Justia Insurance Law Opinion SummariesArticles Posted in Ohio Supreme Court
State ex rel. Bailey v. Indus. Comm’n
Between 1996 and 2003, Appellant filed several workers’ compensation claims, which were allowed for certain conditions. Appellant subsequently filed two applications for permanent-total-disability compensation. The Industrial Commission denied the applications, relying in part on the report of Dr. Lee Howard, a psychologist, who determined that Appellant could perform work without significant limitations. Appellant filed a complaint for a writ of mandamus, arguing that the Commission abused its discretion when it relied on Dr. Howard’s report because the report was stale. The court of appeals denied the writ, determining that Dr. Howard’s report was relevant evidence. The Supreme Court affirmed, holding that the Commission did not abuse its discretion when it relied on Dr. Howard’s report in denying permanent-total-disability compensation. View "State ex rel. Bailey v. Indus. Comm'n" on Justia Law
State ex rel. Sheppard v. Indus. Comm’n
Robert Sheppard was injured while working for Employer. After Sheppard retired, he filed an application for permanent-total-disability (PTD) compensation, which a staff hearing officer granted. Employer filed a request for reconsideration on the basis that the staff hearing officer’s order contained mistakes of fact and law. After a hearing, the Industrial Commission issued an order confirming that the staff hearing officer’s order contained a clear mistake of law and denying the underlying request for PTD compensation. Sheppard filed a complaint for a writ of mandamus alleging that the Commission abused its discretion when it exercised continuing jurisdiction and denied PTD compensation. The court of appeals denied the writ, concluding (1) the staff hearing officer’s mistake of law was sufficient for the Commission to invoke its continuing jurisdiction; and (2) once the Commission properly invoked its continuing jurisdiction, it had authority to reconsider the issue of PTD compensation. The Supreme Court affirmed, holding (1) the staff hearing officer made a mistake of law justifying the exercise of continuing jurisdiction; and (2) the Commission’s continuing jurisdiction vested it with authority to issue a new order denying PTD compensation. View "State ex rel. Sheppard v. Indus. Comm'n" on Justia Law
State ex rel. Honda of Am. Mfg., Inc. v. Indus. Comm’n
Robert Corlew was an employee of Honda of America Manufacturing, Inc. when he was injured while working. Honda’s long-term-disability insurance carrier eventually determined that Corlew was not eligible for ongoing disability benefits because he was capable of gainful employment outside of Honda. Corlew subsequently retired because there was no position available at Honda. One year later, Corlew underwent surgery on his wrist. The Industrial Commission awarded temporary-total-disability (TTD) compensation to be paid during Corlew’s postsurgical recovery, concluding that Corlew had not voluntarily retired or abandoned the workforce. The court of appeals denied Honda’s request for a writ of mandamus, concluding that Corlew’s retirement was due to his industrial injury, and thus was involuntary, and that there was no evidence that Corlew had abandoned the entire workforce. The Supreme Court affirmed, holding that Corlew was eligible for TTD compensation even though he suffered no economic loss that could be directly attributed to his industrial injury. View "State ex rel. Honda of Am. Mfg., Inc. v. Indus. Comm'n" on Justia Law
State ex rel. Jacobs v. Indus. Comm’n
In 2006, Appellant injured her lower back while working for Employer, who was self-insured. Later that year, Employer discharged Appellant for violating the company’s absenteeism policy and failing to accept the light-duty work offered. The Industrial Commission denied Appellant’s request for temporary total disability (TTD) compensation, concluding that Appellant had abandoned her employment and that the abandonment barred payment of TTD compensation. Three and a half years after the denial of benefits, Appellant filed a complaint for a writ of mandamus. The appellate court denied the writ, concluding that the Commission did not abuse its discretion when it denied Appellant’s request for TTD benefits, as her conduct had amounted to a voluntary abandonment of employment. The Supreme Court affirmed, holding that the Commission did not abuse its discretion when it denied Appellant’s request for compensation, as the Commission’s order was supported by the evidence. View "State ex rel. Jacobs v. Indus. Comm'n" on Justia Law
State ex rel. Cline v. Abke Trucking, Inc.
Employee was injured while working as a truck driver for Employer. Employee's claim was allowed for the injuries. The next year, Employee returned to work. Two days later, Employer terminated Employee for violating written work rules. A staff hearing officer later denied temporary total disability (TTD) compensation, determining that Employee's termination was a voluntary abandonment of employment that barred compensation for TTD. The court of appeals concluded that the Industrial Commission abused its discretion in determining that Employee was ineligible for TTD compensation based upon his termination from Employer and granted mandamus relief to Employee. The Supreme Court (1) reversed, holding that the Commission's order did not meet the standards of State ex rel. Noll v. Indus. Comm'n because the court did not specifically state the evidence relied upon or explain the reason behind its decision that Employee had voluntarily abandoned his employment with Employer; and (2) returned the matter to the Commission to issue a new order stating the evidence relied upon and explaining its reasoning consistent with Noll. View "State ex rel. Cline v. Abke Trucking, Inc." on Justia Law
Cullen v. State Farm Mut. Auto. Ins. Co.
Michael Cullen sued State Farm Mutual Automobile Insurance Company requesting class certification and a declaratory judgment that State Farm failed to disclose all benefits available to policyholders who made claims for damaged windshields. The trial court certified the class, concluding that Cullen and the class satisfied the requirements of Ohio R. Civ. P. 23. The court of appeals affirmed the order certifying the class but reversed the portion of the decision defining the class and remanded with instructions to the trial court to redefine it. The Supreme Court reversed, holding (1) because the declaratory relief at issue here was incidental to an individualized claim for monetary damages, Cullen failed to meet the requirement for certification set forth in Rule 23(B)(2); and (2) Cullen failed to prove that this action satisfied Rule 23(B)(3) because individual questions predominated over the questions common to the proposed class. Remanded. View "Cullen v. State Farm Mut. Auto. Ins. Co." on Justia Law
State ex rel. Scott v. Indus. Comm’n
Appellant was employed as a laborer by County Saw & Knife. Appellant successfully sought workers' compensation after he developed respiratory problems from his exposure to metal dust. One year later, Appellant applied for an additional award, alleging that Country Saw violated specific safety requirements (VSSRs). The Industrial Commission denied Appellant's application, concluding that County Saw had not violated the VSSRs. The court of appeals denied Appellant's request for a writ of mandamus that would require the Commission to vacate its order denying Appellant's application. The Supreme Court affirmed, holding that Appellant did not present sufficient evidence to establish that he was entitled to an award for a VSSR in addition to his extant workers' compensation benefits. View "State ex rel. Scott v. Indus. Comm'n" on Justia Law
State ex rel. Coleman v. Indus. Comm’n of Ohio
Employee was injured while in the course and scope of his employment. Employee's industrial claim was allowed for certain injuries. Fourteen years later, Employee successfully requested compensation for the total loss of the functional use of his right arm. Based on the Industrial Commission's award for loss of use, one year later Employee filed a motion for compensation for statutory permanent total disability. A staff hearing officer denied the application. The court of appeals granted Employee's writ of mandamus, concluding that the loss of use of Employee's arm could not be relitigated and that the Commission was bound by the doctrine of collateral estoppel to issue the award. The Supreme Court reversed the judgment of the court of appeals and denied the writ of mandamus, holding (1) the Commission must conduct an independent evaluation of the facts when considering an application for statutory permanent disability under Ohio Rev. Code 4123.58(C) even if a prior award for the same body parts has been given pursuant to Ohio Rev. Code 4123.57(b); and (2) the evidence in the record supported the basis for the Commission's decision. View "State ex rel. Coleman v. Indus. Comm'n of Ohio" on Justia Law
Armstrong v. John R. Jurgensen Co.
Employee was involved in a motor-vehilce accident while operating a one-ton dump truck within the course of his employment by Employer. Employee applied for and received benefits for his physical injuries. Employee subsequently requested an additional allowance for posttraumatic-stress disorder (PTSD) that arose contemporaneously as a result of the accident. The Bureau of Workers' Compensation (BWC) allowed Employee's additional claim. The trial court held that Employee's PTSD was not compensable because it did not arise from his physical injuries. The court of appeals affirmed. The Supreme Court affirmed, holding (1) for a claimant's PTSD to qualify as a compensable injury under Ohio Rev. Code 4123.01(C)(1), the claimant must establish his PTSD was causally related to his compensable physical injuries and not simply to his involvement in the accident; and (2) the court of appeals appropriately determined that the record contained competent, credible evidence supporting the trial court's finding that Employee's physical injuries did not cause his PTSD and that Employee's PTSD was, therefore, not a compensable injury under section 4123.01(C)(1). View "Armstrong v. John R. Jurgensen Co. " on Justia Law
Marusa v. Erie Ins. Co.
Maria Marusa was driving her car when it was struck by a police cruiser driven by a police officer (Officer). Marusa and her daughter (collectively, Appellants) were injured in the accident. Appellants filed suit against Marusa's insurer (Insurer), seeking damages to compensate for medical expenses and pain and suffering. Insurer answered that it was not obligated to pay damages because even though the policy included uninsured-motorist coverage and the officer was an uninsured motorist, Appellants were not "legally entitled to recover" because Officer was immune under the Ohio Political Subdivision Tort Liability Law (OPSTLL). The trial court granted summary judgment for Insurer, and the court of appeals affirmed. The Supreme Court reversed, holding that the language of the policy unambiguously provides uninsured/underinsured motorist coverage when the insured is injured by an owner or operator who is immune under the OPSTLL. View "Marusa v. Erie Ins. Co." on Justia Law