2019 Ohio 2578
Ohio Ct. App.2019Background
- Manor Care, a self-insured employer, paid PTD (permanent total disability) benefits to two former employees; the PTD orders did not state the compensation rates.
- Because the reported PTD rates were below statutory minima, the Ohio BWC paid Disabled Workers’ Relief Fund (DWRF) supplements and billed Manor Care for those DWRF amounts.
- A 2014 BWC audit found Manor Care had underpaid PTD benefits for the two claimants; BWC ordered Manor Care to pay the underpayments, which Manor Care paid under protest.
- Manor Care sought reimbursement or a credit from BWC for the DWRF amounts it had reimbursed to BWC, arguing the DWRF payments effectively covered the PTD underpayments.
- The Bureau’s Self‑Insured Review Panel (SIRP) denied relief, the administrator’s designee affirmed, and Manor Care filed this mandamus action seeking reversal.
- The court denied the writ, finding no abuse of discretion in SIRP/administrator decisions and concluding Manor Care failed to show clear legal right to reimbursement, in part because self‑insurers bear responsibility to ensure correct PTD rates and both BWC and the employer operated under a mutual mistake of fact.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Manor Care is entitled to reimbursement or a credit from BWC for DWRF payments after Manor Care paid prior PTD underpayments | Manor Care: DWRF payments (paid by BWC and reimbursed by Manor Care) covered the underpayments; Manor Care already reimbursed BWC and therefore should get reimbursement/credit for the PTD amounts it paid | BWC: Self‑insured employers must pay correct PTD amounts and must reimburse BWC for DWRF; PTD underpayment cannot be offset by DWRF overpayment accepted in good faith; BWC need not indemnify employer for its own mistakes | Denied — court finds no abuse of discretion and that Manor Care failed to show clear legal right to reimbursement; employer bore responsibility and mutual mistake principles apply |
Key Cases Cited
- State ex rel. Martin v. Connor, 9 Ohio St.3d 213 (1984) (payments made and accepted in good faith may not be recouped by BWC in certain circumstances)
- Wean Inc. v. Industrial Commission, 52 Ohio St.3d 266 (1990) (self‑insured employers are responsible to reimburse BWC for DWRF disbursements regardless of date of injury)
- State ex rel. Van Gundy v. Industrial Commission, 111 Ohio St.3d 395 (2006) (mandamus standard: relator must show clear legal right, respondent clear duty, and lack of adequate remedy)
- State ex rel. Doner v. Zody, 130 Ohio St.3d 446 (2011) (standard of proof in mandamus is clear and convincing evidence)
- State ex rel. Pressley v. Industrial Commission, 11 Ohio St.2d 141 (1967) (mandamus evidentiary principles)