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

Citation: 1998-Ohio-685

Docket Number: 19961393

State: ohio

Court: Ohio Supreme Court

Date: 1998-12-02T00:00:00Z

Document:
THE STATE EX REL. DIROSA, APPELLANT, v. INDUSTRIAL COMMISSION OF OHIO, 
APPELLEE. 
[Cite as State ex rel. DiRosa v. Indus. Comm. (1998), ___ Ohio St.3d ___.] 
Workers’ compensation — Denial of wage-loss compensation by Industrial 
Commission an abuse of discretion, when. 
(No. 96-1393 — Submitted October 13, 1998 — Decided December 2, 
1998.) 
APPEAL from the Court of Appeals for Franklin County, No. 95APD02-193. 
 
In December 1991, appellant-claimant, Michael F. DiRosa, Jr., held two 
jobs, one as a full-time self-employed insurance agent and the other as an “on-
call” fireman/EMT for the Bath Township Fire Department.  On December 6, 
1991, claimant was responding to a fire call when he struck a car that had turned 
in front of him. As a result of the injuries arising therefrom, appellee, Industrial 
Commission of Ohio, allowed a workers’ compensation claim for “cervical, 
thoracic and lumbar sprain/strain.” 
 
As a result of his injuries, claimant was permanently restricted by attending 
physician Dr. James F. Grow, Jr., from doing heavy lifting, which prevented 
claimant from returning to his fireman/EMT job.  Dr. Grow also prescribed a 
gradual return to work for claimant to full-time insurance duties.  On March 15, 
1992, claimant was “released [to work] as ins. agent—3 hours/day light office 
duties.”  In June 1992, he was released to perform “light outside sales [and] * * * 
office duties,” not to exceed six hours per day.  In 1993, claimant was released to 
work seven hours per day of “nearly full outside sales [and] * * * office duties.”  
Finally, in an April 25, 1994 letter, Dr. Grow indicated that claimant was “able to 
work no more than 8 hours a day as an insurance agent,” due to the chronicity of 
his allowed conditions. 
 
2
 
Claimant eventually moved the commission for wage-loss compensation 
pursuant to R.C. 4123.56(B).  Claimant submitted medical evidence from Dr. 
Grow that documented claimant’s physical restrictions as well as his income 
information from both employers.  A commission district hearing officer denied 
claimant’s motion, writing: 
 
“It is the finding of the District Hearing Officer that the Claimant did not 
present sufficient probative evidence of Wage Loss Compensation to justify an 
award from 3-15-92 to the present (1-25-94). 
 
“Therefore, Wage Loss Compensation form [sic ] the above period is 
denied.” 
 
A staff hearing officer affirmed that order on March 31, 1994 as follows: 
 
“The order of the District Hearing Officer, dated 1-25-94[,] is affirmed. 
 
“Prior to the within injury, claimant had full-time employment as a self-
employed insurance agent and also worked ‘on-call’ as a fireman/EMT for the 
within named employer.  Claimant responded to fires/emergencies by beeper, had 
a few other duties, and was primarily compensated in that job for the calls to 
which he responded. 
 
“Claimant was released to return to work as a self-employed insurance agent 
(C-84 report of Dr. Grow) and, therefore, is not eligible for wage loss 
compensation for loss of earnings due to being unable to return to that 
employment.  Claimant testified at hearing that he had not increased his labors as 
an insurance agent in order to attain [sic ] any of the lost earnings from his 
fireman’s position, nor did he seek other employment within his physical 
capabilities to replace lost income from the fireman/EMT position.  Therefore, the 
Hearing Officer finds claimant did not make a good faith effort to seek 
employment within his physical capabilities.” 
 
3
 
Claimant filed a complaint in mandamus in the Court of Appeals for 
Franklin County, alleging that the commission abused its discretion in denying 
wage-loss compensation.  The court of appeals disagreed and denied the writ. 
 
This cause is now before this court upon an appeal as of right. 
__________________ 
 
Michael I. Shapero & Associates and John P. McGinnis, for appellant. 
 
Betty D. Montgomery, Attorney General, Miltina A. Gavia and Cordelia A. 
Glenn, Assistant Attorneys General, for appellee. 
__________________ 
 
Per Curiam.  R.C. 4123.56(B) provides: 
 
“Where an employee in a claim allowed under this chapter suffers a wage 
loss as a result of returning to employment other than his former position of 
employment or as a result of being unable to find employment consistent with the 
claimant’s physical capabilities, he shall receive compensation at sixty-six and 
two-thirds per cent of his weekly wage loss not to exceed the statewide average 
weekly wage for a period not to exceed two hundred weeks.” 
 
Additionally, Ohio Adm.Code  4121-3-32(D) states: 
 
“In injury claims in which the date of injury * * * is on or after August 22, 
1986, the payment of compensation [f]or wage loss pursuant to division (B) of 
Section 4123.56 of the Revised Code shall commence upon application with the 
finding of any of the following: 
 
“(1) The employee as a direct result of the allowed conditions in the claim, 
returns to employment other than his former position of employment and suffers a 
wage loss. 
 
“(2) The employee returns to his former position but suffers a wage loss. 
 
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“(3) The employee, as a direct result of the allowed conditions in the claim, 
is unable to find work consistent with the employee’s physical capabilities and 
suffers a wage loss.” 
 
To prevail on his claim, a claimant must demonstrate an actual wage loss 
that is causally related to his or her injury.  State ex rel. Watts v. Schottenstein 
Stores Corp. (1993), 68 Ohio St.3d 118, 623 N.E.2d 1202.  Therefore, voluntary 
acts by a claimant that limit income can foreclose wage-loss compensation.  State 
ex rel Pepsi-Cola Bottling Co. v. Morse (1995), 72 Ohio St.3d 210, 648 N.E.2d 
827. 
 
The commission, in this case, found a voluntary limitation of income, citing 
claimant’s failure to replace his lost fireman/EMT wages by “increased labors” in 
his insurance business or elsewhere.  Fatal to this reasoning, however, is the 
commission’s inherent assumption that claimant was medically capable of 
increasing his labors.  The commission does not dispute claimant’s description of 
his insurance agent position as having “minimal physical demands.”  Dr. Grow 
nevertheless concluded that claimant’s allowed conditions were such that a 
restriction in the number of hours that claimant could do such work was necessary.  
Since there is no evidence that claimant was working fewer hours than the 
maximum medically permitted, the commission abused its discretion in expecting 
claimant to devote more hours to either his insurance business or any other 
employment. 
 
Accordingly, we reverse the judgment of the court of appeals and return the 
cause to the commission with instructions that it vacate its denial of wage-loss 
compensation, determine the dates over which such compensation is payable, and 
issue an appropriate order. 
Judgment reversed 
 
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and cause returned. 
 
DOUGLAS, RESNICK, F.E. SWEENEY and PFEIFER, JJ., concur. 
 
MOYER, C.J., COOK and LUNDBERG STRATTON, JJ., dissent. 
__________________ 
 
LUNDBERG STRATTON, J., dissenting.  I respectfully dissent.  I do not find 
Dr. Grow’s opinion conclusive that DiRosa is unable to work at any employment 
longer than eight hours per day.  Therefore, I agree with the court of appeals that 
this claimant failed to prove that he qualifies for wage-loss compensation as a 
result of his allowed conditions. 
 
The claimant suffers from a soft tissue injury.  Dr. Grow opined that DiRosa 
is medically restricted from any heavy lifting, but that he is capable of returning to 
his job as an insurance agent.  Dr. Grow’s additional statement that DiRosa “is 
able to work no more than 8 hours a day as an insurance agent” is conclusory and 
unsubstantiated by the facts or medical evidence.  This is insufficient evidence that 
DiRosa is physically unable to perform any other types of employment in an effort 
to replace the income lost from his fireman/EMT position. 
 
Therefore, I would affirm the judgment of the court of appeals. 
 
MOYER, C.J., and COOK, J., concur in the foregoing dissenting opinion.