State ex rel. Ellis v. Industrial Commission

751 N.E.2d 1015, 92 Ohio St. 3d 508, 2001 Ohio LEXIS 2132
CourtOhio Supreme Court
DecidedAugust 15, 2001
DocketNo. 00-1472
StatusPublished
Cited by11 cases

This text of 751 N.E.2d 1015 (State ex rel. Ellis v. Industrial Commission) is published on Counsel Stack Legal Research, covering Ohio Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
State ex rel. Ellis v. Industrial Commission, 751 N.E.2d 1015, 92 Ohio St. 3d 508, 2001 Ohio LEXIS 2132 (Ohio 2001).

Opinion

Per Curiam.

Appellant-claimant, Bobby D. Ellis, was injured on January 31, 1997, in the course of and arising from his employment with the Columbus Board of Education. His workers’ compensation claim was allowed for “sprained right shoulder/arm.”

Claimant submitted to appellee Ohio Bureau of Workers’ Compensation (“BWC”) a request for temporary total disability compensation (“TTC”) through a C-84 form, which requires both claimant and physician verifications. A July 1, 1997 C-84 lists claimant’s last date worked as January 31, 1997. On the form, claimant responded negatively to the following question:

“Have you worked, in any capacity (include full-time, part-time, self-employment or commission work) during the disability period shown above?”

The claimant’s portion of the form concluded with the declaration:

“I understand that I am not permitted to work while receiving temporary total compensation. I have answered the foregoing questions truthfully and completely. I am aware that any person who knowingly makes a false statement, misrepresentation, concealment of fact or any other act of fraud to obtain compensation as provided by BWC or who knowingly accepts compensation to which that person is not entitled is subject to felony criminal prosecution and may, under appropriate criminal provisions, be punished by a fine or imprisonment or both.”

The physician’s portion of the C-84 included a questionnaire completed by the attending physician, Dr. Wesley F. Hard. It certified claimant as temporarily and [509]*509totally disabled from January 31, 1997 through an estimated December 1, 1997. The questionnaire certified that claimant was unable to perform his work as a truck driver and “other employment including light duty, alternative work, modified work or transitional work.” Based on those forms and others like it, the bureau paid TTC from February 1,1997 through April 30,1998.

On August 18, 1997, the bureau acted on a tip that claimant was working as a cleaning person at a commercial building referred to as the “Morrison building.” An investigation by the bureau’s special investigations unit (“SIU”) recorded several noteworthy events. An August 28, 1997 investigative entry stated:

“Investigator Tami Martin received a call from Ken Vaughn [property manager] of Ohio Equities who stated that he had met with David Yeager of Ohio Janitorial and was given the names of all employees who clean the 670 Morrison building: Bob Ellis (lead cleaner), Marge Ellis (his wife) and Cathy Ellis (his cousin). Vaughn stated that he reminded Yeager that no one was to be allowed in the building unless they were Yeager’s payroll employees under his direct control.- Vaughn reiterated that there were to be no sub-contractors.' Yeager adamantly stated to Vaughn that all the people working there were his direct employees. Yeager told Vaughn that all his employees had been with him for some time and that there was very little turnover. Yeager also stated that the Ellis’s [sic] worked full-time for him and worked in other locations than the Morrison Rd. building.”

Video-camera surveillance on September 10, 11, 12 and 15, 1997, revealed claimant to be actively participating in building cleaning using his injured right arm. Claimant was observed emptying trash, pushing large trash cans, and vacuuming and mopping.

SIU also interviewed several occupants of the Morrison Building. On December 8,1997, Douglas Holliday stated the following:

“[I]t appeared that this individual [claimant] is the lead worker as he is [sic] always seems to be in charge of the access keys and the others seem to turn to him for direction and access to secured areas. Holliday'stated that he has seen the IW (injured worker) performing cleaning duties and never sees the individual just sitting down and doing nothing.”

Five other frequenters of the Morrison building indicated that they, too, believed the claimant to be the crew leader. Dudley King, for example, had “seen the IW performing cleaning duties and assumed he was the team leader, partly because when additional cleaning requests were made, the IW accepted the requests and didn’t refer King to anyone else.” Michelle Skladany also “believed him to be in charge of the cleaning crew because if there was a problem with the cleaning, he was the person who was contacted.”

[510]*510On December 1, 1997, two SIU investigators confronted claimant at the Morrison building with their surveillance evidence. Claimant denied doing any significant work, claiming that he was simply assisting his wife, who was an Ohio Janitorial employee. He stated, “I sometimes help her, but not much. I help her out a little bit.” Ironically, when interviewed independently immediately thereafter, claimant’s wife stated that “her husband just drove her to work, waited for her and never did any work at the building. She stated that he didn’t even help her at all, at anytime.”

Investigators met with David Yeager, owner of Ohio Janitorial, on December 9, 1997, with further questions regarding claimant’s employment status. Yeager stated that claimant “had worked for him in 1996 and early 1997, but that Ellis was only supposed to be in the building after that just to wait on his wife Margie.” The investigator noted that ‘Yeager ‘waffled’ during this visit on whether he knew that Ellis was in the building on a daily basis.”

Kenneth Vaughn’s same-day statement contradicted Yeager’s. According to the investigator, ‘Vaughn stated that his primary contact for the cleaning crew at that location is David Yeager, owner of Ohio Janitorial. He stated that on July 29, 1997 he issued a notice to Yeager that only his [Yeager’s] employees were allowed in the building after hours under any circumstances. Vaughn stated that Yeager gave him a verbal list of the employees for that building, telling Vaughn that Bob Ellis was the lead man there. On Aug. 28, 1997, Vaughn reiterated his directive to Yeager. Yeager again verbally gave Vaughn the list with the IW as the lead man, working for him full time and adamantly stated that all the people working there were his employees. Vaughn stated that on December 3, 1997, (after Investigator Tami Martin’s contact with Yeager) Yeager told Vaughn that the IW was an ex-employee and that he had no knowledge of the IW being in the building.”

On May 1, 1998, the BWC referred the matter to appellee Industrial Commission of Ohio for a hearing. Both the district hearing officer and staff hearing officer found that claimant had been gainfully employed from February 1, 1997 through December 1, 1997, and declared that compensation over that period had been overpaid. They declined to declare as overpaid TTC from December 1, 1997 through April 30,1998, finding insufficient evidence of employment over that period.

On appeal, the commission vacated the staff hearing officer’s order and declared an overpayment for the entire period. The commission wrote:

“It is the finding of the Industrial Commission that the claimant committed fraud in this claim. It is the finding of the Industrial Commission that the Bureau of Workers’ Compensation sustained its burden of proving by a preponderance of the evidence that the claimant knowingly used deception to obtain [511]*511Workers’ Compensation benefits.

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751 N.E.2d 1015, 92 Ohio St. 3d 508, 2001 Ohio LEXIS 2132, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-ex-rel-ellis-v-industrial-commission-ohio-2001.