CHRISTINE M. JONES, APPELLEE VS. CATHOLIC HEALTHCARE PARTNERS, INC., еt al., APPELLANT
CASE NO. 11 MA 23
STATE OF OHIO, MAHONING COUNTY IN THE COURT OF APPEALS SEVENTH DISTRICT
December 31, 2012
2012-Ohio-6269
Hon. Cheryl L. Waite, Hon. Gene Donofrio, Hon. Joseph J. Vukovich
CHARACTER OF PROCEEDINGS: Civil Appeal from the Court of Common Pleas of Mahoning County, Ohio Case No. 07CV4679. JUDGMENT: Affirmed.
For Appellee: Atty. Patrick E. Parry 434 High Street P.O. Box 792 Warren, Ohio 44482
For Appellant: Atty. Thomas R. Wyatt Atty. Jerry P. Cline Andrews & Wyatt, LLC 561 Boston Bills Road, Suite 700 Hudson, Ohio 44236
{¶1} Appellant, Catholic Healthcare Partners, Inc., appeals the trial court‘s decision to grant summary judgment in favor of Appellee, Christine M. Jones. The trial court‘s judgment upheld a bureau of workers’ compensation decision to allow benefits for physical injuries and posttraumatic stress disorder (“PTSD“) resulting from a hostage incident. Appellant does not dispute Appellee‘s right to recovery for the physical injury. However, Appellant argues that the award for PTSD was inappropriate. Appellant contends that there was insufficient evidence that Appellee‘s PTSD was a covered condition under applicable law, and that the trial court should not have granted summary judgment affirming the bureau award and compensation. Appellant‘s argument is without merit and is overruled.
Factual and Procedural History
{¶2} Appellee‘s initial application for workers’ compensation was based on the events of April 4, 2007. On that date, Appellee was employed at St. Elizabeth Medical Center in Youngstown, Ohio and working as a unit clerk and monitor technician. She and five others were taken hostage by an inmate who had been transported to the hospital for treatment. The grouр was held for approximately twenty-five minutes by the inmate, who then escaped. Appellee described portions of the incident to her evaluating physician as follows:
He took a gun from a guard * * * the inmate “grabbed my left wrist. I yanked away from him. Then he grabbed my right wrist, and pulled it and banged it against a doorway and pressed it there—holding me.
That‘s when he brought the gun up and said, ‘I‘ll f*****g kill both of you.’ * * * ‘I kept telling him to calm down. He kept saying over and over that he would kill us—at least 15 times. He said he wouldn‘t kill us if we did what he said until his brother got there. I told Francine (other hostage) that I wouldn‘t let him hurt her.’ ”
(3/28/08 Heltzel Depo., Exh. A, p. 2.) The examining physician noted that she described interacting extensively with the hostage-taker, including having been forced to assist him when he changed into the guard‘s uniform, and that she was later able to alert hospital security. (3/28/08 Heltzel Depo., Exh. A, p. 2.) Although the hostage-taker escaped, he was subsequently apprehended in another state. Appellee‘s wrist injury had not been fully diagnosed when she originally met with Dr. Heltzel, and the physician referred to the injury in his initial report but stated that at that time an assessment of the psychological aspect of her physical injury would be deferred. (3/28/08 Heltzel Depo., Exh. A, p. 3.) Dr. Heltzel later explained during two depositions that the assault and resulting physical injury to Appellee‘s wrist as well as the continuing close physical proximity of the hostage-taker were contributing and perhaps aggravating factors in her resulting PTSD.
{¶3} Appelleе filed a workers’ compensation claim for the wrist injury and for PTSD resulting from the same incident. Initially, Appellee‘s compensation claim for PTSD was denied by the bureau of workers’ compensation. Compensation was allowed for the physical injury to her wrist. Although the parties did not include the bureau file in the record on appeal, they appear to agree as to the proceedings below
{¶4} Appellant challenged the compensation award by filing an administrative appeal of the hearing officer‘s decision with the Industrial Commission of Ohio. The commission refused to hear Appellant‘s appeal. Apparently after exhausting the administrative remedies, Appellant appealed both the decision allowing compensation for Appellee‘s PTSD and the dеnial of an administrative appeal of the award to the common pleas court. Although Appellant identified both the award of compensation for PTSD and the denial of review by the commission as the grounds for review in the trial court, subsequent trial proceedings dealt only with whether PTSD was a covered condition. In the proceedings before the trial court there was no dispute between the parties concerning the factual events that caused the wrist fracture and PTSD.
{¶5} When asked by counsel for Appellant whether the hostage incident alone, rather than in combination with the assault and physical injury to Appellee‘s wrist, was the cause of her PTSD during the March 28, 2008 deposition, Dr. Heltzel
Again, I have to be very careful, because the fact that he grabbed her, I mean, that does contribute to trauma, if you can imagine.
It‘s not like he was well across the room threatening her. He was in close contact with her and he physically grabbed her. I think that that aspect of it, you know, is a part of it for her and I just don‘t believe that the wrist injury per se can explain the Post-Traumatic Stress Disorder.
(3/28/08 Heltzel Depo., p. 23.) According to the doctor‘s testimony during the deposition, the anxiety and constant state of hyper-vigilance Appellee was experiencing due to her disorder was interfering with her interpersonal communication, her ability to concentrate and sustain focus, and the resulting level of suffering and distress prevented her from working. (3/28/08 Heltzel Depo., p. 23.)
{¶6} Dr. Heltzel was deposed for a second time by Appellant on August 9, 2010. During that deposition, unlike the March 28, 2008 deposition, the doctor was questioned by both counsel for Appellee and for Appellant. During the second deposition, the doctor further explained the steps he took in diagnosing Appellee‘s PTSD, and responded to additional questions concerning the definition of PTSD and the role of physical injury in the development of the disorder. Dr. Heltzel summarized the definition of the disorder as follows:
I‘ll need to scan my -- the definition becausе it‘s quite lengthy. The essential aspect of post-traumatic stress disorder is an experience of an
event that involves actual or threatened death or serious injury or other threat to one‘s physical integrity; so that the concept of the physical injury is incorporated into that initial definition. Further on the definition states that the disorder may be especially severe and long-lasting when the stresser [sic] is of human design, such as torture or rape. The likelihood of developing this disorder may increase as the intensity of the physical proximity to the stresser [sic] increase.
(8/9/10 Heltzel Depo., p. 15.) Dr. Heltzel expressed his opinion that the proximity of the stressor to the victim was a significant factor in the trauma, and explained that the primary causes of the disorder are the perception of danger to one‘s well-being coupled wit the possibility of death. The doctor emphasized that there is not a single trigger and what is referred to as the “traumatic event” is not a single moment, but may “encompass many different facets.” (8/9/10 Heltzel Depo., pp. 16-17.) He explained that “the direct threat with a weapon and the verbal threat by the inmate, as well as the physical assault on Ms. Jones, which conveys a dominance over a person, increase the sense of helplessness” and that these aspects contributed to Appellee‘s disorder. (8/9/10 Heltzel Depo., p. 17.) Dr. Heltzel concluded by saying that the physical аttack and fracture of Appellee‘s wrist, which occurred during the hostage incident, were “a definite contributing factor as one important feature of an overall traumatic event” resulting in a clinical diagnosis of post-traumatic stress disorder. (8/9/10 Heltzel Depo., p. 20.)
{¶8} The matter was unsuccessfully referred to mediation. Various subsequent filings continued through 2009 and into 2010, when Dr. Heltzel was deposed for a second time and trial was scheduled. Although three notices of deposition indicate Appellant‘s intent to depose Appellee and one indicates an intent by Appellant to depose her husband, no transcript of deposition of Appellee or her husband appears in the record. On August 6, 2010, Appellee sought leave to file a motion for summary judgment. Leave was granted and the motion was ultimately
{¶9} The trial court granted Appellee‘s motion for summary judgment on January 14, 2011. The trial court referred to Dr. Heltzel‘s testimony in the August 9, 2010 deposition and noted that “Dr. Heltzel consistently testified during both depositions that the physical injury was a cause of Ms. Jones‘[sic] PTSD, albeit not the sole cause.” (1/14/11 J.E., p. 1.) The trial court concluded that under the applicable law, because it was undisputed that Appellee suffered both a covered physical injury and PTSD resulting from events that occurred during the course of her employment, Appellee‘s PTSD “arose from and was accompanied by the allowed injury.” (1/14/11 J.E., p. 3.) The court ordered that Appellee was to participate in the workers’ compensation fund “by reason of the injury and condition post traumatic stress disorder.” (1/14/11 J.E., p. 3.) Appellant filed а timely appeal from this judgment.
Argument and Law
The trial court erred as a matter of law in finding that there is no genuine issue of material fact to be litigated and Plaintiff is entitled to summary judgment as a matter of law.
{¶10} Although Appellant mentions both the trial court‘s decision to grant summary judgment in favor of Appellee and the commission‘s decision not to hear an appeal of the bureau hearing officer‘s decision, the appellate brief focuses solely on the decision to grant summary judgment. No record of proceedings in the bureau or before the commission was included in the record on appeal. For these reasons, the only issue before us is whether the trial court properly granted summary judgment in favor of Appеllee. Appellant posits that Appellee should be required to show that a compensable physical injury was the sole cause of her PTSD before she can receive compensation for her condition. The trial court, however, applied the same proximate cause standard generally applied in tort and adopted by the Supreme Court for use in workers’ compensation cases in Murphy v. Carrollton Co., 61 Ohio St.3d 585, 575 N.E.2d 828 (1991).
{¶11} Under
{¶12} On appeal, Appellant challenges the trial court‘s decision characterizing Dr. Heltzel‘s testimony as consistent. Appellant rejects the court‘s acceptance of the doctor‘s statement that the injury to Appellee‘s wrist was “a cause,” “albeit not the sole cause” was sufficient to support the conclusion that Appellee is entitled to compensation for PTSD under
{¶13} When considеring “the issue of proximate cause in the workers’ compensation context, * * * the definition of and principles governing * * * the determination of ‘proximate cause’ in the field of torts are applicable.” Murphy v. Carrollton Mfg. Co., 61 Ohio St.3d 585, 587, 575 N.E.2d 828 (1991) citing Oswald v. Connor, 16 Ohio St.3d 38, 42 476 N.E.2d 658 (1985). “It is a well-established principle of tort law that an injury may have more than one proximate cause.” Murphy at 587. In “Ohio, when two factors combine to produce damage or illness, each is a proximate cause.” Id. at 588 quoting Norris v. Babcock & Wilcox Co., 48 Ohio App.3d 66, 67, 548 N.E.2d 304, 305 (1988).
{¶14} The language of
(C) “Injury” includes any injury, whether caused by external accidental means or accidental in character and result, received in the course of, and arising out of, the injured employee‘s employment. “Injury” does not inсlude:
(1) Psychiatric conditions except where the claimant‘s psychiatric conditions have arisen from an injury or occupational disease sustained by that claimant or where the claimant‘s psychiatric conditions have arisen from sexual conduct in which the claimant was forced by threat of physical harm to engage or participate;
When applying the definitions of
{¶15} The definition of injury pursuant to
{¶16} The second 2006 amendment to
{¶17} In contrast to the 2006 amendments requiring that the injury and psychiatric condition both be suffered by the same claimant and allowing coverage of psychiatric conditions resulting from sexual assault suffered in the workplace, the legislature has declined to modify the statute to specifically include or exclude the Ohio Supreme Court‘s 1984 expansive interpretation of
{¶18} The history of revision, expansion, and inaction surrounding
{¶19} Two Ohio Supreme Court cases on this subject are instructive: State ex rel. Clark v. Industrial Commission, 92 Ohio St.3d 455, 751 N.E.2d 967 (2001); and McCrone v. Bank One Corp., 107 Ohio St.3d 272, 2005-Ohio-6505, 839 N.E.2d 1. In Clark, the earlier of the two cases, the Supreme Court decided whether hostage leave pay, which was paid pursuant to the terms of a collective bargaining
{¶20} Clark was held by the inmates from April 11, 1993 until April 15, 1993, and suffered multiple physical injuries including abrasions on his wrists, a laceration on his forearm, an abrasion on his face, dehydration, and malnutrition. According to the Supreme Court, “Clark suffered severe stress and anxiety as a direct result of being held hostage as well as having been beaten.” Clark, p. 456. Thirteen days after his rеlease, Clark filed a claim with the Ohio Bureau of Workers’ Compensation for his injuries. Initially the bureau allowed a claim for “dehydration; malnourishment; abrasions bilateral wrists and face; laceration right upper arm; [and] atrial fibrillation.” Id. The bureau later allowed compensation for his claim of “post-traumatic stress disorder” and his temporary total disability payments began on July 11, 1993. Id.
{¶21} After his release by the inmates but apparently prior to filing his workers’ compensation claim, Clark also applied for and was granted hostage leave pay by the Ohio Department of Rehabilitation and Corrections pursuant to the collective bargaining agreement between the department and the Ohio Civil Services Emрloyees Association. According to the Court, Clark received hostage leave payable at his regular rate beginning on April 18, 1993 and continuing until July 10, 1993. Subsequently, Clark filed a workers’ compensation claim for temporary total disability benefits covering the period from April 12, 1993 through July 10, 1993,
{¶22} The Ohio Supreme Court reviewed the appellate court decision and examined the purposes of both workers’ compensation and the setoff provision contained in
{¶23} The Court emphasized that “[i]n order to qualify for hostage leave, Clark was not required to have suffered any physical injury; he was required to show only
{¶24} Officer Clark suffered a variety of physical injuries, both when he was taken hostage (lacerations, abrasiоns) and due to being held (dehydration, malnutrition, wrist abrasions). The Court‘s description of Clark‘s covered injuries reflects multiple stressors that contributed to the covered psychiatric condition: “[i]n
{¶25} The Court subsequently cited Clark in support of the proposition that covered “[c]onditions suffered by the claimant could be mental disorders, provided that they arose from a physical injury.” McCrone, supra, ¶16. In McCrone, the Ohio Supreme Court determined that the exclusion of benefits for psychiatric conditions that do not arise from a compensable physical injury or occupational disease does not rise to the level of a violation of the equal protection clauses of the Ohio and United States Constitutions. In McCrone, the claimant filed for PTSD but had suffered no physical injury during two armed robberies at the bank where she worked. The claimant was diagnosed with PTSD as a result of having witnessing the first robbery and then being the tellеr robbed during the second. The claimant argued that a workers’ compensation scheme that denies compensation for psychiatric harm except where such harm is accompanied or evidenced by a physical injury violates the equal protection clauses of the United States and the Ohio Constitutions. The Fifth District Court of Appeals found the statute unconstitutional,
{¶26} The Court began its evaluation of the question by discussing the history of the definition and the treatment of covered injuries by the courts and by the Ohio Bureau of Workers’ Compensation. The Court noted that “courts have held that compensable injuries under the workers’ compensation system require a physical component suffered by the claimant” both before and after amendments to the definition of injury that explicitly excluded psychiatric conditions in the absence of physical harm. Id. ¶16. Similarly, the Ohio Bureau of Workers’ Compensation itself “has required a physical injury to the claimant before granting compensation for a psychiatric condition both before and after the 1986 amendments.” Id. at ¶17. The Court concluded: “Because the General Assembly has classified mental conditions as compensable under workers’ compensation laws only when they are accompanied by physical injury,” “psychological or psychiatric conditions that do not arise from a compensable physical injury or occupational disease are excluded from the definition
{¶27} None of the various appellate court cases cited by Appellant in an attempt to support the enhanced standard Appellant would have us adopt involve the denial of coverage to a claimant suffering both a covered physical injury and a psychiatric condition resulting from the same work-place incident. The cases cited by Appellant generally involve a denial of coverage to a claimant suffering from a work related psychiatric condition who has not suffered a concurrent physical injury. (E.g. Bunger, supra (no physical injury); Rambaldo, supra (no physical injury, denied claim by an employee who charged that he suffered from major depression and mixed personality disorder because his employer required him to do things which were dishonest or somewhat unethical); Banks v. LTV Steel Co., 100 Ohio App.3d 585 (1995) (recovery is allowed to claimant who was diagnosed with PTSD in addition to the chest, spinal, arm and leg injuries she suffered in an industrial accident); Karavolos v. Brown Derby, Inc. 99 Ohio App.3d 548 (1994) (remanded for trial to determine whether there exists a connection between employee‘s back injury and various mental conditions including drug addiction); Wood v. Ohio State Hwy. Patrol, 156 Ohio App.3d 725, 2004-Ohio-1765 (5th Dist.) (no physical injury); Ireland v. S. Ohio Corr. Facility, 2006-Ohio-3519 (5th Dist.) (no physical injury). Appellant also
{¶28} Although no Ohio court has ruled on the precise issue raised by Appellant, the Second District Court of Appeals has affirmed a trial court decision that denied recovery for PTSD where the claimant also sustained physical injuries as a result of employment. However, the court did not apply the “sole cause” formulation advocatеd by Appellant. Armstrong v. Jurgenson Co., 2nd Dist. No. 2011-CA-6, 2011-Ohio-6708. The 2011 decision affirmed the trial court‘s finding that the physical
{¶29} At trial, the parties stipulated that the accident was work-related; that claimant suffered a variety of physical injuries due to the accident; and that claimant was suffering from PTSD due to the accident. However, the employer presented a contradicting expert witness who concluded that although the claimant was suffering from PTSD, the cause of the disorder was the act of witnessing the collision and resulting harm to the other driver (who died), and was not related in any way to the claimant‘s own back and shoulder injuries.
{¶30} The reviewing court‘s majority opinion agreed with the trial court‘s reading of the statute‘s limitation on coverage to those psychiatric conditions that “have arisen from an injury or occupational disease sustained by that claimant.” The court held that in order to be compensable, psychiatric conditions must be “started by and therefore result[ing] from a physical injury or occupational disease the claimant suffered.” Id. at ¶35. Both the trial court and the reviewing court relied on the testimony of the employer‘s expert who testified that there was no causal link between the physical injuries and PTSD, rather than the testimony of the treating
{¶31} The matter before us does not involve conflicting testimony. It does involve a claim for both physical injury and psychiatric condition resulting from a single hostage-taking incident. The two depositions of Appellee‘s treating physician provide consistent testimony that the physical injury to Appellee is a proximate cause of her PTSD, although concededly not the sole proximate cause. She also suffers from the stress of being taken hostage. Both factors contributed to and resulted in her PTSD. In this instance, Appellee is most similarly situated to the claimant in Clark, who was similarly held hostage and was physically injured by his assailant. Without evidence ruling out her physical injury as one cause of PTSD, it appears that, were we to reverse the bureau‘s decision granting compensation and the trial court‘s decision allowing recovery, we must interpret the statute more narrowly than does the Ohio Supreme Court. This would result in the imposition of an evidentiary standard on claimants suffering from multiple work-related harms that ignores the principles of causation applicable to workers’ compensation. This is not reflective of controlling precedent. Accordingly, applying the principles of causation prescribed by the Ohio Supreme Court in Murphy and its progeny, the judgment of the trial court is affirmed.
Conclusion
Donofrio, J., concurs.
Vukovich, J., concurs.