Wheeling-Pittsburgh Steel Corp. v. Indus. Comm., 06ap-175 (6-5-2007)
Wheeling-Pittsburgh Steel Corp. v. Indus. Comm., 06ap-175 (6-5-2007)
Opinion of the Court
{¶ 2} R.C. Chapter 4123 sets forth a comprehensive scheme for workers' compensation. Anders v. Powertrain Div., General Motors Corp,
{¶ 3} As pertinent here, R.C.
{¶ 4} Commission Resolution R96-1-01 ("R96-1-01"), adopted February 26, 1996, requires a claimant to submit certain evidence before the administrator may refer the claim to a qualified medical specialist pursuant to R.C.
{¶ 5} With the foregoing in mind, we turn to the instant matter. On May 22, 2003, claimant filed a First Report of an Injury, Occupational Disease or Death ("FROI-1") alleging that he developed chronic obstructive pulmonary disease and chronic bronchitis as a result of his exposure to particulates, including dust and dirt, over the course of his 30-year employment with relator. Relator, a self-insured employer, denied the claim. Thereafter, the claim progressed through the appropriate administrative channels and was ultimately denied on grounds that claimant failed to meet the evidentiary criteria established by R96-1-01 and R03-1-02. *Page 4
{¶ 6} On December 22, 2004, claimant filed another FROI-1 alleging, in essence, that which was alleged in the original FROI-1. Following a hearing on July 19, 2005, a DHO dismissed the claim for failure to satisfy R96-1-01 and R03-1-02.
{¶ 7} Claimant appealed, and after a hearing on August 30, 2005, an SHO issued an interlocutory order finding that the claimant had satisfied the prerequisites of R96-1-01; accordingly, the SHO referred the claim to the administrator to arrange for an examination by a qualified pulmonary specialist pursuant to the provisions of R.C.
{¶ 8} Pursuant to the SHO's interlocutory order, a pulmonary specialist examined claimant and issued a report of his findings. Upon receipt of the examination results, an SHO held a hearing and thereafter issued an order on November 22, 2005, which allowed the claim for "occupational asthma" and "chronic obstructive pulmonary disease." Another SHO refused relator's appeal.
{¶ 9} On January 27, 2006, pursuant to R.C.
{¶ 10} On February 24, 2006, relator filed the instant complaint in mandamus. Relator asserts that the process employed by the commission unlawfully denied relator its statutory right to a district level hearing "on the merits" of the claim allowance. Relator claims that R.C.
{¶ 11} The matter was referred to a magistrate of this court pursuant to Civ.R. 53 and Loc.R. 12(M) of the Tenth District Court of Appeals. The magistrate issued a decision, including findings of fact and conclusions of law, recommending that this court deny relator's request for a writ of mandamus. (Attached as Appendix A.)
{¶ 12} Relator has filed an objection to the magistrate's decision. Claimant and the commission have filed responses in support of the magistrate's decision. In addition, the commission contends that mandamus does not lie in this action because relator has an adequate remedy at law in the form of the R.C.
{¶ 13} Relying upon State ex rel. Elyria Foundry Co. v. Indus.Comm. (1998),
{¶ 14} R.C.
The claimant or the employer may appeal an order of the industrial commission made under division (E) of section
4123.511 of the Revised Code in any 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. * * * If the claim is for an occupational disease, the appeal shall be to the court of common pleas of the county in which the exposure which caused the disease occurred. Like appeal may be taken from an order of a staff hearing officer made under division (D) of section4123.511 of the Revised Code from which the commission has refused to hear an appeal. * * *
{¶ 15} The Supreme Court of Ohio has narrowly construed R.C.
{¶ 16} The court reiterated the rationale of Afrates in Felty v. AT T Tech., Inc. (1992),
{¶ 17} In State ex rel. Liposchak v. Indus. Comm. (2000),
{¶ 18} In State ex rel. Walls v. Indus. Comm. (2000),
"A `claim' in a workers' compensation case is the basic or underlying request by an employee to participate in the compensation system because of a specific work-related injury or disease. A decision by the commission determines the employee's right to participate if it finalizes the allowance or disallowance of an employee's `claim.' [Therefore, the] only action by the commission that is appealable under R.C.
4123.519 [now 4123.512] is this essential decision to grant, to deny, or to terminate the employee's participation or continued participation in the system." [Felty v. AT T Technologies, Inc. (1992),65 Ohio St.3d 234 ,602 N.E.2d 1141 ] at 239,602 N.E.2d at 1145 .An objection to R.C.
4123.522 relief does not fit this criterion.
* * * Id.
{¶ 19} Similarly, relator's challenge to the commission's failure to follow the statutory process of R.C.
{¶ 20} Further, Elyria Foundry is distinguishable from the instant case. Therein, the commission, using the lawful hearing process, entered a final order that both allowed a claim and awarded temporary total disability ("TTD") compensation. The employer appealed the allowance of the claim to the common pleas court and challenged the TTD compensation award in a mandamus action. The Supreme Court of Ohio held that the mandamus challenge to the compensation decision was premature because the issue of *Page 9 the allowance of the entire claim was pending in the court action. Id. at 89. Had the court appeal proved successful, the commission's award of compensation would be negated.
{¶ 21} It is well-settled that mandamus will lie to compel the commission to perform a statutory duty. State ex rel. Coen v. Indus.Comm. (1933),
{¶ 22} Relator also offers this court's decision in State ex rel.Wells v. Indus. Comm., Franklin App. No. 04AP-758,
* * * [I]n an appeal, pursuant to R.C.
4123.512 , the issues to be addressed by the [court of common pleas] would be those relating to the presence of a medical condition and whether or not it was a work-related injury, and the [court of common pleas] would not address and could not correct an improper exercise of jurisdiction by the commission granting reconsideration pursuant to R.C.4123.52 . * * *
Id., citing State ex rel. Forrest v. Anchor Hocking Consumer Glass, Franklin App. No. 03AP-190,
{¶ 23} We determined that the claimant's common pleas court action was "not an adequate remedy to address the isolated issue of the commission's exercise of continuing jurisdiction[,]" the procedural point at issue. Wells, at ¶ 11. We concluded that this procedural issue did not "fall under the penumbra of a right-to-participate action." Id. Because the procedural issue could not be challenged in the claimant's common pleas court action, we concluded that the magistrate "correctly declined to dismiss the present mandamus action." Id.
{¶ 24} Applying the Supreme Court of Ohio's decisions in Afrates,Felty, Liposchak and Walls and this court's decision in Wells, we concur in relator's position that mandamus is the proper means by which to challenge the administrative procedure employed by the commission in the instant case.
{¶ 25} Having so determined, we now address relator's objection to the substance of the magistrate's decision. The magistrate rejected relator's contention that it had a *Page 11
clear legal right under R.C.
* * * The claimant in Webb maintained, as Jones does here, that new evidence of disqualifying factors must be submitted first to a DHO, who possesses original jurisdiction in "contested claims matters' involving TTD under R.C.
4121.34 (B). The Webb court disagreed, holding that the [Dayton Regional Board of Review] had jurisdiction to review all aspects of a claimant's TTD eligibility, including evidence that the claimant's condition had become permanent, notwithstanding that the issue of permanency or maximum medical improvement ("MMI") had not been determined initially by the DHO. * * *In effect, Webb reasoned that "contested claims matters," as used in former R.C. 412134.(B)(2) (now R.C.
4121.34 [B][3]), granted DHOs authority to resolve the claimant's overall TTD eligibility, which depends on whether the claimant qualified initially for benefits and continues to be qualified. * * * The Webb court concluded that where the claimant seeks TTD, the "contested matter" is the challenged allowance of the entire claim, not the various considerations, such as permanency, that may factor into this determination. The DHO in Webb had already exercised original jurisdiction in initially awarding TTD. Thus, the court concluded hat the administrative appeal necessarily placed before the [Dayton regional Board of Review] developments occurring since the DHO's order that could disqualify the claimant from receiving TTD.
Jones, at 505-506.
{¶ 26} The magistrate first observed that R.C.
{¶ 27} The magistrate concluded that the commission complied with the procedures set forth in both R.C.
{¶ 28} The magistrate concluded that R.C.
{¶ 29} Relator's objection essentially reargues the issue presented to the magistrate. Indeed, relator reiterates its position that R.C.
{¶ 30} Although neither case is precisely on point, Webb andJones instruct that, where a DHO has already exercised original jurisdiction in a contested-claims matter, the administrative appeal necessarily places before the SHO developments occurring since the DHO issued his or her order. In this case, after claimant filed the December 22, 2004 FROI-1, the DHO assumed original jurisdiction over the contested claim pursuant to R.C.
{¶ 31} In short, we agree with the magistrate's conclusion that R.C.
{¶ 32} For the foregoing reasons, we adopt the magistrate's decision as our own, including his findings of fact and conclusions of law, and deny the requested writ of mandamus.
Objection overruled; writ denied.
Findings of Fact:
{¶ 34} 1. Effective February 26, 1996, the commission enacted resolution R96-1-01 which declares:THEREFORE BE IT RESOLVED that it is the policy of the Industrial Commission that at a minimum the following evidence is necessary to be submitted by the claimant prior to the referral of the claim to the Administrator for an examination by a qualified medical specialist pursuant to the provisions of Section
4123.68 concerning claims for occupational diseases of the respiratory tract resulting from injurious exposure to dust.• A written interpretation of x-rays by a certified "B reader."
• Pulmonary functions studies and interpretation by a licensed physician.
• An opinion of causal relationship by a licensed physician.
(Emphasis sic.)
{¶ 35} 2. Effective March 5, 2003, the commission enacted resolution R03-1-02 which declares:
THEREFORE BE IT RESOLVED that Resolution R96-1-01 be modified to the extent that it is the policy of the Commission that, at a minimum, the following evidence is necessary to be submitted by the injured worker prior to the referral of the claim to the Administrator for an examination by a qualified medical specialist pursuant to the provisions of Section
4123.68 of the Ohio Revised Code concerning claims for asbestosis, as well as for claims for sillcosis, coal miners pneumoconiosis, and for occupational diseases of the respiratory tract resulting from injurious exposure to dust, and at a minimum, the following evidence is also necessary to be submitted by an injured worker prior to the adjudication *Page 17 of a contested claim filed for any asbestos-related occupational disease, other than mesothelioma:• A written interpretation of x-rays by a certified "B reader."
• Pulmonary functions studies and interpretation by a licensed physician.
• An opinion of causal relationship by a licensed physician.
(Emphasis sic.)
{¶ 36} 3. On May 22, 2003, claimant filed an industrial claim on a form captioned First Report of an Injury, Occupational Disease or Death ("FROI-1"). Therein, claimant alleged that he developed chronic obstructive pulmonary disease and chronic bronchitis as a result of his employment with relator, a self-insured employer under Ohio's workers' compensation laws.
{¶ 37} 4. Following a June 30, 2003 hearing, a district hearing officer ("DHO") issued an order denying the May 22, 2003 industrial claim on grounds that claimant had failed to meet the requirements of commission resolution R96-1-01.
{¶ 38} 5. Claimant administratively appealed the June 30, 2003 DHO's order.
{¶ 39} 6. Following an August 5, 2003 hearing, a staff hearing officer ("SHO") issued a so-called interlocutory order that ordered the Ohio Bureau of Workers' Compensation ("bureau") to ascertain whether the report of Dr. Kochhar is compliant with commission resolutions R96-1-01 and R03-1-02 and to arrange a pulmonary examination in that event. The SHO's order further provided that upon completion of the examination, the matter was to be reset before a DHO.
{¶ 40} 7. Apparently, the bureau did not schedule a pulmonary examination pursuant to the August 5, 2003 SHO's order. *Page 18
{¶ 41} 8. The matter of claimant's May 22, 2003 industrial claim was scheduled for hearing on September 16, 2003, before a DHO.
{¶ 42} 9. Following the September 16, 2003 hearing, the DHO determined that the SHO's order of August 5, 2003, had improperly remanded the matter to the DHO's docket. Accordingly, the DHO issued an order declaring that he had heard the matter as an SHO rather than a DHO. The order of September 16, 2003, dismissed the May 22, 2003 industrial claim on grounds that claimant had failed to meet the requirements of commission resolution R96-1-01.
{¶ 43} 10. Apparently, by letter dated November 11, 2003, claimant's counsel requested that the May 22, 2003 industrial claim (FROI-1) be processed because the prerequisites had now been allegedly met. Apparently, the May 22, 2003 FROI-1 was then refiled.
{¶ 44} 11. Following a January 22, 2004 hearing, a DHO issued an order that dismissed the refiled FROI-1.
{¶ 45} 12. Claimant administratively appealed the DHO's order of January 22, 2004.
{¶ 46} 13. Following a March 9, 2004 hearing, an SHO mailed an order on March 13, 2004, vacating the January 22, 2004 DHO's order. The SHO's order of March 9, 2004, holds that the DHO of January 22, 2004, had no jurisdiction to rule on the refiled FROI-1, because the May 22, 2003 FROI-1 had previously been dismissed by the DHO/SHO's order of September 16, 2003.
{¶ 47} 14. On December 22, 2004, claimant filed another FROI-1 alleging essentially the same matters contained in his original FROI-1 filed May 22, 2003. *Page 19
{¶ 48} 15. Following a July 19, 2005 hearing, a DHO issued an order that dismisses the FROI-1 filed December 22, 2004, on grounds that claimant has failed to meet the prerequisites of commission resolution R96-1-01.
{¶ 49} 16. On August 5, 2005, claimant filed an appeal from the DHO's order of July 19, 2005.
{¶ 50} 17. Following an August 30, 2005 hearing, an SHO mailed a so-called interlocutory order stating:
The claim is referred to the Administrator to arrange for an examination of the claimant by a qualified specialist pursuant to the provisions of ORC
4123.68 concerning claims for occupational diseases of the respiratory tract resulting from continuance [sic] exposure to dust.The claimant has met the minimal provisions for such a referral. * * *
{¶ 51} 18. On October 7, 2005, another SHO mailed an order refusing relator's administrative appeal from the SHO's order of August 30, 2005.
{¶ 52} 19. Pursuant to the SHO's order of August 30, 2005, claimant was examined on October 11, 2005, by Robert DeMarco, M.D., who issued a report of his findings.
{¶ 53} 20. Following the issuance of Dr. DeMarco's report, a hearing was scheduled before an SHO on November 22, 2005. Following the November 22, 2005 hearing, the SHO issued an order stating:
*Page 20The order of the District Hearing Officer, from the hearing dated 01/22/2004 [sic], is VACATED. Therefore, the Appeal, filed 02/10/2004 [sic], is GRANTED TO THE EXTENT OF THIS ORDER.
Therefore, the FROI-1, filed 05/22/2003 [sic], is GRANTED TO THE EXTENT OF THIS ORDER.
Based upon claimant's testimony as to his working conditions during the past 12 years, and upon the 03/23/2000 report of Dr. Kochkar [sic], the 03/22/2004 report of Dr. Sanchez, the 04/08/2003 report of Dr. Kuruc, and the 10/11/2005 report of BWC Dr. DeMarho [sic], the claim is allowed for OCCUPATIONAL ASTHMA and CHRONIC OBSTRUCTIVE PULMONARY DISEASE.
(Emphasis sic.)
{¶ 54} 21. On November 30, 2005, relator filed an appeal from the SHO's order of November 22, 2005, that allowed the industrial claim.
{¶ 55} 22. On December 8, 2005, another SHO mailed an order refusing relator's administrative appeal from the SHO's order of November 22, 2005.
{¶ 56} 23. On January 27, 2006, pursuant to R.C.
{¶ 57} 24. On February 24, 2006, relator, Wheeling-Pittsburgh Steel Corp., filed this mandamus action.
Conclusions of Law:
{¶ 58} According to relator, the procedure employed by the commission denied it a right to a district level hearing "on the merits" of the claim allowance. Relator claims that R.C.{¶ 59} Because the magistrate finds that relator was not denied a clear legal right under R.C.
{¶ 60} At the outset, the magistrate notes that the SHO's order of November 22, 2005 contains an error as to which DHO's order is being vacated and correspondingly which appeal is being granted. Clearly, the only DHO's order over which the SHO had appellate jurisdiction at the November 22, 2005 hearing was the DHO's order of July 19, 2005. Correspondingly, the SHO actually heard the appeal filed by claimant on August 5, 2005. Moreover, it was the FROI-1 filed on December 22, 2004, that was contested at the July 19, 2005 DHO's hearing.
{¶ 61} Relator points out the errors in the SHO's order of November 22, 2005, when it states:
Although the order claims on its face to be a decision on the appeal of the district level order of January 22, 2004, it could not possibly have been such, as that district level order had already been vacated by a final staff level order mailed March 13, 2004. * * *
(Relator's brief, at 7.) However, relator does not claim here that the above-noted errors in the SHO's order of November 22, 2005 compel the issuance of a writ of mandamus. However, relator does claim that the commission failed to follow procedure mandated by R.C.
{¶ 62} R.C.
{¶ 63} R.C.
{¶ 64} R.C.
{¶ 65} R.C.
{¶ 66} Unfortunately, there is no case that is directly on point. However, State ex rel. Jones v. Indus. Comm. (1996),
* * * The claimant in Webb maintained, as Jones does here, that new evidence of disqualifying factors must be submitted first to a DHO, who possesses original jurisdiction in "contested claims matters" involving TTD under R.C.4121.34 (B). The Webb court disagreed, holding that the [Dayton Regional Board of Review] had jurisdiction to review all aspects of a claimant's TTD eligibility, including evidence that the claimant's condition had become permanent, notwithstanding that the issue of permanency or maximum medical improvement ("MMI") had not been determined initially by the DHO. * * *In effect, Webb reasoned that "contested claims matters," as used in former R.C.
4121.34 (B)(2) (now R.C.4121.34 [B][3]), granted DHO's authority to resolve the claimant's overall TTD eligibility, which depends on whether the claimant *Page 23 qualified initially for benefits and continues to be qualified. Accord State ex rel. Jeep Corp. v. Indus. Comm. (1991),62 Ohio St.3d 64 ,66 * * * (claimant's right to continued compensation contingent on successive medical reports that claimant has burden to produce). The Webb court concluded that where the claimant seeks TTD, the "contested matter" is the challenged allowance of the entire claim, not the various considerations, such as permanency, that may factor into this determination. The DHO in Webb had already exercised original jurisdiction in initially awarding TTD. Thus, the court concluded that the administrative appeal necessarily placed before the [Dayton Regional Board of Review] developments occurring since the DHO's order that could disqualify the claimant from receiving TTD.We agree with the court's analysis in Webb[.] * * *
(Emphasis sic.) Id. at 505-506.
{¶ 67} In effect, relator claims that after claimant was examined by Dr. DeMarco pursuant to the SHO's interlocutory order of August 30, 2005, the matter of the contested claim allowance was required to be heard by a DHO rather than the SHO who heard the matter on November 22, 2005. Relator would characterize such a hearing before a DHO as "on the merits." Thus, relator claims that it had a clear legal right under R.C.
{¶ 68} Analysis of relator's arguments begins with the observation that R.C.
{¶ 69} Here, following claimant's December 22, 2004 filing of another FROI-1, a DHO assumed original jurisdiction over the contested claim when the matter was heard *Page 24
on July 19, 2005, and an order was thereafter issued. Thus, the commission complied with R.C.
{¶ 70} Claimant administratively appealed the DHO's order of July 19, 2005 and, pursuant to R.C.
{¶ 71} Following Dr. DeMarco's examination and report, the matter was again referred to an SHO who heard the matter on November 22, 2005, and thereafter issued an order allowing the claim.
{¶ 72} Undisputedly, there was additional medical evidence before the SHO on November 22, 2005 and, by then, the preliminary issue of compliance with the commission's resolutions had been resolved by the SHO's interlocutory order.
{¶ 73} However, that the issues regarding the contested claim allowance had changed after the SHO's interlocutory order and Dr. DeMarco's examination did not require the commission to refer the matter to a DHO. Nothing in R.C.
{¶ 74} Accordingly, for all the above reasons, it is the magistrate's decision that this court deny relator's request for a writ of mandamus. *Page 1
Reference
- Full Case Name
- State Ex Rel. Wheeling-Pittsburgh Steel Corp., Relator v. Industrial Commission of Ohio and Carl Filler
- Cited By
- 1 case
- Status
- Published