Court Opinion

ID: 9379959
Source: CourtListenerOpinion
Date Created: 2023-03-16 18:07:43.242051+00
Date Added: 2024-06-11T17:16:20.715919
License: Public Domain

[Cite as State ex rel. Borling v. State Teachers Retirement Sys. Bd. of Ohio, 2023-Ohio-838.]

                              IN THE COURT OF APPEALS OF OHIO

                                    TENTH APPELLATE DISTRICT

State of Ohio, ex rel.                                   :
Darlene Borling,
                                                         :                  No. 22AP-294
                 Relator-Appellee,                                      (C.P.C. No. 20CV-7365)
                                                         :
                                                                     (REGULAR CALENDAR)
v.                                                       :

State Teachers Retirement                                :
System Board of Ohio,
                                                         :
                 Respondent-Appellant.
                                                         :

                                          D E C I S I O N

                                      Rendered on March 16, 2023

                 On brief: Seeley, Savidge, Ebert & Gourash, Co., LPA,
                 Gary A. Ebert, and Clare C. Moran for appellee. Argued:
                 Clare C. Moran.

                 On brief: Dave Yost, Attorney General, Samuel A. Peppers,
                 III, and Lisa A. Reid for appellant. Argued: Lisa A. Reid.

                   APPEAL from the Franklin County Court of Common Pleas

MENTEL, J.
        {¶ 1} Respondent-appellant, State Teachers Retirement System Board of Ohio
(“STRS”), appeals from a May 12, 2022 decision and entry of the Franklin County Court of
Common Pleas granting the request for a writ of mandamus of relator-appellee, Darlene
Borling (“Borling”), to remand this action to STRS for review of her disability application
to consider whether her mixed connective tissue disorder (“MCTD”), is a disabling
condition entitling her to disability benefits. For the reasons that follow, we affirm.
No. 22AP-294                                                                                                 2

I. FACTS AND PROCEDURAL HISTORY
        {¶ 2} Borling was employed as a teacher with Columbia Local School District and
is a member of STRS. Borling last worked as a teacher on February 22, 2019. On March 8,
2019, Borling was admitted at the Cleveland Clinic for treatment related to cryptococcal
meningitis (“CM”). (Jan. 6, 2021 Record of Proceedings at 0F364-N91.) Borling was
discharged on March 21, 2019.1 On March 26, 2019, Borling was readmitted to the hospital
experiencing “[f]evers * * * likely attributable to an IRIS syndrome or her connective tissue
disease.” (Record of Proceedings at 0F364-N77.) Borling was later discharged on April 3,
2019.    Borling’s internist, Dr. Rena Bose (“Bose”), provided treatment for CM and
recommended follow up with a rheumatologist for “underlying [m]ixed connective tissue
disorder.” (Record of Proceedings at 0F364-N80.)
        {¶ 3}    On April 26, 2019, Borling filed an application for disability benefits with
STRS. The application included an attending physician’s report by Bose and medical
records from the Cleveland Clinic. According to the application, Borling identified Bose as
the physician treating her primary disabling medical condition, CM, and noted her
admission to the Cleveland Clinic on both March 8 and March 26, 2019. (Record of
Proceedings at 0F364-N66.) In section 7, Borling consented to the release of medical
reports from both Bose and her rheumatologist, Dr. Judith Manzon (“Manzon”). (Record
of Proceedings at 0F364-N67.)
        {¶ 4} Borling provided an Attending Physician’s Report by Bose with her
application.2 In the report, Bose identified CM as Borling’s primary disabling condition
and listed MCTD and amyloidosis as “[o]ther significant medical condition(s).” (Record of
Proceedings at 0F364-N74.) Bose indicated that both CM and MCTD were disabling
conditions.3 In the recommendation section, Bose certified Borling was disabled by CM
and expected to last 12 or more months. Bose provided various medical records from
Borling’s March 8 and March 26, 2019 hospitalizations at the Cleveland Clinic. Of note, the

1 Of note, the hospital’s discharge summary documented Borling’s past medical history for “RRMS on no DMT,

MCTD, localized amyloidosis, and mesenteric panniculitis on chronic steroids.” (Emphasis added.) (Record
of Proceedings at 0F364-N91.)
2 Per the instructions provided in the applications, “[c]onditions listed as disabling will only be reviewed if

standard objective medical evidence is provided.” (Record of Proceedings at 0F364-N74.)
3 The form states that the Attending Physician’s Report should be provided by the physician treating the

applicant’s “primary disabling medical condition” and “[o]nly one Attending Physician’s Report is required.”
(Emphasis sic.) (Record of Proceedings at 0F364-N66.)
No. 22AP-294                                                                                3

medical records confirmed Borling was being treated for both CM and MCTD during this
period. (See Record of Proceedings at 0F364-N76-77, N80.)
       {¶ 5} In a letter dated April 26, 2019, STRS informed Borling that “more disability
application information [was] required” asking Borling to “have [her] physician submit the
discharge summary from [her] stay at Cleveland Clinic Main Campus.”               (Record of
Proceedings at 0F364-P59.)      STRS did not seek any other information or note any
deficiencies in the application at that time.     STRS received the requested discharge
summaries on May 2, 2019. Relevant to the instant appeal, additional evidence of Borling’s
connective tissue disease was included in the records. STRS deemed Borling’s application
complete on May 2, 2019. (Record of Proceedings at 0F364-O82.)
       {¶ 6} On May 7, 2019, Dr. Martin Gottesman (“Gottesman”), on behalf of the STRS
Medical Review Board, advised Borling a period of treatment of six-months was needed
prior to any determination of disability. Gottesman reasoned that “[t]his is based on the
current information in the medical records which indicate disability for medical reasons.”
(Record of Proceedings at 0F364-O7.) On May 8, 2019, STRS notified Borling that her
completed application was received and wrote “[e]xaminations for determining eligibility
for disability benefits will be assigned by the Medical Review Board only for conditions
listed as permanently disabling and supported with medical evidence by your physician(s).
Your attending physician(s) provided support for the following condition, [CM], to be
processed.” (Record of Proceedings at 0F364-P60.)
       {¶ 7} Borling sought additional treatment during the six-month period.            The
records provided include progress notes from Borling’s June 13, 2019 examination with
Manzon noting Borling’s diagnosis of “[u]ndifferentiated connective tissue disease.”
(Record of Proceedings at 0F364-O16.) On July 22, 2019, Borling provided additional
medical records to STRS that included a July 17, 2019 letter from her infectious disease
physician, Dr. Patricia Bartley (“Bartley”). Bartley “certif[ied]” that Borling has been under
her care for CM “complicated with immune reconstitution syndrome in setting
immunosuppression from multiple sclerosis, undifferentiated connective tissue disease,
[and] amyloidosis (likely AA), localized around mid trachea, Hx of chronic pulmonary
nodules mesenteric panniculitis, requiring Medrol dose between 2 to 6 mg.” (Record of
Proceedings at 0F364-O26.) Bartley recommended that Borling not return to work and
No. 22AP-294                                                                                              4

should continue with restrictions. On October 31, 2019, Borling provided additional
medical records regarding her treatment for both CM and MCTD. These records included
an October 17, 2019 letter from Bartley recounting Borling’s treatment and diagnosis for,
among other things, undifferentiated connective tissue disease. (Record of Proceedings at
0F364-O52.) The records also included a letter from Bose that stated Borling was still
receiving treatment for CM and still suffered from, among other diagnoses, connective
tissue disease. (Record of Proceedings at 0F364-O64.)
        {¶ 8} On November 7, 2019, STRS instructed Dr. Donald Mann (“Mann”), to
provide an independent medical examination of Borling “only on the condition of [CM].”
(Record of Proceedings at 0F364-P69.) On December 12, 2019,4 Mann provided a report
of his examination. Mann began his report qualifying his findings noting that his review
was limited to examining whether CM was a disabling condition. (Record of Proceedings
at 0F364-O78.) Mann found,”[Borling] experienced a bout of [CM] earlier this year which
required intense treatment. From that condition she has recovered.”                             (Record of
Proceedings at 0F364-O80.)5 Mann concluded that Borling was not disabled for CM as she

4The report was received on December 13, 2019.
5We are struck by the juxtaposition between Mann’s conclusion that Borling has recovered from the CM and
his description of her extensive medical limitations. Mann described Borling’s medical history and condition
as follows:
                 Ms. Borling age 63 is troubled with numbness in four extremities extending
                 from the forearm to the fingers greater on the right side and in both shins
                 and feet. This symptom has been persistent for the past fifteen years. She
                 experiences difficulty walking moderate distances at which point legs cramp
                 and she must sit down for relief. Daily bladder incontinence is present
                 required a pad.

                Fatigue is such that minor household chores such as meal preparation and
                light cleaning require a rest after which she starts all over again.

                Over the past year stinging pains have been present in the lower extremities
                brought on by standing or walking and in the upper extremities by manual
                activity.

                The first diagnosis of multiple sclerosis came in 1998 with left visual field
                distortion which slowly recovered. The condition was relatively quiet up
                until 2019 when, amongst other things, she had three episodes of leg
                weakness in June and October requiring admission for intravenous steroids.
                In 2019 she developed [CM] requiring hospitalization from March eight to
                twenty-one. In October an esophageal lesion was discovered to be Barretts.
No. 22AP-294                                                                                  5

was not “considered to be physically or mentally incapacitated from * * * her most recent
job duties for 12 continuous months from the application complete date.” (Record of
Proceedings at 0F364-O81.)
        {¶ 9} A three-member medical review board consisting of Dr. Marc Cooperman,
Dr. James Allen, and Dr. Albert Kolibash reviewed Mann’s report and unanimously
recommended Borling’s application be denied. Dr. Marc Cooperman wrote, “[i]t is my
opinion that Ms. Borling is not disabled based on [CM]. She has received appropriate
treatment, and has recovered from her acute illness.” (Record of Proceedings at 0F364-
O83.) On January 14, 2020, Gottesman advised STRS that the medical review board
recommended Borling’s application be denied. (Record of Proceedings at 0F364-O88.)
        {¶ 10} On February 20, 2020, STRS denied Borling’s application for disability
benefits, which Borling appealed. On February 27, 2020, STRS requested Borling provide
additional medical evidence related to her condition of CM. Borling supplemented the
application with additional medical documentation.                  The medical records included
documentation from Bose and Bartley on her treatment for CM. Borling also provided
records from Manzon of her diagnosis of undifferentiated connective tissue disorder and
tracheobraonchial AL Amyloidosis.
        {¶ 11} Manzon wrote:
                Ms. Borling was hospitalized March 2019 for posterior [CM].
                Her occupation as an educator for school children and the
                immunosuppressive therapy that she has been receiving puts
                her at higher risk for infection. Because of the functional
                limitations related to her autoimmune arthritis and the health
                complications stemming from her immunosuppressed status,
                she is currently disabled and has been unable to perform active

                Immune suppression agents for multiple sclerosis were instituted twice; on
                each occasion systemic reaction occurred requiring cessation.

                Ms. Borling suffers from Lupus Erythematosus over the past ten years, for
                which she has been taking Prednisone in varying doses.

                Lastly, Amylolysis of the trachea was discovered incidentally and is being
                watched.

                Brain MRI September, 2019 showed new cervical cord lesions. In 2018 the
                brain MRI also showed new lesion in the white matter.
(Sic passim.) (Record of Proceedings at 0F364-O79-80.)
No. 22AP-294                                                                                6

               work since March 1, 2019. The duration of the disability cannot
               be estimated since the disease is characterized by periods of
               disease flares.
(Record of Proceedings at 0F364-P16.)

         {¶ 12} On August 6, 2020, Borling filed her statement of appeal and additional
medical evidence. On August 14, 2020, STRS provided Mann the additional medical
records and asked him to offer an opinion on whether CM was a disabling condition
entitling Borling to disability benefits. Also on August 14, 2020, STRS wrote to Borling that
it received the additional medical information. Regarding Borling’s claimed disability for
MCTD, STRS wrote:
               The chair of the medical review board reviewed all information
               received on appeal. The initial Attending Physician’s report
               from Dr. Bose dated, April 12, 2019, did not provide medical
               evidence to support processing of [MCTD] or any other
               conditions other than [CM].
(Emphasis sic.) (Record of Proceedings at 0F364-Q4.)

         {¶ 13} On August 24, 2020, Mann issued a report and opinion based on the
supplemental medical evidence. Mann concluded that his original recommendation did
not change and believed Borling had recovered from CM. On September 3, 2020, STRS
informed Borling that the medical review board did not find substantial evidence that
conflicts with its prior decision. STRS informed Borling that the disability review panel will
evaluate the appeal on September 16, 2020 to provide a recommendation to the retirement
board.
         {¶ 14} On September 9, 2020, Gottesman filed a memorandum of the record writing
that “[w]hile Dr. Bose’s Attending Physician Report listed the condition of [MCTD] (for
which Ms. Borling saw a rheumatologist), no medical records were supplied with the initial
application to document this condition or support the condition as disabling.” (Record of
Proceedings at 0F364-P56.) Gottesman concluded that the medical review board continues
to recommend that disability benefits be denied to Borling as CM was not a disabling
condition in this case. Following the September 16, 2020 appeal hearing, STRS took official
action to affirm its prior decision to deny Borling’s application for disability benefits.
(Record of Proceedings at 0F364-Q19.)
No. 22AP-294                                                                              7

       {¶ 15} On November 12, 2020, Borling filed a writ of mandamus in the Franklin
County Court of Common Pleas against STRS seeking reversal of its denial of her
application for disability benefits. On May 12, 2022, the common pleas court granted in
part and denied in part, Borling’s request for a writ of mandamus. The common pleas court
found that there was “some evidence” to support STRS’ conclusion, and ultimate denial of
Borling’s claim, that CM was not a disabling condition entitling her to disability benefits.
The common pleas court, however, found “STRS abused its discretion and acted arbitrarily
by refusing to consider whether her connective tissue disease was a disabling condition.”
(May 12, 2022 Decision & Entry at 10.) The trial court concluded that Borling’s initial
application for disability benefits identified both CM and MCTD as disabling conditions
and the medical records attached to the application documented both conditions. The trial
court wrote that STRS’ narrow review led to “borderline absurd medical reports and
opinions regarding whether [Ms. Borling] suffers from a disabling condition.” (Decision &
Entry at 11.) The case was remanded to STRS to consider whether MCTD was a disabling
condition entitling Borling to disability benefits.
       {¶ 16} STRS filed a timely appeal on May 17, 2022.
II. ASSIGNMENT OF ERROR

       {¶ 17} STRS assigns the following as trial court error:
              THE COMMMON PLEAS COURT ERRED IN REMANDING
              BORLING’S DISABILITY APPLICATION BACK TO STRS FOR
              CONSIDERATION OF MIXED CONNECTIVE TISSUE
              DISORDER (“MCTD”) BECAUSE NO CAUSAL STATEMENT
              OF A PHYSICIAN ACCOMPANIED BY MEDICAL EVIDENCE
              SUPPORTING MCTD AS A DISABLING CONDITION WAS
              SUBMITTED WITH HER APPLICATION, AND ABSENT
              THAT SUPPORT, STRS WAS WELL WITHIN ITS
              DISCRETION IN DECLINING TO EXPAND THE SCOPE OF
              THE MEDICAL INQUIRY.

III. LEGAL ANALYSIS
       A. STRS’ Sole Assignment of Error
       {¶ 18} In STRS’ sole assignment of error, STRS argues that the court of common
pleas erred in remanding Borling’s disability application for consideration as to whether
MCTD was a disabling condition “because no causal statement of a physician accompanied
No. 22AP-294                                                                              8

by medical evidence supporting MCTD as a disabling condition was submitted with her
application.” (Bold removed.) (STRS’ Brief at vi.)
       {¶ 19} The decision whether a member of STRS is entitled to disability retirement
benefits falls within the sole province of STRS. State ex rel. Hulls v. State Teachers
Retirement Bd. of Ohio, 113 Ohio St.3d 438, 2007-Ohio-2337, ¶ 26, quoting R.C.
3307.62(F) (“The state teachers retirement board shall render an order determining
whether or not the applicant shall be granted a disability benefit.”). Consequently, as the
STRS decision is not appealable, a writ of mandamus is available to remedy instances where
the board has abused its discretion in determinations regarding disability retirement
benefits. State ex rel. Ewart v. State Teachers Retirement Sys. Bd. of Ohio, 10th Dist. No.
20AP-21, 2020-Ohio-4147, ¶ 24, citing Hulls at ¶ 27.
       {¶ 20} In order to be entitled to a writ of mandamus, a relator must demonstrate:
“(1) a clear legal right to the requested relief, (2) a clear legal duty on the part of the
respondent to provide such relief, and (3) the lack of an adequate remedy in the ordinary
course of the law.” Ewart at ¶ 25, citing State ex rel. Withers v. State Teachers Retirement
Sys. of Ohio Bd., 10th Dist. No. 17AP-124, 2017-Ohio-7906, ¶ 19, citing State ex rel. Brown
v. Indus. Comm. of Ohio, 10th Dist. No. 14AP-722, 2015-Ohio-2923, ¶ 10.
       {¶ 21} We review a trial court’s decision to grant a writ of mandamus under an abuse
of discretion analysis. Ewart at ¶ 26, citing State ex rel. Altman-Bates v. Pub. Emps.
Retirement Bd. 148 Ohio St.3d 21, 2016-Ohio-3100, ¶ 23, citing State ex rel. Mun. Constr.
Equip. Operators’ Labor Council v. Cleveland, 141 Ohio St.3d 113, 2014-Ohio-4364, ¶ 24.
It is well-established law that an abuse of discretion connotes a decision that is
unreasonable, arbitrary, or unconscionable. Blakemore v. Blakemore, 5 Ohio St.3d 217,
219 (1983). STRS abuses its discretion when its order is not supported by at least “some
evidence.” State ex rel. Hayslip v. State Teachers Retirement Sys. Bd., 10th Dist. No.
20AP-64, 2021-Ohio-3495, ¶ 4, quoting State ex rel. Marchiano v. School Emps.
Retirement Sys., 121 Ohio St.3d 139, 2009-Ohio-307, ¶ 20, citing State ex rel. Grein v. Ohio
State Hwy. Patrol Retirement Sys., 116 Ohio St.3d 344, 2007-Ohio-6667, ¶ 9. Accordingly,
“[m]andamus will lie only if the board’s decision is not supported by any evidence.” Hayslip
at ¶ 4, citing State ex rel. Woodman v. Ohio Pub. Emps. Retirement Sys., 144 Ohio St.3d
367, 2015-Ohio-3807, ¶ 17.
No. 22AP-294                                                                                                9

        {¶ 22} Here, STRS has a clear legal duty to provide relief if Borling has a legal right
to the disability benefits. There is also no adequate remedy in the ordinary course of the
law as there is no right to a direct appeal of the decision. Ewart at ¶ 24, citing Hulls at ¶ 27.
The question becomes whether the court of common pleas abused its discretion finding that
Borling had a clear legal right to the requested review of her application to determine
whether MCTD is a disabling condition.
        {¶ 23} The General Assembly enacted R.C. Chapter 3307 to establish a retirement
system for teachers of public schools with funds for payment of retirement allowances,
among other benefits, under the management of STRS. State ex rel. Ewart v. State
Teachers Retirement Sys. Bd. of Ohio, 10th Dist. No. 18AP-826, 2019-Ohio-2459, ¶ 27,
citing R.C. 3307.03. Initial eligibility for disability benefits is set forth under R.C. 3307.62.
Pursuant to R.C. 3307.62(C), a member of STRS is entitled to disability benefits when the
member is “mentally or physically incapacitated for the performance of duty by a disabling
condition, either permanent or presumed to be permanent for twelve continuous months”
after the submission of an application to STRS. See also Ohio Adm.Code 3307:1-7-01(K)
(“A disabling condition shall be ‘presumed to be permanent,’ if it physically or mentally
incapacitates an applicant from the performance of regular duty for a period of at least
twelve months from the date of the retirement system’s receipt of the completed
application.”).
        {¶ 24} Effective June 3, 2021, Ohio Adm.Code 3307:1-7-01(B)6 states, in order to
receive benefits, members must file an application using a form approved by STRS and
include, “(1) [a]n application for disability benefits; and (2) [f]or each physician listed on
the application for disability benefits, an attending physician’s report based on an in-person
examination that was completed within the last two months and includes medical evidence;
and (3) [a]n employer report including an official job description provided by the last
employer. The requirement to submit a job description may be waived by the chair of the
medical review board.” Ohio Adm.Code 3307:1-7-01(B)(1) through (3); R.C. 3307.62(B).
The attending physician must have a therapeutic relationship with the applicant “and have

6 As discussed below, the most recent iteration of the Ohio Adm.Code 3307:1-7-01(B) was not in effect at the
time Borling’s application was denied. However, for the purpose of subsequent examination of this issue, it is
instructive to provide the most recent version of the administrative code within the body of this decision.
No. 22AP-294                                                                              10

completed a report and certified on forms provided by the retirement system the attending
physician’s opinion regarding a recipient’s ability to return to employment. The attending
physician shall provide standard objective and pertinent medical evidence supporting the
opinion.” Ohio Adm.Code 3307:1-7-01(C)(2). The term “[m]edical evidence” is defined as
“current physician examinations, observed clinical findings, laboratory findings, diagnosis,
treatment prescribed with response and prognosis, hospital discharge summaries and
diagnostic testing relevant to the applicant’s claimed disabling condition.” Ohio Adm.Code
3307:1-7-01(H).
       {¶ 25} Once an application is submitted, an independent medical examiner will
review the applicant and issue a report to STRS. Ewart, 2019-Ohio-2469, at ¶ 27, citing
State ex rel. Menz v. State Teachers Retirement Bd., 144 Ohio St.3d 26, 2015-Ohio-2337,
¶ 3, citing R.C. 3307.62(C). If the independent examiner concludes that an applicant is
disabled, and STRS agrees, STRS will approve the application. Id. at ¶ 27, citing Menz at
¶ 3, citing Ohio Adm.Code 3307:1-7-02 and 3307:1-7-01(F); R.C. 3307.62(E). If the
independent medical examiner concludes the applicant is not disabled, the application and
medical records are reviewed by three independent physicians on a medical review board.
Id.
       {¶ 26} Ohio Adm.Code 3307:1-7-05 supplements R.C. 3307.62 by setting forth the
procedures and notice requirements to appeal the denial of a disability benefits application.
Franta v. State Teachers Retirement Sys. of Ohio, 10th Dist. No. 20AP-230, 2020-Ohio-
6843, ¶ 16. When an applicant files an administrative appeal of a denial of benefits, the
applicant is permitted to “present additional medical evidence orally at an appeal hearing
that will be scheduled by the retirement system or that additional medical evidence as
defined in this rule may be presented in writing. Such additional medical evidence shall
not have been previously considered by the independent medical examiner or the medical
review board.”    Ohio Adm.Code 3307:1-7-05(B)(3)(a).         STRS is allowed to request
additional medical evidence or order additional testing by an independent medical
examiner. Ohio Adm.Code 3307:1-7-05(B)(5)(e).
       {¶ 27} After a careful review of the Attending Physician’s Report, we conclude Bose
indicated that she treated Borling for CM, MCTD, and amyloidosis. Bose found CM and
MCTD were disabling conditions while amyloidosis was not a disabling condition. The
No. 22AP-294                                                                               11

medical records provided with the initial application, as well as the additional documents
supplemented before the application was deemed completed, indicate Bose diagnosed and
provided treatment for both CM and MCTD. The records also show that during Borling’s
March 26, 2019 hospitalization for CM, she was treated for fevers attributed to her
connective tissue disease. Bose’s assessment at the time included treatment for CM and
follow up with a rheumatologist for “underlying [m]ixed connective tissue disorder.”
(Record of Proceedings at 0F364-N80.) There is no doubt the medical records included
with the initial application provided objective medical evidence that both CM and MCTD
were disabling conditions.
       {¶ 28} While STRS does not contest that Borling has a therapeutic relationship with
Bose in some fashion, it argues that Bose only provided support for Borling’s condition of
CM as a disabling condition and not MCTD. STRS argues that Borling was required to
provide a separate physician’s report by her rheumatologist, Manzon, “causally linking
MCTD to her permanent disability.” (STRS’ Brief at 18.) STRS cites Ohio Adm.Code
3301:1-7-01 in support of its contention that the administrative code provision “clearly
contemplates that more than one attending physician may submit a report on an applicant’s
behalf.” (STRS’ Brief at 16.)
       {¶ 29} STRS mistakenly relies on the most recent version of Ohio Adm.Code 3307:1-
7-01 instead of the provision in effect when Borling filed her application. Compare Ohio
Adm.Code 3307:1-7-01, effective June 3, 2021, “[f]or each physician listed on the
application for disabling benefits, an attending physician’s report based on an in-person
examination that was completed within the last two months and includes medical
evidence,” with Ohio Adm.Code 3307:1-7-01, effective June 10, 2016, “an application for
disability benefits; an attending physician’s report based on an examination that was
completed within the last two months and includes medical evidence, an employer report,
and a job description provided by the last employer.” The revised language stating “[f]or
each physician listed on the application for disab[ility]” was not in place when Borling filed
her disability benefits application. Id. As the application was filed on April 26, 2019, the
Ohio Adm.Code 3307:1-7-01, effective June 10, 2016, would control. In addition to the
prior language in the administrative code, STRS’ claim that multiple physicians were
No. 22AP-294                                                                               12

required is contradicted by the plain language of the disability benefits application. Section
4 of the application titled, “Attending Physician’s Information” reads:
               An Attending Physician’s Report should be provided to your
               physician/specialist treating your primary disabling medical
               condition. Your physician will be asked to submit the objective
               medical evidence used to diagnose your disabling condition as
               well as a recent examination and treatments prescribed. Only
               one Attending Physician’s Report is required.
(Emphasis added.) (Record of Proceedings at 0F364-N66.)

       {¶ 30} In the case sub judice, as Bose is the physician treating Borling’s primary
disabling condition, CM, she was the most suitable individual to complete the Attending
Physician’s Report. As Bose also treated Borling’s other disabling condition, MCTD, she
was qualified to complete the form for MCTD as well. The form plainly states that “[o]nly
one Attending Physician’s Report is required.” Id. There is no reasonable interpretation of
the application that requires Borling to provide an additional physician’s report. While
Borling listed her rheumatologist, Manzon, as a physician that could provide records, based
on the plain language of the administrative code and application, there is no support for
STRS’ claim that Borling was required to provide a causal statement from Manzon in the
initial application.
       {¶ 31} Next, STRS argues that Borling “volitionally limited her application to the one
condition certified by Dr. Bose as disabling - CM.” (STRS’ Brief at 16.) Upon review, we
disagree with STRS’ contention on this issue. The portions of the application provided by
Borling do not limit her application solely to CM. Furthermore, as indicated by the below
section of the Attending Physician’s Report, Bose “certif[ied]” that Borling was under her
professional care since 2013; her last examination was within the last two months; that
Borling’s primary medical condition was CM; and that the condition was “disabling and
expected to last at least 12 or more months” from the date on the form. (Bold removed.)
(Record of Proceedings at 0F364-N74.) Bose identified, as part of her certification, that
both CM and MCTD were disabling conditions while amyloidosis was not a disabling
condition. The application plainly states, “[c]onditions listed as disabling will only be
reviewed if standard objective medical evidence is provided.” Id. Here, STRS’ use of the
phrases “primary medical condition” and “[o]ther significant medical condition(s) I
No. 22AP-294                                                                                13

provide treatment for” suggests that the two provisions of the form are to be read together.
Id. Therefore, the most natural reading of the report is that Bose certified all the statements
within this section, i.e., that both CM and MCTD were disabling conditions.

Id.
       {¶ 32} STRS contends Bose “declined to certify that [MCTD] was disabling and
expected to last 12 months or more, as explicitly required by R.C. 3307.62(C) and Ohio
Adm. Code 3307:1-7-01(K). [Id.] Dr. Bose clearly determined that MCTD was not
permanently disabling.” (Emphasis deleted.) (STRS’ Brief at 18.) STRS relies on the
recommendation section, which reads that Bose “certif[ies] that in my opinion as the
treating physician the above-named applicant is incapacitated for the performance of duty
and that the disability [CM] expected to last 12 or more months from the date I sign this
certification form.” (Record of Proceedings at 0F364-N75.)
No. 22AP-294                                                                                                14

           {¶ 33} As an initial matter, in contravention to STRS’ claims, neither
R.C. 3307.62(C)7 nor Ohio Adm.Code 3307:1-7-01(K)8 include any certification language.
As required in R.C. 3307.62(C) and Ohio Adm.Code 3307:1-7-01(K), Bose identified both
MCTD and CM as disabling conditions and concluded that Borling was mentally or
physically incapacitated for the performance of duty by a disabling condition, either
permanent or presumed to be permanent for 12 continuous months. Ohio Adm.Code
3307:1-7-01(C)(2) does have some certification language; however, the provision is far
broader than STRS claims. Pursuant to Ohio Adm.Code 3307:1-7-01(C)(2), the attending
physician must have a therapeutic relationship with the applicant “and have completed a
report and certified on forms provided by the retirement system the attending physician’s
opinion regarding a recipient’s ability to return to employment. The attending physician
shall provide standard objective and pertinent medical evidence supporting the opinion.”
Per the plain language of Ohio Adm.Code 3307:1-7-01(C)(2), Bose has a therapeutic
relationship with Borling, completed the report, and “certified on the forms provided by the
retirement system” his opinion as to Borling’s “ability to return to employment.” Id. Bose’s
recommendation was supported by objective medical evidence supporting this opinion.
The plan language of the provision requires a physician’s certification as Borling’s ability to
return to work not to each alleged disabling condition.
           {¶ 34} We are also not persuaded that Bose did not find MCTD was disabling
because it was not repeated as a disabling condition in the succeeding portion of the
application. The subsequent portion of the form does not negate Bose’s prior certification

7   R.C. 3307.62(C) states:
                   Medical examination of the member shall be conducted by a competent,
                   disinterested physician or physicians selected by the board to determine
                   whether the member is mentally or physically incapacitated for the
                   performance of duty by a disabling condition, either permanent or
                   presumed to be permanent for twelve continuous months following the
                   board’s receipt of an application. The disability must have occurred since
                   last becoming a member, or it must have increased since last becoming a
                   member to such an extent as to make the disability permanent or
                   presumably permanent for twelve continuous months following the board’s
                   receipt of an application.
8 Ohio Adm.Code 3307:1-7-01(K) states, “[a] disabling condition shall be ‘presumed to be permanent,’ if it
physically or mentally incapacitates an applicant from the performance of regular duty for a period of at least
twelve months from the date of the retirement system’s receipt of the completed application.”
No. 22AP-294                                                                                               15

that MCTD was a disabling condition. At least one member of the medical review board
reached the same conclusion. As acknowledged in Dr. James Allen’s December 20, 2019
letter, “Dr. Bose recommended that [Borling] is disabled due to [CM] and [MCTD].”
(Record of Proceedings at 0F364-O84.) At the very least, the recommendation section is
vague on this point creating more reliance on the far more detailed discussion of Bose’s
treatment in the “Report of Attending Physician” portion of the application.9 Given these
facts, STRS’ consideration of additional medical evidence for CM but refusal—based on the
purported issue in the initial application—to consider Manzon’s February 20, 2020 letter
concluding MCTD is a disabling condition constitutes an arbitrary denial of Borling’s claim.
This is not an instance of conflicting medical opinions or varying accounts of an applicant’s
injury. This is a simple case of STRS failing to review all of the claimed disabling conditions
then asserting, erroneously, that the initial application was deficient. As such, STRS abused
its discretion and acted arbitrarily by refusing to consider whether connective tissue disease
was a disabling condition.
        {¶ 35} STRS next cites Ohio Adm.Code 3307:1-7-02(A)(2) contending that medical
review board examinations are only assigned for “ ‘conditions listed as disabling by the
attending physician and supported by objective medical evidence.’ “ (STRS’ Brief at 17),
quoting Ohio Adm.Code 3307:1-7-02(A)(2). STRS also cites Ohio Adm.Code 3307:1-7-
02(A)(1), for the proposition that the attending physician will only review conditions the
applicant’s attending physician “ ‘claims as disabling.’ “ Id., quoting Ohio Adm.Code
3307:1-7-02(A)(1). Pursuant to Ohio Adm.Code 3307:1-7-05(B)(3)(a)(i)(a), any “additional
medical evidence must be related to the conditions presented and supported as part of the
initial application.” As evidenced in the above section of Borling’s initial application, Bose,
certified—or as required in the above provisions of the administrative code, “listed,”
“claim[ed],” or “presented”—MCTD as a disabling condition and supported this conclusion
with objective medical evidence. Accordingly, we also find this argument without merit.
        {¶ 36} STRS goes on to argue that the trial court suggests that STRS should “fish
through voluminous records, identify potentially disabling conditions, and then obtain

9This is not to suggest that Borling’s condition of MCTD is necessarily a permanent disability. We merely note
that Bose certified both injuries as disabling in the initial application. Whether STRS or subsequent medical
professionals decide otherwise is outside the scope of this appeal.
No. 22AP-294                                                                              16

additional medical records or schedule exams on conditions not identified by the applicant
as disabling.” (STRS’ Brief at 19.) STRS loses its way with this argument. Bose identified
CM and MCTD as disabling conditions in Borling’s initial application and provided
objective medical records requiring review. Despite Borling’s initial claim that MCTD was
a disabling condition, STRS limited the physicians in their review to solely determine
whether CM rendered Borling disabled entitling her to disabling benefits. While STRS
contends there was a “panoply” of serious medical conditions listed on Borling’s
application, only two were ever identified as disabling conditions, CM and MCTD. Id.
Arguendo, STRS’ argument would have merit if Borling had claimed STRS should have
examined whether amyloidosis constituted a disabling condition as Bose expressly
concluded in the initial application that, unlike CM and MCTD, amyloidosis was not a
disabling condition. MCTD, however, has been consistently identified as a disabling
condition since the initial application. As such, STRS’ claim that obtaining additional
medical records or scheduling exams for MCTD is somehow an additional burden is
disingenuous at best.
       {¶ 37} STRS cites our decision in Hayslip for the proposition that it has the
discretion, but is not required, to expand the scope of its inquiry to consider whether MCTD
was a disabling condition entitling Borling to disability benefits. A brief review of Hayslip
is instructive.
       {¶ 38} In Hayslip, relator filed an initial application with STRS for disability
benefits. After the initial examination and three members of the STRS medical review
board reviewed the matter, STRS concluded that Hayslip’s application for disability
retirement should be denied finding none of his conditions prevented him from performing
his teaching duties. On appeal, Hayslip provided additional medical evidence with a report
from an internist that stated, “Hayslip was restricted to lifting no greater than ten pounds
occasionally, medically required the use of a cane for standing or walking, and that Hayslip
could sit or stand for three to six hours in a work day, and stand or walk for up to one and
one-half hours. (Stip. at 151.) Dr. Hochman concluded that Hayslip was limited to
sedentary work. (Stip. at 151.).” Id. at 16. Hayslip also included documentation from a
vocational specialist as to whether Hayslip’s physical limitations impacted the position of a
substitute teacher. The specialist found “there were no school teaching positions that could
No. 22AP-294                                                                              17

be performed at the sedentary exertional level, and noted that a pertinent reference work,
the Dictionary of Occupational Titles, defines all teaching positions as light-duty work, not
sedentary.” (Emphasis sic.) Id. at 17. The additional medical evidence in support of
Hayslip’s appeal was reviewed by the initial physician and medical review board, which
maintained their continued recommendation that disability benefits be denied. After the
STRS review panel again denied disability benefits, Hayslip filed his complaint in
mandamus with this court. Id. at 18. Pursuant to Civ.R. 53 and Loc.R. 13(M), we referred
the matter to a magistrate. The magistrate concluded:
              [T]he actual job duties described by the employer, which were
              not contradicted by any evidence in the record, are the
              substantive standard in this case and supersede any formal
              classification as “light duty” or “sedentary duty” for purposes of
              ascertaining disability. Dr. Klejka opined, and the board’s
              Medical Review Board agreed, that Hayslip can perform the
              essential duties of his job as substitute teacher. There is some
              evidence in the record to support the board’s conclusion, and it
              is therefore the magistrate’s decision and recommendation that
              the writ of mandamus be denied based on the absence of any
              abuse of discretion on the part of the board.
Hayslip at 24-25.

       {¶ 39} The relator filed objections to the magistrate’s recommendation. This court
overruled relator’s objections concluding that the doctor’s report constituted “some
evidence” supporting the denial by STRS of relator’s disability benefits.          We also
determined that while there could be contrary evidence that technically classified teaching
as “light duty” rather than “sedentary duty” it was not dispositive and did not overcome the
“some evidence” standard of review. Id. at 5. Relevant to the instant appeal, relator cited
our prior decision in State ex rel. Bruce v. State Teachers Retirement Bd. of Ohio, 153 Ohio
App.3d 589, 2003-Ohio-4181 “for the proposition that STRS is required to expand the
scope of medical inquiry and examine all the medical evidence, whether certified as
disabling or not by the attending physician’s report.” Hayslip at 22. We rejected this
argument writing that STRS has the discretion to expand the scope of medical inquiry
beyond the certified conditions but is not required to do so.
       {¶ 40} Hayslip is distinct in several ways. First, the Hayslip court found that there
was some evidence in the record that relator could perform the essential duties of his job as
No. 22AP-294                                                                               18

a substitute teacher based on the identified disabling conditions. Here, despite Bose
certifying and providing objective medical documentation that Borling’s MCTD was a
disabling condition, MCTD was never reviewed by STRS. Moreover, Hayslip’s other
conditions were not identified as “disabling of themselves.” Hayslip at 7. Despite this
conclusion, the board’s independent medical expert in Hayslip examined the relator and
reviewed his records. The independent medical expert “indicated a comprehensive physical
examination and assessment of all Hayslip’s conditions.           Even considering all the
conditions, and the report does not, until its final conclusions expressly limit its
examination, Dr. Klejka ultimately determined that relator could perform his job as a
substitute teacher.” (Emphasis added.) Hayslip at 22-23. Conversely, the physicians in
this case were limited in their review as to whether CM, alone, was a disabling condition.
While STRS does have discretion to expand the scope of the medical inquiry, it must review
the certified disabling conditions if objective medical evidence is provided in the initial
application. The form plainly states that “[c]onditions listed as disabling will only be
reviewed if standard objective medical evidence is provided.” (Record of Proceedings at
0F364-N74.) While STRS did not abuse its discretion by declining to expand the search to
other conditions not identified as disabling, e.g. amyloidosis, it erred by failing to include
MCTD in its initial inquiry as to whether Borling was entitled to disability benefits.
       {¶ 41} Finally, STRS argues that there is “some evidence” based on Mann’s report
and addendum supporting STRS’ decision to deny Borling’s application. We disagree.
       {¶ 42} On November 7, 2019, STRS instructed Mann to provide an independent
medical examination of Borling “only on the condition of [CM].” (Record of Proceedings at
0F364-P69.) On December 12, 2019, Mann wrote “Ms. Borling experienced a bout of [CM]
earlier this year which required intense treatment. From that condition she has recovered.”
(Record of Proceedings at 0F364-O80.) In its August 14, 2020 letter, STRS requested
Mann “provide [his] opinion of whether the member is incapacitated from the performance
of duty * * * based on the condition of [CM] only.” (Record of Proceedings at 0F364-Q5.)
Mann never found Borling was not disabled based on MCTD. In fact, Mann expressly
limited his review “[r]egarding reconsideration of disability status based on new
information as it relates to [CM] only.” (Record of Proceedings at 0F364-P53.) Similarly,
the physicians composing the medical review board, Dr. Marc Cooperman, Dr. James Allen,
No. 22AP-294                                                                            19

and Dr. Albert Kolibash, noted Borling’s health issues, including MCTD, but denied
disability benefits on the limited basis of her recovery from CM. Given these facts, we
disagree that there is some evidence in Mann’s report that Borling is not disabled as the
disabling condition at issue, MCTD, was never reviewed.
      {¶ 43} Accordingly, based on the above evidence, the trial court’s determination that
STRS “acted in an unreasonable and arbitrary manner in failing to allow review of whether
Ms. Borling’s mixed connective tissue disorder was a disabling condition” was reasonable
and not an abuse of discretion. (Decision & Entry at 12.) STRS’ sole assignment of error is
overruled.
IV. CONCLUSION
      {¶ 44} Having overruled STRS’ sole assignment of error, we affirm the judgment of
the Franklin County Court of Common Pleas.
                                                                      Judgment affirmed.
                    BEATTY BLUNT, P.J. and JAMISON, J., concur.
                                   _____________