Brown v. Bur. of Workers' Comp. , 2011 Ohio 3695 ( 2011 )

[Cite as Brown v. Bur. of Workers’ Comp., 2011-Ohio-3695.]
Court of Appeals of Ohio
EIGHTH APPELLATE DISTRICT
COUNTY OF CUYAHOGA
JOURNAL ENTRY AND OPINION
No. 96209
EDWIN O. BROWN, JR.
PLAINTIFF-APPELLANT
vs.
BUREAU OF WORKERS’ COMP., ET AL.
DEFENDANTS-APPELLEES
JUDGMENT:
AFFIRMED
Civil Appeal from the
Cuyahoga County Court of Common Pleas
Case No. CV-736193
BEFORE: Cooney, J., Kilbane, A.J., and S. Gallagher, J.
RELEASED AND JOURNALIZED: July 28, 2011
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ATTORNEYS FOR APPELLANT
Michael H. Gruhin
Gloria S. Gruhin
Gruhin & Gruhin
2000 Auburn Drive, 2nd Floor
Beachwood, Ohio 44122
ATTORNEYS FOR APPELLEES
For Greater Cleveland RTA
Sheryl King Benford
General Counsel G.C.R.T.A.
Lisa Anne Cottle
Associate Counsel
Greater Cleveland RTA
1240 West 6th Street
Cleveland, Ohio 44113
For Bureau of Workers’ Compensation
Michael Dewine
Ohio Attorney General
30 East Broad Street
State Office Tower
Columbus, Ohio 43215
Michael J. Zidar
Assistant Attorney General
Workers’ Compensation Sect.
615 W. Superior Ave., 11th Floor
Cleveland, Ohio 44113
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COLLEEN CONWAY COONEY, J.:
{¶ 1} Plaintiff-appellant, Edwin O. Brown, Jr. (“Brown”), appeals the trial court’s
judgment dismissing his complaint against defendant-appellee, the Greater Cleveland Regional
Transit Authority (“RTA”). Finding no merit to the appeal, we affirm.
{¶ 2} In 1995, while employed by RTA, Brown sustained a work-related injury to his
left knee. Brown’s workers’ compensation claim was approved. After attempting to return
to work, Brown took full disability leave in 1997. Brown managed his injury with
“self-treatment and over the counter medications” for the last 13 years.
{¶ 3} In 2010, Brown’s orthopedic doctor submitted a request to reactivate Brown’s
1995 claim in order to cover medical treatments. The request was denied by RTA. The
claim proceeded to a hearing by the Ohio Industrial Commission (“OIC”). The OIC district
hearing officer denied Brown’s claim, finding that the proposed treatment was “not related to
the allowed conditions in this claim.” Brown appealed this decision, and the matter was
heard by a staff hearing officer, who also affirmed the denial.
{¶ 4} Brown then filed an appeal and a complaint in the court of common pleas,
naming both RTA and the Administrator of the Ohio Bureau of Workers’ Compensation.
RTA filed a motion to dismiss pursuant to Civ.R. 12(B)(1), claiming that the trial court lacked
subject matter jurisdiction over Brown’s claim because R.C. 4123.512 precludes an appeal
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from a decision of the OIC relating to questions of “extent of disability.” The court granted
the motion.
{¶ 5} It is from this dismissal that Brown now appeals, raising one assignment of
error.
{¶ 6} In his sole assignment of error, Brown argues that the trial court erred in
granting RTA’s motion to dismiss. Brown claims that the denial of his claim constitutes a
complete bar to all future treatment and, therefore, a termination of his right to participate in
the workers’ compensation fund. RTA argues that the trial court committed no error in
dismissing Brown’s claim because it was not allowed under R.C. 4123.512(A).
{¶ 7} We apply a de novo standard of review to the trial court’s granting of a motion
to dismiss under Civ.R. 12(B)(1) for lack of subject matter jurisdiction. See Internatl. Total
Serv., Inc. v. Garlitz, Cuyahoga App. No. 90441, 2008-Ohio-3680, ¶6, citing Dzina v. Avera
Internatl. Corp., Cuyahoga App. No. 86583, 2006-Ohio-1363, and Madigan v. Cleveland,
Cuyahoga App. No. 93367, 2010-Ohio-1213, ¶20, citing Perrysburg Twp. v. Rossford, 103
Ohio St. 3d 79, 2004-Ohio-4362, 814 N.E.2d 44, ¶5. Under this standard of review, we must
independently review the record and afford no deference to the trial court’s decision.
Herakovic v. Catholic Diocese of Cleveland, Cuyahoga App. No. 85467, 2005-Ohio-5985.
{¶ 8} R.C. 4123.512(A) provides that a:
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“claimant * * * may appeal an order of the industrial commission made under division
(E) of section 4123.511 of the Revised Code in an injury or occupational disease case,
other than a decision as to the extent of disability to the court of common pleas of the
county in which the injury was inflicted * * *.”
{¶ 9} Thus, an injured worker may only appeal a decision involving the “right to
participate” in the workers’ compensation fund. See White v. Conrad, 102 Ohio St. 3d 125,
2004-Ohio-2148, 807 N.E.2d 327, at ¶10-13; State ex rel. Liposchak v. Indus. Comm. (2000),
90 Ohio St. 3d 276, 278-279, 737 N.E.2d 519; Felty v. AT&T Technologies, Inc. (1992), 65
Ohio St. 3d 234, 239, 602 N.E.2d 1141.
{¶ 10} The only right-to-participate question that is subject to judicial review is
“whether an employee’s injury, disease, or death occurred in the course of and arising out of
his or her employment.” Liposchak at 279; Felty, paragraph two of the syllabus; Afrates v.
Lorain (1992), 63 Ohio St. 3d 22, 584 N.E.2d 1175, paragraph one of the syllabus; State ex rel.
Evans v. Indus. Comm. (1992), 64 Ohio St. 3d 236, 594 N.E.2d 609. An OIC decision that
pertains to the extent of the claimant’s disability is not appealable to the court of common
pleas. Such a decision must be challenged in an action for mandamus. Liposchak; Thomas
v. Conrad (1998), 81 Ohio St. 3d 475, 477, 692 N.E.2d 205; Felty, paragraph two of the
syllabus. “Once the right of participation for a specific condition is determined * * *, no
subsequent rulings, except a ruling that terminates the right to participate, are appealable * *
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*.” (Emphasis added.) Felty v. AT&T Technologies, Inc. (1992), 65 Ohio St. 3d 234, 602
N.E.2d 1141, paragraph two of the syllabus.
{¶ 11} An order terminates an employee’s right to participate when the order
permanently forecloses the employee from receiving any further benefits under the recognized
claim. Id. at 239.
“Ordinarily, an order regarding payment or authorization of specific medical treatment
deals with the extent of the employee’s disability and does not foreclose the employee
from receiving further compensation under the recognized claim.” Ballinger v.
Conrad (2000), Cuyahoga App. No. 76969, Blackmon, J., dissenting.
{¶ 12} However, an order that permanently forecloses further benefits under a claim
that has been filed is appealable. Evans, paragraph two of the syllabus.
{¶ 13} In the instant case, Brown argues that the decision to deny his request for
coverage of certain treatments, a request that would reactivate his 1995 dormant claim,
effectively terminates his right to participate in the fund. However, in Evans, the Ohio
Supreme Court explicitly held:
“The Industrial Commission’s refusal to reactivate benefits under an existing claim
does not finalize the disallowance of the employee’s claim because that decision does
not foreclose all future compensation under that claim. For this reason, the Industrial
Commission’s decision to deny or grant additional benefits under a previous claim does
not determine the worker’s right to participate in the State Insurance Fund, and is not
subject to appeal pursuant to R.C. 4123.519.” Id. at 240.
{¶ 14} In addition, the Ohio Supreme Court found in Felty that:
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“[R]equests by a litigant for additional activity in a case, for temporary suspension of a
claim, or for one of the myriad interlocutory orders the commission may issue in
administering a case are not ‘claims.’ For example, a decision by the commission to
allow or deny additional compensation for a previously allowed condition when there
is no new condition is not appealable because it goes to the extent of the injury —
there is no new claim.” Id. at 239.
{¶ 15} Brown relies on a Sixth District case, Newell v. TRW, Inc. (2001), 145 Ohio
App.3d 198, 762 N.E.2d 419, to support his claim that the denial terminated his right to
participate. In Newell, the claimant was denied further medical treatment because the
hearing officer found that “there [was] no need for treatment relative to the residuals of the * *
* industrial injury,” and the temporary total disability was denied. The Newell court held
that this finding barred Newell from all future participation. Thus, the court held that the
common pleas court had jurisdiction to hear the claimant’s appeal.
{¶ 16} Similarly, in Ortiz v. G & S Metal Products Co., Cuyahoga App. No. 91811,
2009-Ohio-1781, this court found that the trial court erred in dismissing a workers’
compensation claim in which the hearing officer determined that Ortiz “no longer needed
treatment” for his pre-existing injury to his wrist and thus foreclosed him from further
benefits.
{¶ 17} However, Brown’s reliance on Newell and Ortiz is misplaced because his case
is factually distinguishable. Brown’s OIC denial does not contain any language that indicates
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“no need for treatment” and that would permanently bar his participation in the workers’
compensation fund. Brown’s OIC denial stated, in pertinent part:
“District Hearing Officer finds the requested treatment is not reasonably related and/or
medically necessary for treatment of the allowed condition in this claim based upon the
addendum report of Dr. Levy date 04/05/2010.
“District Hearing Officer further denies the C-9 dated 04/19/2010 requesting
retroactive authorization for reactivation of claims, including payment of the
11/09/2009 office visit, as the 11/09/2009 visit and subsequent treatment to the left
knee is not related to the allowed conditions in this claim.”
{¶ 18} Pursuant to Evans, we find that the language of Brown’s denial does not
constitute a complete termination of his participation in the fund. Moreover, Brown did not
allege a new injury in his attempt to reactivate his pre-existing claim. The language of the
denial clearly illustrates that the commission’s decision did not terminate Brown’s entire
claim, but merely denied coverage for the specific treatment. Having denied coverage of that
medical treatment, there was no reason to reactivate his claim. This denial in no way
prevents Brown from filing subsequent requests for coverage and if/when those requests are
reasonably related to and/or medically necessary, his claim will be reactivated. See Ochs v.
Bur. of Workers’ Comp., Cuyahoga App. No. 93824, 2010-Ohio-2103, appeal not allowed,
126 Ohio St. 3d 1586, 2010-Ohio-4542, 934 N.E.2d 357. Brown’s denial was based purely
on an “extent of injury” issue that is not appealable to the court of common pleas under R.C.
4123.512. Thus, the trial court committed no error in dismissing the complaint.
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{¶ 19} Accordingly, Brown’s sole assignment of error is overruled.
Judgment affirmed.
It is ordered that appellees recover of appellant costs herein taxed.
The court finds there were reasonable grounds for this appeal.
It is ordered that a special mandate issue out of this court directing the
common pleas court to carry this judgment into execution.
A certified copy of this entry shall constitute the mandate pursuant to
Rule 27 of the Rules of Appellate Procedure.
______________________________________________
COLLEEN CONWAY COONEY, JUDGE
MARY EILEEN KILBANE, A.J., and
SEAN C. GALLAGHER, J., CONCUR