In a decision released on July 7, 2011, the Supreme Court of Ohio ruled 6-1 that because aggravation of a preexisting medical condition is a type of causation, it is not a separate condition or distinct injury as defined by R.C. 4123.01, and a claimant can present evidence on any theory of causation for a medical condition that already has been addressed administratively.
The case, Starkey v. Builders FirstSource Ohio Valley, L.L.C., 2011-Ohio-3278, arose out of injuries Joseph Starkey suffered to his left hip while working as a service technician for Builders FirstSource Ohio Valley (Builders). Starkey was awarded workers’ compensation benefits for a number of medical conditions arising from the accident. He later applied for benefits based on the additional condition of “degenerative osteoarthritis of the left hip.”
The Industrial Commission granted the requested additional condition. Builders appealed the decision to the Hamilton County Court of Common Pleas. During the court proceedings, medical experts for both parties testified that in their opinion Starkey had arthritis in his hip before the workplace accident, but that the accident aggravated the condition. Builders moved to dismiss the case, arguing that in common pleas court a claimant may seek to participate in the workers’ compensation fund only for those conditions addressed in the administrative order. The court granted Builders’ motion. Starkey appealed, and the 1st District Court of Appeals reversed the trial court and reinstated Starkey’s benefit. Builders then appealed to the Supreme Court of Ohio.
Justice Judith Ann Lanzinger, for the majority, wrote:
The ultimate question in a workers’ compensation appeal is the claimant’s right to participate in the fund for an injury received in the course of, and arising out of, the claimant’s employment. As long as the injury has a causal connection – whether direct or aggravated – to the claimant’s employment, the claimant is entitled to benefits.
We therefore agree with the [appellate] courts that have held that a claimant is not required to advance a specific theory of causation at the administrative level if he or she wishes to use that theory in the trial court, because R.C. 4123.512 allows for introduction of new evidence provided that it relates to the same medical condition or injury.
This decision will obviously alter the approach and the preparation needed for employers to successfully defend workers’ compensation claims. Specifically, reviewing physicians will now need to be queried regarding any and all potential theories of causation. Of note is that this claim arose under the previous “symptomatic aggravation” standard. The majority did not address how such cases can and should proceed under the current “substantial aggravation” standard, given the heightened level of evidence required, although such difficulties were alluded to in the dissent by Justice O’Donnell.