Handicap Reimbursement Program

BY: JUSTICE PAUL E. PFEIFER

Should hyper­ten­sion be con­sid­ered a “hand­i­cap” that is eli­gi­ble for work­ers’ com­pen­sa­tion reim­burse­ment to employ­ers? That’s the ques­tion that was at the heart of a case that came before us here, at the Ohio Supreme Court.

The case orig­i­nated with Fair­field City Schools and one of its employ­ees, Edward Car­pen­ter Jr. In 2002, Car­pen­ter injured his back at work. The injury resulted in a con­sid­er­able amount of dis­abil­ity com­pen­sa­tion – first tem­po­rary total, and now per­ma­nent total compensation.

In 2008, Fair­field requested hand­i­cap reim­burse­ment from the Ohio Bureau of Work­ers’ Com­pen­sa­tion for at least part of the dis­abil­ity pay­ments made to Car­pen­ter. Fair­field alleged that Carpenter’s pre­ex­ist­ing hyper­ten­sion – which he’s had since at least 1995 – is a car­diac dis­ease that delayed his recov­ery from back surgery, and thus con­tributed to pro­longed dis­abil­ity payments.

In mak­ing this claim, Fair­field was refer­ring to the hand­i­cap reim­burse­ment pro­gram. Cre­ated in 1955, the pro­gram encour­ages employ­ers to hire per­sons with cer­tain men­tal or phys­i­cal con­di­tions that could hin­der employ­ment. The pro­gram does this by charg­ing the state sur­plus fund all or part of the cost of a long list of dis­eases or con­di­tions. If one of those dis­eases or con­di­tions either caused or aggra­vated the indus­trial injury lead­ing to death or dis­abil­ity, the sur­plus pays some or all of the compensation.

Hyper­ten­sion is not on the list, but “car­diac dis­ease” is. To sup­port its claim, Fair­field sub­mit­ted the report of a doc­tor who had reviewed Carpenter’s med­ical records. The report stated that Car­pen­ter had hyper­ten­sion, which was man­aged with medication.

The report also said that the hyper­ten­sion would rea­son­ably con­tribute to a “hand­i­cap assess­ment” with respect to Carpenter’s back surgery. “Chronic hyper­ten­sion plays a role in delay­ing heal­ing from these surg­eries, exac­er­bated by his chronic smok­ing. Hyper­ten­sion results in stiffer arter­ies, which lim­its heal­ing, par­tic­u­larly involv­ing the fusion surgeries.”

But the Bureau rejected the doctor’s report as “insuf­fi­cient to estab­lish car­diac dis­ease as a pre-existing con­di­tion that delayed recov­ery.” The bureau described the report as “spec­u­la­tive and ten­u­ous” and stated that it didn’t show that Carpenter’s injury was affected by hyper­ten­sion but instead merely explained that in gen­eral, injuries are affected by hypertension.

The Bureau denied reim­burse­ment. After that, Fair­field appealed to the Indus­trial Com­mis­sion of Ohio, which han­dles such matters.

A staff hear­ing offi­cer for the Com­mis­sion denied reim­burse­ment for three rea­sons. First, because hyper­ten­sion isn’t one of the enu­mer­ated dis­eases listed in the statute. Sec­ond, because Fair­field did not estab­lish that Carpenter’s hyper­ten­sion con­sti­tuted a car­diac dis­ease. And third, because there was insuf­fi­cient evi­dence to estab­lish that Carpenter’s high blood pres­sure con­tributed to the cost of his work­ers’ com­pen­sa­tion claim.

The next stop was the court of appeals, where Fair­field chal­lenged the denial of reim­burse­ment. Fair­field relied heav­ily on a newly sub­mit­ted piece of evi­dence – a one-page Bureau of Work­ers’ Com­pen­sa­tion doc­u­ment enti­tled “Hand­i­cap Reim­burse­ment Guidelines.”

The doc­u­ment stated that “evi­dence of high blood pressure/hypertension, with­out more expla­na­tion, does not con­sti­tute evi­dence of car­diac dis­ease.” Fair­field argued that it had sat­is­fied the guide­lines by sub­mit­ting the doctor’s reports that explained why Carpenter’s hyper­ten­sion should be con­sid­ered a car­diac disease.

But the court of appeals stressed that the guide­lines on which Fair­field relied weren’t from the Indus­trial Com­mis­sion, but rather from the Bureau of Work­ers’ Com­pen­sa­tion. Describ­ing them as inter­nal guide­lines, the court of appeals noted that Fair­field had cited no author­ity that bound one state agency to the inter­nal guide­lines of another.

The court also held that the Indus­trial Commission’s exclu­sive author­ity to weigh the evi­dence per­mit­ted it to con­clude that the doctor’s reports were insuf­fi­cient. Empha­siz­ing the Commission’s sub­stan­tial exper­tise in the area of hand­i­cap reim­burse­ment, the court of appeals con­cluded that the Com­mis­sion did not abuse its dis­cre­tion in find­ing that hyper­ten­sion was not a car­diac dis­ease for hand­i­cap reim­burse­ment purposes.

After the court of appeals issued its find­ing, the case came before us for a final review.

Fair­field argued that because the hand­i­cap reim­burse­ment statute does not define “car­diac dis­ease,” it must be “accorded its plain, every­day mean­ing.” In mak­ing this asser­tion that Carpenter’s high blood pres­sure should be clas­si­fied as a car­diac dis­ease, Fair­field relied on a bit of extrap­o­la­tion: because the term “car­diac” means relat­ing to the heart and hyper­ten­sion affects the blood ves­sels that sup­ply the heart, hyper­ten­sion is a car­diac dis­ease. We rejected that proposition.

If the mere fact of blood cir­cu­la­tion were suf­fi­cient to trans­form a chronic con­di­tion into a car­diac dis­ease, then leukemia and ane­mia would also be car­diac dis­eases because they, too, affect the blood. Fairfield’s rea­son­ing could per­mit employer reim­burse­ment for many con­di­tions never antic­i­pated by the legislature.

Fairfield’s logic would also per­mit hand­i­cap reim­burse­ment in sit­u­a­tions where a person’s hyper­ten­sion has never man­i­fested itself with the symp­toms of a car­diac dis­ease. High blood pres­sure can cer­tainly lead to seri­ous heart prob­lems, but many peo­ple – includ­ing Car­pen­ter – con­trol it and suf­fer no heart-related effects. The doc­tor reported that Carpenter’s hyper­ten­sion was man­aged with med­ica­tion, with no car­diac implications.

The stated pur­pose of the hand­i­cap reim­burse­ment law is to encour­age employ­ers to hire and retain hand­i­capped employ­ees with the con­di­tions that are listed – such as cere­bral palsy, Parkinson’s dis­ease, or mus­cu­lar dys­tro­phies. To an employer, any of the con­di­tions may raise con­cerns about an employee’s pro­duc­tiv­ity or the employer’s abil­ity to respond in the event of an emer­gency. With­out an incen­tive to hire peo­ple suf­fer­ing from these con­di­tions, an employer might be less inclined to employ them.

But accord­ing to the Amer­i­can Heart Asso­ci­a­tion, one in three adults has hyper­ten­sion, so no incen­tive is needed to hire some­one with high blood pres­sure. In addi­tion, high blood pres­sure, unlike many of the con­di­tions listed in the law, can be con­trolled, so it’s far less likely to dis­rupt work­place pro­duc­tiv­ity or safety. Sim­ply put, hyper­ten­sion isn’t the imped­i­ment to employ­ment that the other con­di­tions might be.

There­fore – by a seven-to-zero vote – we affirmed the court of appeals’ judg­ment. The Com­mis­sion did not abuse its dis­cre­tion in deny­ing Fairfield’s appli­ca­tion for hand­i­cap reimbursement.

EDITOR’S NOTE: The case referred to is: State ex rel. Fair­field City Schools v. Indus. Comm., 129 Ohio St.3d 312, 2011-Ohio-2378. Case No. 2010–0674. Decided May 24, 2011. Opin­ion Per Curiam.

Posted by Paul Pfeifer on Jan 21 2012. You can follow any responses to this entry through the RSS Feed. Both comments and pings are currently closed.