A workers’ comp ruling from Ohio’s highest court reverses decades of precedent and shortens the period during which total temporary disability (TTD) benefits must be paid.
This case involves Loretta Dillon, who suffered a work-related back injury near the start of April of 2019.
The court’s decision described the injury as “strain muscle, fascia, tendon lumbar.”
A district hearing officer allowed Dillon’s claim for lumbar sprain and strain and awarded TTD benefits.
Physician: ‘You’re not going to get any better’
Dillon’s employer obtained an independent medical examination from a physician who said she had reached maximum medical improvement.
After a hearing that was held near the end of October of 2019, a hearing officer agreed that Dillon had reached maximum medical improvement and terminated her TTD compensation as of August 8.
At the time of that determination, Dillon had already received some TTD compensation after August 8.
The bureau of workers’ compensation sought an order to recoup $5,549.40 it had overpaid to Dillon. But Dillon said there was no overpayment and that she was entitled to get benefits up until the date of the October determination.
The question of when benefits should stop reached the Supreme Court of Ohio.
Workers’ comp case raises an important question
The precise question: Should benefits stop on the date of a physician’s determination of maximum medical improvement, or should they continue until the date of the termination hearing?
In 1998, Ohio’s high court determined that the proper date was the date of the termination hearing – and not the earlier date of the physician’s determination.
That changed when this court ruled that the date for termination of TTD benefits is the date on which any physician finds that the workers’ comp claimant has reached maximum medical improvement.
This includes physicians who are hired by the employer to determine whether the claimant has reached maximum medical improvement.
The court explained that TTD benefits are intended to compensate injured workers for loss of earnings suffered while their injuries heal. These benefits go only to workers with disabilities that are temporary, it stressed.
Benefits end when maximum medical improvement is reached
Once there is maximum medical improvement, TTD compensation becomes unavailable because the condition is no longer temporary.
This does not mean that no benefits of any kind are thereafter unavailable, the court explained. Instead, injured employees may still seek permanent disability benefits.
The language of the relevant state statute does not permit claimants to receive TTD compensation after they reach maximum medical improvement, the state’s highest court said.
The decision was a close one, with three of the seven judges dissenting to say that injured workers should continue to get TTD benefits a hearing is held and the state’s Industrial Commission finds that maximum medical improvement has been reached.
But those judges were outnumbered, and employers in Ohio will now be able to recoup more overpayments.
Bottom line is good news for Ohio employers
The time between a physician’s determination of maximum medical improvement and a hearing producing the same result can be months. As in this case, thousands of dollars in payments can be made during that time.
Employers in Ohio will now have to wait to see whether the state’s lawmakers undo this significant change to workers’ comp law in the state. It will also be interesting to see whether the state tries to reduce the time between a physician’s determination of maximum medical improvement and termination hearings.
For now, Ohio employers stand to significantly reduce their workers’ comp costs as a result of the ruling.
State v. Industrial Comm’n of Ohio, No 2024-OHIO-744 (Ohio 3/5/24).
