Thomas v. Logue, Admr. of Ohio Bur. of Workers' Comp. , 2022 Ohio 1603 ( 2022 )


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  • [Cite as Thomas v. Logue, Admr. of Ohio Bur. of Workers' Comp., 
    2022-Ohio-1603
    .]
    IN THE COURT OF APPEALS OF OHIO
    TENTH APPELLATE DISTRICT
    Lamar Thomas,                                      :
    Plaintiff-Appellant,               :
    No. 21AP-385
    v.                                                 :              (Ct. of Cl. No. 2021-00112JD)
    John Logue, Administrator,                         :              (REGULAR CALENDAR)
    Ohio Bureau of Workers' Compensation,
    :
    Defendant-Appellee.
    :
    D E C I S I O N
    Rendered on May 12, 2022
    On brief: Garson Johnson LLC, James A. DeRoche, and
    Jeffrey D. Johnson; Weisman, Kennedy & Berris Co., L.P.A.,
    R. Eric Kennedy, and Daniel P. Goetz; Ciano Goldwasser,
    LLP, and Andrew S. Goldwasser, for appellant. Argued:
    James A. DeRoche.
    On brief: Brennan, Manna & Diamond, LLC, Robert A.
    Hager, Justin M. Alaburda, and Daniel J. Rudary; Dave Yost,
    Attorney General, and Timothy M. Miller, for appellee.
    Argued: Daniel J. Rudary.
    APPEAL from the Court of Claims of Ohio
    DORRIAN, J.
    {¶ 1} Plaintiff-appellant, Lamar Thomas, appeals the June 28, 2021 decision and
    judgment entry of the Court of Claims of Ohio finding defendant-appellee, Ohio Bureau of
    Workers' Compensation ("BWC"), was entitled to judgment as a matter of law and granting
    BWC's motion for judgment on the pleadings. For the following reasons, we reverse.
    No. 21AP-385                                                                                                2
    I. Facts and Procedural History
    {¶ 2} On March 4, 2021, appellant filed a complaint in the Court of Claims asserting
    claims for equitable restitution and unjust enrichment in addition to seeking declaratory
    and injunctive relief. In his complaint, appellant alleged that on September 5, 2013, he was
    injured in the course and scope of his employment in an automobile accident. Appellant
    filed a claim for workers' compensation benefits, and such claim was allowed by BWC for
    cervical and lumbar sprain. According to appellant, his injury was caused by the negligence
    of a third party, and appellant pursued a separate claim against such party.
    {¶ 3} As a result of his injury, appellant sought medical treatment from a physician
    and received physical therapy. Appellant's physician, Dr. Adam Friedman, authored a
    report opining that, as a result of the accident, appellant sustained a lumbar sprain and
    substantially aggravated pre-existing degenerative disc disease as well as pre-existing
    spondylothesis. On June 14, 2014, appellant filed a request with BWC for an additional
    allowance for the conditions in Dr. Friedman's report.
    {¶ 4} In response to appellant's request for additional allowances, BWC referred
    the claim to an independent medical examiner, Dr. Gerald Yosowitz, who reviewed
    appellant's medical records and opined that the additional conditions identified by Dr.
    Friedman were degenerative and unrelated to the injury sustained by appellant in the
    automobile accident. Based on Dr. Yosowitz's review, BWC referred appellant's claim to
    the Industrial Commission of Ohio ("commission").1 In front of the commission, BWC
    argued the commission should deny appellant's request for additional allowances.2 On
    January 16, 2015, the commission hearing officer disallowed the claim for the requested
    additional conditions based on Dr. Yosowitz's report. On February 26, 2015, a second
    commission hearing officer denied appellant's appeal of the January 16, 2015 commission
    decision. On March 20, 2015, the commission refused appellant's appeal. As a result,
    1 BWC, in its brief in the present matter, states that it denied appellant's request for additional allowances
    "[b]ased on Dr. Yosowitz's independent review" of appellant's medical records. (BWC's Brief at 23.)
    2The  decisions of the commission do not appear in the record before us. The facts summarized here are based
    on those allegations contained in appellant's complaint. See below ¶ 9 (discussing standard for judgment on
    the pleadings under Civ.R. 12(C)).
    No. 21AP-385                                                                               3
    appellant was not able to participate in the workers' compensation fund for the additional
    conditions.
    {¶ 5} Appellant further alleged that following the settlement of his third-party
    claim, BWC asserted a right of subrogation in the amount of $6,044.36 from appellant's
    settlement pursuant to R.C. 4123.93 and 4123.931. BWC's asserted subrogation interest
    was based in part on a list of medical bills in the amount of $5,544.01. Among the charges
    listed by BWC for appellant's medical bills was the cost of the record review and report
    performed by Dr. Yosowitz. Appellant paid BWC $6,044.36 from his third-party settlement
    to satisfy BWC's asserted subrogation interest. In his complaint, appellant alleged BWC
    had no legal right to recover the cost of Dr. Yosowitz's services as part of its subrogation
    interest on the proceeds of appellant's third-party claim and, therefore, BWC was unjustly
    enriched.
    {¶ 6} On April 30, 2021, BWC filed an answer. On May 3, 2021, BWC filed a motion
    for judgment on the pleadings pursuant to Civ.R. 12(C). On May 14, 2021, appellant filed a
    memorandum contra BWC's May 3, 2021 motion. On June 28, 2021, the Court of Claims
    filed a decision holding that BWC's motion for judgment on the pleadings should be granted
    because appellant could prove no set of facts in support of his claims that would entitle him
    to relief and BWC was entitled to judgment as a matter of law. On the same date, the Court
    of Claims filed a judgment entry granting BWC's motion for judgment on the pleadings.
    II. Assignment of Error
    {¶ 7} Appellant appeals and presents the following sole assignment of error for our
    review:
    The trial court erroneously interpreted "subrogation interest"
    [R.C. 4123.93(D)] to include administrative costs that neither
    the injured worker nor the statutory subrogee could recover
    from a liable third party.
    III. Assignment of Error—Interpretation of R.C. 4123.93(D)
    {¶ 8} In his assignment of error, appellant asserts the court erred by granting
    judgment on the pleadings in favor of BWC because it incorrectly interpreted the statutory
    definition of the term "subrogation interest" under R.C. 4123.93(D) to include
    No. 21AP-385                                                                              4
    administrative costs paid by BWC unrelated to an injured worker's medical treatment or
    compensation.
    A. Motion for Judgment on the Pleadings Under Civ.R. 12(C)
    {¶ 9} Pursuant to Civ.R. 12(C), "[a]fter the pleadings are closed but within such
    time as not to delay the trial, any party may move for judgment on the pleadings." A court
    considering a motion under Civ.R. 12(C) must construe the material allegations in the
    complaint and all reasonable inferences to be drawn by the same in favor of the nonmoving
    party as true. Ohio Mfrs. Assn. v. Ohioans for Drug Price Relief Act, 
    147 Ohio St.3d 42
    ,
    
    2016-Ohio-3038
    , ¶ 10. Viewing the allegations in such light, the court may only grant a
    motion under Civ.R. 12(C) where it finds no material factual issues exist and the movant is
    entitled to judgment as a matter of law. Hinkle v. L Brands, Inc. World Headquarters, 10th
    Dist. No. 21AP-80, 
    2021-Ohio-4187
    , ¶ 9. Thus, a motion under Civ.R. 12(C) " 'tests the
    allegations of the complaint and presents a question of law.' " Jackson v. Ohio Dept. of
    Rehab. & Corr., 10th Dist. No. 19AP-621, 
    2020-Ohio-1518
    , ¶ 11, quoting Zhelezny v. Olesh,
    10th Dist. No. 12AP-681, 
    2013-Ohio-4337
    , ¶ 9. See Lytal v. Crawl for Cancer, Inc., 10th
    Dist. No. 17AP-771, 
    2018-Ohio-2017
    , ¶ 8, citing State ex rel. Midwest Pride IV, Inc. v.
    Pontious, 
    75 Ohio St.3d 565
    , 570 (1996), citing Peterson v. Teodosio, 
    34 Ohio St.2d 161
    , 166
    (1973) (stating that a court is permitted to consider both the complaint and answer in
    resolving the question of law presented by a Civ.R. 12(C) motion).
    B. Subrogation Under Ohio Workers' Compensation Law
    {¶ 10} R.C. Chapter 4123 provides the statutory framework for Ohio's workers'
    compensation system. See Stolz v. J & B Steel Erectors, Inc., 
    146 Ohio St.3d 281
    , 2016-
    Ohio-1567, ¶ 10. Under this chapter, the entity responsible for paying workers'
    compensation benefits to an injured claimant has a right of reimbursement from any
    recovery obtained by the claimant from a third party responsible for the injury. Ohio Bur.
    of Workers' Comp. v. Miller, 10th Dist. No. 12AP-753, 
    2013-Ohio-2072
    , ¶ 10, citing Ohio
    No. 21AP-385                                                                                                  5
    Bur. of Workers' Comp. v. McKinley, 
    130 Ohio St.3d 156
    , 
    2011-Ohio-4432
    , ¶ 27.3 This right
    of subrogation is codified in R.C. 4123.931(A), which provides that "[t]he payment of
    compensation or benefits [under workers' compensation statutes] creates a right of
    recovery in favor of a statutory subrogee against a third party, and the statutory subrogee
    is subrogated to the rights of a claimant against that third party. The net amount recovered
    is subject to a statutory subrogee's right of recovery." R.C. 4123.93 defines the terms used
    in the provisions of workers' compensation statutes related to subrogation:
    (A) "Claimant" means a person who is eligible to receive
    compensation, medical benefits, or death benefits under this
    chapter or Chapter 4121., 4127., or 4131. of the Revised Code.
    (B) "Statutory subrogee" means the administrator of workers'
    compensation, a self-insuring employer, or an employer that
    contracts for the direct payment of medical services pursuant
    to division (P) of section 4121.44 of the Revised Code.
    (C) "Third party" means an individual, private insurer, public
    or private entity, or public or private program that is or may be
    liable to make payments to a person without regard to any
    statutory duty contained in this chapter or Chapter 4121., 4127.,
    or 4131. of the Revised Code.
    (D) "Subrogation interest" includes past, present, and
    estimated future payments of compensation, medical benefits,
    rehabilitation costs, or death benefits, and any other costs or
    expenses paid to or on behalf of the claimant by the statutory
    subrogee pursuant to this chapter or Chapter 4121., 4127., or
    4131. of the Revised Code.
    3 Although it is not necessary to analyze the history of subrogation under workers' compensation law to dispose
    of the question presented in this case, we nevertheless note that the present statutory scheme was substantially
    amended in response to a decision of the Supreme Court of Ohio. In Holeton v. Crouse Cartage Co., 
    92 Ohio St.3d 115
     (2001), the Supreme Court struck down a prior version of the workers' compensation subrogation
    law, finding that it "operates unconstitutionally * * * because it allows for reimbursement from proceeds that
    do not constitute a double recovery." Holeton at 126. Following Holeton, the General Assembly enacted 2002
    Sub.S.B. No. 227 ("S.B. 227"), which amended subrogation provisions in R.C. 4123.93 and 4123.931. See State
    ex rel. United Auto., Aerospace & Agricultural Implement Workers of Am. v. Ohio Bur. of Workers' Comp.,
    
    108 Ohio St.3d 432
    , 
    2006-Ohio-1327
    , ¶ 14. The Supreme Court noted that Sub.S.B. 227 repealed the
    provisions that had been found unconstitutional in Holeton and found that, in replacing those provisions, "the
    manifest objective of the General Assembly in enacting S.B. 227 was to comply with our holding in Holeton."
    Id. at ¶ 17.
    No. 21AP-385                                                                                                  6
    C. Interpretation of R.C. 4123.93(D)
    {¶ 11} This case presents a question of statutory interpretation regarding the scope
    of the statutory subrogee's subrogation interest as that term is defined under R.C.
    4123.93(D). When interpreting statutory provisions, "our paramount concern is the
    legislative intent in enacting the statute." State ex rel. Steele v. Morrissey, Aud., 
    103 Ohio St.3d 355
    , 
    2004-Ohio-4960
    , ¶ 21, citing State ex rel. United States Steel Corp. v. Zaleski,
    
    98 Ohio St.3d 395
    , 
    2003-Ohio-1630
    , ¶ 12. " 'If the meaning of the statute is unambiguous
    and definite, it must be applied as written and no further interpretation is necessary.' "
    State ex rel. Natl. Lime & Stone Co. v. Marion Cty. Bd. of Commrs., 
    152 Ohio St.3d 393
    ,
    
    2017-Ohio-8348
    , ¶ 14, quoting State ex rel. Savarese v. Buckeye Local School Dist. Bd. of
    Edn., 
    74 Ohio St.3d 543
    , 545 (1996). See State v. Porterfield, 
    106 Ohio St.3d 5
    , 2005-Ohio-
    3095, ¶ 11 (stating that "[o]nly when a definitive meaning proves elusive should rules for
    construing ambiguous language be employed. Otherwise, allegations of ambiguity become
    self-fulfilling"); State v. J.L.S., 10th Dist. No. 18AP-125, 
    2019-Ohio-4173
    , ¶ 71.4
    {¶ 12} Statutory interpretation presents a question of law subject to a de novo
    standard of review. Natl. Lime & Stone at ¶ 14, citing Ceccarelli v. Levin, 
    127 Ohio St.3d 231
    , 
    2010-Ohio-5681
    , ¶ 8; State ex rel. Peregrine Health Servs. of Columbus, L.L.C. v.
    Sears, Dir., Ohio Dept. of Medicaid, 10th Dist. No. 18AP-16, 
    2020-Ohio-3426
    , ¶ 23. The
    Supreme Court of Ohio has held that courts " 'must give due deference to an administrative
    interpretation formulated by an agency that has accumulated substantial expertise, and to
    which the General Assembly has delegated the responsibility of implementing the
    legislative command.' " Bernard v. Unemp. Comp. Rev. Comm., 
    136 Ohio St.3d 264
    , 2013-
    Ohio-3121, ¶ 12, quoting Swallow v. Indus. Comm., 
    36 Ohio St.3d 55
    , 57 (1988). If the
    statute in question " 'is silent or ambiguous with respect to the specific issue, the question
    4 We note that R.C. 4123.95 provides: "Sections 4123.01 to 4123.94, inclusive, of the Revised Code shall be
    liberally construed in favor of employees and the dependents of deceased employees." See State ex rel.
    McDonald v. Indus. Comm., 10th Dist. No. 20AP-386, 
    2021-Ohio-4494
    , ¶ 27; State ex rel. Gen. Motors Corp.
    v. Indus. Comm., 10th Dist. No. 06AP-373, 
    2006-Ohio-6786
    , ¶ 20, fn. 7 (stating that R.C. 4123.95 requires
    liberal construction of a statute where "the statute is ambiguous and requires construction"). See generally
    Daugherty v. Cent. Trust Co. of Northeastern Ohio, N.A., 
    28 Ohio St.3d 441
    , 447 (1986), quoting Dennis v.
    Smith, 
    125 Ohio St. 120
    , 124 (1932) (stating that " ' "liberal construction" is not meant that words and phrases
    shall be given an unnatural meaning, or that the meaning shall be * * * expanded to meet a particular state of
    facts' "). As we do not find the statutory provisions at issue in this matter to be ambiguous, we need not apply
    R.C. 4123.95.
    No. 21AP-385                                                                                                          7
    for the court is whether the agency's answer is based on a permissible construction of the
    statute.' " Lang v. Dir., Ohio Dept. of Job & Family Servs., 
    134 Ohio St.3d 296
    , 2012-Ohio-
    5366, ¶ 12, quoting Chevron, U.S.A., Inc. v. Natural Resources Defense Council, Inc., 
    467 U.S. 837
    , 843 (1984).5 See Collateral Mgt. L.L.C. v. Ohio Dept. of Commerce, 10th Dist.
    No. 20AP-123, 
    2021-Ohio-1641
    , ¶ 24, citing Clark v. State Teachers Retirement Sys., 10th
    Dist. No. 18AP-105, 
    2018-Ohio-4680
    , ¶ 38. However, courts grant no deference to an
    administrative agency's interpretation of a statute when that interpretation conflicts with
    the express terms of an unambiguous statute. Employer's Choice Plus, Inc. v. Ohio Dept.
    of Job & Family Servs., 10th Dist. No. 18AP-297, 
    2019-Ohio-4994
    , ¶ 24, quoting Lang at
    ¶ 12. See Clark at ¶ 38.
    {¶ 13} Appellant contends BWC improperly included its administrative costs in
    calculating its subrogation interest. Specifically, appellant argues that BWC improperly
    included the cost of Dr. Yosowitz's record review and report as part of the medical bills in
    its subrogation interest following the settlement of appellant's third-party claim. BWC
    responds that Dr. Yosowitz's report should be included in its subrogation interest because
    it was a cost or expense paid "on behalf of" appellant as that term is used in R.C. 4123.93(D).
    {¶ 14} The court, construing the meaning of "costs or expenses" and "on behalf of"
    under R.C. 4123.93(D) according to rules of grammar and common usage, found that such
    terms "pertain to an amount paid by BWC or expenditure paid by BWC in the name of, on
    the part of, or as the agent or representative of a claimant." (June 28, 2021 Decision at 8.)
    As a result, the court found that "the costs and expenses incurred by BWC in connection
    with an injured worker's medical review—in this case [appellant]—are included within the
    statutory definition of 'subrogation interest' under R.C. 4123.93(D) because it is an
    expenditure paid by BWC on the part of a claimant." (June 28, 2021 Decision at 8.)
    5 We note that Chevron, on which Lang relies for its interpretation of agency authority, was based on the
    policy formulation and rulemaking process employed by federal agencies. See Chevron at 843-44, quoting
    Morton v. Ruiz, 
    415 U.S. 199
    , 231 (1974) (" 'The power of an administrative agency to administer a
    congressionally created . . . program necessarily requires the formulation of policy and the making of rules to
    fill any gap left, implicitly or explicitly, by Congress.' If Congress has explicitly left a gap for the agency to fill,
    there is an express delegation of authority to the agency to elucidate a specific provision of the statute by
    regulation."). See also R.C. 1.49(F) (providing that where "a statute is ambiguous, the court, in determining
    the intention of the legislature, may consider among other matters * * * [t]he administrative construction of
    the statute"). The case before us does not involve policy formulation or rulemaking.
    No. 21AP-385                                                                                                8
    {¶ 15} Here, we find the express terms of the statute to be unambiguous, though in
    so finding, we reach a different conclusion from BWC and the Court of Claims. The phrase
    "on behalf of" is not defined by the statute. Where "a term is not defined in the statute, it
    should be accorded its plain and ordinary meaning." Rhodes v. New Philadelphia, 
    129 Ohio St.3d 304
    , 
    2011-Ohio-3279
    , ¶ 17, citing Sharp v. Union Carbide Corp., 
    38 Ohio St.3d 69
    ,
    70 (1988). In reviewing the statutory language, we must read words and phrases in context
    and construe them according to the rules of grammar and common usage. R.C. 1.42.6 See
    In re Acubens, L.L.C., 10th Dist. No. 17AP-870, 
    2018-Ohio-2607
    , ¶ 14, citing Steele at ¶ 21,
    citing State ex rel. Rose v. Lorain Cty. Bd. of Elections, 
    90 Ohio St.3d 229
    , 231 (2000);
    Great Lakes Bar Control, Inc. v. Testa, 
    156 Ohio St.3d 199
    , 
    2018-Ohio-5207
    , ¶ 9, quoting
    Scalia & Garner, Reading Law: The Interpretation of Legal Texts 56 (2012) (" 'The words
    of a governing text are of paramount concern, and what they convey, in their context, is
    what the text means.' "). In giving words their common, everyday meaning, it is common
    for a court to rely on dictionary definitions. See Centerville v. Knab, 
    162 Ohio St.3d 623
    ,
    
    2020-Ohio-5219
    , ¶ 24; DLZ Corp. v. Ohio Dept. of Adm. Servs., 
    102 Ohio App.3d 777
    , 780
    (10th Dist.1995).
    {¶ 16} Merriam-Webster's Collegiate Dictionary defines "on behalf of" both as "in
    the interest of" and "as a representative of." Merriam-Webster's Collegiate Dictionary 110
    (11th Ed.2014).7 Similarly, the New Oxford American Dictionary defines "on behalf of" to
    mean: (1) "in the interests of a person, group, or principle"; (2) "as a representative of"; and
    (3) "on the part of; done by." New Oxford American Dictionary 150 (3d Ed.2010). The
    American Heritage Dictionary of the English Language defines "on behalf of" both as "[f]or
    the benefit of; in the interest of," and "[a]s the agent of; on the part of." The American
    Heritage Dictionary of the English Language 162 (5th Ed.2018). Webster's Third New
    6R.C. 1.42 requires that where "[w]ords and phrases that have acquired a technical or particular meaning,
    whether by legislative definition or otherwise," they must be "construed accordingly." See Youngstown Sheet
    & Tube Co. v. Lindley, 
    56 Ohio St.2d 303
    , 309 (1978). Here, the parties have not submitted any authority to
    support a technical or particular meaning for the phrase "on behalf of" under R.C. 4123.93(D). As a result, we
    must proceed with the command of R.C. 1.42 to read and construe the statute in question "in context and * * *
    according to the rules of grammar and common usage." Charvat v. Farmers Ins. Columbus, Inc., 
    178 Ohio App.3d 118
    , 
    2008-Ohio-4353
    , ¶ 12 (10th Dist.).
    7See Merriam-Webster, Behalf, https://www.merriam-webster.com/dictionary/behalf (accessed May 12,
    2022).
    No. 21AP-385                                                                                                     9
    International Dictionary defines "on behalf of" as "in the interest of," "as the representative
    of," and "for the benefit of." Webster's Third New International Dictionary 198 (2002).8
    The Random House Dictionary of the English Language 188 (2d Ed.1987) defines "on
    behalf of" to mean "as a representative of or a proxy for"; it also defines "on (someone's)
    behalf" to mean "in the interest or aid of (someone)." Thus, under the common sense
    meaning of "on behalf of" as defined above, any costs or expenses that are paid either in the
    interest of or as a representative of the claimant are within the scope of the statutory
    subrogee's subrogation interest under R.C. 4123.93(D). We find this common sense
    meaning of "on behalf of" resolves the question before us when applied to the facts of this
    case. See Madden v. Cowen & Co., 
    576 F.3d 957
    , 973 (9th Cir.2009) (finding the phrase
    "on behalf of" in a statutory provision had an "unambiguous, common sense meaning" that
    did not necessitate inquiring of other statutes); Rine v. Imagitas, Inc., 
    590 F.3d 1215
    , 1224-
    25 (11th Cir.2009) (considering the "ordinary meaning" of the phrase "on behalf of").
    {¶ 17} BWC argues that its subrogation interest includes the payment to Dr.
    Yosowitz for his record review and report because such payment was made on behalf of
    appellant. BWC supports this by arguing that appellant voluntarily initiated the request for
    additional allowances and, therefore, BWC was acting "to determine the propriety of
    [appellant's] request" by ordering the record review and report. (BWC's Brief at 24.) As a
    result, BWC argues that the cost or expense of the medical record review and report was
    8 We note BWC's argument that there exists a distinction between the phrases "on behalf of" and "in behalf
    of." However, while this may have been true, modern sources acknowledge that such distinction is no longer
    observed, or observed only infrequently. See Merriam-Webster at 110 ("A body of opinion favors in with the
    'interest, benefit' sense of behalf and on with the 'support, defense' sense. This distinction has been observed
    by some writers but overall has never had a sound basis in actual usage. In current British use, on behalf (of)
    has replaced in behalf (of); both are still used in American English, but the distinction is frequently not
    observed."); American Heritage Dictionary at 162 ("Statistically, on behalf of is used far more frequently than
    in behalf of, and in fact the Usage Panel prefers on behalf of for both meanings.") (Emphasis sic.); Garner's
    Modern English Usage 103 (4th Ed.2016) ("The phrases in behalf of and on behalf of have traditionally
    signified different things. In behalf of means 'in the interest or for the benefit of' * * * on behalf of means 'as
    the agent or representative of' * * *. In current usage, the distinction is seldom followed; on behalf of is much
    more common in both senses."); United States v. Romero, 
    293 F.3d 1120
    , 1126 (9th Cir.2002) (stating that
    "the plain meaning of 'on behalf of' is broader than 'to the benefit of,' as the term also encompasses acting in
    a representative capacity") (Emphasis sic.); Colony Tire Corp. v. Fed. Ins. Co., 217 F. Supp.3d 860, 866
    (E.D.N.C.2016); Occidental Fire & Cas. Co. v. Soczynski, D.Minn. No. 11-2412 (JRT/JSM), 
    2013 U.S. Dist. LEXIS 2687
     (Jan. 8, 2013), fn. 15 (noting that "the strict distinction between 'on behalf of' and 'in behalf of'
    * * * has been largely abandoned in the English language"); Jamison v. First Credit Servs., Inc., 
    290 F.R.D. 92
    , 99 (N.D.Ill.2013). Regardless, any difference between these phrases is immaterial to our resolution of the
    question presented as the result is the same under either definition.
    No. 21AP-385                                                                              10
    incurred in appellant's name and on his behalf. Despite this creative framing of the facts,
    BWC's argument belies its relationship with claimants, such as appellant, and contravenes
    the common sense meaning of the phrase "on behalf of" as it is used in R.C. 4123.93(D).
    {¶ 18} Appellant alleged in his complaint that he filed his claim for additional
    allowances after consulting his doctor, undergoing an evaluation, and providing support
    for his claim in the form of his doctor's medical report. BWC's actions upon receiving the
    claim were in its ministerial capacity through its review and processing of the claim by
    authorizing Dr. Yosowitz's review of appellant's medical records. In making its argument,
    BWC correctly notes that the workers' compensation process is designed as a
    nonadversarial system. See State ex rel. Ohio AFL-CIO v. Ohio Bur. of Workers' Comp., 
    97 Ohio St.3d 504
    , 
    2002-Ohio-6717
    , ¶ 49 (stating that the "workers' compensation system is
    designed to avoid the adversarial character of the civil justice system"). However, the
    nonadversarial nature of the claim review process does not mean that BWC's actions are
    undertaken as the representative of or for the benefit of the claimant. Rather, BWC's
    operations in reviewing claims, including, as here, requests for additional allowances, are
    in the nature of its ministerial or administrative function. This crucial distinction is
    supported by BWC's own statements.
    {¶ 19} As previously noted, BWC states that in ordering Dr. Yosowitz's record review
    and report, it was acting "to determine the propriety of [appellant's] request." (Emphasis
    added.) (BWC's Brief at 24.) BWC states that Dr. Yosowitz's medical review "was necessary
    to evaluate whether [appellant] was entitled to participate in the workers' compensation
    fund for the additional allowances." (Emphasis added.) (BWC's Brief at 22.) In order "[t]o
    assist in this determination," BWC relied on its authority under Ohio Adm.Code 4123-3-
    09(C)(4) to " 'at any point in the processing of an application for benefits, require the
    employee to submit to a physical examination or may refer a claim for investigation.' "
    (Emphasis added.) (BWC's Brief at 22, quoting Ohio Adm.Code 4123-3-09(C)(4).) See R.C.
    4123.53(A) (providing that BWC "may require any employee claiming the right to receive
    compensation to submit to a medical examination"). By these statements, it is clear that
    BWC was not ordering the record review in the interest of or as the representative of
    appellant, but, rather, to fulfill its ministerial purpose of administering the workers'
    No. 21AP-385                                                                                 11
    compensation system. See State ex rel. Crabtree v. Bur. of Workers' Comp., 
    71 Ohio St.3d 504
    , 507 (1994) (stating that the statutory framework of Ohio's workers' compensation
    system "consistently reflected" that the BWC's "role is ministerial"); Greene v. Conrad, 10th
    Dist. No. 96APE12-1780 (Aug. 21, 1997); Broyles v. Conrad, 2d Dist. No. 20670, 2005-
    Ohio-2233, ¶ 12. See also Willitzer v. McCloud, 
    6 Ohio St.3d 447
    , 449 (1983) (stating,
    under a prior version of workers' compensation scheme that an independent physician
    examining workers' compensation claimants, at the request of the commission for the
    purpose of reporting their medical conditions was performing an "investigative-medical
    fact-finding function").
    {¶ 20} BWC states that its "mission" is "to ensure that a claimant is fully and fairly
    compensated to the extent he or she is entitled to be—no more and no less." (Emphasis
    sic.) (BWC's Brief at 27.) Citing another provision of Ohio's workers' compensation
    statutes, BWC acknowledges that its "role" in this process is to serve "as steward and
    fiduciary of the State Insurance Fund." (BWC's Brief at 25, citing R.C. 4123.32(B).) See
    State ex rel. Daily Servs., L.L.C. v. Morrison, 
    154 Ohio St.3d 498
    , 
    2018-Ohio-2151
    , ¶ 25
    (stating that BWC "has a fiduciary responsibility to safeguard the Workers' Compensation
    Fund"); State ex rel. Harry Wolsky Stair Builder, Inc. v. Indus. Comm., 
    58 Ohio St.3d 222
    ,
    224 (1991) (stating that BWC's "sole fiduciary responsibility is to the State Insurance
    Fund"). Contrary to BWC's contentions, these statements of its purpose do not demonstrate
    that BWC is acting as the representative of or in the interest of claimants. Instead, they
    provide more support for BWC's ministerial role in fairly administering the claims
    presented to it by claimants.
    {¶ 21} Next, BWC argues that "any" is a term that expands the scope of costs or
    expenses to include " 'all' costs or expenses of 'whatever kind' that were paid 'to or on behalf
    of' the claimant." (BWC's Brief at 19.) While it is true that the term "any" expansively
    qualifies the types of costs or expenses within the scope of subrogation interest under R.C.
    4123.93(D), it is also true that "any" such costs or expenses must still be "paid to or on
    behalf of the claimant." Thus, considering the word in context, as we are required to do by
    R.C. 1.42, our determination as to the plain language of the statute is unchanged.
    No. 21AP-385                                                                                     12
    {¶ 22} BWC cites McManus v. Indus. Comm., 
    66 Ohio App. 14
     (1st Dist.1940), for
    the proposition that it was acting as " ' "the representative, if not the champion, of the
    claimant, to the extent of seeing that exact justice is done him" ' " by ordering Dr. Yosowitz
    to complete a medical record review and report. McManus at 21, quoting Miles v. Elec.
    Auto-Lite Co., 
    133 Ohio St. 613
    , 616 (1938), quoting Roma v. Indus. Comm., 
    97 Ohio St. 247
    , 252 (1918). First, it is important to note that McManus and the cases quoted therein
    were decided prior to amendments to Ohio's workers' compensation statutes which
    substantially changed the framework under which BWC and the commission operate. See
    State ex rel. Ohio AFL-CIO v. Voinovich, 
    69 Ohio St.3d 225
    , 226 (1994) (discussing 1993
    Am.Sub.H.B. No. 107 which "abolished the five-member Industrial Commission of Ohio,
    created a new three-member Industrial Commission, substantially amended the workers'
    compensation law, and made appropriations for the Bureau of Workers' Compensation and
    the new commission"); Druck v. Dynalectric Co. of Ohio, 2d Dist. No. 19688, 2003-Ohio-
    3767, ¶ 14, fn. 2, citing Greene, supra (stating that "BWC claims examiners are charged with
    'reviewing and processing' claims for benefits and 'investigating the facts,' but they no
    longer conduct adjudicative hearings").9
    {¶ 23} Second, significant factual differences distinguish Roma, the case which
    originated the language in McManus cited by BWC, from the present matter. In Roma, the
    court considered the question of whether an appeal from an order of the commission to the
    Mahoning County Common Pleas Court was timely because the claimant did not receive
    actual notice of the commission's order denying compensation for the claimant's injury.
    Because the claimant's attorney withdrew from representation and the record reflected that
    the claimant did not have actual notice of the commission's denial, which was sent to the
    claimant's former attorney, the court found the claimant's appeal to the common pleas
    court was timely. In so finding, the court noted that "the principles and objects sought to
    be attained by the Workmen's Compensation Act" included "obviat[ing] the necessity of
    claimants dealing with the board through agents, representatives or attorneys." Roma at
    252. The court found that by "voluntarily submit[ting] to the decision of the Board of
    9We further note the provisions at issue here were enacted and amended subsequent to McManus and the
    decisions cited therein.
    No. 21AP-385                                                                                  13
    Awards," the claimant "denied to himself the right he may have had, if any, to prosecute his
    claim in the courts of the state." Id. In this context, the court found that "[t]he state of Ohio
    by the very terms of the law becomes in fact the representative, if not the champion, of the
    claimant, to the extent of seeing that exact justice is done him, and it is quite manifestly the
    intention of the law that the ordinary rules of procedure, although wise and fair in the
    abstract, must give way, if, in adhering to them, any conclusion even savoring of injustice
    would result." Id. at 252-53. Therefore, we find BWC's citation of McManus is not
    dispositive of the question before us in the present matter both due to the substantial
    developments in the law following the issuance of Roma, the decision on which the quoted
    portion of McManus relies, and factual distinctions separating that matter from the
    present.
    {¶ 24} Thus, we cannot agree that including the cost of a record review and report
    performed by mandate of BWC in furtherance of BWC's administrative mission of
    discerning the merits of appellant's request for additional allowances comports with the
    common sense meaning of the phrase "on behalf of." Indeed, this interpretation strains the
    natural and most obvious reading of the statute's language. See Stolz at ¶ 9, citing Ohio
    Neighborhood Fin., Inc. v. Scott, 
    139 Ohio St.3d 536
    , 
    2014-Ohio-2440
    , ¶ 22 (stating in the
    context of applying an unambiguous statute that "a court must give effect to the natural and
    most obvious import of a statute's language, avoiding any subtle or forced constructions").
    Appellant did not request or authorize the services of Dr. Yosowitz; nor was BWC acting as
    appellant's representative by requesting the record review to further its ministerial
    function. Applying the common meaning of the express terms of the statute to the
    undisputed facts of this case leads to a straightforward, unambiguous result—BWC's
    administrative costs are not encompassed by the definition of subrogation interest. As a
    result, the Court of Claims erred in finding Dr. Yosowitz's medical review and report was
    properly included in BWC's subrogation interest.
    {¶ 25} We note appellant also argues that the court erred in failing to consider
    potential conflict between the parties' differing interpretations of the definition of
    subrogation interest and other provisions of workers' compensation law. Although analysis
    of other statutory code provisions is unnecessary given our resolution of the question under
    No. 21AP-385                                                                               14
    the common, everyday meaning of the text at issue, and recognizing precedent of the
    Supreme Court applying the in pari materia rule of construction to ambiguous statutory
    language, we nevertheless find the context of the subrogation provision at issue within the
    broader scope of workers' compensation law to be of note. See Ohio Neighborhood at ¶ 34,
    citing State v. Krutz, 
    28 Ohio St.3d 36
    , 37-38 (1986) (citing Krutz for the proposition that
    "in pari materia rule applies only when a statute is ambiguous or the significance of its
    terms is doubtful"); State ex rel. Herman v. Klopfleisch, 
    72 Ohio St.3d 581
    , 585 (1995). See
    also R.C. 1.42; Great Lakes Bar Control at ¶ 9.
    {¶ 26} The Supreme Court has stated the following with regard to potentially
    conflicting statutory provisions:
    First, all statutes which relate to the same general subject
    matter must be read in pari materia. And, in reading such
    statutes in pari materia, and construing them together, this
    court must give such a reasonable construction as to give the
    proper force and effect to each and all such statutes. The
    interpretation and application of statutes must be viewed in a
    manner to carry out the legislative intent of the sections. All
    provisions of the Revised Code bearing upon the same subject
    matter should be construed harmoniously. This court in the
    interpretation of related and co-existing statutes must
    harmonize and give full application to all such statutes unless
    they are irreconcilable and in hopeless conflict.
    (Internal citations omitted.) Johnson's Markets, Inc. v. New Carlisle Dept. of Health, 
    58 Ohio St.3d 28
    , 35 (1991). Thus, "[t]he statutory-construction canon of in pari materia
    instructs that statutes relating to the same subject 'be construed together, so that
    inconsistencies in one statute may be resolved by looking at [the] other statute on the same
    subject.' " State v. Smith, __Ohio St.3d __, 
    2022-Ohio-274
    , ¶ 30, quoting Black's Law
    Dictionary 911 (10th Ed.2014). See Thomas v. Freeman, 
    79 Ohio St.3d 221
    , 225 (1997)
    (stating that the "maxim of in pari materia indicates that acts will be given full meaning and
    effect if they can be reconciled"); State v. Pribble, 
    158 Ohio St.3d 490
    , 
    2019-Ohio-4808
    ,
    ¶ 12, quoting State v. Moaning, 
    76 Ohio St.3d 126
    , 128 (1996) (" 'It is a well-settled rule of
    statutory interpretation that statutory provisions be construed together and the Revised
    Code be read as an interrelated body of law.' "); Meyers v. Hadsell Chem. Processing,
    L.L.C., 10th Dist. No. 18AP-387, 
    2019-Ohio-2982
    , ¶ 34.
    No. 21AP-385                                                                                15
    {¶ 27} R.C. 4123.53(A) provides in pertinent part as follows:
    The administrator of workers' compensation or the industrial
    commission may require any employee claiming the right to
    receive compensation to submit to a medical examination,
    vocational evaluation, or vocational questionnaire at any time,
    and from time to time, at a place reasonably convenient for the
    employee, and as provided by the rules of the commission or
    the administrator of workers' compensation. A claimant
    required by the commission or administrator to submit to a
    medical examination or vocational evaluation, at a point
    outside of the place of permanent or temporary residence of the
    claimant, as provided in this section, is entitled to have paid to
    the claimant by the bureau of workers' compensation the
    necessary and actual expenses on account of the attendance for
    the medical examination or vocational evaluation after
    approval of the expense statement by the bureau.
    Thus, in the process of reviewing a claimant's claim, BWC may require the claimant to
    submit to a medical examination pursuant to R.C. 4123.53(A). It is further noteworthy that,
    in the event a claimant is required to submit to an examination outside the claimant's place
    of residence, the claimant is entitled to be paid for the expense of attending the
    examination. Similarly, Ohio Adm.Code 4123-3-09(C)(4) provides that "[t]he bureau or
    commission may, at any point in the processing of an application for benefits, require the
    employee to submit to a physical examination or may refer a claim for investigation."
    {¶ 28} R.C. 4123.341 provides in pertinent part:
    The administrative costs of the industrial commission, the
    bureau of workers' compensation board of directors, and the
    bureau of workers' compensation shall be those costs and
    expenses that are incident to the discharge of the duties and
    performance of the activities of the industrial commission, the
    board, and the bureau under this chapter and [other listed
    workers' compensation statutes], and all such costs shall be
    borne by the state and by other employers amenable to this
    chapter * * *.
    Thus, under R.C. 4123.341, BWC's administrative costs include those costs and expenses
    that are incident to the discharge of its duties and performances of its activities. BWC, along
    with subject employers, is required to bear the burden of paying for such administrative
    costs, and is prohibited from passing such costs on to claimants. See Cirino v. Ohio Bur. of
    Workers' Comp., 
    153 Ohio St.3d 333
    , 
    2018-Ohio-2665
    , ¶ 4, quoting R.C. 4123.341 (stating
    No. 21AP-385                                                                                 16
    that "the bureau * * * is required to ensure that all 'administrative costs'—that is, all costs
    that are 'incident to the discharge of the duties and performance of the activities of the * * *
    bureau'—are borne by the state and employers").
    {¶ 29} From the foregoing, it is clear that, in the processing of a claim for benefits,
    BWC has the authority to refer such claim for investigation, as was done in this case when
    BWC sought Dr. Yosowitz's opinion of appellant's medical records. The fact that this
    procedure occurs in the processing of an application for benefits, renders this procedure
    "incident to the discharge of the duties and performance of the activities" of the BWC. R.C.
    4123.341. As a result, BWC, not the claimant, is required to bear the expense of such
    administrative cost. Considering R.C. 4123.53(A), Ohio Adm.Code 4123-3-09(C)(4), and
    R.C. 4123.341 in pari materia with R.C. 4123.93, it is apparent that the cost or expense of
    the medical record review and report prepared by Dr. Yosowitz at the direction of BWC was
    an administrative cost, and, as such, was required to be borne by BWC, not charged to
    appellant as part of BWC's subrogation interest. Therefore, having found under the
    common, everyday meaning of the plain language of R.C. 4123.93(D) that the cost or
    expense paid by BWC for Dr. Yosowitz's record review and report cannot be considered to
    be encompassed under the statutory definition of subrogation interest, we must sustain
    appellant's assignment of error and remand this matter for further proceedings.
    {¶ 30} Accordingly, we sustain appellant's sole assignment of error.
    IV. Conclusion
    {¶ 31} Having sustained appellant's sole assignment of error, we reverse the
    June 28, 2021 decision and judgment entry of the Court of Claims of Ohio and remand this
    matter to that court for further proceedings consistent with law and this decision.
    Judgment reversed
    and cause remanded.
    KLATT and MENTEL, JJ., concur.
    

Document Info

Docket Number: 21AP-385

Citation Numbers: 2022 Ohio 1603

Judges: Dorrian

Filed Date: 5/12/2022

Precedential Status: Precedential

Modified Date: 5/12/2022

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