Title: State ex rel. Ross v. Indus. Comm.

State: ohio

Issuer: Ohio Supreme Court

Document:

[Cite as State ex rel. Ross v. Indus. Comm., 118 Ohio St.3d 73, 2008-Ohio-1739.] 
 
 
THE STATE EX REL. ROSS, APPELLANT, v. INDUSTRIAL  
COMMISSION OF OHIO ET AL., APPELLEES. 
[Cite as State ex rel. Ross v. Indus. Comm., 118 Ohio St.3d 73, 2008-Ohio-
1739.] 
Workers’ compensation—R.C. 4123.57(A)—Increase in compensation for 
permanent partial disability—Changed circumstances. 
(No. 2007-1007 – Submitted March 25, 2008 – Decided April 16, 2008.) 
APPEAL from the Court of Appeals for Franklin County,  
No. 06AP-560, 2007-Ohio-2215. 
__________________ 
Per Curiam. 
{¶ 1} At issue is the denial of appellant Anita Ross’s application for 
permanent partial disability compensation (“PPD”).  Ross sustained a lumbar 
sprain on January 21, 2002.  She missed minimal time from work, and treatment 
was brief.  Nine days after her injury occurred, Ross reported that her pain was 
“98% better” and that she did not need further physical therapy or analgesics.  
There is no indication that she had any further treatment. 
{¶ 2} In mid 2004, Ross applied to the Bureau of Workers’ 
Compensation for a PPD award.  She did not, however, submit any medical 
evidence in support of her application.  The bureau had her examined by Dr. 
Lawrence A. Kale, who thought that Ross’s condition had completely resolved 
and left her with no permanent impairment.  The bureau, relying on Dr. Kale, 
found no impairment and made no award.  Ross objected, and the matter was set 
for hearing before a district hearing officer of appellee Industrial Commission of 
Ohio.  Ross again submitted no medical evidence, and the district hearing officer 
SUPREME COURT OF OHIO 
2 
accordingly found no impairment.  Ross apparently did not move for 
reconsideration. 
{¶ 3} Five months later, Ross moved for an increase in permanent partial 
disability.  This time, she submitted the report of Dr. Brian W. Marshall.  His 
report confirmed that Ross had had no treatment since that rendered in the first 
few days after the injury.  He did not refer to any recent exacerbation of the injury 
or any increase in alleged symptoms since Dr. Kale examined her.  Dr. Marshall 
concluded that she had an eight percent impairment. 
{¶ 4} Dr. Waleed Mansour reviewed the medical file at the bureau’s 
request.  Based on the findings of Dr. Marshall, Dr. Mansour assessed a five 
percent permanent partial impairment.  The bureau made a five percent award 
based on that report. 
{¶ 5} Ross again objected and submitted a second report from Dr. 
Marshall.  Having the same date as his previous report, the report was a verbatim 
copy of the earlier one with one exception — his assessment of impairment was 
now 11 percent instead of eight percent.  No reason was given for the increase. 
{¶ 6} A district hearing officer assessed five percent impairment based 
on Dr. Mansour’s findings.  Ross’s former employer moved for reconsideration.  
A staff hearing officer vacated the award and found a zero percent impairment: 
{¶ 7} “The Injured Worker previously filed a C-92 Application for 
Determination of Percentage of Permanent Partial Disability * * * and said 
Application was ruled upon by the Administrative Order of 10/14/2004.  Based 
upon the 9/10/2004 medical examination by Lawrence A. Kale, M.D., the 
Administrator * * * found that there was no Percentage of a Permanent Partial 
Disability resulting from the allowed [condition]. * * * 
{¶ 8} “Then, on 5/23/2005, the Injured Worker filed a C-92-A 
Application for a subsequent determination (increase) of Percentage of Permanent 
Partial Disability. 
January Term, 2008 
3 
{¶ 9} “However, under Ohio Revised Code Section 4123.57(B), the 
Injured Worker bears the burden of proving that there are ‘new and changed 
circumstances’ which have developed since the time of the hearing on the last 
determination of Percentage of Permanent Partial Disability, in order to obtain an 
increase in the Permanent Partial Disability award. 
{¶ 10} “The Injured Worker was previously examined, on 9/10/2004, by 
Edmund Wymyslo, M.D.  Dr. Wymyslo reviewed the Injured Worker’s medical 
records and noted that, ‘At the time of last treatment on 1/30/2002, she was found 
to be “98% better.”’  He also made note of the fact that, although she had been 
scheduled for physical therapy, she told the physical therapist that she was better 
and did not need physical therapy and was no longer taking pain medications.  
After further review of her medical records and the performance of a physical 
examination, Dr. Wymyslo stated his professional medical opinion that, ‘The 
claimant’s current complaints are, more probably than not, not related to the soft 
tissue injury resulting from the 2002 claim.’ 
{¶ 11} “It is the finding of this Staff Hearing Officer that the Injured 
Worker failed to meet her burden of proving ‘new and changed circumstances’ 
since the time of the prior hearing on the original C-92 Application * * *.  Two 
reports have been submitted by the Injured Worker, both from Brian W. Marshall, 
D.O., one indicating an 8% and the other indicating an 11% Percentage of 
Permanent Partial Disability.  However, both of those exams are word-for-word 
identical, except for the percentage stated.  Therefore, this Staff Hearing Officer 
does not find the opinion of Dr. Marshall to be persuasive, in light of the prior 
well-reasoned opinion of Edmund Wymyslo, M.D. 
{¶ 12} “* * * 
{¶ 13} “It is the further finding of this Staff Hearing Officer that the 
Injured Worker does not have any Permanent Partial Disability resulting from the 
residual of the allowed sprain * * *.”  (Emphasis sic.) 
SUPREME COURT OF OHIO 
4 
{¶ 14} Ross’s complaint for a writ of mandamus in the Court of Appeals 
for Franklin County was unsuccessful.  The court upheld the commission’s 
conclusion that no new and changed circumstances supported an increase. 
{¶ 15} Ross now appeals to this court as of right. 
{¶ 16} R.C. 4123.57(A) requires that an application for an increase in 
PPD be “supported by substantial evidence of new and changed circumstances 
developing since the time of the hearing on the original or last determination.” 
{¶ 17} Contrary to Ross’s representation, the mere submission of new 
evidence is not automatically a new and changed circumstance.  State ex rel. 
Keith v. Indus. Comm. (1991), 62 Ohio St.3d 139, 141-142, 580 N.E.2d 433; State 
ex rel. Poneris v. Indus. Comm., 111 Ohio St.3d 264, 2006-Ohio-5702, 855 
N.E.2d 1203. 
{¶ 18} The only medical evidence before the commission on Ross’s first 
application for PPD indicated that her condition had resolved.  She thus was 
required to demonstrate, in her second application, that something had changed — 
e.g., an exacerbation of her condition or the allowance of a new condition.  Ross 
did not do this.  She simply submitted the reports of a doctor who disagreed with 
Dr. Kale’s opinion.  Dr. Marshall’s reports do not indicate that Ross suffered a 
flare-up or even underwent renewed treatment, and Ross herself makes no such 
allegation.  There is nothing to indicate that Ross’s medical status is any different 
than it was eight months earlier when Kale saw her.  Marshall simply thinks she 
has an impairment.  The reports do no more than reflect disagreement between 
two examiners.  They do not show a new and changed circumstance. 
{¶ 19} Ross assails any reliance to Kale’s report, accusing the commission 
of reviving a stale report to deny her compensation.  That is not what the 
commission did.  Sometimes new and changed circumstances cannot be 
determined without knowing what the old circumstances were.  That is why the 
commission necessarily referred to Kale’s earlier report. 
January Term, 2008 
5 
{¶ 20} Ross cites Dr. Mansour’s report as evidence of new and changed 
circumstances, but her reliance is misplaced.  Mansour’s evaluation was based not 
on an examination of Ross but on a review of Dr. Marshall’s first report.  Because 
Dr. Marshall listed no new and changed circumstances, Dr. Mansour was 
precluded from reaching a different conclusion. 
{¶ 21} Finally, Ross criticizes the staff hearing officer’s repeated 
reference to a report from Dr. Edmund Wymyslo.  All parties agree that no such 
report exists, but contrary to Ross’s argument, this reference is not fatal.  
Information discussed in the order was taken verbatim from Dr. Kale’s report.  
The hearing officer referred to him repeatedly by the wrong name, but there is no 
doubt to whom, and to which report, the staff hearing officer was referring. 
{¶ 22} The judgment of the court of appeals is affirmed. 
Judgment affirmed. 
 
MOYER, 
C.J., 
and 
PFEIFER, 
LUNDBERG 
STRATTON, 
O’CONNOR, 
O’DONNELL, LANZINGER, and CUPP, JJ., concur. 
__________________ 
Bevan & Associates, L.P.A., Inc., Cindy Kobal, and Thomas W. Bevan, 
for appellant. 
Marc Dann, Attorney General, and Kevin J. Reis, Assistant Attorney 
General, for appellee. 
______________________