Title: State ex rel. Kroger Co. v. Morehouse

State: ohio

Issuer: Ohio Supreme Court

Document:

The State ex rel. Kroger Company, Appellant, v. Morehouse; Industrial 
Commission of Ohio, Appellee. 
[Cite as State ex rel. Kroger Co. v. Morehouse (1995), _____ Ohio St. 3d 
_____.] 
Workers’ compensation -- Award of temporary total disability 
compensation for two disputed periods -- Industrial Commission 
abuses its discretion in awarding compensation for one of the 
periods when no evidence supports the award of temporary total 
disability compensation. 
 
 
(No. 94-879--Submitted October 10, 1995--Decided November 29, 
1995.) 
 
Appeal from the Court of Appeals for Franklin County, No. 93AP-
272. 
 
Claimant, Susan C. Morehouse, was injured in the course of and 
arising from her employment with appellant, Kroger Company.  She 
received intermittent temporary total disability compensation until 
approximately October 15, 1990 when she quit Kroger, allegedly to take 
another job.  Her employment with Eagle Buckeye Corporation was 
confirmed as being from February 22, 1991 through July 19, 1991. 
 
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On May 14, 1992, attending physician Dr. Maged Hanna saw 
claimant for the first time since September 1991.  In a May 20, 1992 C84 
“physician’s report supplemental,” he stated that claimant had been 
temporarily and totally disabled since July 22, 1990, and would be able to 
return to her former position of employment on December 31, 1992.  That 
form was followed by a C85A claim reactivation application that requested, 
among other things, temporary total disability compensation from October 
14, 1990 to December 31, 1992. 
 
On June 19, 1992, a district hearing officer for appellee, Industrial 
Commission of Ohio, denied temporary total disability compensation 
because: 
 
“(A)  Medical evidence in file from claimant’s physician (DL [sic] 
Hanna) has described claimant’s condition as ‘chronic.’  This is notable in 
light of the minimal treatment evident in this claim which leads the District 
Hearing Officer to reasonably conclude that claimant’s condition has 
remained static over the recent past and that temporary total compensation 
is, therefore, inappropriate in this claim.   
 
3
 
“(B)  The period of temporary total compensation requested is 
disproportionately long when considering the quality (i.e. probativeness) of 
the medical evidence in file.  As noted in item (A) above, there has been 
minimal treatment in this claim and related to this, a lack of sufficient 
narrative medical evidence to adequately support a request for temporary 
total compensation in this regard[.]  [T]he District Hearing Officer found 
neither claimant’s testimony nor Dr. Hanna’s 6-9-92 report [a letter stating 
that claimant had not been in Hanna’s office from September 1991 to May 
1992] to be persuasive.” 
 
Ten days later, Dr. Hanna wrote: 
 
“This letter is being written * * * to further elucidate Susan 
Morehouse’s condition.  Ms. Morehouse has been treated by me since July 
22, 1990 * * *.  Since that period of time, Ms. Morehouse has received 
physical therapy, traction, trial of TENS unit therapy, and multiple 
medications with transient improvement.  She currently exhibits spasm, 
tenderness and significant restriction of motion of her posterior neck 
musculature.  Her neurovascular status of the upper extremities is 
completely intact.  She has mildly decreased range of motion of her lower 
 
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lumbar spine with minimal spasm, but again, neurovascular exam of the 
lower extremities is completely normal.  Her diagnoses have not changed 
since treatment was initiated. 
 
“Ms. Morehouse[’s] condition has left her with unrelenting pain and 
disabling headaches.  Because of this, she has been unable to sustain work 
on even a part-time basis. With aggressive therapy using multiple modalities 
Ms. Morehouse has been shown to remain functional; certainly her 
condition is not ‘static.’  It should be noted that Ms. Morehouse is otherwise 
a healthy, motivated young woman who desires to enter the work force.  I 
truly believe that she would greatly benefit from a work hardening program 
to allow her to re-enter the work force; this was requested in the past but 
refused.  Until this multi-disciplinary treatment is initiated, I feel Ms. 
Morehouse still has not reached maximal medical improvement and is still 
unable to return to any sort of meaningful employment.”  (Emphasis sic.) 
 
Based on this letter, claimant’s counsel filed a C86 motion that asked 
that the commission “reconsider the order of the [district hearing officer] 
dated 6-26-92 denying Claimant’s request for temporary total 
compensation.”  That motion contains this notation: 
 
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“Construe As An Appeal -- Send to Regional Board [of Review]. 
 
“D. Binkovitz * * * Staff Hearing Officer 7/14/92.” 
 
On August 5, 1992, Dr. Hanna completed another C84 that certified 
claimant had been temporarily and totally disabled from July 22, 1990, and 
would be able to return to her former position of employment on December 
31 1992.  The C84 was presented the next day to the regional board of 
review.  The regional board apparently continued the matter, for in 
ultimately awarding temporary total disability compensation, the board 
relied in part on the September 30, 1992 report of Dr. H. Tom Reynolds, 
who certified a temporary inability to return to the former position of 
employment.  Specifically, the board wrote: 
 
“That portion of the order which denied all temporary total 
compensation requested is hereby vacated. 
 
“Temporary total compensation is awarded from October 14, 1990 
through February 21, 1991, and from February 22, 1991 through September 
25, 1992 and to continue upon submission of appropriate medical proof, not 
to exceed the statutory maximum. 
 
6
 
“This portion of the decision and order is based on the reports and C-
84’s of Dr. Maged Hanna, the letter of Robert C. Aivarzian of Eagle 
Buckeye Corporation dated June 3, 1992, testimony at hearing, and the 
specialist report of Dr. H. Tom Reynolds, who concluded, based on his 
September 25, 1992 examination of the claimant that: 
 
“* * * 
 
“From the physical medicine standpoint concerning the allowed 
conditions in the claim, it is my opinion that this claimant continues to have 
an impairment that is temporary in nature.  I do not feel she could perform 
her regular work duties at this time, and this inability is temporary, as I do 
feel she has a good potential to return to her previous level of employment 
and job requirements.  I would strongly recommend and agree with Dr. 
Hanna that she could benefit from work hardening and would recommend a 
referral from the Rehabilitation Division for participation in their 
programming.  I would not recommend continued long-term use of Valium 
medication for management.  I would recommend re-evaluation of the 
claimant within the next four to six months to determine her level of 
impairment at that time and response to work hardening should she elect to 
 
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participate and be found to be an appropriate candidate.  I do not feel she 
has experienced maximum recovery from the physical medicine standpoint 
and could benefit from referral to rehabilitation.” 
 
Staff hearing officers modified the regional board, stating that: 
 
“* * * [The] employer’s appeal be granted, and the order of the 
Regional Board be modified to the extent of this order. 
 
“Temporary total compensation is denied for the period of 2/22/91 
through 7/19/91, as claimant worked for a different employer during this 
time. 
 
“In all other aspects that order of the Regional Board is affirmed.” 
 
Kroger filed a complaint in mandamus in the Court of Appeals for 
Franklin County, alleging that the commission abused its discretion in 
awarding temporary total disability compensation.  The appellate court, in a 
split decision, disagreed, finding “some evidence” in support of the 
commission’s order.  Judge Deshler, in dissent, essentially found no 
evidence supporting the award of temporary total disability compensation. 
 
This cause is now before this court upon an appeal as of right. 
______________ 
 
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Porter, Wright, Morris & Arthur, Charles J. Kurtz III and 
Christopher C. Russell, for appellant. 
 
Betty D. Montgomery, Attorney General, and William J. McDonald, 
Assistant Attorney General, for appellee. 
______________ 
 
Per Curiam. 
 
There are two disputed periods of temporary total disability 
compensation awards: October 14, 1990 through February 21, 1991; and 
July 20, 1991 to December 31, 1992.  Kroger objects both procedurally and 
substantively to the awards.  We sustain these objections in part, and the 
appellate judgment is reversed in part and affirmed in part. 
 
Procedurally, Ohio Adm. Code 4123-3-18(A)(4) states: 
 
“(A)  Administrative appeals 
 
“* * * 
 
“(4)  Appeal (also called ‘Notice of Appeal’) should be made on form 
OIC 3000, formerly I-12, or as provided by rules of the industrial 
commission.  ‘Notice of Appeal’ shall state the names of the claimant and 
 
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the employer, the number of the claim, the date of the decision appealed 
from and the fact that the appellant appeals therefrom.” 
 
Ohio Adm. Code 4123-3-16 also reads: 
 
“(A)  Form C-86 shall be used to present motions to the bureau or 
commission. 
 
“(B)  Motions may be submitted by the employee or the employer to 
seek a determination by the  bureau or the commission on any matter not 
otherwise provided for in these rules.  It is appropriate to file a motion in 
order to secure allowance of a disability or condition not previously 
considered in a claim.  In no event should a motion be used as a substitute 
for an appeal, an application to reactivate a claim, an application for the 
determination of the percentage of permanent partial disability, or an 
application to increase an award of percentage of permanent partial 
disability.”  (Emphasis added.) 
 
Claimant’s counsel did not use form OIC 3000 to contest the district 
hearing officer’s initial temporary total disability compensation denial.  She 
instead used a C86 to request further administrative review.  Because 
 
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claimant did not use the proper form, Kroger claims that the commission 
erred in treating claimant’s motion as an appeal.  We disagree. 
 
Kroger correctly states that an administrative agency cannot ignore its 
own rules.  At the same time, R.C. 4123.95 directs that the Workers’ 
Compensation Act be construed liberally in favor of employees.  Weighing 
these competing concerns, the appellate court referee -- utilizing reasoning 
that the appellate majority adopted -- stated: 
 
“Such a narrow construction, however, is overridden by the equally 
compelling principle contained in R.C. 4123.95 that the workers’ 
compensation law shall be liberally construed in favor of employees.  A 
liberal construction does not permit a claimant substantive entitlement to 
benefits to be defeated by technical reading of procedural rules, particularly 
where the C-86 motion was served on relator’s counsel and relator was 
represented at the hearing on claimant’s ‘appeal’ at the regional board.  
Under these circumstances, relator has not demonstrated material prejudice 
resulting from any of the procedural defects alleged which would amount to 
an abuse of discretion.” 
 
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It is clear from the document itself that claimant was seeking further 
administrative review of her request for temporary total disability 
compensation.  Applying R.C. 4123.95, we find that the commission did not 
abuse its discretion in construing claimant’s C86 as it did.  See State ex rel. 
Gen. Refractories Co. v. Indus. Comm. (1989), 44 Ohio St. 3d 82, 541 N.E. 
2d 52. 
 
Turning to the compensation award itself, the commission awarded 
temporary total disability compensation based on the reports of Drs. Hanna 
and Reynolds.  Because Dr. Reynolds examined claimant just once, on 
September 25, 1992, his report is not probative of claimant’s condition 
before then.  See State ex rel. Case v. Indus. Comm. (1986), 28 Ohio St.3d 
383, 28 OBR 442, 504 N.E. 2d 30.  Consequently, the report is not “some 
evidence” supporting temporary total disability compensation prior to 
September 25, 1992.  It is, however, “some evidence” supporting temporary 
total disability after that date. Therefore, the award of temporary total 
disability compensation from September 25, 1992 to December 31, 1992 is 
defensible. 
 
12
 
Prior to September 25, 1992, compensation eligibility rests 
exclusively with Dr. Hanna.  Upon review, we find that neither his narrative 
reports nor C84 forms are “some evidence” supporting an award of 
temporary total disability compensation. 
 
Over the period in which temporary total disability compensation was 
requested, two segments of time are particularly noteworthy.  The first 
covers September 1991 to May 1992, during which time Dr. Hanna, by his 
own admission, did not see the claimant.  The second is February 22, 1991 
through July 19, 1991, when claimant was actually working. 
 
The lengthy period during which Dr. Hanna had no patient contact 
casts considerable doubt on the reliability of his certification of temporary 
total disability over that period, but, in and of itself, does not invalidate his 
certification in its entirety.  However, when combined with the fact that 
claimant actually worked during part of the certification period, we find Dr. 
Hanna’s certification to be too flawed to support the payment of temporary 
total disability compensation over any of the disputed periods prior to 
September 25, 1992. 
 
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Accordingly, that portion of the court of appeals’ judgment that found 
“some evidence” supporting the award of temporary total disability 
compensation from September 25, 1992 to December 31, 1992 is affirmed.  
The rest of the judgment is reversed. 
Judgment affirmed in part 
and reversed in part. 
 
MOYER, C.J., DOUGLAS, WRIGHT, PFEIFER and COOK, JJ., CONCUR. 
 
RESNICK, J., dissents in part and would affirm the judgment of the 
court of appeals in its entirety. 
 
F.E. SWEENEY, J., dissents and would affirm the court of appeals in 
toto.