State ex rel Seibert v. Indus. Comm.
2016 Ohio 8335
| Ohio Ct. App. | 2016Background
- Kenneth J. Seibert received permanent total disability (PTD) benefits based on allowed 1990–91 claims; BWC SID began investigating in 2013 after discovering an active groomer/owner license and later surveilled him at Lebanon Raceway (Apr–Jun 2014).
- Surveillance and interviews showed Seibert exercised, groomed, and otherwise worked with horses several days a week; he owned horses, had purse winnings (first identified March 26, 2009), and split winnings or received waived stable fees in a barter arrangement with Jim Davis.
- SID obtained bank records, race-license information, witness statements, and Seibert’s own admissions that he had worked at the raceway for years and that his doctor/attorney knew about his horse activities.
- BWC filed a C-86 motion asking the Industrial Commission to (1) terminate PTD, (2) declare all PTD paid since March 26, 2009 overpaid, and (3) find fraud; a staff hearing officer (SHO) granted the motion and found both overpayment (effective March 26, 2009) and fraud.
- Seibert sought mandamus review; the magistrate recommended granting relief only as to the fraud finding, but the court rejected that and denied mandamus in full, upholding both the overpayment and the fraud determination.
Issues
| Issue | Seibert's Argument | Industrial Commission/BWC's Argument | Held |
|---|---|---|---|
| Whether Seibert engaged in sustained remunerative employment beginning March 26, 2009 | Ownership/winnings alone don't prove remunerative employment; no barter established before 2012 | Evidence (purse payment 3/26/2009, admissions, witness statements, waived stable fees, services rendered) shows barter-like arrangement and sustained remunerative work | Court: Some evidence supports finding of sustained remunerative employment as of 3/26/2009; overpayment affirmed |
| Whether the commission abused discretion in finding fraud (knowing concealment) | Seibert: no knowing misrepresentation — work was unpaid or in-kind; he admitted activities and did not lie; lacked intent that activities be treated as compensable work | BWC: Seibert had duty to disclose, answered BWC contact letters falsely, admitted awareness he couldn’t work on PTD, and received in-kind remuneration/waived fees — supports knowing concealment and reliance | Court: Some evidence supports fraud finding (Seibert aware activities could be work and failed to disclose); McBee distinguished; fraud finding affirmed |
Key Cases Cited
- State ex rel. Lowe v. Cincinnati, Inc., 124 Ohio St.3d 204 (2009) (PTD barred where evidence shows sustained remunerative employment, physical ability to work, or medically inconsistent activities)
- State ex rel. Lawson v. Mondie Forge, 104 Ohio St.3d 39 (2004) (same three-bar test for PTD disqualification)
- State ex rel. McBee v. Indus. Comm., 132 Ohio St.3d 209 (2012) (fraud requires a knowing misrepresentation — claimant must be aware activities could be considered work)
- Gaines v. Preterm–Cleveland, Inc., 33 Ohio St.3d 54 (1987) (elements of fraud defined for claims against employers/administrative bodies)
- State ex rel. Kroger Co. v. Stover, 31 Ohio St.3d 229 (1987) (mandamus inappropriate where some evidence supports commission findings)
- State ex rel. Noll v. Indus. Comm., 57 Ohio St.3d 203 (1991) (commission must state evidence relied on and briefly explain reasoning)