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State ex rel. Pilarczyk v. Geauga County

Supreme Court of Ohio

July 18, 2019

The State ex rel. Pilarczyk, Appellee,
v.
Geauga County et al.; Industrial Commission of Ohio, Appellant.

          Submitted April 23, 2019

          Appeal from the Court of Appeals for Franklin County, No. 17AP-174, 2018-Ohio-1478.

          Dworken & Bernstein Co., L.P.A., Stacy M. Callen, and Patrick J. Perotti, for appellee.

          Dave Yost, Attorney General, and Jacquelyn McTigue, Assistant Attorney General, for appellant.

          PER CURIAM

         {¶ 1} The Tenth District Court of Appeals held that appellant, Industrial Commission of Ohio, abused its discretion by relying on a report by a licensed psychologist to deny the request of appellee, Joshua N. Pilarczyk, for permanent-total-disability ("PTD") compensation because the report is equivocal and therefore is not proper evidence to support the commission's determination. The Tenth District issued a limited writ of mandamus ordering the commission to vacate its order, to adjudicate Pilarczyk's request for PTD compensation in conformity with the court's decision, and to enter a new order. We affirm the Tenth District's judgment and deny Pilarczyk's motion for oral argument.

         I. FACTS AND PROCEDURAL BACKGROUND

         {¶ 2} Pilarczyk sustained a back injury in 2002 while working as a maintenance worker for Geauga County. His workers' compensation claims were allowed for various spinal and psychological conditions. He received temporary-total-disability compensation until June 15, 2015. In July 2015, Pilarczyk applied for PTD compensation.

         {¶ 3} In 2015, Pilarczyk underwent a series of physical and psychological examinations. In January, his treating orthopedic physician, Dr. Michael Kellis, opined that Pilarczyk's physical conditions would continue indefinitely "without any present indication of recovery," that his injuries prevented him from engaging in "any gainful employment," and that he was permanently and totally disabled as a direct result of his work-related injuries.

         {¶ 4} In April, Dr. Kenneth Gruenfeld undertook an independent psychological evaluation of Pilarczyk at the request of the Bureau of Workers' Compensation. The purpose of the evaluation was to obtain Dr. Gruenfeld's opinions regarding the extent of Pilarczyk's psychological disability, the medical necessity and appropriateness of Pilarczyk's treatment, and the potential for Pilarczyk to return to work. In his report, Dr. Gruenfeld responded to six questions posed by the bureau. In response to question No. 1, Dr. Gruenfeld opined that Pilarczyk had reached maximum medical improvement ("MMI") with respect to his psychological conditions. Question Nos. 2 and 3 and Dr. Gruenfeld's responses to those questions were as follows:

2. Can the injured worker return to his/her former position of employment? If yes, are there any restrictions or modifications?
The claimant's mental health issues likely do prevent him from returning to his former position of employment. His problems with depression continue to manifest including problems with focus and motivation. It is believed that his problems with distractibility and motivation inhibit his ability to return to work at this time.
3. Please provide a summary of any functional limitations solely due to the psychological condition in this claim. In other words, please indicate the type of work the injured worker can perform and supportive rational[e] for your opinion.
Given his current mental health issues, he is unlikely to thrive in a moderate to high stress job setting. He is more likely able to work a job in an office where there is less stress to trigger his depressive based condition.

(Boldface sic.) In response to question No. 4, Dr. Gruenfeld recommended vocational rehabilitation for Pilarczyk and expressed his opinion that "he may be able to manage a vocational rehabilitation program at this time." In response to question Nos. 5 and 6, Dr. Gruenfeld restated his belief that Pilarczyk had reached MMI and stated that Pilarczyk was no longer obtaining any benefits from psychotherapy and should complete his treatment goals and finalize the termination of therapy over the ensuing five months.

         {¶ 5} After Pilarczyk applied for PTD compensation, the commission referred him to musculoskeletal specialist Dr. Bina Mehta for a physical assessment and to Dr. Joseph P. Pecorelli for a psychological assessment. Both found that Pilarczyk had reached MMI for his allowed conditions. Dr. Mehta opined that based solely on Pilarczyk's allowed physical conditions, he "could perform work within the sedentary work capacity category" though he would require breaks and an ambulatory assistive device. Dr. Pecorelli opined, however, that Pilarczyk's "ongoing symptoms of emotional distress * * * would prove to be barriers for any return to gainful employment" and that Pilarczyk was "incapable of work."

         {¶ 6} In October 2015, a commission staff hearing officer ("SHO") issued a tentative order granting Pilarczyk's application for PTD compensation based on Dr. Pecorelli's report. The bureau submitted a notice of appeal, arguing that PTD compensation should be denied because Dr. Gruenfeld's report had stated that Pilarczyk was likely able to work in an office job and that he could participate in vocational rehabilitation. The bureau also stated that Pilarczyk had declined rehabilitation.

         {¶ 7} In June 2016, a different SHO issued an order denying Pilarczyk's application for PTD compensation based on the reports of Drs. Mehta and Gruenfeld and on nonmedical factors. The order did not mention Dr. Pecorelli's report or his conclusion that Pilarczyk was incapable of work. It instead stated with respect to Pilarczyk's psychological condition, "Dr. Gruenfeld opines Injured Worker is capable of work in a low stress job." Pilarczyk twice moved for reconsideration, arguing in part that the commission's reliance on Dr. Gruenfeld's report was improper because the report is equivocal and "internally inconsistent." The commission denied both requests.

         {¶ 8} In March 2017, Pilarczyk filed a complaint for a writ of mandamus in the Tenth District. He claimed that the commission had abused its discretion by denying his request for PTD compensation in reliance on Dr. Gruenfeld's report, reiterating his assertions that the report is equivocal and that equivocal medical opinions do not constitute evidence on which the commission may rely. Pilarczyk specifically argued that Dr. Gruenfeld's report does not unequivocally state that Pilarczyk can work or that he can engage in vocational rehabilitation and that even if the court found that Dr. Gruenfeld's report does state that he could work, the report is contradictory because it also says that his "problems with distractibility and motivation inhibit his ability to return to work at this time." The commission countered that the report is not equivocal.

         {¶ 9} The Tenth District's magistrate agreed with Pilarczyk that the commission abused its discretion by denying PTD compensation based on Dr. Gruenfeld's report. Although the magistrate concluded that Dr. Gruenfeld's response to the third question could be accepted as Dr. Gruenfeld's opinion that Pilarczyk is capable of working in a low-stress job, the magistrate found that Dr. Gruenfeld's report should be excluded as evidence because Dr. Gruenfeld responded ambiguously to question No. 2. Dr. Gruenfeld's response to question No. 2 states both that Pilarczyk's mental-health issues "prevent him from returning to his former position of employment" and that "his problems with distractibility and motivation inhibit his ability to return to work at this time." (Emphasis added.) The magistrate noted that "former position of employment" has a specialized meaning in workers' compensation law and found that it was unclear whether the phrase "return to work" referred solely to a return to Pilarczyk's former position or "whether Dr. Gruenfeld intended to stray beyond the scope of the second query and to offer an opinion that [Pilarczyk] cannot return to any work at this time." 2018-Ohio-1478, ¶ 41-43. The magistrate stated that it was not the court's role to resolve this ambiguity and determined that "Dr. Gruenfeld's report must be eliminated from further evidentiary consideration unless he subsequently resolves the ambiguity." Id. . at ¶ 44.

         {¶ 10} The Tenth District overruled the commission's objection to the magistrate's decision, adopted the decision, and issued a writ of mandamus ordering the commission to vacate its order denying PTD compensation and to enter a new order adjudicating Pilarczyk's application in conformity with the court's decision. The commission appealed the Tenth District's judgment.

         II. ...


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