Case Title: State ex rel. Navistar Internatl. Transp. Corp. v. Indus. Comm.

Citation: 2006-Ohio-4089

Docket Number: 20051483

State: ohio

Court: Ohio Supreme Court

Date: 2006-08-23T00:00:00Z

Document:
[Cite as State ex rel. Navistar Internatl. Transp. Corp. v. Indus. Comm., 110 Ohio St.3d 159, 
2006-Ohio-4089.] 
 
 
THE STATE EX REL. NAVISTAR INTERNATIONAL  
TRANSPORTATION CORPORATION, APPELLANT, v. INDUSTRIAL  
COMMISSION OF OHIO ET AL., APPELLEES. 
[Cite as State ex rel. Navistar Internatl. Transp. Corp. v. Indus. Comm.,  
110 Ohio St.3d 159, 2006-Ohio-4089.] 
Workers’ compensation — Industrial Commission — Industrial Commission need 
not consider an employer’s on-site physical-therapy facility when 
determining whether a claimant may receive treatment at another facility 
— Judgment affirmed. 
(No. 2005-1483 – Submitted May 23, 2006 – Decided August 23, 2006.) 
APPEAL from the Court of Appeals for Franklin County,  
No. 04AP-638, 2005-Ohio-3284. 
__________________ 
Per Curiam. 
{¶ 1} When a self-insured employer voluntarily establishes an on-site 
physical-therapy facility, does State ex rel. Miller v. Indus. Comm. (1994), 71 
Ohio St.3d 229, 643 N.E.2d 113, require the Industrial Commission of Ohio to 
consider the employer’s facility-related costs in determining whether a claimant 
may receive treatment at another physical-therapy facility recommended by his 
doctor?  For the reasons to follow, we hold that Miller does not contain this 
requirement. 
{¶ 2} Appellee Thomas Clifford has an allowed workers’ compensation 
claim for “right shoulder strain[,] * * * tear of right rotator cuff * * * and biceps 
tendon tear, right shoulder.”  Clifford eventually required shoulder surgery and 
received follow-up physical therapy at Springfield Physical Therapy as requested 
by his attending physician, Dr. Paul Nitz.  Appellant-employer, self-insured 
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Navistar International Transportation Corporation, approved the request on the 
condition that Clifford receive his physical therapy at Navistar’s on-site medical 
facility.  Because Clifford would not agree to physical therapy at Navistar’s 
facility, Navistar denied treatment authorization. 
{¶ 3} The dispute moved to the appellee Industrial Commission.  After 
protracted hearings, the commission found that “this decision simply comes down 
to an interpretation of the test enunciated in the case of State ex rel. Miller v. 
Indus. Comm.”  It reviewed Miller’s three-pronged test for authorization of 
medical services:  (1) Are the services reasonably related to the allowed 
condition?  (2) Are the services reasonably necessary for treatment of the allowed 
condition?  (3) Is the cost of the service “medically reasonable”?  Id. at 232, 643 
N.E.2d 113.  After answering each question in the affirmative, the commission 
authorized therapy with Springfield Physical Therapy. 
{¶ 4} Navistar filed a complaint in mandamus in the Court of Appeals 
for Franklin County, alleging that the commission abused its discretion in 
authorizing treatment at the Springfield facility.  Navistar argued that if physical 
therapy is authorized at a facility other than its own, it will “pay twice” — i.e., 
once for the cost of the off-site facility and again for the expense of its own 
facility.  It argued that because of the commission’s failure to address that 
consideration, its analysis is deficient.  The court of appeals was not persuaded, 
holding that the commission’s analysis was appropriate under Miller and the 
conclusion was supported by evidence.  The writ was denied. 
{¶ 5} The cause is now before this court on an appeal as of right. 
{¶ 6} We begin by clarifying that the issue in this case is not about a 
claimant’s free choice of doctors.  Contrary to Navistar’s representation, neither 
the commission nor the court below ruled – directly or inferentially – that 
Clifford’s physical-therapy request for treatment with Springfield Physical 
Therapy was granted because Clifford had an unfettered right to treatment 
January Term, 2006 
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anywhere and anytime.  The commission granted – and the court of appeals 
upheld – the motion because Clifford’s request satisfied the three-prong test in 
Miller. 
{¶ 7} The parties agree that Clifford’s request satisfies the first two 
prongs delineated in Miller, and they focus solely on the third prong:  whether, 
under the circumstances, the costs that Navistar has been ordered to assume are 
“medically reasonable.”  Navistar concedes that Clifford’s request of physical 
therapy from the Springfield Physical Therapy group, “when considered in a 
vacuum,” is medically reasonable.  Navistar proposes, however, that the cost of 
the services cannot be viewed in a vacuum and that the commission must balance 
the proposed costs against the employer’s own facility-related costs.  In other 
words, the commission must consider the fact that if Clifford’s request is granted 
as submitted, Navistar will effectively incur double the cost because it has already 
incurred the cost of creating its own facility and will now have to assume the cost 
for treatment at Springfield Physical Therapy as well. 
{¶ 8} Miller does not contain the requirement advocated by Navistar.  
Accordingly, the commission did not abuse its discretion in failing to consider 
Navistar’s facility-related costs.  Regarding the question of evidentiary support 
for the commission’s determination that Miller was satisfied, Dr. Nitz’s C-9 
motion for authorization of physical therapy at Springfield Physical Therapy 
supported the commission’s decision.  Although it is admirable that Navistar has 
voluntarily created its own facility to provide physical-therapy treatment to 
injured employees, it may not condition treatment authorization on an employee's 
agreement to use its facility rather than any other. 
{¶ 9} The judgment of the court of appeals is affirmed. 
Judgment affirmed. 
MOYER, C.J., RESNICK, PFEIFER, O’CONNOR, O’DONNELL and LANZINGER, 
JJ., concur. 
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LUNDBERG STRATTON, J., concurs separately. 
__________________ 
 
LUNDBERG STRATTON, J., concurring. 
{¶10} I concur in the majority’s decision because it follows what the law 
allows. 
{¶11} However, Navistar’s position is a valid one.  It seems to be a sound 
policy to encourage companies to establish on-site physical-therapy facilities for 
both the convenience of the employees and for cost savings to the employers and 
the workers’ compensation system.  But this court does not set Bureau of 
Workers’ Compensation policy.  Navistar’s issues are more appropriately directed 
to the legislature.  Current law simply applies three tests, which the claimant 
satisfied.  Therefore, I concur in the decision of this court.  
__________________ 
Vorys, Sater, Seymour & Pease, L.L.P., Joseph A. Brunetto, and Gina R. 
Russo, for appellant. 
Jim Petro, Attorney General, and Dennis H. Behm, Assistant Attorney 
General, for appellee Industrial Commission. 
Robert Bumgarner, for appellee Thomas Clifford. 
Stewart Jaffy & Associates Co., L.P.A., Stewart R. Jaffy, and Marc J. 
Jaffy, urging affirmance for amicus curiae Ohio AFL-CIO. 
Philip J. Fulton Law Office, Philip J. Fulton, and William A. Thorman III, 
urging affirmance for amicus curiae Ohio Academy of Trial Lawyers. 
______________________