Opinion ID: 4565860
Heading Depth: 3
Heading Rank: 2

Heading: Griffith

Text: {¶ 17} Griffith, 87 Ohio St.3d 154, 718 N.E.2d 423, was not a medicalservice-reimbursement case and did not involve an application of the Miller test. Instead, Griffith involved a request for temporary-total-disability (“TTD”) compensation for a period of disability caused by the injured worker’s need to recover from knee surgery. Id. at 154-155. The self-insured employer had both approved and paid for the surgery based on the treating physician’s certification that the procedure was to treat the injured worker’s allowed conditions—contusion and meniscus tear. Id. at 155. However, the physician’s reports on the day of surgery stated that degenerative arthritis, a nonallowed condition, was the reason 7 SUPREME COURT OF OHIO for the procedure. Id. This led the commission to deny the request for TTD compensation: because the surgery was not for an allowed condition, the period of disability caused by the surgery did not result from the industrial injury. Id. {¶ 18} Before this court, the injured worker argued that the employer had implicitly certified her arthritis as an allowed condition by approving the knee surgery with the knowledge that she also suffered from nonallowed arthritis in her knee. Id. at 156. Our response to that argument forms the basis of Omni Manor’s argument in this case. {¶ 19} In rejecting the notion that the employer had implicitly allowed the arthritic condition by approving the knee surgery, we first took note of the treating physician’s statement that while early arthritic changes were present in the knee, they “ ‘would really not [have] chang[ed] the fact that she [was] having enough trouble for arthroscopic procedure.’ ” (Brackets sic.) Id. Therefore, we said, “The court of appeals reasonably concluded that even with the accompanying nonallowed arthritic condition, this statement suggested that the allowed knee condition, by itself, necessitated the planned surgery.” (Emphasis added.) Id. We then stated: And since the existence of a contributing nonallowed condition is not a legitimate reason for refusing to pay for medical treatment independently required for an allowed condition, State ex rel. Waddle v. Indus. Comm. (1993), 67 Ohio St.3d 452, 457, 619 N.E.2d 1018, 1021, approval of the surgery in reliance on the letter would not imply acceptance of a new condition. Id. at 156-157. We concluded, “The court of appeals correctly found that some evidence supported the commission’s denial of TTD.” Id. at 157. 8 January Term, 2020 {¶ 20} Because Griffith was a TTD-compensation case, not a medicalservice-reimbursement case, the issue whether the commission had abused its discretion by authorizing medical services was not before us. We did not mention, let alone apply, the Miller test. See Griffith, 87 Ohio St.3d at 154-157, 718 N.E.2d 423. The statement we quoted above merely explained that the employer did not face a choice between rejecting the surgery or implicitly allowing a nonallowed condition—i.e., the nonallowed condition was irrelevant as long as the surgery was properly approved for the allowed condition. Our citation to Waddle demonstrates this intent: Waddle was a permanent-total-disability-compensation case that, like Griffith, did not involve an application of the Miller test. Waddle at 455, 457. Indeed, Waddle is often cited for the concept that nonallowed conditions cannot be used to advance or defeat a claim for compensation. See id. {¶ 21} Moreover, the “independently required” standard that Omni Manor argues Griffith created for cases involving contributing nonallowed conditions would be inconsistent with the underlying Miller test. Omni Manor argues that Griffith requires claimants in such cases to show that the requested medical services would be required even if the nonallowed conditions did not exist. But the Miller test does not obligate a claimant to show that the requested medical services are required—only that they are “reasonably related to” and “reasonably necessary for treatment of” an allowed condition. (Emphasis added.) Miller, 71 Ohio St.3d at 232, 643 N.E.2d 113. This inconsistency is not addressed in Griffith, because we intended no such modification of the Miller test. {¶ 22} Given the issue that we were deciding in Griffith, our statement must be read as one couched in the context of the existing medical-servicereimbursement framework rather than as a significant yet undiscussed alteration of that framework. Accordingly, the phrase “independently required for an allowed condition,” id. at 156, may be stated another way as “satisfying the Miller test as to the allowed condition.” 9 SUPREME COURT OF OHIO