The single most important question at the outset of a workers' compensation claim is, “Did the claimant suffer a compensable injury?” Under Ohio Revised Code Section 4123.01(C), an “injury” is defined as “any injury, whether caused by external accidental means or accidental in character and result, received in the course of, and arising out of, the injured employee's employment.” Webster’s Dictionary defines “injury” as “hurt, damage, or loss sustained.” This sounds easy enough to prove, right? The reality is different.
Most Industrial Commission claim allowance hearings focus on witness testimony and the medical evidence. Initial treatment records are key as they normally delineate diagnosed conditions. Every so often, though, a treating doctor will give a generic diagnosis of “pain.” With a back injury, the initial diagnosis may even be “radiculopathy.” Technically, though, these are symptoms and not conditions, and thus litigation ensues.
Recently, the Tenth District Court of Appeals for the State of Ohio decided the compensability of a claim based on an application for “chest pain.” In the case of Edney v. Life Ambulance Serv., Inc., 2012-Ohio-4305 decided on September 20, the claimant alleged an “injury” of “chest pain” as the result of second hand smoke in the workplace. In its decision, the court discussed at length the definition of a “symptom” versus an “injury.” The court cited the medical records from claimant's hospital visit as indicating that he was diagnosed with chest pain of an unclear etiology or cause. In the end, the court ruled that the Industrial Commission properly denied this claim since pain is a symptom and claimant did not establish that he suffered an injury within the statutory definition.