As most employers know, a court appeal may be filed concerning a claimant’s right to participate in the workers’ compensation fund. Typically, the issue of initial allowance of a claim or the additional allowance of a condition in a claim is the subject of these court appeals; however, there is often confusion surrounding whether a claimant may pursue a different theory of causation than the one pursued administratively. For instance, if the claimant sought the additional allowance of his claim for a disc herniation by way of direct causation at the administrative level, may he or she argue that the disc herniation was instead aggravated by the work injury in the court appeal? The Ohio Supreme Court addressed this very issue in Starkey v. Builders FirstSource Ohio Valley, (2011), 130 Ohio St.3d 114.
In Starkey, the claimant’s workers’ compensation claim was additionally allowed for degenerative osteoarthritis of the left hip. The employer filed a court appeal. In preparation for trial, the employer’s counsel deposed the claimant’s treating physician, who testified that the degenerative osteoarthritis at issue was aggravated by the claimant’s work injury. At trial, the employer moved for dismissal, arguing that because a claimant may seek participation in the workers’ compensation fund in court for only those conditions addressed administratively, he cannot ask the court to address an aggravation theory of causation.
The trial court agreed with the employer and entered judgment in its favor. The claimant appealed and the First District Court of Appeals reversed the trial court’s decision. Upon further appeal, the Ohio Supreme Court held that a workers’ compensation appeal allows a claimant to present evidence of any theory of causation pertinent to a claim for a medical condition that has already been addressed administratively. The Court emphasized that the Ohio Revised Code addresses a claimant’s right to participate in the workers’ compensation fund for a specific injury, not for a specific type of causation.
The Starkey decision makes it clear that any theory of causation is available to claimants in a court appeal. As a result, employers involved in a workers’ compensation court appeal should make sure to develop their discovery strategy and trial preparation strategy with an eye toward all possible theories of causation, including the theory of substantial aggravation, even if that theory was never argued at the administrative level.