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

State: ohio

Issuer: Ohio Supreme Court

Document:

# 9926 
The State ex rel. Verbanek, Appellant, v. Industrial Commission of Ohio et 
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al., Appellees. 
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[Cite as State ex rel. Verbanek v. Indus. Comm. (1995), ______ Ohio 
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St.3d _____.] 
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Workers’ compensation -- Denial of request for payment for medical 
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services -- Evidence rejected by Industrial Commission may not later 
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be relied on to deny claim. 
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(No. 94-508 -- Submitted June 6, 1995 -- Decided August 30, 1995.) 
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Appeal from the Court of Appeals for Franklin County, No. 93AP-
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276. 
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Appellant-claimant, Edward Verbanek, was injured in 1987 while in 
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the course of and arising from his employment with respondent LTV Steel 
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Company.  His workers’ compensation claim was allowed for lumbosacral 
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myofascitis.  He missed approximately three months of work before 
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resuming his regular duties. 
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Claimant later applied to appellee, Industrial Commission of Ohio to 
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determine his percentage of permanent partial disability.  Among other 
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evidence before the commission was the report of Dr. George D. Boutouras.  
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He recited claimant’s history of pre-injury back problems as follows: 
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“1.  11/07/78-- Off work since October 25, 1978.  Injured his back 
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moving a refrigerator at home and was treated for ‘lumbosacral sprain.’  He 
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was treated by his private medical doctor for ‘acute lumbar myoscitis [sic].’   
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“2. 08/14/78-- Off work since July 12, 1978.  Treated for ‘lumbar 
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myositis.’  Injured on July 28, 1988 when he was ‘physically assaulted --  
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back injury from being kicked.’ 
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“3.  11/16/76 -- Left work because on November 3, 1976 he 
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‘wrenched his back when moving furniture.’ 
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“4.  05/13/74 -- Off work for 1 1/2 months because he ‘sprained his 
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back.’ 
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“5.  6/18/73 -- Left work because of ‘sore back, upper left’ he 
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sustained ‘playing volleyball at a picnic’ on July 17, 1973.” 
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Based on the lack of objective findings at the time of his examination, 
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Dr. Boutouras assessed a zero percent permanent partial impairment.  The 
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commission, however, on September 21, 1989,  made a fifteen-percent 
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award of permanent partial disability. 
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There is no evidence of, nor does claimant allege that there was any, 
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medical treatment for the next two years.  On October 3, 1991, however, 
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claimant filed a C85A claim reactivation form, seeking payment for medical 
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services rendered from September 9, 1991, as well as authorization for 
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continued treatment.  When asked if claimant’s “present disability [is] due 
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to the injury in this claim,” Gregg Battersby, D.C., who completed the form, 
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responded affirmatively. 
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A district hearing officer denied the request for payment of medical 
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services, stating: 
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“* * * there is insufficient medical proof to causally relate the 
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claimant’s current low back symptoms to the 05/05/87 industrial injury.  
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The District Hearing Officer notes that Dr. Boutouras’s 02/15/89 report 
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detailed the claimant’s history of low back problems beginning in 1974, 
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thirteen (13) years prior to the industrial injury.” 
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The order was administratively affirmed. 
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Claimant filed a complaint for a writ of mandamus in the Court of 
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Appeals for Franklin County, alleging that the commission abused its 
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discretion in denying authorization for payment of medical services.  The 
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court disagreed and denied the writ. 
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This cause is now before this court upon an appeal as of right. 
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_____________________ 
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Ben Sheerer Co., L.P. A., and Paula Goodwin, for appellant. 
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Betty D. Montgomery, Attorney General, and Gerald H. Waterman, 
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Assistant Attorney General, for appellee Industrial Commission. 
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Baughman & Associates Co., L.P.A., R. Patrick Baughman and 
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Sandra Becher Sommers, for appellee LTV Steel Company. 
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______________________ 
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Per Curiam.  One issue is presented: Is Dr. Boutouras’ report “some 
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evidence” supporting the denial of payment for medical services?  For the 
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reasons to follow, we find that it is not. 
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State ex rel. Zamora v. Indus. Comm. (1988), 45 Ohio St.3d 17, 19, 
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543 N.E.2d 87, 89, stated that “it [is] inconsistent to permit the commission 
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to reject * * * [a] report at one level, for whatever reason, and rely on it at 
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another.”  
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In this case, the commission expressly relied on Dr. Boutouras’ 
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report.  Two elements of that narrative are relevant -- his recitation of 
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claimant’s prior history and his assessment of zero-percent impairment.  The 
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latter was clearly rejected when the fifteen-percent award of permanent 
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partial disability was made, so it could not be relied upon later. 
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We recognize that the credibility of claimant’s recited history does 
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not depend on Boutouras’ impairment assessment and is, thus, in a sense, 
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severable from it.  However, even if the recited-history element of the report 
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was somehow preservable under an exception to Zamora, it would be 
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insufficient to sustain the commission’s decision.  We are not convinced 
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that the commission could have reached its decision without reliance upon 
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the zero-percent impaired assessment that eliminated claimant’s industrial 
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injury as a potential  source of claimant’s renewed back problems. 
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Finding that a crucial element of the commission’s reasoning is 
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unsupported by “some evidence,” the judgment of the court of appeals is 
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hereby reversed and the writ of mandamus is allowed.. 
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Judgment reversed 
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and writ allowed. 
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Moyer, C.J., Douglas, Resnick and F.E. Sweeney, JJ., concur. 
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Wright, Pfeifer and Cook, JJ., dissent. 
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State ex rel. Verbanek v. Indus. Comm. 
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WRIGHT, J., dissenting.  Unlike the majority, I believe there is “some 
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evidence” supporting the Industrial Commission’s decision to not reactivate 
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relator’s claim.  Consequently, I dissent to the majority’s decision to reverse 
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the court of appeals and grant a writ of mandamus in this case. 
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In deciding whether to reactivate relator’s claim, the commission had 
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before it the report of Dr. George D. Boutouras.  As noted by the majority, 
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Dr. Boutouras’ report consisted of two parts.  First, it recited relator’s 
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history of back problems.  Second, it contained Dr. Boutouras’ opinion, 
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based upon a medical examination of relator, that relator suffered from zero 
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percent permanent partial impairment. 
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The majority erroneously finds that based upon our decision in State 
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ex rel. Zamora v. Indus. Comm. (1988), 45 Ohio St.3d 17, 543 N.E.2d 87, 
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the portion of Dr. Boutouras’ opinion setting forth relator’s history of back 
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problems cannot constitute “some evidence” in support of the commission’s 
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decision to not reactivate relator’s claim.  The majority reads Zamora 
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broadly to stand for the proposition that if any portion of a report is rejected 
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at one level of the commission, the commission cannot rely on any other 
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portion of the report at the same or different level later in the life of the 
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claim.  However, the majority’s broad interpretation excludes material in a 
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report that is legitimately separate and distinct from the portion of the report 
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that was previously rejected.  Therefore, unlike the facts of Zamora, where 
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the commission rejected a report at one level and then relied improperly on 
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the same portion of a report at another level, it would not be inconsistent or 
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unreasonable to allow the commission to reject a portion of the report at one 
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level and rely on another portion of that report at another or the same level. 
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I believe this case falls within the above-mentioned exception to 
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Zamora.  The medical history of the relator, as set forth in Dr. Boutouras’ 
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report, is completely independent from Dr. Boutouras’ opinion as to the 
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percentage of relator’s permanent partial impairment.  The former is factual 
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and the latter consists of an opinion based on Dr. Boutouras’ examination of 
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relator.  As such, the two portions of the report are independent and each 
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may be accepted or rejected by the commission. 
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The portion of Dr. Boutouras’ report detailing relator’s history of 
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back problems constitutes “some evidence” to support the commission’s to 
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decision not reactivate relator’s claim.  The majority overreaches its proper 
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role in concluding that this evidence is not sufficient because the majority is 
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“not convinced that the commission could have reached its decision without 
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reliance upon the zero-percent impaired assessment.”  Our role is limited to 
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determining whether “some evidence” supports the commission’s 
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determination.  State ex rel. Burley v. Coil Packing, Inc. (1987), 31 Ohio 
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St.3d 18, 31 OBR 70, 508 N.E.2d 936, syllabus.  Once “some evidence” is 
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found in support of the commission’s decision, which is the case here, our 
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review should end. 
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COOK AND PFEIFER, JJ., concurs in the foregoing dissenting opinion. 
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