St Ex Rel. Wal-Mart Stores v. Indus. Comm., Unpublished Decision (3-31-2005)

2005 Ohio 1517
CourtOhio Court of Appeals
DecidedMarch 31, 2005
DocketNo. 04AP-188.
StatusUnpublished
Cited by2 cases

This text of 2005 Ohio 1517 (St Ex Rel. Wal-Mart Stores v. Indus. Comm., Unpublished Decision (3-31-2005)) is published on Counsel Stack Legal Research, covering Ohio Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
St Ex Rel. Wal-Mart Stores v. Indus. Comm., Unpublished Decision (3-31-2005), 2005 Ohio 1517 (Ohio Ct. App. 2005).

Opinion

DECISION
ON OBJECTIONS TO THE MAGISTRATE'S DECISION
{¶ 1} Relator, Wal-Mart Stores, Inc., commenced this original action in mandamus seeking an order compelling respondent Industrial Commission of Ohio ("commission") to vacate its order deeming that relator authorized arthroscopic surgery and post-operative physical therapy for respondent Lora M. Perdue ("claimant") pursuant to Ohio Adm. Code4123-19-03(K)(5) and to order that the commission adjudicate the request for authorization on its merits. Relator further requested that the writ order the commission to vacate its order extending TTD compensation and to reinstate the order of the DHO that the industrial injury has reached maximum medical improvement ("MMI").

{¶ 2} Pursuant to Civ.R. 53(C) and Loc.R. 12(M) of the Tenth District Court of Appeals, this matter was referred to a magistrate of this court who issued a decision, including findings of fact and conclusions of law. (Attached as Appendix A.) In his decision, the magistrate concluded that the commission properly determined that relator, through its agent, was in receipt of claimant's written request for treatment (form C-9) at least as of April 2, 2003, and that relator failed to grant or deny claimant's request within ten days of that receipt. Therefore, the magistrate found that the commission properly deemed that relator authorized the requested treatment pursuant to Ohio Adm. Code4123-19-03(K)(5). The magistrate also rejected relator's argument that Ohio Adm. Code 4123-19-03(K)(5)'s ten-day rule conflicts with Ohio Adm. Code 4123-7-02. Lastly, the magistrate concluded that Dr. Tuggle's C-84 opinion was some evidence upon which the commission could rely in finding that the claimant had not reached MMI. Therefore, the magistrate has recommended that this court deny relator's request for a writ of mandamus.

{¶ 3} Relator has filed objections to the magistrate's decision. Relator first argues that the ordinary meaning of the word "receipt" contemplates a change of possession from one party to another. Although relator's legal representative obtained the C-9 from the Bureau of Workers' Compensation ("BWC"), relator contends it was not in receipt of the C-9 as contemplated by Ohio Adm. Code 4123-19-03(K)(5) to trigger the ten-day response time. At a minimum, relator argues that the word "receipt" as used in the administrative rule is ambiguous and, therefore, requires the application of principles of statutory construction.

{¶ 4} We agree with relator's assertion that the purpose of the administrative rule at issue is to prevent abuse by self-insured employers in administering and processing claims for medical care by encouraging prompt action. Ohio Adm. Code 4123-19-03(K)(5) states:

The employer shall approve or deny a written request for treatment within ten days of the receipt of the request. If the employer fails to respond to the request, the authorization for treatment shall be deemed granted and payment shall be made within thirty days of receipt of the bill.

{¶ 5} We also agree with relator that the word "receipt" as used in the context of this administrative rule contemplates a change of possession of a written request from the employee requesting treatment (or the employee's agent or doctor) and the employer. Here, there was no exchange of possession of a written request between the employee and employer. It is undisputed that neither the claimant nor the claimant's doctor sent the C-9 to relator or to relator's representative. Rather, the claimant's doctor mistakenly sent the completed C-9 form to the BWC. It was only by happenstance that relator's legal representative obtained a copy of the C-9 by accessing the BWC's document repository via the internet. Therefore, relator's legal representative did not "receive" the C-9. Rather, she obtained it on her own through the internet. Contrary to the legal conclusion of the magistrate, we find that the word "receive" as used in Ohio Adm. Code 4123-19-03(K)(5) does not mean simply "to come into possession of." Rather, as discussed above, the concept of receipt necessarily entails delivery or change of possession of a written request from the employee requesting treatment (or the employee's agent or doctor) and the employer. That exchange of possession did not occur here. Therefore, we sustain relator's first objection to the magistrate's decision.

{¶ 6} Relator asserts in its second objection that the magistrate erred by finding that unambiguous language of Ohio Adm. Code 4123-7-02 is subject to and superseded by Ohio Adm. Code 4123-19-03(K)(5). However, the magistrate made no such finding. Rather, the magistrate determined that there was no conflict between the two rules. We agree with that determination. Ohio Adm. Code 4123-19-03(K)(5) simply sets forth a procedural requirement that must be satisfied if the employer wishes to deny the requested treatment. Therefore, we overrule this objection.

{¶ 7} By its third objection, relator contends that the magistrate erred by finding that the commission did not abuse its discretion when it ordered the payment of TTD compensation. We disagree. As the magistrate points out, even if the commission's reliance on the C-9 was improper for purposes of assessing MMI, Dr. Tuggle opined in his C-84 that the left ankle sprain (an allowed condition) was not at MMI. Dr. Tuggle's C-84 opinion regarding MMI is some evidence supporting the commission's decision to reinstate TTD. Therefore, we overrule relator's third objection.

{¶ 8} We adopt the findings of fact contained in the magistrate's decision, but not the conclusions of law. We only adopt those portions of the magistrate's conclusions of law which address the issues that are the subject of relator's second and third objections. We further find that a writ of mandamus should be issued ordering the commission to vacate its order deeming that relator authorized the treatment requested in the C-9, and we remand this matter to the commission for a merits determination of the claimant's request for treatment. We deny the remaining relief requested by relator.

Objections sustained in part and overruled in part; writ of mandamusgranted.

Brown, P.J., and Lazarus, J., concur.

APPENDIX A
IN THE COURT OF APPEALS OF OHIO TENTH APPELLATE DISTRICT
State of Ohio ex rel.          :
Wal-Mart Stores, Inc.,         :
                               :
             Relator,          :
v.                             :        No. 04AP-188
                               :
Industrial Commission of Ohio  :     (REGULAR CALENDAR)
and Lora M. Perdue,            :
                               :
Respondents.                   :

MAGISTRATE'S DECISION
Rendered on October 21, 2004
Bricker Maxfield LLC, and Shane M. Dawson, for relator.

Jim Petro, Attorney General, and Stephen D. Plymale, for respondent Industrial Commission of Ohio.

Law Office of Stanley R. Jurus, and Joseph R. Sutton, for respondent Lora M. Perdue.

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Related

State ex rel. Foster v. Indus. Comm.
2021 Ohio 4221 (Ohio Court of Appeals, 2021)
State ex rel. Wal-Mart Stores, Inc. v. Indus. Comm.
828 N.E.2d 640 (Ohio Supreme Court, 2005)

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2005 Ohio 1517, Counsel Stack Legal Research, https://law.counselstack.com/opinion/st-ex-rel-wal-mart-stores-v-indus-comm-unpublished-decision-ohioctapp-2005.