordered the 
commission to give it further consideration.  This cause is now before this court 
upon an appeal and cross-appeal as of right. 
 
R.C. 4123.57(B) 1 provides a compensation schedule for the loss of 
enumerated body members, designating a number of weeks of compensation for 
loss of each member.  Originally covering loss by amputation — with the obvious 
                                                          
 
1.  Formerly R.C. 4123.57(C). 
 
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3 
exceptions of hearing and sight, which were measured by different standards — 
compensation was later expanded to include a loss of use.  State ex rel. Walker v. 
Indus. Comm. (1979), 58 Ohio St.2d 402, 12 O.O.3d 347, 390 N.E.2d 1190.  A 
compensable loss of use, however, must be “ ‘to the same effect and extent as if 
[the body part] had been amputated or otherwise physically removed.’ ” Id. at 
403-404, 12 O.O.3d at 348, 390 N.E.2d at 1192, quoting State ex rel. Gassmann 
v. Indus. Comm. (1975), 41 Ohio St.2d 64, 67, 70 O.O.2d 157, 159, 322 N.E.2d 
660, 662.  Consequently, the only compensable loss of use under R.C. 4123.57(B) 
is a permanent and total one. 
 
Claimant’s entitlement to R.C. 4123.57(B) compensation, by either means, 
is at issue by virtue of the commission’s order — which discussed both — and the 
court of appeals’ decision that ordered the commission to further consider loss of 
use.  Upon review, we affirm that judgment only in part. 
 
Regarding claimant’s amputation, one question is raised: Should 
claimant’s eligibility for his scheduled loss award be determined as of the time he 
was injured or from the point of reattachment and recovery?  We find in favor of 
the latter. 
 
Claimant relies on two cases in advocating the former: State ex rel. 
Mansfield Tire & Rubber Co. v. Indus. Comm. (1973), 40 Ohio App.2d 417, 69 
O.O.2d 371, 320 N.E.2d 742; and State ex rel. Kroger Co. v. Stover (1987), 31 
Ohio St.3d 229, 31 OBR 436, 510 N.E.2d 356.  Mansfield Tire examined whether 
a claimant who had lost by accidental amputation most of his thumb and fingers 
could be compensated for the loss of a hand.  In answering affirmatively, the court 
of appeals stated that the presence of a stump beyond the wrist was not 
determinative.  In so doing, it observed: 
 
“[W]e have evidence of severance of the major portions of both hands 
without evidence of loss of use.  We find that the question of loss of use is 
irrelevant to the determination of the issue herein.  For if there were a total and 
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complete severance of the hands, but the stumps were fitted with artificial hands, 
which, through the miracle of modern technology, would restore the ability of 
claimant to function as well as before the amputation, there would be no question 
that there would be a compensable severance under the law * * *.”  (Emphasis 
added.)  Id. at 419, 69 O.O.2d at 372, 320 N.E.2d at 743. 
 
Claimant offers the highlighted language to support his assertion that 
medical efforts to ameliorate damage are irrelevant to eligibility for compensation 
under R.C. 4123.57(B).  Claimant, however, overlooks the key distinction 
between his case and Mansfield Tire.  His case does not involve a prosthetic 
device, but, instead, a reattachment of the severed digit itself.  As the Rhode 
Island Supreme Court noted after rejecting a similar attempt to equate the two: 
 
“The employee * * * argues that the substitution of his index finger for a 
severed thumb should be equated with the furnishing of a prosthetic device.  The 
analogy in our judgment fails.  Live tissue from an injured workers’ body applied 
by a skilled surgeon as a replacement for an injured thumb is not equatable with a 
prosthetic device purchased from a surgical appliance dealer.  One is real; the 
other artificial.” Fogarty v. State (1967), 103 R.I. 228, 236 A.2d 247, 248-249. 
 
There is no dispute among the litigants or the judiciary that a prosthesis 
does not foreclose an amputation award under the statute.  See Kroger, supra.  
That is not, however, the issue before us. 
 
Claimant’s stronger case is Kroger, a decision that generated considerable 
discussion by a divided court.  There, an industrial burn caused an eighty percent 
loss of vision of the claimant’s right eye.  A successful cornea transplant 
ultimately reduced that loss to twenty-five percent.  Claimant received an award 
for the eighty percent loss nevertheless, and Kroger’s challenge eventually ended 
up here. 
 
Controversy centered on the parameters of “uncorrected vision,” the 
vaguely defined measure of loss.  Claimant argued that glasses, contacts, and 
January Term, 2001 
5 
corneal transplants were all corrective means, and since the first two clearly did 
not prohibit recovery, neither did a transplant.  Kroger responded that there was a 
distinction between optical devices such as glasses and contacts and a cornea 
transplant. 
 
The majority, in ultimately siding with the claimant, acknowledged that 
Kroger’s “distinction could be made and presents a close case of first impression 
for this court.”  Id. at 233, 31 OBR at 440, 510 N.E.2d at 360.  Kroger’s position 
was rejected, however: 
 
“To make the distinction Kroger asks would require us to find that a 
corneal transplant is not merely corrective, but restores vision permanently.  We 
decline to accept that position. 
 
“Undeniably Stover sustained the substantial vision loss found by the 
commission.  His loss resulted from severe burning and scarring of his corneas.  
The question is whether a transplant eliminates the loss of vision or is a correction 
of vision.  A corneal transplant does not necessarily result in permanent or 
trouble-free restoration.  This conclusion is substantiated by the medical 
testimony in this case which shows that Stover has twice suffered a rejection of 
the grafts in his right eye, and that at the time there was reason to believe that 
rejection in the left eye was possible. 
 
“We acknowledge that advances in medical technology might, at some 
future time, permit the conclusion that a corneal transplant eliminates the loss (as 
for example the re-setting of broken bones could).  But, at the present and on this 
record, a corneal transplant is no more than a correction to lost vision. Indeed, a 
patient might well decide not to have a corneal transplant.” Id. at 233-234, 31 
OBR at 440, 510 N.E.2d at 360-361. 
 
Vigorously dissenting were Justices Holmes and Wright. Justice Wright 
focused on the statutory definition of “loss of uncorrected vision” as “the 
percentage of vision actually lost as the result of the injury.”  He noted that the 
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statute did not specify “whether the phrase ‘actually lost’ refers to the injured 
employee’s condition immediately after the injury, or whether the condition 
should be evaluated after medical treatment or surgical repair has been 
performed.” Id. at 236, 31 OBR at 442, 510 N.E.2d at 362. 
 
Justice Wright stressed that inherent in the award was a permanent loss 
and that permanency was “a clear signal from the legislature that the award is not 
to be predicated upon the state of the claimant’s vision immediately after the 
industrial injury but, instead, within a reasonable time thereafter so as to allow for 
the effect of natural healing, medical treatment, surgical repair or rehabilitation.” 
Id. at 236-237, 31 OBR at 442, 510 N.E.2d at 363.  He added: 
 
“Regrettably, the majority concludes that any improvement to vision as 
the result of corneal transplants is a correction to vision and cannot be considered 
when determining a loss of vision award under [former] R.C. 4123.57(C).  In 
reaching this conclusion, the majority states without explanation that ‘a corneal 
transplant is no more than a correction to lost vision.’  Presumably, the majority 
perceives corneal transplants as functionally equivalent to prosthetic devices such 
as contact lenses or glasses and, therefore, the court has determined that 
appellee’s disabilit[ies] should be determined at the time he sustained the injury 
and not after advanced medical procedures had been invoked in order to alleviate 
damage caused by the injury.  Such a posture is just plain wrong.  More 
incredibly, the court concludes that ‘at some future time’ corneal transplants may 
eliminate the loss, but at present, this procedure constitutes no more than a 
correction to vision.  The majority reaches this conclusion about the current state 
of the art of corneal transplantation despite no such evidence in the record or 
citation to authority.”  (Emphasis sic.)  Id. at 237, 31 OBR at 442-443, 510 N.E.2d 
at 363. 
 
Justice Holmes shared concerns over the permanency of loss: 
January Term, 2001 
7 
 
“[T]here is no doubt whatsoever that the term ‘permanent’ cannot 
rationally be applied to a former injury in part of the body, when that part has 
thereafter been surgically renewed.  The per se rule adopted by the commission 
and the majority opinion violates the legislative mandate that temporary injuries, 
i.e., those of limited duration, receive separate treatment.  R.C. 4123.56.  By 
refusing to recognize that surgery may ameliorate particular injuries, including 
those at issue, the majority has not only directed surgical cures out of the analysis 
but has allowed the ‘permanent loss’ to fully encompass an injury of limited 
duration. 
 
“The operation at issue, a keratoplasty, requires the transplantation of a 
living organ, the cornea, into the eye of one whose cornea has been injured or 
destroyed.  Thereafter, the successfully implanted organ receives nourishment and 
oxygen from the blood of the recipient through the eye’s pre-existing blood 
vessels.  If injured, it heals itself.  It functions as, and becomes in fact, a living 
part of the recipient’s living tissues, thus eliminating the prior loss.  
Consequently, to classify the results of this operation as a mere ‘correction to 
vision,’ in the same category as a pair of glasses, ignores the obvious intent of the 
statute as well as its particular terms. 
 
“Moreover, the majority’s characterization of keratoplasties as failing to 
‘eliminate the loss’ because of uncertainties in ‘the current state of the medical 
art’ ignores the reality that such operations have been regularly performed as 
standard medical procedures since the 1940s.  Nor has the ‘current state of the 
medical art’ diminished Stover’s expectations and efforts at surgically obtaining 
normal, healthy eyes, since he had another transplantation surgery immediately 
following the Industrial Commission’s award to him for permanent loss.  As a 
matter of scientific fact, a successful keratoplasty will eliminate, on a permanent 
basis, any organic loss which Stover originally experienced.  To the degree the 
new corneas do not provide the previously enjoyed standard of vision, their 
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function may be corrected by artificial lenses, i.e., glasses.” (Footnotes omitted.)  
Id. at 242-243, 31 OBR at 447-448, 510 N.E.2d at 367. 
 
Permanency of loss was also addressed in Rhode Island — the only other 
jurisdiction to confront this issue.  In Fogarty, supra, surgeons fashioned a digit 
from a damaged finger and reattached it at the site of the accidentally severed 
thumb.  Hand function was greatly enhanced as a result. 
 
In determining the point from which to determine extent of loss, the 
claimant and employer advanced the same arguments seen here.  The Fogarty 
court ruled for the employer, reasoning: 
 
“A full opportunity for achieving whatever beneficial effects medical 
science may have on an injury must of necessity precede any determination of 
what has been the percentage of loss of usefulness.  Until those effects can, 
without speculating or delving into mere possibilities, be reasonably foretold, it is 
impossible to ascertain what will be the percentage of the permanent loss of 
usefulness. * * *  It is permanency which is essential because it is only for a 
permanent loss, not for any loss, that the statute provides benefits.” (Emphasis 
sic.)  Fogarty, 103 R.I. at 230-231, 236 A.2d at 248. 
 
Adopting claimant’s point-of-injury position runs counter to most 
workers’ compensation principles.  For purposes of determining permanent total 
disability, for example, maximum medical improvement can never be assessed 
until time has established that treatment and rehabilitation have run their course.  
See Ohio Adm.Code 4121-3-32(A)(1) and its definition of “maximum medical 
improvement.”  More broadly, the entire scheme has been adjudicated as 
generally unamenable to the application of res judicata simply because the 
passage of time alters a claimant’s condition.  State ex rel. B.O.C. Group, Gen. 
Motors Corp. v. Indus. Comm. (1991), 58 Ohio St.3d 199, 569 N.E.2d 496. 
 
Equally important, as touched upon early in Fogarty, reattachment is the 
closest possible way of returning the claimant to a preinjury state and eliminates 
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the element of disfigurement which probably played a part in the creation of the 
scheduled-loss concept. 
 
In this case, it is simply ignoring reality to pretend that claimant’s 
amputation was the end of the story.  And continuing jurisdiction can keep the 
story alive and allow for a scheduled loss award if the reattachment, somewhere 
down the road, becomes ineffective.  At this time, however, claimant has not 
sustained the requisite loss to qualify for an award under R.C. 4123.57(B). 
 
Turning to the issue of loss of use without regard to amputation, the court 
of appeals found through its magistrate that the commission did not adequately 
discuss the issue, based on State ex rel. White v. U.S. Gypsum Co. (1990), 49 Ohio 
St.3d 134, 551 N.E.2d 139.  That case, however, is distinguishable.  In White, the 
commission denied a loss-of-use award based on reports that specifically found 
that claimant did have a permanent and total loss.  The court ordered the 
commission to further clarify its order.  Here, the commission cited evidence that 
did indeed say that claimant had remarkably preserved function in the reattached 
thumb, which contradicts a finding of loss of use.  Consequently, a writ of 
mandamus is inappropriate. 
 
That portion of the court of appeals judgment that found claimant 
ineligible for compensation for amputation is affirmed.  The balance is reversed. 
Judgment reversed in part 
and affirmed in part. 
 
MOYER, C.J., F.E. SWEENEY, PFEIFER, COOK and LUNDBERG STRATTON, 
JJ., concur. 
 
DOUGLAS and RESNICK, JJ., dissent and would affirm the judgment of the 
court of appeals in its entirety. 
__________________ 
 
Green, Haines, Sgambati, Murphy & Macala Co., L.P.A., Ronald E. 
Slipski and Steven L. Paulson, for appellant and cross-appellee. 
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Betty D. Montgomery, Attorney General, and Craigg E. Gould, Assistant 
Attorney General, for appellee and cross-appellant Industrial Commission. 
 
Manos, Pappas & Stefanski Co., L.P.A., Leonard J. Pappas and James A. 
Neff, for appellee and cross-appellant Northeast Fabricators, Inc. 
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