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Injured worker's disability benefits stopped after treatment plateaus

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A woman who reached maximum medical improvement after treatment for a work-related injury is no longer entitled to temporary total disability benefits despite ongoing treatment authorized by the Ohio Bureau of Workers’ Compensation, the state Supreme Court has ruled.

Ruth McCormick slipped and fell while working at a McDonald’s restaurant in December 2002, according to court records. She received workers compensation benefits for a concussion, neck sprain, a bulging disc and bilateral stenosis, among other injuries, court records show.

Nearly eight years later, the Ohio workers compensation bureau requested an independent medical examination to determine the extent of Ms. McCormick’s disability. A physician determined that she had reached a “treatment plateau” and did not require further treatment for the allowed conditions, records show. She was cleared to return to work without restrictions.

Meanwhile, Ms. McCormick’s treating physician had requested an authorization for steroid injections, which were approved by a managed-care organization for the bureau, according to records.

However, on Oct. 8, 2010, a district hearing officer granted the bureau’s request terminate her temporary total disability compensation based on the independent medical examination, records show. Ms. McCormick appealed.

According to records, Ms. McCormick received the three steroid injections between Sept. 14 and Oct. 19, 2010. The order to terminate her temporary total disability benefits was later affirmed by a staff hearing officer and the Industrial Commission of Ohio.

Ms. McCormick then filed a complaint saying she was still temporarily and totally disabled as a result of her work-related injury and that the commission’s decision to terminate her benefits was “not supported by the evidence, was contrary to law, and was an abuse of discretion,” records show. Ohio’s 10th District Court of Appeals denied her request, according to records.

Ms. McCormick then took her case to the Ohio Supreme Court, arguing that it was factually inaccurate to say she reached maximum medical improvement because the steroid injections were approved in the interim, records show.

But the court ruled Tuesday that the commission’s order terminating Ms. McCormick’s temporary total disability compensation was supported by evidence in the record.

Maximum medical improvement “is a treatment plateau at which no fundamental functional or physiological change can be expected within reasonable medical probability in spite of continuing medical or rehabilitative procedures,” the ruling states. “An injured worker may need supportive treatment to maintain this level of function.”

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