Luft v. Young
| Decision Date | 06 June 1961 |
| Parties | , 18 O.O.2d 367 LUFT, Appellant, v. YOUNG, Adm'r, Bureau of Workmen's Compensation, et al., Appellees. |
| Court | Ohio Court of Appeals |
Syllabus by the Court.
Rule 6 of the Industrial Commission, providing that 'fee bills for medical, hospital and nursing services and for medicines and appliances, are forever barred from payment unless they are filed within two years from the time such services were supplied * * *,' is valid, and does not deny or unreasonably restrict any rights of a claimant.
R. Brooke Alloway, Columbus, for appellant.
Mark McElroy, Atty. Gen., William G. Carpenter and Albert A. Yannon, Columbus, for appellees.
This is an action in which the claimant-appellant is seeking to require the Industrial Commission to order payment of certain medical bills incurred as the result of an injury received in the course of and arising out of her employment.
The claimant was injured March 27, 1953. The Industrial Commission allowed her claim and granted compensation from the date of injury to January 10, 1960. In June 1958, fee bills submitted by her physician to the commission for services rendered in connection with the injury were heard before the administrator. The administrator made the following order:
'That medical bill of Dr. P. C. Staker be granted for treatments for period June 5, 1956, to May 16, 1958, in the sum of $591.00; that treatments rendered from March 30, 1953, to June 1, 1956, be denied as fee bill was not submitted within two years from date of treatments and does not comply with the rule of the Commission and R.C. 4123.52.'
The Columbus Regional Board of Review affirmed the administrator's order. The Industrial Commission denied an appeal. Claimant then appealed to the Common Pleas Court of Franklin County where the appeal was denied and the constitutionality and statutory validity of Rule 6 of the Industrial Commission were upheld. Rule 6 provides as follows 'Fee bills for medical, hospital and nursing services and for medicines and appliances, are forever barred from payment unless they are filed within two years from the time such services were supplied, or within six months from the time the Bureau of Workmen's Compensation has assumed jurisdiction in a contested or reopened claim.'
The claim here is not a contested or reopened claim. Accordingly, the sixmonths provision is not in controversy. Neither the claimant's application nor the award given are in question here. The award given covers the period during which the medical services were rendered. It follows therefore that payment for the medical services in question is not barred by the time limitation on applications provided in Section 4123.84, Revised Code, nor on back awards provided in Section 4123.52, Revised Code. It is thus apparent that the commission has the statutory authority to make the payment. See in particular Section 4123.66, Revised Code.
The basic issue in this court is the validity of Rule 6 and whether that rule denies or unreasonably restricts any right of the claimant.
Section 4123.66, Revised Code, provides in part as follows:
In its earlier forms, the statute contained a dollar limitation. The commission could exceed the limitation by a unanimous vote where it was 'clearly shown that the actually necessary medical, nurse and hospital services and medicine exceed the amount * * *.' Section 1465-89, General Code. The granting of any amount in excess of the dollar limitation was discretionary. State ex rel. Jeffrey v. Industrial Commission (1955), 164 Ohio St. 366, 131 N.E.2d 215; State ex rel. Ramsey v. Industrial Commission (1942), 140 Ohio St. 246, 42 N.E.2d 981.
The determination of medical expenses involves a number of difficulties that do not arise, at least as acutely, in the determination of disability benefits for lost wages. Questions may arise on the nature, causal relationship, need and reasonable value of the services rendered. The discretion granted the commission by the statute appears to reflect the difficulty of developing a satisfactory formula for medical awards. Expenses or debts incurred by a claimant for reasonable medical services resulting from his injury obviously constitute a pecuniary loss to the claimant just as does a loss of wages. However, unlike the basic concept of common-law tort, the Workmen's Compensation Act in general, and this statute in particular, do not contemplate full recovery of all pecuniary losses. In view of these considerations, and the interpretation of earlier versions, we believe the present statute gives the commission discretion not only to determine causal relationship, value and similar questions, but also to determine the total amount of medical award to be made for all medical services. In this connection the dollar limitations in earlier versions of the statute are particularly significant.
The claimant here received some allowance for medical expenses. To show a denial of his statutory right in this strict sense, it would be necessary to show not only that he received certain services related to his injury, that they were necessary, and that the charge was reasonable, but also that the total amount allowed by the commission for all medical services was unreasonable. The operation of Rule 6 does not on its face necessarily give such a result, and the claimant has not attempted to establish such facts in this case.
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State ex rel. Jordan v. Indus. Comm., 2007 Ohio 5157 (Ohio App. 9/28/2007)
... ... , value and similar questions, but also to determine the total amount of medical award to be made for all medical services." (Emphasis sic.) Luft v. Young (1961), 114 Ohio App. 73, 75 ... {¶8} Under Ohio law, a statute is retroactive if it "`takes away or impairs vested ... ...
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Thompson v. Ohio Fuel Gas Co.
... ... In Luft v. Young, Admr. (1961), 114 Ohio App. 73, 180 N.E.2d 292, this court considered the law with respect to medical payments under the Workmen's ... ...