Treating Doctor Explains Ambiguous Report

Treating Doctor Explains Ambiguous Report

Posted: March, 1999

State, ex rel. Petronio v. Indus. Comm. (2/10/99), 84 Ohio St.3d 427.

Issue: Can the Commission deny temporary total based on a doctor’s report which seems to indicate that the injured worker is not temporary total, but which the doctor later clarifies?

Background: Petronio was receiving temporary total. His doctor documented his continued temporary total with medical reports. Some of the doctor’s reports represented that Petronio’s condition had become permanent and others suggested that other nonallowed conditions had caused his disability.

The doctor later explained his conflicting report, but the BWC had already cut off temporary total and assessed an overpayment. The Commission administratively affirmed the BWC. The Court of Appeals denied mandamus relief.

Decision: Supreme Court reverses.

The Court finds this case similar to State, ex rel. Eberhardt v. Flxible Corp. (1994), 70 Ohio St.3d 649, which held that

[w]here a physician renders an ambiguous opinion regarding a claimant’s medical condition but thereafter clarifies the ambiguity, the Industrial Commission may not revive the ambiguity as a basis for rejecting the physician’s opinion.

Petronio’s doctor explained in his last report that Petronio’s condition was temporary total and resulted from his work injury. The Eberhardt rule required the Commission to accept the doctor’s explanation, notwithstanding the Commission’s authority to determine credibility.

No other evidence indicated that Petronio’s condition had become permanent or MMI. The Court thus finds that the Commission abused its discretion in terminating temporary total and declaring an overpayment.

Information courtesy of the Ohio Workers’ Compensation Bulletin. Subscribe to the Ohio Workers’ Compensation Bulletin to keep informed about the Ohio workers’ compensation system.