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

Citation: 2004-Ohio-737

Docket Number: 20030865

State: ohio

Court: Ohio Supreme Court

Date: 2004-03-03T00:00:00Z

Document:
[Cite as State ex rel. Josephson v. Indus. Comm., 101 Ohio St.3d 195, 2004-Ohio-737.] 
 
 
THE STATE EX REL. JOSEPHSON, APPELLEE, v. INDUSTRIAL COMMISSION OF 
OHIO; OHIO STATE UNIVERSITY, APPELLANT. 
[Cite as State ex rel. Josephson v. Indus. Comm., 101 Ohio St.3d 195, 
2004-Ohio-737.] 
Workers’ compensation — Industrial Commission’s denial of reinstatement of 
temporary total disability compensation after commission determined 
that claimant’s allowed conditions were at maximum medical 
improvement not an abuse of discretion, when — Claimant’s recovery 
from chemotherapy was not a new and changed circumstance that 
warranted a resumption of temporary total disability compensation while 
claimant participated in a rehabilitation program. 
(No. 2003-0865 — Submitted December 15, 2003 — Decided March 3, 2004.) 
APPEAL from the Court of Appeals for Franklin County, No. 02AP-823, 2003-
Ohio-1673. 
__________________ 
 
Per Curiam. 
{¶1} 
Appellee-claimant Sally Josephson sprained her low back at work 
on March 31, 1999.  A workers’ compensation claim was allowed, and temporary 
total disability compensation (“TTC”) was started.  In late 1999, claimant was 
diagnosed with cancer.  Surgery for that disease was performed in January 2000. 
{¶2} 
After her operation, claimant began a Bureau of Workers’ 
Compensation rehabilitation program, including a work-hardening program.  
After she began chemotherapy, she and the bureau agreed to suspend further 
rehabilitative efforts because of the ill effects of the therapy.  Claimant’s 
rehabilitation plan was accordingly closed on July 27, 2000. 
SUPREME COURT OF OHIO 
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{¶3} 
On August 23, 2000, claimant was examined by Dr. Akram 
Sadaka. He opined that claimant’s allowed conditions were at maximum medical 
improvement (“MMI”).  This prompted the bureau to move to terminate TTC, and 
the Industrial Commission of Ohio granted that request on November 7, 2000.  
The claimant did not appeal. 
{¶4} 
By February 2001, claimant had recovered from her chemotherapy 
and was cleared by her oncologist, Dr. Lynne A. Eaton, to begin an exercise 
program.  Claimant’s attending physician, Dr. William R. Adrion, followed up 
that release by asking the bureau to authorize a new work-hardening and exercise 
program with the goals of decreasing claimant’s pain and “increasing general 
function and physical capacities.”  That request was approved on September 12, 
2001. 
{¶5} 
Shortly thereafter, claimant moved the bureau for reinstatement of 
TTC.  The matter was eventually referred to the commission.  Among the 
evidence before the commission was a February 6, 2001 C-84 physician’s report 
from Dr. Adrion, which indicated that claimant had not achieved MMI. There 
were also, however, his office notes dated February 6, 2001, March 7, 2001, and 
March 23, 2001, which stated that when viewed against her previous history, 
claimant’s back condition had remained unchanged. 
{¶6} 
A district hearing officer’s award of TTC was reversed on appeal.  
In reversing, the staff hearing officer wrote: 
{¶7} 
“The Staff Hearing Officer does not find new and changed 
circumstances exist which would support a new period of temporary total 
compensation beginning 02/01/2001.  The Staff Hearing Officer relies on the 
following.  The allowances of this claim were found to have reached maximum 
medical improvement per an 11/07/2000 District Hearing Officer order * * * 
[based on] Dr. Sadaka’s 08/23/2000 narrative report.  The claimant had treatment 
in 2000 for cancer (specifically chemotherapy).  Dr. Adrion certifies the claimant 
January Term, 2004 
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as being totally disabled as of 02/01/2001 per a C-84 dated 02/06/2001. * * * 
There are no new and changed findings or circumstances set forth on the C-84 
dated 02/06/2001. * * *  [A] 02/06/2001 office note of Dr. Adrion indicates ‘no 
changes,’ [and that] the claimant is having a lot of back pain, feels weak if she 
tries to do anything and wants to try physical therapy again to strengthen her back 
muscles again. * * *  The claimant argues that the fact that her cancer treatments 
ended and she was released to an exercise program on 02/20/2001 (by Dr. Eaton) 
amounts to new and changed circumstances.  The Staff Hearing Officer does not 
find further conservative treatment of a 1999 lumbar sprain adequately supports a 
finding of new and changed circumstances.  The Staff Hearing Officer finds 
additional conservative treatments of 1999 soft tissue injuries do not support a 
new period of temporary total compensation.” 
{¶8} 
Further appeal was refused. 
{¶9} 
The claimant petitioned the Court of Appeals for Franklin County 
for a writ of mandamus, alleging that the commission had abused its discretion in 
denying TTC.  The court of appeals agreed, finding that claimant’s recovery from 
chemotherapy was a new and changed circumstance that warranted a resumption 
of TTC while claimant participated in the rehabilitation program. 
{¶10} The cause is now before this court upon an appeal as of right. 
{¶11} MMI is “a treatment plateau (static or well-stabilized) at which no 
fundamental functional or physiological change can be expected within 
reasonable medical probability in spite of continuing medical or rehabilitative 
procedures.  A claimant may need supportive treatment to maintain this level of 
function.” Ohio Adm.Code 4121-3-32 (A)(1). 
{¶12} The parties contest neither the initial MMI declaration nor the 
principle that TTC can be reinstated notwithstanding that declaration, should new 
and changed circumstances demand.  See State ex rel. Bing v. Indus. Comm. 
(1991), 61 Ohio St.3d 424, 575 N.E.2d 177.  They instead debate the sufficiency 
SUPREME COURT OF OHIO 
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of the changed circumstance in this case to compel renewed TTC.  For the reasons 
to follow, we find that the new and changed circumstance is insufficient to 
compel further TTC. 
{¶13} Unquestionably, claimant’s situation changed after MMI was 
assessed:  she recovered from chemotherapy.  But as the employer argues, not 
every new occurrence merits reinstatement of TTC. 
{¶14} For example, in Bing, the claimant’s condition temporarily 
worsened after MMI had been declared.  We renewed TTC, reasoning that during 
the flare-up, claimant was not at MMI, and until she regained that level, she 
should be compensated with TTC. 
{¶15} We reached the same result in State ex rel. Conrad v. Indus. 
Comm. (2000), 88 Ohio St.3d 413, 727 N.E.2d 872, and State ex rel. Value City 
Dept. Stores v. Indus. Comm., 97 Ohio St.3d 187, 2002-Ohio-5810, 777 N.E.2d 
249.  Conrad described Bing as “recogniz[ing] that claimants who had previously 
been declared as MMI could experience temporary exacerbation of their condition 
that justified further treatment or even temporary total disability compensation, as 
the claimant struggled to recover his or her previous level of well-being.”  88 
Ohio St.3d at 415-416, 727 N.E.2d 872.  Similarly, the claimant in Value City 
experienced a medical deterioration when the leads on her injury-related nerve 
stimulator failed.  This worsening, combined with the favorable prognosis for 
improvement once those leads were replaced, was enough to resume TTC despite 
an earlier declaration of MMI. 
{¶16} These cases establish that, to date, the only new and changed 
circumstance sufficient to re-entitle a worker to TTC is the worsening of the 
claimant’s allowed conditions accompanied by a prognosis that the worsening is 
only temporary.  The commission in this case ruled that the claimant’s allowed 
condition had not worsened after MMI was declared.  There was some evidence 
to support this conclusion, and claimant does not seriously contest it. 
January Term, 2004 
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{¶17} Claimant instead asks us to expand what constitutes new and 
changed circumstances sufficient to reinstate TTC.  We decline to do so here.  We 
recognize that there are many legitimate reasons for interrupting medical 
treatment.  It is questionable, however, whether the court of appeals’ rationale 
would have the same appeal if the reason for interruption of claimant’s treatment 
had been, for example, the need to recover from cosmetic surgery or childbirth or 
relocation to a new home.  In each case, both the cessation and resumption of 
treatment would be unrelated to any change in the allowed conditions.  Unless 
there is a worsening of an allowed condition, a mere prospect of improvement 
beyond the level previously declared MMI will not justify a new recognition of 
temporary total disability. 
{¶18} We, therefore, hold that claimant’s change in situation is 
insufficient to warrant renewed TTC.  Absent a worsening of claimant’s allowed 
condition, she is in effect saying no more than that the earlier declaration of MMI 
was premature.  That, however, is a matter that—when given the opportunity—
claimant chose not to appeal. 
{¶19} The judgment of the court of appeals is reversed, and the 
commission’s order is reinstated. 
Judgment reversed. 
 
MOYER, 
C.J., 
PFEIFER, 
LUNDBERG 
STRATTON, 
O’CONNOR 
and 
O’DONNELL, JJ., concur. 
 
RESNICK and F.E. SWEENEY, JJ., dissent and would affirm the court of 
appeals. 
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Kennedy & Colasurd Co., L.P.A., and Michael D. Colasurd, for appellee. 
Kegler, Brown, Hill & Ritter, L.L.P., Timothy T. Tullis and David M. 
McCarty, for appellant. 
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