Insights

Dec
13

No PPD when PTD

This proclamation comes from a recent decision by the Ohio Supreme Court involving a workers’ compensation claim, State ex rel. Ohio Presbyterian Retirement Servs., Inc. v. Indus. Comm. The case was decided on December 8, 2016.

The claim involves an injured worker who sustained a work-related injury in 2003. The claim was allowed for physical injuries to the low back, and as a result of the underlying physical injuries, the claim was also allowed for a psychological condition. (For any workers’ compensation claim, it’s always important to know what the claim is allowed for; the allowed conditions determine the extent of disability, both in terms of medical coverage and compensation benefits).

In 2010, the injured worker was awarded Permanent Total Disability (PTD) compensation. The award was based soled on the allowed psychological condition. In other words, based only on the psychological condition – without even needing to consider the allowed physical conditions – it was determined that the injured worker was unable to perform any sustained remunerative employment.

Three years later, in 2013, the injured worker applied for Permanent Partial Disability (PPD) compensation. It was conceded that she was not entitled to PPD benefits for her psychological condition (for which she was already receiving PTD benefits), but the PPD compensation was applied for based on the allowed physical conditions. The Supreme Court determined that PPD compensation is not available in this scenario:

We hold that the commission has no authority to award an injured worker permanent-partial-disability compensation under R.C. 4123.57(A) when the worker has been previously found to be permanently totally disabled under R. C. 4123.58 in the same claim, even when the new finding is based on a condition or conditions in the claim that formed no part of the basis for the prior finding of permanent total disability.

While I believe the Supreme Court’s decision in this case is unfortunate, there are some good points of explanation concerning the differences between PPD versus PTD compensation. As explained in the decision, “An award for permanent and total disability [PTD] is generally aimed at compensating for impairment of earning capacity, while benefits for partial disability [PPD] are more akin to damages for work-related injuries.” That is a helpful distinction.

I disagree, however, with other portions of the Court’s reasoning. For example, the Court states “The purpose of permanent-total-disability benefits is to compensate an insured worker for impairment of earning capacity,” whereas “permanent partial disability compensation is intended to compensate injured claimants who can still work.” If permanent partial disability compensation is akin to an award for damages, then it has nothing to do with whether the injured worker is, or is not, still working. In other words, we recognize that PTD benefits are intended as an earnings replacement for someone who, because of their allowed conditions, can no longer work. PPD benefits, however, have nothing to do with replacing someone’s earnings; they are intended to compensate for permanent bodily damage (whether physical or psychological). I’ve had many clients over the years who have been eligible for PPD awards, and it makes no difference whether or not the person is, or is not, still working.

There is a dissenting opinion by Justice Pfeifer in the State ex rel. Ohio Presbyterian Retirement Servs., Inc., concurred with by Justice O’Neill. These Justices would have allowed the concurrent award of benefits; namely, PTD benefits based on the allowed psychological condition, and a PPD award for the permanent bodily damage resulting from the allowed physical conditions. While cases are decided based on the majority of the Justices’ opinions, it’s one of the great things about our judicial branch of government that dissenting opinions are included and reported right along with the majority’s opinion. Courts will from time-to-time reverse themselves, and having a dissenting opinion helps make that more of a possibility in the future.