Maloney v. Conrad, Unpublished Decision (12-5-2003)
Maloney v. Conrad, Unpublished Decision (12-5-2003)
Opinion of the Court
{¶ 2} Since suffering the work-related injuries, Maloney has received periodic chiropractic treatment. He left DuBois Chemical in 1999 for his current job as a stocker for the Kroger Company. In 2000, Diversey notified Maloney that it would no longer pay for the chiropractic treatments. Therefore, in May 2001, Maloney filed with the Industrial Commission a C-86 motion under the claim numbered L41500-22, seeking authorization of treatment and the payment of his chiropractic bills. Maloney's motion was denied by both the district and staff hearing officers. The Industrial Commission denied further administrative review. In January 2002, Maloney filed a C-86 motion under the claim numbered L250232-22, seeking authorization for treatment and the payment of his chiropractic bills. Again, the district and staff hearing officers denied his motion and the Industrial Commission denied further review.
{¶ 3} Maloney then filed a complaint in the common pleas court, pursuant to R.C.
{¶ 4} In opposing the defendants' motion for summary judgment, Maloney argued that it was not clear from the decisions whether the Industrial Commission had ruled upon the "extent of disability" or foreclosed all future compensation and medical treatment under the claims. If the decisions did the latter, then they terminated Maloney's right to participate in the fund and are subject to the judicial review provided for in R.C.
{¶ 5} The trial court agreed with Diversey and granted summary judgment, holding that the administrative decisions pertained to the "extent of disability," foreclosing the court's jurisdiction over the complaint. Maloney has appealed, arguing in his sole assignment of error that the trial court erred in granting summary judgment.
{¶ 7} The decision of the district hearing officer denying Maloney's C-86 motion for his "cervical sprain/strain; thoracic sprain/strain; trapezius sprain" claim states, in relevant part, that "[t]he claimant's request for payment of bills for treatment rendered and for authorization of chiropractic treatment is denied. The District Hearing Officer finds that the requested treatment is not medically necessary for the allowed conditions from the 04/02/92 industrial injury. Dr. Fisher causally relates the need for continuing care to the claimant's current work as a stocker [at Kroger], rather than the 04/02/92 injury." The staff hearing officer's decision affirming the district hearing officer's decision reads, in relevant part, "The Staff Hearing Officer finds that the requested medical treatment by Dr. Collins and Dr. Kemmet consisting of chiropractic treatment beginning January 2000 to the present time is not medically reasonable and appropriate for treatment of the allowed conditions stemming from this industrial injury. Therefore, the requested treatment is denied. This order is based upon the medical report of Dr. Fisher dated 01/24/2002."
{¶ 9} The decisions are confusing for two reasons. First, the district hearing officer's decisions state that Maloney's need for chiropractic care is due to an intervening cause — his stocker job at Kroger. The reviewing decisions do not mention the intervening cause, but rely upon the medical reports making that conclusion. Where intervening incidents are involved in the denial of disability compensation, the hearing officer must clearly state the nature of the intervening incident, the causal nexus between the intervening trauma and the claimed disability, and, if possible, whether such a causal nexus forecloses all future compensation and medical treatment under a claim.2
{¶ 10} Second, the decisions use words such as "on-going" and "continuing care" in describing the treatment denied, which could indicate a permanent foreclosure of payment for the treatment of allowed conditions. The hearing officer must clarify the breadth of a preclusion in order for a court to meaningfully address the issue of jurisdiction in an appeal from the hearing officer's decision.3
Judgment vacated and cause remanded.
Doan, P.J., and Winkler, J., concur.
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