Cook v. Mayfield

Decision Date06 September 1989
Docket NumberNo. 88-1009,88-1009
Citation543 N.E.2d 787,45 Ohio St.3d 200
PartiesCOOK, Appellee, v. MAYFIELD, Admr., et al., Appellants.
CourtOhio Supreme Court

Syllabus by the Court

In decisions involving intervening incidents, district hearing officers, regional boards of review and the Industrial Commission must clearly and fully state the exact nature of the intervening incident, including whether it was work related and whether there was a causal nexus between the intervening trauma and the claimed disability.

On April 10, 1984, Daniel Cook, plaintiff-appellee, an employee of the Orr Felt Company, sustained an accidental injury during the course of and arising out of his employment. He filed a claim under the Workers' Compensation Act which was allowed.

On April 8, 1985, pursuant to what appears from the record before us to have been a claim for further compensation filed by appellee, a district hearing officer issued an order, stating, in part: " * * * Claim has been recognized for the following disabilities: 'Cervical sprain and low back strain and acute soft tissue injury, right posterium knee.' " The district hearing officer found that appellee was temporarily and totally disabled and "unable to perform his regular occupation as a Maintenance Man as a result of the recognized condition in this claim. Therefore, Temporary Total Compensation is to be awarded from 9-26-84 through 12-2-84. Further compensation is to be considered upon submission of competent medical evidence in accordance with the provisions of O.R.C. 4123.56."

Orr Felt appealed this order to the Dayton Regional Board of Review. On July 19, 1985, the board of review issued its order, modifying the order of the district hearing officer to the extent that "[c]laimant was not temporarily totally disabled from 9-26-84 to 12-2-84. Intervening incident on 9-19-84." On December 2, 1985, the Industrial Commission of Ohio affirmed the decision of the board of review "for the reason that it is supported by proof of record and is not contrary to law."

Appellee, pursuant to R.C. 4123.519, appealed to the Court of Common Pleas of Miami County. Orr Felt answered appellee's complaint by stating that the injury for which appellee sought compensation "was not related or brought about by plaintiff's employment but was the result of an altercation between plaintiff and law enforcement officers."

Defendants-appellants, James L. Mayfield, Administrator, and the Industrial Commission, moved the trial court to dismiss appellee's action. Appellants argued that the December 2, 1985 order of the commission was a decision as to the extent of disability, and hence not appealable under R.C 4123.519. The trial court sustained appellants' motion to dismiss.

The court of appeals reversed the trial court. This cause is now before this court pursuant to the allowance of a motion to certify the record. 1

Larrimer & Larrimer and James C. Ayers, Columbus, for appellee.

Anthony J. Celebrezze, Jr., Atty. Gen., Michael L. Squillace, Merl H. Wayman and Gerald H. Waterman, Columbus, for appellants.

RESNICK, Judge.

The issue before this court is whether an order by the Industrial Commission which denies a claim for further compensation apparently because of an "intervening incident" is a decision other than "as to the extent of disability." Deciding whether a decision is other than as to the extent of disability is not a new issue for this court. In fact it is a threshold question for courts to decide when determining if there is subject-matter jurisdiction over a decision appealed from the Industrial Commission. 2 This is because the commission has authority "to determine all rights of claimants." Section 35, Article II, Ohio Constitution. The commission has "sole and final jurisdiction to determine extent of disability, and thus the * * * amount of compensation to which a claimant is entitled to under the Act. * * * " Rummel v. Flowers (1972), 28 Ohio St.2d 230, 233, 57 O.O.2d 467, 469, 277 N.E.2d 422, 424.

The only right to appeal a decision of the Industrial Commission is that which is granted by statute. " 'The jurisdiction of the Court of Common Pleas over claims upon the State Insurance Fund * * * is wholly statutory, and is not included within its general jurisdiction. The Courts of Common Pleas do not have inherent jurisdiction in workmen's compensation cases but only such as is bestowed upon them under the provisions of the act.' " Jenkins v. Keller (1966), 6 Ohio St.2d 122, 126, 35 O.O.2d 147, 149, 216 N.E.2d 379, 382. See, also, Szekely v. Young (1963), 174 Ohio St. 213, 22 O.O.2d 214, 188 N.E.2d 424, paragraph one of the syllabus; Hospitality Motor Inns v. Gillespie (1981), 66 Ohio St.2d 206, 209, 20 O.O.3d 209, 210, 421 N.E.2d 134, 136, fn. 3.

Hence our decision focuses on R.C. 4123.519, in which the right to appeal a decision of the Industrial Commission is granted to both claimant and employer. R.C. 4123.519 provides that if a decision goes to the extent of disability, neither claimant nor employer may appeal. However, if the Industrial Commission's decision is one going to the claimant's right "to participate or to continue to participate in the fund," id., then it is appealable. 3 See State, ex rel. General Motors Corp., v. Indus. Comm. (1975), 42 Ohio St.2d 278, 71 O.O.2d 255, 328 N.E.2d 387; Gilbert v. Midland-Ross (1981), 67 Ohio St.2d 267, 21 O.O.3d 168, 423 N.E.2d 847.

Despite its apparently straightforward language, R.C. 4123.519 has been the source of considerable discussion by this court as well as by trial and appellate courts. "Clear though the above quoted language [in R.C. 4123.519] may have seemed to the drafters thereof, the myriad complications of industrial injury, and legislative and administrative efforts to justly cope therewith, have resulted in diffuse efforts by litigants and courts to resolve ensuing conflicts and uncertainties. Predictably, much attention has been directed to the meaning of 'extent of disability.' " State, ex rel. Campbell, v. Indus. Comm. (1971), 28 Ohio St.2d 154, 155, 57 O.O.2d 397, 397-398, 277 N.E.2d 219, 220.

In Zavatsky v. Stringer (1978), 56 Ohio St.2d 386, 10 O.O.3d 503, 384 N.E.2d 693, Chief Justice Leach, writing for a unanimous court, thoroughly analyzed the phrase "extent of disability" and attempted to provide much needed guidance as to what decisions were appealable. A review of cases by this court, as well as by appellate courts since Zavatsky, on the issue of appealability of a commission decision shows that determining whether a decision is one going to the extent of disability still can be an abstruse task for a court. The Industrial Commission makes our job more difficult when it does not explicitly state what evidence and factors it relied upon in rendering its decision. From as early as 1938, we consistently have stated that the Industrial Commission must clearly and precisely word its decisions so that " * * * confusion and delay could thus be avoided in the disposition of claims for compensation." Simmons v. Indus. Comm. (1938), 134 Ohio St. 456, 457, 13 O.O. 42, 43, 17 N.E.2d 751, 752. See, also, Rummel v. Flowers, supra, at 237, 57 O.O.2d at 471, 277 N.E.2d at 426.

The decisions of the board of review and the Industrial Commission in the case before us demonstrate how imprecisely written decisions make it difficult for courts to determine whether a cause goes to the extent of disability or to the claimant's right to participate in the fund. The decision of the Dayton Regional Board of Review states that the "[c]laimant was not temporarily totally disabled from 9-26-84 to 12-2-84. Intervening incident on 9-19-84." This order was affirmed by the Industrial Commission which merely stated that the order is "supported by proof of record and is not contrary to law."

Such statements are insufficient and ineffective in determining whether an order is appealable. It is imperative that the district hearing officers, regional boards of review and the Industrial Commission, in decisions involving intervening incidents, clearly and fully state the exact nature of the intervening incident including whether it was work related and whether there was a causal nexus between the intervening trauma and the claimed disability. To do otherwise results in a situation as we have before us. The appellate court had to "assume" from the record before it "that the intervening incident and not the original injury was the cause of any disability between September 26, 1984 and December 2, 1984." Without the administrative decision being explicit there is no way to determine whether the question is one of "right to participate" or "extent of disability."

The appellate court appears to have relied on the language in the syllabus of both Gilbert, supra, and State, ex rel. Roope, v. Indus. Comm. (1982), 2 Ohio St.3d 97, 2 OBR 649, 443 N.E.2d 157, which discusses the presence of an intervening injury or trauma. In Gilbert, we stated, at paragraph two of the syllabus, that "[a] decision to reactivate a previously allowed claim now dormant, when there has been an intervening trauma, is, in effect, a decision going to claimant's right to participate in the fund for an injury or impairment not previously claimed or passed upon and is appealable." (Emphasis added.)

In Roope, again the focus was on intervening trauma. "A decision of the Industrial Commission to grant or deny additional compensation for a previously allowed claim, when there is no intervening trauma but merely aggravation of a previously existing condition, is a decision which goes to a claimant's extent of disability and is not appealable. * * * " (Emphasis added.) Id. at the syllabus.

Appellants herein correctly point out that this court, in Roope, distinguished between an intervening industrial injury or trauma occurring at work and an aggravation of a previously existing condition occurring at home. In Roope, the...

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