State ex rel. Williams v. Cincinnati Country Club - Ohio Supreme Court Opinion - Ohio Supreme Court Decision

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THE STATE EX REL. WILLIAMS, APPELLANT, v. CINCINNATI COUNTRY CLUB;
INDUSTRIAL COMMISSION OF OHIO ET AL., APPELLEES.
[Cite as State ex rel. Williams v. Cincinnati Country Club (1998), ___ Ohio St.3d
___.]
Workers' compensation -- Industrial Commission's denial of temporary total
disability compensation not an abuse of discretion, when -- Approval of a
weight-loss program does not preclude a finding of maximum medical
improvement.
(No. 95-2216 -- Submitted June 9, 1998 -- Decided September 30, 1998.)
APPEAL from the Court of Appeals for Franklin County, No. 94APD08-1159.

Appellant-claimant David Williams's 1978 workers' compensation claim
was allowed for several low back conditions. Claimant's physical condition prior
to his industrial injury is unknown. However, in March 1991, an examining
physician listed claimant's height and weight at 5'5-3/4" and 285 pounds.

Claimant's weight prompted attending physician Richard B. Budde to send
a letter to appellee, Industrial Commission of Ohio in March 1992. That letter
stated:

"This patient's low back problem is made worse by the fact that he is
overweight. I believe it would be helpful to him to get into a weight reduction
program and suggested to him to go to the Good Samaritan Hospital for this
treatment. * * *"

One month later, Dr. Kenneth R. Hanington indicated in his report that
claimant "has reached maximum medical improvement, as he is not a candidate for
further surgery, due to his size." In August of that year, claimant successfully
moved the commission for approval of a hospital-supervised weight-loss program.

On March 23, 1993, claimant moved the commission for temporary total
disability compensation ("TTD") from August 26, 1992 and to continue, based on
Dr. Budde's March 2, 1993 report. That report stated:

"The patient continues to experience disabling lower back symptoms. He
does have multiple disc protrusions in the low back, particularly the last 3 discs. I
believe that he could possibly be helped some time in the future by re-exploratory
surgery and a fusion, but at the present time, due to his excessive weight, it would
not be advisable. I believe the [sic] he would need to loose [sic] a significant
amount of weight in order to benefit from any such surgery."

A district hearing officer denied TTD on August 27, 1993, stating:

"The claimant's motion filed requesting Temporary Total Disability
Compensation beginning 8-26-92 based on claimant's future acceptance and
attendance in a weight loss program is denied. The District Hearing Officer does
not find a substantial change in circumstances to warrant a period of Temporary
Total Disability Compensation. * * *

"This order is based upon the medical report(s) of Dr. Hannington [sic], Dr.
Budde[,] the evidence in the file and the evidence adduced at hearing."

A staff hearing officer affirmed the DHO's order.

Claimant filed a complaint in mandamus in the Court of Appeals for
Franklin County, alleging that the commission abused its discretion in denying
TTD. The court of appeals disagreed and denied the writ.

This cause is now before this court upon an appeal as of right.
__________________

Butkovich, Schimpf, Schimpf & Ginocchio Co., L.P.A., James A. Whittaker
and Stephen P. Gast, for appellant.

2

Betty D. Montgomery, Attorney General, and Lisa A. Sotos, Assistant
Attorney General, for appellees.
__________________

Per Curiam. In State ex rel. Miller v. Indus. Comm. (1994), 71 Ohio St.3d
229, 232, 643 N.E.2d 113, 115-116, we held that approval of a weight-loss
program was appropriate only where the "weight loss [is] geared towards
improving the allowed industrial conditions, improvement must be curative and
not merely palliative. * * * It is not enough that weight loss decreases pain
associated with the allowed conditions; weight loss must actually improve those
conditions."

Miller also ruled that as to TTD, "a recommended weight-reduction
program may or may not be consistent with the concept of MMI." Id. at 235, 643
N.E.2d at 118. In this case, the commission found that approval of a weight-loss
program did not preclude a finding of MMI. We uphold that decision.

Claimant argues that, under Miller, the commission's authorization for a
weight-loss program establishes that participation was deemed curative. This, in
turn, renders a declaration of MMI premature. We disagree for two reasons.

First, the commission's 1992 order preceded Miller, which did not issue
until 1994. It cannot, therefore, be presumed that the commission intended to
definitively declare participation to be curative.

Second, claimant's contention ignores the somewhat tenuous relationship
between weight loss and potential improvement. Dr. Budde -- on whom claimant
relies -- did not say that weight loss, in and of itself, would improve claimant's
back condition. He stated that weight loss would make claimant more amenable to
surgery that may better his condition.

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This adds a dual element of speculation to this case. Weight loss -- even if
successful -- does not guarantee that claimant will proceed with surgery. A
claimant cannot be forced to undergo surgery for obvious reasons relating to the
risk inherent in all invasive procedures. Equally important, Dr. Budde indicated
only that claimant's condition "could possibly" be helped by surgery.

Accordingly, the commission did not abuse its discretion in determining that the
potential for improvement was too speculative to outweigh Dr. Hanington's
assessment of MMI.

Claimant's reliance on State ex rel. Eberhardt v. Flxible Corp. (Feb. 9,
1993), Franklin App. No. 92AP-492, unreported, 1993 WL 31647, is misplaced.
Eberhardt held that the commission could not base MMI on a report that
concluded that claimant's condition would not improve unless he underwent
rehabilitation. We reasoned on appeal that the qualification on MMI was such that
a permanency declaration was premature. State ex rel. Eberhardt v. Flxible Corp.
(1994), 70 Ohio St.3d 649, 640 N.E.2d 815.

There are two distinctions between this case and Eberhardt. Eberhardt did
not involve a weight-loss program, which because of the dynamics of obesity,
involves unique considerations. Second, unlike Eberhardt, the immediacy of
improvement is one step removed in this case. In Eberhardt, it was the
rehabilitation itself that would improve claimant's condition. Here, it is not the
weight loss that would improve claimant's condition; it is the surgery that weight
loss would facilitate.

Accordingly, the judgment of the court of appeals is affirmed.
Judgment affirmed.

MOYER, C.J., DOUGLAS, RESNICK, F.E. SWEENEY, PFEIFER, COOK and
LUNDBERG STRATTON, JJ., concur.

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