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Ohio Rules on Pre-existing Conditions in Workers’ Comp Cases

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Expert analysis from Reminger Law.

Post by Shelby McMillan, Esq., Reminger Law
(reprinted with permission)

In Ohio, a claimant seeking to participate in the Workers’ Compensation fund for an injury must show a causal relationship between a workplace accident and the alleged injury.  For injury claims, Ohio law recognizes four theories of causation: direct causation, substantial aggravation of a pre-existing condition, repetitive trauma, and flow-through injuries.

When alleging a substantial aggravation of a pre-existing condition the First District Court of Appeals recently required the Plaintiff to submit evidence to establish the aggravation of a pre-existing condition actually pre-dated the date of injury.

The First District Court of Appeals in Houlihan v. Morrison held that without such evidence, the injured worker cannot establish that the requested condition had been substantially aggravated by the work injury. This case is important as it is the first reported case to rely on the objective proof standard for substantial aggravations.

When you have professional liability insurance coverage through Alta Pro Insurance, you’ll have the claims repair and legal defense experts of Reminger Law on your side. Want to have a resource like that in your practice? Here’s how to get it.

Houlihan v. Morrison

After sustaining two low back injuries at work within a period of four years, the injured worker obtained a lumbar MRI in 2017 which showed one disc herniation and two disc protrusions. On review of the MRI the attending orthopedist opined the abnormalities pre-dated the first work injury in 2013 and were also substantially aggravated by the 2013 injury.  The Ohio Industrial Commission did not agree, and denied the request to add the allegedly aggravated disc conditions to the claim, and the case thereafter proceeded to trial where the injured worker again lost. 

In affirming the trial court’s verdict, Ohio First District Court of Appeals held R.C. 4123.01(C)(4) necessarily requires evidence that the disputed conditions pre-dated the date of injury.  In reviewing the record, the court first noted there was no imaging evidence obtained before the 2013 injury to establish the existence of the alleged pre-existing conditions.  Then, and most significantly for the defense bar, the court held that the MRI from 2017 was insufficient to support the finding of a substantial aggravation as neither expert could establish from that study, or the clinical evidence, that the disc conditions existed prior to the first injury in 2013. 

The First District’s decision to focus on an objective point of reference from before the injury is significant.  From a claim management standpoint, this decision demonstrates why it is important to fully understand what medical evidence exists that predates the date of injury.  From a litigation standpoint, this case is instructive to the practitioner in the importance of probing the opposing expert’s ability to identify the age of the disc found on the MRI, and whether the appearance of the disc on the date of the study was any different from before the injury.

If you would like a full copy of the opinion, or if you have questions related to the standard of establishing an aggravation of a pre-existing injury, feel free to call upon one of our Workers’ Compensation attorneys.

This has been prepared for informational purposes only. It does not contain legal advice or legal opinion and should not be relied upon for individual situations. Nothing herein creates an attorney-client relationship between the Reader and Reminger. The information in this document is subject to change and the Reader should not rely on the statements in this document without first consulting legal counsel.

Source: What Hurts and When Did You Hurt It? Litigating Substantial Aggravation by Investigating the Injured Worker’s Medical History: Reminger Attornys at Law

ABOUT THE AUTHOR

Shelby is a shareholder practicing in the area of Workers’ Compensation. Her litigation practice focuses on the defense of claims against state funded and self-insured employers. Shelby has served as lead counsel in numerous cases in the Courts of Common Pleas in Hamilton, Montgomery, Warren, Butler and Clermont Counties in Ohio.

If you practice in Wisconsin, Texas, Minnesota, Ohio, Illinois, Indiana or Michigan, you can stay on top of ethics and risk management news by being a member of Alta Pro Lawyers RPG. You’ll get access to free webinars, the Pro Practice Playbook, Reminger ProLink, Ask the Risk Pro and more. Here’s how to join.

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