Gilbrath v. Autozone, Inc.

2014 Ohio 2347
Ohio Court of Appeals·Decided May 27, 2014·No. 13CA1·Published·Cited by 1 cases

Opinion

IN THE COURT OF APPEALS OF OHIO FOURTH APPELLATE DISTRICT JACKSON COUNTY

TERRY L. GILBRAITH, :

Plaintiff-Appellant, : Case No. 13CA1 vs. :

AUTOZONE, INC., et al., : DECISION AND JUDGMENT ENTRY Defendants-Appellees. :

APPEARANCES:

COUNSEL FOR APPELLANT: C. Russell Canestraro, Agee, Clymer, Mitchell & Laret, 226 North Fifth Street, 5th Floor, Columbus, Ohio 43215

COUNSEL FOR APPELLEE BUREAU OF WORKERS’ COMPENSATION: Michael Dewine, Ohio Attorney General, and Patsy A.

Thomas, Ohio Assistant Attorney General, 150 East Gay Street, 22nd Floor, Columbus, Ohio 43215

COUNSEL FOR APPELLEE AUTOZONE STORES, INC.: John C. Albert, Crabbe, Brown & James, LLP, 500 South Front Street, Suite 1200, Columbus, Ohio 43215

CIVIL CASE FROM COMMON PLEAS COURT DATE JOURNALIZED: 5-27-14 ABELE, P.J.

{¶ 1} This is an appeal from a Jackson County Common Pleas Court judgment that granted motions to dismiss for lack of subject matter jurisdiction filed by AutoZone Stores, Inc., and the Bureau of Workers’ Compensation (BWC), defendants below and appellees herein.

{¶ 2} Terry L. Gilbraith, plaintiff below and appellant herein, assigns the following error for review:

“THE INDUSTRIAL COMMISSION’S 9/23/2010 DECISION HAS INDICATED THAT PLAINTIFF’S RIGHT TO PARTICIPATE IN THE OHIO BUREAU OF WORKERS’

COMPENSATION SYSTEM HAS NOT BEEN TERMINATED.

HOWEVER, FOR ALL PRACTICAL PURPOSES, THERE IS NO VEHICLE IN LAW OR EQUITY THAT REESTABLISHES A CAUSAL CONNECTION ONCE BROKEN. THE INDUSTRIAL COMMISSION IS BOUND BY ITS ORDERS WHICH PREVIOUSLY FOUND THE CAUSAL CONNECTION TO PLAINTIFF’S INDUSTRIAL INJURY HAS BEEN SEVERED. SUBSEQUENT ORDERS THAT HOLD THAT IT IS NOT ARE ILLUSIONARY.”

{¶ 3} On February 12, 2003, appellant sustained a work-related injury. He received workers’ compensation for “lumbar sprain; aggravation of pre-existing herniated nucleus pulposus L4-L5.” On May 10, 2008, appellant sustained a non-work-related injury while shoveling in his yard. Appellant’s doctor subsequently certified that appellant was temporarily totally disabled beginning on May 12, 2008 due to “lumbar sprain and aggravation of pre-existing herniated disc L5-S1.”

{¶ 4} On June 11, 2008, appellant filed a C-86 motion requesting temporary total disability (TTD) compensation. On July 23, 2008, a district hearing officer (DHO) denied appellant’s motion. The DHO determined that appellant was not temporarily totally disabled due to the allowed conditions in his 2003 workers’ compensation claim. The DHO found that the May 10, 2008 injury was an intervening injury and that appellant’s period of disability following the intervening injury was not causally related to the allowed conditions in his claim. The DHO observed: “The C-84 reports * * * do not certify the claimant as being disabled due to the disc condition at L4-5. Instead, Dr. Kincaid refers to the presence of a non-allowed

JACKSON, 13CA1 3 herniated disc at L5-S1 (and not to any herniated disc at L4-5).” Appellant appealed the DHO’s decision to a staff hearing officer (SHO).

{¶ 5} On August 20, 2008, the SHO affirmed the DHO’s decision. The SHO found that appellant requested TTD for conditions that were not allowed in his workers’ compensation claim. The SHO determined that “the medical evidence does not document the allowed conditions independently render the injured worker temporary totally disabled.” The SHO stated: “It is the further order that the injured worker sustained an intervening injury on 05/10/2008 that broke the chain of causation to the original injury in this claim. * * * Dr. Vogelstein clearly states the injured worker sustained an intervening injury as the result of the shoveling event on 05/10/2008.” The Industrial Commission refused appellant’s further appeal.

{¶ 6} On November 7, 2008, appellant appealed to the Jackson County Common Pleas court. He later dismissed the appeal.

{¶ 7} On October 7, 2009, appellant filed a C-86 motion that requested the payment of medical bills. On November 3, 2009, a DHO denied appellant’s motion. The DHO determined that appellant “failed to satisfy his burden of proving that these treatments were reasonably necessary and appropriate care for the allowed conditions in the claim.” The DHO explained:

i. “[S]eparate Staff Hearing Officers have held that the event of 05/10/2008 was an intervening injury which broke the chain of causation to the original injury in this claim. The Injured Worker has submitted no evidence that the treatments for which payment is sought are based upon any new and changed circumstances.

Consequently, the medical evidence submitted by the Injured Worker does not adequately document that the bills are for treatments which are in any way different from treatments and compensation which has previously been denied. While Dr.

Kincaid does certify that the treatments were for the Injured Worker’s lumbar sprain and herniated nucleus pulposus at L4-5,

JACKSON, 13CA1 4

the conditions allowed in the claim, there has not been an adequate demonstration that they do not arise out of the previously found intervening incident, rather than the 2003 industrial injury.

Consequently, all of these bills are found not properly payable.”

{¶ 8} On December 9, 2009, a SHO affirmed the DHO’s order denying appellant’s motion. The SHO agreed that appellant failed to show “that these treatments were reasonably necessary and appropriate care to the allowed conditions under this claim.” The Industrial Commission refused appellant’s further appeal.

{¶ 9} Appellant then re-filed his previously dismissed complaint and added the more recent 2009 orders denying his motion for payment of medical bills. AutoZone subsequently filed a motion to dismiss appellant’s complaint. AutoZone asserted that the trial court lacked jurisdiction because the orders appellant attempted to appeal were not appealable under R.C. 4123.512.

{¶ 10} On April 5, 2010, the trial court overruled AutoZone’s motion to dismiss and remanded the matter to the BWC. The court directed the BWC to clarify the effect of appellant’s 2008 injury on his right to participate in the workers’ compensation fund for his 2003 injury.

{¶ 11} On September 23, 2010, the DHO clarified its prior order by stating:

“[Appellant]’s request for temporary total compensation for the period 05/12/2008 through 08/20/2008 (date of Staff Hearing Officer order) is specifically denied. The District Hearing Officer finds that [appellant] has not met his burden of proving that this disability for the period at issue is causally related to the allowed conditions in the claim. The District Hearing Officer notes that the C-84 Requests of Dr. Kincaid dated 05/19/2008 and 06/25/2008 specifically list the condition ‘herniated disc at L5-S1' which is a non-allowed condition in the claim. Therefore, the District Hearing Officer finds that [appellant]’s disability is not related to the allowed conditions in the claim.

As noted above the District Hearing Officer order of 07/23/2008 and the

JACKSON, 13CA1 5

Staff Hearing Officer order of 08/20/2008 denied [appellant]’s request for temporary total compensation in part because of a finding that [appellant]

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Gilbrath v. Autozone, Inc., 2014 Ohio 2347 (Ohio Ct. App. 2014).

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