Temporary Total Awarded Where Unable to Work Due to Allowed Conditions

Temporary Total Where Unable to Work Due to Allowed Conditions

Posted: August, 2003

State, ex rel. Ignatious v. Indus. Comm. (7/23/03), 99 Ohio St.3d 285, 2003-Ohio-3627.

Issue: Can the Commission deny temporary total when the doctor’s notes reference an unallowed condition but later indicated that the injured worker is temporary total due to the allowed conditions?

Background: Ignatious was injured and his claim was allowed for a sprained neck and herniated discs C4-5 and C5-6. He had surgery for these conditions and was initially scheduled to return to work on November 6, 2000. However, he did not return to work.

On November 9, 2000, his treating doctor indicated that Ignatious could not return to work and would not be able to return to work until additional testing was performed.

On November 28, 2000, the treating doctor filled out a C-84 listing the ICD codes for the allowed conditions as allowed conditions which prevent return to work. The treating doctor had referenced her office notes which referred to both the allowed conditions and a non-allowed carpal tunnel condition in responding “no” to a question which asked if Ignatious could return to his former job.

The BWC sent a letter to the treating doctor questioning the reason that Ignatious was off work. The BWC indicated that it seemed that Ignatious was off work due to the non-allowed carpal tunnel, and requested the doctor to provide clarification.

In response, the treating doctor sent the BWC her December 15, 2000 office notes which indicated that Ignatious’ problem was due to the cervical disc herniations, which were causing neck pain. She also sent an additional C-84, dated January 9, 2001, which indicated that Ignatious could not return to work due to neck pain and that treatment was for the allowed conditions. The treating physician also submitted a letter stating that Ignatious was temporary total “due to his allowed condition of sprain of neck and herniated disc C4-5 and C5-6.”

The Commission denied temporary total. The Commission indicated that the C-84 of November was based on a non-allowed condition (carpal tunnel) because of the reference to the office notes. It also stated that the treating doctor had not explained why she changed her opinion from that C-84 to the later ones.

Ignatious filed a complaint for a writ of mandamus in the Court of Appeals, challenging the Commission’s denial of temporary total. The Court of Appeals granted a limited writ of mandamus and ordered the Commission to re-examine the evidence and issue a new order. The Commission appealed.

Decision: Supreme Court rules Ignatious entitled to temporary total.

The Court states that all that a claimant must prove to be entitled to temporary total is a “causal relationship” between the inability to work and the allowed conditions. In the present case, the evidence from Ignatious’ treating doctor did so.

The Court notes that the Commission apparently denied temporary total because of the presence of carpal tunnel syndrome and the failure of the evidence to state that carpal tunnel was not disabling. This was improper because a claimant does not have to prove a negative.

Because all of the evidence links the inability to work to the allowed conditions, the Court finds Ignatious entitled to temporary total and orders payment of temporary total.

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