THE STATE EX REL. CRABTREE v. BUREAU OF WORKERS’ COMPENSATION.
No. 94-1319
Supreme Court of Ohio
Submitted November 30, 1994—Decided December 30, 1994.
71 Ohio St.3d 504
“Proposition of Law No. XX[:] Where the trial court abuses its discretion, in denying a defendant‘s motion to permit the three-judge panel to view the scene, it violates a defendant‘s rights as guaranteed by the Fifth, Sixth, Eighth and Fourteenth Amendments to the United States Constitution and Sections 10 and 16, Article I of the Ohio Constitution.
“Proрosition of Law No. XXI[:] The Fifth, Sixth, Eighth and Fourteenth Amendments to the United States Constitution and Sections 2, 9, 10 and 16, Article I of the Ohio Constitution establish the requirements for a valid death penalty scheme. Ohio Revised Code, Section 2903.01, 2929.02, 2929.021, 2929.022, 2929.023, 2929.03, 2929.04 and 2929.05, Ohio‘s statutory provisions governing the imposition of the death penalty, do not meet the prescribed requirements and thus are unconstitutional, both on their face and as applied.”
[Cite as State ex rel. Crabtree v. Ohio Bur. of Workers’ Comp. (1994), 71 Ohio St.3d 504.]
Lee I. Fisher, Attorney General, and Dennis L. Hufstader, Assistant Attorney General, for respondent.
PFEIFER, J. Relator argues that the bureau policy at issue lacks statutory authority and is unconstitutional. Relator presents a compelling argument that the bureau‘s policy violates the Due Process Clause,
“The administrator of workers’ compensation shall do all of the following:
“(A) Review and process all applications for claims;
“(B) Award compensation and make payment on all noncontested claims;
“(C) Make payment on orders of the industrial commission and district and staff hearing officers as provided in
section 4123.511 of the Revised Code * * *”
The limited power
The bureau‘s duty under
The commission order, pursuant to
On the other hand, the bureau must pay TTD compensation if all conditions precedent are met. Thus, if the commission order makes payment contingent on proof of disability and the claimant tenders such evidence, the bureau must cоntinue compensation regardless of the existence of contrary evidence. Conflicting evidence turns an established entitlement to TTD compensation into a dispute over TTD compensation, and it is at that point that the bureau‘s tеrmination authority ends.
The present case involves a contested claim for TTD compensation. The bureau argues that
The bureau correctly notes that
While
“The jurisdiction of the industrial commission and the authority of the administrator of workers’ compensation over eaсh case is continuing, and the commission may make such modification or change with respect to former findings or orders with respect thereto, as in its opinion is justified.” (Emphasis added.)
R.C. 4123.52 .
Finally,
“* * * If the employer disputes the attending physician‘s report, payments may be terminated only upon application and hearing by a district hearing officer pursuant to division (C) of
section 4123.511 of the Revised Code . Payments shall continue pending the determination of the matter, however payment shall not be made for the period when any еmployee has returned to work, when an employee‘s treating physician has made a written statement that the employee is capable of returning to his former position of employment, when work within the physical capabilities of the employee is made available by the employer or another employer, or when the employee has reached the maximum medical improvement. * * *”
The bureau may unilaterally terminate compensation under these four exceptions to continued payment only when there is, in essence, no remaining dispute, and no facts at issue. In the first instance, a person returns to work and the necessity of compensation is over. The second exceptiоn occurs when the claimant‘s own treating doctor states that he is able to return to work. The third exception occurs when the employer or another employer gives the employee work within his physical capabilities. Since thе phrase “work within the physical capabilities of the employee is made available” is used in a conclusory manner, as if that issue has already been decided, the bureau may unilaterally terminate compensation under this excеption only in cases where the issue is effectively decided, i.e., where the employee offers no conflicting evidence about whether he is physically able to perform the work offered. Likewise, the fourth exception, the onе relevant to this case, comes into play “when the employee has reached the maximum medical improvement.” It cannot be judged with the certainty implicit in the statute that the employee has reached that threshold until after the hearing officer has made his determination on that issue. Thus, the bureau may unilaterally terminate compensation under this exception only when there is
Pursuant to the bureau‘s theory,
“In order to obtain a writ of prohibition, relator must prove: (1) that the court or officer against whom the writ is sought is about to exercise judicial or quasi-judicial power, (2) that the exercise of that power is unauthorized by law, and (3) that denying a writ will result in injury for which no other adequate remedy exists in the ordinary course of law.” State ex rel. Keenan v. Calabrese (1994), 69 Ohio St.3d 176, 178, 631 N.E.2d 119, 121. Crabtree seeks to discontinue the bureau‘s termination policy on behalf of himself and all other claimants. Since the bureau is exercising a power fоr which it does not have statutory authority, and since the normal appeals process is inadequate, the relator has satisfied the requirements for a writ of prohibition, and we therefore grant the requested relief.
Crabtree also requеsts a writ of mandamus to compel reinstatement of his TTD compensation pending adjudication of the issue of maximum medical improvement by a commission district hearing officer. In order to be entitled to a writ of mandamus, the relator must establish that he has a clear legal right to the relief prayed for, that respondent has a clear legal duty to perform the requested act, and that the relator has no plain and adequate remedy at law. State ex rel. Seikbert v. Wilkinson (1994), 69 Ohio St.3d 489, 633 N.E.2d 1128. Since we have already determined that the bureau has a clear legal duty to reinstate Crabtree‘s TTD compensation until a district hearing officer has determined the maximum medical improvement issue, and that the appeals process is inadequate, we herеby grant the writ.
Writs granted.
A.W. SWEENEY, RESNICK and F.E. SWEENEY, JJ., concur.
DOUGLAS, J., concurs separately.
MOYER, C.J., and WRIGHT, J., dissent.
DOUGLAS, J., concurring. I concur in the well-reasoned opinion of Justice Pfeifer. I write separately to make one additional point.
“The administrator of workers’ compensation and the industrial commission jointly shall adopt rules covеring the following general topics with respect to this chapter [4121] and Chapter 4123. of the Revised Code:
“* * *
“(C) All claims, whether of a state fund or self-insuring employer, be processed in an orderly, uniform, and timely fashion.” (Emphasis added.)
Clearly, the respоndent bureau (pursuant to its promulgated “policy“) is not handling TTD disputes in a “uniform” fashion as required by the statute. This is so because State Fund claimants are affected by the “policy” but employee-claimants of a self-insured employer are nоt. Really, given
WRIGHT, J., dissenting. I would deny both the writ of mandamus and the writ of prohibition, because I believe that relator has adequate remedies at law.
With regard to relator‘s request for a writ of mandamus, relator exercised his right to appeal the bureau‘s decision within fourteen days to the Industrial Commission. If relator had obtained a favorable result upon appeal, his temporary total disability compensation would have been reinstated. However, the relator‘s administrative appeal is either being held in abeyance or has been dropped. A writ of mandamus is completely inappropriate given these circumstances.
With regard to relator‘s request for a writ of prohibition, relator has the right to challenge the bureau‘s policy concerning the termination of temporary total disability compensation by filing a declaratory judgment action in an appropriate court. Instead of following these adequate legal avenues, relator inappropriately requests this court to grant a writ of prohibition.
Accordingly, I respectfully dissent.
MOYER, C.J., concurs in the foregoing dissenting opinion.