State ex rel. Lutheran Hosp. v. Buehrer, 2015 Ohio 380

Elmira Brown was injured while employed by Lutheran Hospital (self-insured). An initial ICO order awarded PTD in 1990 but, after rehearing, the PTD award was denied by the Industrial Commission in an order mailed May 8, 1992.
After the initial PTD award, the Ohio Bureau of Workers' Compensation (BWC) began paying DWRF benefits to Brown and, under R.C. 4123.411(C) and O.A.C. 4123-17-29(B), billed the self-insured employer semiannually for those payments.
From c.1990 until August 2009 BWC continued paying DWRF benefits to Brown; Lutheran paid the semiannual invoices without protest. BWC later determined the payments were made in error and terminated payments in 2009.
Lutheran sought reimbursement from BWC for the amounts it had paid on the invoices (initially about $93,608.87, later revised to $99,187.31). BWC denied reimbursement, the Self-Insured Review Panel and the Administrator’s designee affirmed, placing primary fault on Lutheran for failing to question invoices.
Lutheran filed an original mandamus action seeking an order requiring the Administrator to vacate the denial and reimburse Lutheran; the magistrate recommended denial and the Tenth District adopted that recommendation and denied the writ.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether BWC had a clear legal duty to reimburse Lutheran for DWRF payments that BWC made to Brown when she was not eligible	Lutheran: BWC paid DWRF without authority after PTD was vacated; BWC should reimburse the employer for sums it collected	BWC: Statute and rule require self-insured employers to reimburse BWC for DWRF payments; Lutheran paid invoices without protest and thus has no clear right to reimbursement	Denied — mandamus not warranted. Even assuming BWC erred, Lutheran failed to show a clear legal right or that BWC had a clear duty to reimburse; fault attributed largely to Lutheran for not contesting invoices
Whether mutual mistake or fault affects recoupment/recourse	Lutheran: BWC’s payment error creates a duty on BWC to absorb the loss	BWC: Mutual mistake; statutory billing scheme and employer’s responsibility to administer claims mean employer was best positioned to detect error; allowing refund would shift burden to other employers	Court: Both parties acted under a mutual mistake of fact; the administrative decisions reasonably placed responsibility on Lutheran and denied refund; mandamus not available

State ex rel. Van Gundy v. Indus. Comm., 111 Ohio St.3d 395 (mandamus standard requires clear legal right and clear legal duty)
State ex rel. Doner v. Zody, 130 Ohio St.3d 446 (heightened proof required for extraordinary relief such as mandamus)
Wean Inc. v. Indus. Comm., 52 Ohio St.3d 266 (upholding statutory scheme making self-insured employers responsible for DWRF reimbursements regardless of injury date)
State ex rel. Martin v. Connor, 9 Ohio St.3d 213 (administrator has continuing jurisdiction; recoupability of DWRF payments depends on circumstances)
State ex rel. Weimer v. Indus. Comm., 62 Ohio St.2d 159 (overpayment by clerical error characterized as mistake of fact; recoupment upheld against claimant)
Thompson v. Indus. Comm., 1 Ohio St.3d 244 (permitting State Insurance Fund support of DWRF when assessments insufficient)