By: Mark Barnes
Two cases are likely to land in the lap of the Ohio Supreme Court, which will be tasked with clarifying its holding in Ward v. Kroger, 106 Ohio St.3d 35, 2005-Ohio-3560 and the application of R.C. 4123.52, which imparts continuing jurisdiction on the Industrial Commission of Ohio. In Ward, the issue before the court was whether a claimant could litigate a condition for the first time in court without first presenting the condition to the Commission. Ward arose from conflicting decisions from Ohio’s courts of appeals, which held inconsistent positions on the de novo nature of appeals under R.C. 4123.512. The Supreme Court held that claimants must present conditions in the Commission first and cannot seek participation in the workers’ compensation system for such conditions in court otherwise. In its reasoning, the Court wrote “[t]he grant or denial of the right to participate for one injury or condition does not preclude a subsequent claim for participation in the fund based on another injury or condition arising out of the same industrial accident” and cited R.C. 4123.52 as support for this proposition. R.C. 4123.52 provides the Industrial Commission has continuing jurisdiction over claims and “the commission may make such modification or change with respect to former findings or orders with respect thereto, as, in its opinion is justified.”
Recently, in State ex rel. Bd. of Ed. of Toledo Cty. School Dist. v. Indus. Comm., 2021-Ohio-2782, the 10th District Court of Appeals held that the Commission’s continuing jurisdiction under R.C. 4123.52 permits the Commission to hear additional conditions in a claim, which claim was previously denied. Although the claim was denied, the court of appeals reasoned the motion for an additional condition was a request for a subsequent claim. The court of appeals’ decision is curious because it seems contrary to decades-old norms in which the Commission has denied such motions in denied claims. However, the Commission, itself, took the position that it had continuing jurisdiction to address the motion. There appeared to be a question about whether the additional condition (“complex regional pain syndrome”) was being pursued as a residual (“flow through”) condition or as a new condition on a direct causation theory. The school board argued the claimant could not pursue a residual condition in a denied claim. The claimant alleged the CRPS was a new condition. Because Ward reasoned that claimants may bring additional claims for participation in the system, the court of appeals held Commission has continuing jurisdiction to address the motion.
Arguably, State ex rel. Bd. of Ed. does not raise a question under R.C. 4123.52. If, in fact, the claimant was pursuing a new claim, then the Commission’s jurisdiction should arise over R.C. 4123.84, which contains the statute of limitations for filing claims. To hear a new claim, the Commission will not engage in the process of modifying or changing a former finding or order, especially when the original claim has been denied. The Commission will address the claim anew, unless the claim is made as a residual claim. Residual claims are not subject to the statute of limitations in R.C. 4123.84, which is why residual claims are processed as part of an allowed claim. As such, should the claimant have filed a new claim, as opposed to a motion to amend a denied claim?
Five days later, in State ex rel. Toledo Refining Company LLC v. Indus. Comm., 2021-Ohio-2829, the 10th District seemed to answer this very question, rendering a similar decision on the Commission’s continuing jurisdiction. Here, the claimant filed a FROI-1 claim application, which the Bureau of Workers’ Compensation denied for PTSD. The claimant did not appeal the Bureau’s determination and the denial of the claim became final. However, the claimant later filed a second FROI-1 for a “blast concussion,” allegedly caused by the same incident underlying the first FROI-1. Applying the same reasoning as in State ex rel. Bd. of Ed., the court of appeals held the Commission has continuing jurisdiction to consider the second FROI-1 as a new claim. Again, does R.C. 4123.52 grant the Commission authority to consider the second claim or is it R.C. 4123.84?
The takeaway from State ex rel. Bd. of Ed. and State ex rel. Toledo Refining Company is that claimants can pursue additional claims arising from the same incidents in previously disallowed claims as either additional conditions in the disallowed claims or new claims with new claim numbers. Because these cases arose from mandamus complaints, appeals to the Supreme Court are a matter of right. As such, it is a virtual certainty appeals will be filed, and the Supreme Court will further define what is meant by a workers’ compensation claim. Resolution of these case may require the Supreme Court to examine the interplay between R.C. 4123.52 and R.C. 4123.84, and delve into the decades-old norms of claims processing. The ultimate outcome of these cases certainly will have important implications on the filing of claims.