the mercer county chronicle
October 28, 2010 • Page 11
State Supreme Court Issues...
Physical therapy & Workers Comp
In 2004, when Laura
Horvat was awarded
workers’ compensation
for an injury that occurred
through her job at Cambridge
Home Health Care, Inc., it
led to a legal battle that
brought her case before us –
the Supreme Court of Ohio.
Laura’s workers’
compensation claim was
allowed for a right wrist
sprain with arthritis. She
later filed a motion for
compensation for the loss of
use of her hand. In support
of that claim, she submitted
a functional-capacities
evaluation prepared by
physical therapist Barbara
Hornbeek.
The report noted that
Laura’s right hand was
incapable of performing
maneuvers that required
dexterity or repetition.
Hornbeek felt that these
restrictions were permanent,
although she did report that
Laura’s performance was
not entirely substantiated by
objective findings and that at
points, Laura’s performance
may have been self-limited.
The physical therapy
report did not comment
on the degree of loss or
whether Laura had a total
loss of use of her hand.
When Cambridge Home
Health Care had the physical
therapy report reviewed
by Dr. Scott E. Singer, a
licensed physician, he
concluded that Laura’s level
of function – as recorded by
Hornbeek – did not meet the
standard for loss of use.
A staff hearing officer for
the Industrial Commission
of Ohio – which handles
such matters – nevertheless
awarded Laura 175 weeks of
compensation for total loss
of use, relying exclusively
on the physical therapy
report. Cambridge Home
Health Care requested a
reconsideration of that
decision, but the request
was denied. After that, the
company commenced court
action.
The issue in the case was
not the extent or severity of
Laura’s injury, but rather the
hearing officer’s exclusive
reliance on a physical
therapy report to award 175
weeks of compensation.
Cambridge Home Health
Care argued that a loss-of-
use award must be supported
by a physician’s report and
cannot be based solely on a
physical therapy report.
The Industrial
Commission eventually
came to agree that the
hearing officer erred, and
the Commission joined
Cambridge Home Health
Care in asking us to vacate
Laura’s compensation
award. Laura responded
that the hearing officer
did not rely simply on the
physical therapist’s report
and that even if he did, that
reliance was not fatal to her
cause.
By a seven-to-zero vote,
we agreed with the position
taken by Cambridge Home
Health Care.
Contrary to Laura’s
representation, the hearing
officer did rely exclusively
on the physical therapy
report. The closing line
of the report – which is
all standard boilerplate
language – states, “All proof
on file was reviewed and
considered.” This is not, as
Laura claimed, proof that
the hearing officer implicitly
relied on other evidence in
the file.
The reliance on a single
physical therapy report
is an abuse of discretion
for several reasons. First,
regardless of whether a loss-
of-use award is considered
an impairment award or
a disability award – it has
elements of both – a physical
therapist is prohibited from
giving an opinion on either.
The Ohio General
Assembly has prohibited
physical therapists
from issuing disability
conclusions. In fact, the
pertinent law specifically
forbids a physical therapist
to make a “medical
diagnosis of a patient’s
disability.” Furthermore,
our court – through a
number of previous cases –
has restricted determinations
on impairments to doctors.
Second, while the law in
question is silent as to the
proof required, a review of
that law in its entirety favors
Cambridge Home Health
Care’s position. Under the
law, every claimant who
applies for permanent partial
disability compensation
must have an agency medical
examination – which means
an examination by a doctor.
It defies logic to suggest,
for example, that a 2 percent
permanent partial disability
award must be supported
by a physician’s report,
but a loss-of-use award
generating 175 weeks of
benefits does not. And a
physical therapist, of course,
is not a doctor.
Courts in other states
have also disqualified
physical therapists from
offering disability or
impairment conclusions.
The Tennessee Supreme
Court ruled that a physical
therapist’s permanent partial
impairment assessment
could not be used as evidence
in a workers’ compensation
case. The court said
health professionals were
competent “to testify as an
expert only as to matters
within the limited scope
of his or her expertise and
licensure.”
Tennessee’s law
permitted physical
therapists to evaluate and
treat individuals “using
specific means and narrowly
defined methods.” The law
specifically prohibited the
practice of medicine, and
with only a very limited
exception, authorized
physical therapy only upon
referral by a physician.
This referral requirement
prompted the court to
conclude that physical
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GIRLS SOCCER
Coldwater saw its season come to a close in sectional action last week as the lady Cavaliers
fell to Crestview 2-0. Madison Etzler had both lady Knight goals on the day. Megan Foster
therapy is a narrow health had nine saves for the Knights and Krista Wellman recorded six for Coldwater. The Cavaliers
specialty limited in scope. end the season with a record of 5-10-1.
The Tennessee court Celina advanced to the district tournament with a 6-0 win over Wapakoneta on Saturday.
wrote, “A physical therapist Lexi Mills had a hat trick for the lady Bulldogs while Emily Pottkotter recorded two goals.
is not qualified to form Katie Stahl had the other Celina goal. Celina is now 14-1-2 on the season.
and express an expert
opinion as to the permanent BOYS SOCCER
impairment or permanent
physical restrictions of an Celina recorded a 2-1 win over Elida in sectional action at Lima Shawnee High School. Cary
injured person. A physical Miller had both goals for the Bulldogs. The Bulldogs, though, saw their season come to an end
on Saturday as Celina fell to Wapakoneta 2-1 in a shootout. Brock Schmidt had the lone goal
therapist’s testimony must for Celina, which ends the year 11-4-2.
be limited to objective
findings and cannot
classifieds
encompass an opinion on
ultimate disability.”
A United States Court of
Appeals reached the same
result in an automobile
negligence lawsuit. And
federal regulations have long
excluded physical therapists 015 Card of Thanks 040 Notices 040 Notices 050 Work Wanted
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