The Supreme Court of Ohio recently addressed what elements of an injured worker’s claim he/she must present to a judge or jury when an initial claim allowance is on appeal to the Court of Common Pleas. Injured workers bear the burden of proving that their industrial injury was received in the course of and arising out of their employment. They also must prove that their injuries are causally related to the industrial accident or exposure. Injured workers bear this burden of proof at the hearing level and at the trial level. An injured worker bears this burden of proof at trial regardless of whether it is the injured worker’s appeal or the employer’s appeal into Court. Workers’ compensation claims on appeal to the Court of Common Pleas are considered de novo. This means that the claim begins anew, and the parties must re-present all of the relevant evidence and testimony to the judge or jury either supporting or defending the alleged injury.
In Bennett v. Admr., Ohio Bureau of Workers’ Comp., Slip Opinion No. 2012-Ohio-5639, the Ohio Supreme Court held that the nature of workers’ compensation appeals to the Common Pleas Court level puts at issue all elements of a claimant’s right to participate in the workers’ compensation fund. The Court found that it is incumbent on the injured worker to prove not only his/her injury was sustained in the course of and arising out of his/her employment, but also prove a causal connection between the alleged injuries and the workplace. In Bennett, the injured worker’s claim was denied after hearing specifically on the basis that his claim was barred by the “coming and going” rule because his injury was sustained while commuting to work.
Generally claims are not compensable when commuting to or from a fixed place of employment. The final hearing order in Bennett never addressed his alleged injuries to his head, neck, and back, and whether these were directly and proximately caused by the industrial injury. Following the denial of his claim, the injured worker appealed his claim to the Court of Common Pleas.
At trial, the injured worker only presented evidence that his claim was not barred by the “coming and going” rule. He did not present any medical evidence and/or medical opinion causally linking his alleged injuries to the workplace injury. This was fatal to Bennett’s case as the trial court found in favor of the BWC. The trial court determined that the injured worker did not present medical evidence establishing a compensable injury nor a causal relationship between his injuries and his accident. The injured worker then appealed the matter to the Sixth District Court of Appeals, who upheld the decision of the Trial Court. The injured worker then appealed the matter to the Supreme Court of Ohio.
The Supreme Court of Ohio noted that it is not an option under Ohio Revised Code section 4123.512 (the statute providing the right for injured workers and/or employers to appeal allowance issues into court) to send a decision from the Court of Common Pleas back to the Industrial Commission for further proceedings. The Supreme Court rejected the notion advanced by the injured worker in Bennett that the trial court should have only ruled on the compensability of his claim under the “coming and going” rule, and should have referred the matter back to the Industrial Commission for further hearings on whether his alleged injuries were causally related to the workplace event. The Supreme Court found that the basic fundamentals of a workers’ compensation appeal require injured workers to establish that the injury was sustained in the course of and arising out of his/her employment, and to establish the injuries are causally related to the industrial injury.
This decision by the Supreme Court of Ohio in Bennett means that injured workers and employers, at trial, should be prepared to either advance or defend the case when there are multiple matters at issue for the compensability of a claim. Thus, when an employer is defending a case on the basis that the injury was not sustained in the course of and arising out of his/her place of employment, the employer should also be prepared to defend the claim from a medical standpoint. Not in every instance will there be a viable defense for an employer to defend a case from a medical standpoint, i.e. contusions or minor injuries. However, in cases of pre-existing injuries for example, under the Bennett decision, employers should be prepared to also have a defense expert medical opinion concerning the causal relationship between the alleged injury and the workplace accident.
If you would like a copy of the decision, or have any questions regarding workplace injuries or exposures, please contact any member of our Workers’ Compensation Practice Group.