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

State: ohio

Issuer: Ohio Supreme Court

Document:

[Cite as State ex rel. Sachdeva v. Indus. Comm., 102 Ohio St.3d 178, 2004-Ohio-2264.] 
 
 
THE STATE EX REL. SACHDEVA, APPELLANT, v. INDUSTRIAL COMMISSION OF 
OHIO APPELLEE, ET AL. 
[Cite as State ex rel. Sachdeva v. Indus. Comm., 102 Ohio St.3d 178, 2004-
Ohio-2264.] 
Workers’ compensation — Living maintenance wage-loss compensation benefits 
awarded claimant — Overpayment due to claimant’s employment — 
Industrial Commission declares an overpayment and that claimant 
committed fraud — Writ of mandamus sought by claimant denied by 
court of appeals — Court of appeals’ judgment finding claimant 
committed fraud and received more compensation than entitled affirmed. 
(No. 2003-1557 — Submitted March 30, 2004 — Decided May 19, 2004.) 
APPEAL from the Court of Appeals for Franklin County, No. 02AP-1299, 2003-
Ohio-3818. 
__________________ 
Per Curiam. 
{¶1} 
Appellant-claimant, Ashwani K. Sachdeva, injured his right wrist 
on July 22, 1993, while employed as a fabric cutter for Morning Pride 
Manufacturing, Inc.  After a workers’ compensation claim was allowed, he 
entered a rehabilitation program and began receiving living maintenance benefits. 
{¶2} 
After completing the rehabilitation program, claimant found work 
with Gem One Corporation as a salesperson.  He then began receiving living 
maintenance wage-loss (“LMWL”) compensation as set forth in a letter from the 
Bureau of Workers’ Compensation:   
{¶3} 
“[Y]our eligibility has been established to receive rehabilitation 
Living Maintenance Wage Loss payments.  Return to work data have been 
reported to the claims representative handling your claim.  To remain eligible, you 
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must be engaged in gainful employment earning at least $272.00 biweekly (based 
on a 32 hour work week) or $1768.00 per quarter (and no less than $136.00 
biweekly if approved for part-time employment). 
{¶4} 
“It is your responsibility to submit a completed C-94A (Wage 
Statement form) along with a copy of the RH-18 to the Bureau of Workers’ 
Compensation * * * to start L.M. Wage Loss payments.  * * *    
{¶5} 
“The BWC will calculate the difference between the greater of 
your full weekly wage or average weekly wage and your new salary, and will pay 
you 66 2/3 % up to a maximum per week equal to the statewide average weekly 
wage.  Payments may continue for up to a maximum of 200 weeks, but shall be 
reduced by the corresponding number of weeks in which you receive payments 
pursuant to Division (B) of the Ohio Revised Code, Section 4123.56.” 
{¶6} 
Claimant submitted the forms as required, and from June 7, 1998, 
through October 25, 1998, he listed Gem One as his sole employer.  An 
anonymous tip to the bureau, however, sparked an investigation that revealed that 
claimant was also working a second job as a fabric cutter with Fred J. Miller, Inc.  
A Miller supervisor reported that claimant had specifically asked that his name 
not be listed on the company payroll and that his earnings be included in his 
wife’s paycheck, as she also worked for Miller.  The arrangement was agreed 
upon, and claimant, in submitting his LMWL forms to the bureau, consistently 
averred that his earnings at Gem One accurately reflected his total income for the 
period. 
{¶7} 
As a result of his nondisclosure, claimant received more LMWL 
compensation than was justified.  The bureau moved appellee, Industrial 
Commission of Ohio, for declarations of fraud and overpayment.  The 
commission granted the bureau’s request and declared an overpayment of all 
LMWL paid from June 7, 1998, through October 25, 1998.  It also found that 
claimant had committed fraud. 
January Term, 2004 
3 
{¶8} 
Objecting to both findings, claimant turned to the Court of Appeals 
for Franklin County, seeking a writ of mandamus.  The court of appeals concurred 
in the commission’s analysis and upheld its order, prompting claimant’s appeal to 
this court as of right. 
{¶9} 
Claimant does not dispute that he concealed from the bureau that 
he had earned income from Fred J. Miller, Inc., and that as a result, he had 
received more compensation than he was entitled to.  Claimant also does not 
dispute that he had a duty to reveal his income from Miller.  To these two salient 
facts claimant is nonresponsive, focusing instead on the LMWL eligibility of 
claimants engaging in duties compatible with the former position of employment.  
He does not seem to grasp that even if his Miller employment did not foreclose 
LMWL compensation, he still lied to the bureau about his income and, as a result, 
received a higher benefit amount than was justified.  We thus concur in the 
commission’s declaration of fraud, finding that the elements of fraud, as set forth 
in Gaines v. Preterm-Cleveland, Inc. (1987), 33 Ohio St.3d 54, 514 N.E.2d 709, 
were met. 
{¶10} This leaves the issue of the amount of overpayment.  The 
commission vacated the entire award over the disputed period.  Claimant argues 
that some weeks during the disputed time he made less than he had before his 
injury, even when the undisclosed income is included.  He therefore advocates 
that he was overpaid $930.84, not $4,836.40, as calculated by the bureau.  
Claimant’s argument is meritless for two reasons. 
{¶11} First, claimant’s ability to perform the duties of his former position 
of employment, as demonstrated by his fabric-cutting job at Miller, did preclude 
claimant’s entitlement to LMWL compensation.  Claimant’s assertion to the 
contrary is based on his contention that a causal relationship between injury and 
diminished wages is not expressly stated in relevant Administrative Code and 
Revised Code sections and is, therefore, not required.  We disagree.  Causal 
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relationship between injury and wage loss is the cornerstone of the workers’ 
compensation system, and it does not exist in a LMWL situation in which a 
claimant is medically capable of resuming his former job duties.  A return to the 
former job would eliminate the wage loss.  When a claimant could return but does 
not, any diminished earnings are related to a personal decision, not a medical one. 
{¶12} Second, the overpayment in this case did not result from mistake or 
inadvertence.  It was due to claimant’s deliberate withholding of  information 
from the bureau.  When overpayment has been precipitated by a claimant’s 
concealment of activities that would affect compensation eligibility, we have 
routinely affirmed the commission’s determination of  overpayment, regardless of 
whether there was an accompanying fraud declaration.  In cases where allegedly 
totally disabled claimants have been caught working while drawing 
compensation, we have consistently upheld the commission’s decision to vacate 
the entire award – or much of it – even when intermittent employment has 
prevented the commission from pinpointing the exact dates of prohibited activity.  
In State ex rel. Alesci v. Indus. Comm., 97 Ohio St.3d 210, 2002-Ohio-5932, 777 
N.E.2d 835, for example, sporadic employment that claimant had concealed from 
the bureau was sufficient to invalidate an entire permanent total disability award 
subsequent to the first confirmed incident of employment.  An equally expansive 
declaration of overpayment was upheld in State ex rel. Kirby v. Indus. Comm., 97 
Ohio St.3d 427, 2002-Ohio-6668, 780 N.E.2d 275.  There, the claimant, who had 
been declared permanently totally disabled, began regularly performing paid 
home improvement and maintenance jobs in 1991.  Each year from 1997 through 
2000, he specifically denied to the bureau that he had engaged in any work, and 
he continued to deny that he had had sustained remunerative work until 
confronted with the evidence against him.  Id. at ¶ 5-6.  Again, despite the 
bureau’s inability to identify the dates on which he had worked, we affirmed the 
commission’s finding of overpayment of all compensation paid after 1991. 
January Term, 2004 
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{¶13} The present claimant, in effect, asks that we require the 
commission to do the very thing we declined to require of it in Kirby and Alesci:  
pick through records from the relevant time frame and assess overpayment only 
for those weeks that he profited from his dishonesty.  We refuse. 
{¶14} The judgment of the court of appeals is affirmed. 
Judgment affirmed. 
 
MOYER, C.J., RESNICK, F.E. SWEENEY, PFEIFER, LUNDBERG STRATTON, 
O’CONNOR and O’DONNELL, JJ., concur. 
___________________ 
 
Thompson, Meier & Dersom and Adam H. Leonatti, for appellant. 
Jim Petro, Attorney General, and Gerald H. Waterman, Assistant Attorney 
General, for appellee. 
__________________