Preview
Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766
0G402 - Y5
IN THE COURT OF COMMON PLEAS
FRANKLIN COUNTY, OHIO
Gregory N. Thacker Case No.
62183 Forestview Dr.
Cambridge, OH 43725 BWC Claim No. 21-172247
Plaintiff, Jury Demand Endorsed Hereon
vs. Judge
Warner Express, LLC
11354 E. Pike Rd.
Cambridge, OH 43725
and
Administrator, Ohio Bureau of
Workers’ Compensation
30 West Spring Street, 6" Floor
Columbus, OH 43215
Defendants.
COMPLAINT
1 On or about September 2, 2021, Plaintiff, Gregory N. Thacker (“Plaintiff”), was
employed by the Defendant, Warner Express, LLC (Employer).
2 On that date, Warner Express, LLC was an Ohio employer amenable to Chapter
4123 of the Ohio Revised Code.
3 The Administrator of the Bureau of Workers’ Compensation is the duly authorized
agent entrusted with overseeing Ohio Workers’ Compensation claims.
4 On or about «Next Record», Plaintiff accidentally sustained an injury and/or was
diagnosed with having contracted an occupational disease in the course of and arising out of «Next
Record» employment with the employer. Said injury was sustained in Williamsburg, Kentucky.
Venue is proper in Franklin County pursuant to Rule 3 of the Ohio Rules of Civil Procedure.
Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766
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5 Thereafter, the Plaintiff filed with the Ohio Bureau of Workers’ Compensation a
claim to which was assigned claim number 21-172247
6 As a result of the Plaintiff's work injury, the Plaintiffs claim was recognized for
the condition of rupture distal biceps, right.
7 On December 15, 2022, the Plaintiff filed a Motion with the Bureau of Workers’
Compensation requesting that the claim be additionally allowed for the conditions of right elbow
strain and right elbow sprain
8 On January 26, 2023, a hearing was held before a District Hearing Officer of the
Industrial Commission of Ohio who issued an order (Exhibit A) dismissing the Plaintiff's claim
for the additional condition
9 On February 8, 2023, the Plaintiff filed an Appeal to the District Hearing Officer’s
order.
10. On March 6, 2023, a hearing was held before a Staff Hearing Officer who issued
an order (Exhibit B) vacating the District Hearing Officer’s order by disallowing the Plaintiffs
claim for the additional conditions
11. On March 21, 2023, the Plaintiff filed a Notice of Appeal to the Staff Hearing
Officer’s decision.
12. On March 29, 2023, the Industrial Commission of Ohio mailed an order (Exhibit
C) typed March 27, 2023, refusing the Plaintiff’s appeal from the Staff Hearing Officer’s decision.
13. The March 29, 2023, order is a final order disallowing the Plaintiff the right to
participate in her workers’ compensation claim for the additional conditions of right elbow strain
and right elbow sprain
Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766
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WHEREFORE, Plaintiff now prays for the right to participate in the workers’
compensation fund for the additional conditions of right elbow strain and right elbow sprain, for a
jury trial, for costs, statutory attorney’s fees and for such relief as this Court may deem equitable.
Respectfully submitted,
4S/ Kara §. Dolan-West
Kara S. Dolan-West (0093431)
Jacob B. Brandt (0097639)
The Bainbridge Firm, LLC
900 Michigan Ave.
Columbus, Ohio 43215
Telephone: (614) 545-9990
Fax: (614) 224-9300
kdolan@bainbridgefirm.com
jbrandt@bainbridgefirm.com
Attorneys for Plaintiff
Gregory N. Thacker
JURY DEMAND
Plaintiff demands a trial of this cause by Jury.
4S/ Kara S. Dolan-West
Kara S. Dolan-West (0093431)
Jacob B. Brandt (0097639)
Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766
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REQUEST FOR SERVICE
Please serve a copy of the foregoing Complaint in accordance with O.R.C. Section
4123.512 upon the following:
Warner Express, LLC
11354 E. Pike Rd
Cambridge, OH 43725
and
Administrator, Ohio Bureau of
Workers’ Compensation
30 West Spring Street, 6" Floor
Columbus, OH 43215
4S/ Kara S. Dolan-West
Kara S. Dolan-West (0093431)
Jacob B. Brandt (0097639)
Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766
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Exhibit A
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Ohio Industrial Commission
RECORD OF PROCEEDINGS
Claim Number: 21-172247 Claims Heard: 21-172247
Lit ACC-OSIF-COv
PON: 2223621 Gregory N. Thacker
GREGORY N. THACKER
62183 FORESTVIEW DR
CAMBRIDGE OH 43725-9399
Date of Injury: 9/02/2021 Risk Number: 1575309-0
This claim has been allowed for: RUPTURE DISTAL BICEPS, RIGHT.
This matter was heard on 01/26/2023 before District Hearing Officer Kevin W.
Bench pursuant to the provisions of R.C. Sections 4121.34 and 4123.511 on:
€-86 Motion filed by Injured Worker on 12/15/2022.
Issue: 1) Additional Allowance - RIGHT ELBOW STRAIN
2) Additional Allowance - RIGHT ELBOW SPRAIN
Notices were mailed to the Injured Worker, the Employer, their respective
representatives and the Administrator of the Bureau of Workers!’ Compensation not
less than 14 days prior to this date and the following were present:
APPEARANCE FOR THE INJURED WORKER: Atty. Dolan-West via Webex
APPEARANCE FOR THE EMPLOYER: No Appearance
APPEARANCE FOR THE ADMINISTRATOR: No Appearance
The Injured Worker voluntarily waived the right to appear in person for hearing.
It is the order of the District Hearing Officer that the C-86 Motion filed
12/15/2022 is dismissed.
Based on Ohio Administrative Code 4121-3-16(D) stating that a C-86 Motion filed
by a party with a claim shall be used to request action from the Bureau of
Workers! Compensation or the Industrial Commission but the C-86 Motion "shall be
accompanied by substantial competent proof conforming to the standards
established in paragraph (C) of rule 4123-3-09 of the Administrative Code" to
support that request, the fact that the medical evidence listed on the face of
the C-86 Motion filed by Injured Worker on 12/15/2022 does not document any
substantial competent proof supporting the actual presence of today's requested
additional allowances with Injured worker, plus Injured Worker's attorney has
failed to provide or cite any other medical evidence at today's hearing or
within the claim file which actually diagnoses the requested additional
allowances with Injured Worker, District Hearing Officer orders that the C-86
Motion filed by Injured Worker on 12/15/2022 is now dismissed in accordance with
Ohio Admin. Code 4121-3-16(G).
All of the evidence was reviewed and considered in rendering this decision.
An IC-12 Notice of Appeal from this order may be filed within 14 days of the
receipt of the order. The IC-12 Notice of Appeal may be filed online at
www.ic.ohio.gov or the TC-12 Notice of Appeal may be sent to the Industrial
Commission, Cambridge District Office 2130 E Wheeling Ave, Cambridge, OH 43725
Typed By: kb
Date Typed: 01/26/2023 Kevin W. Bench
District Hearing Officer
Notice of Contested Claim: 12/23/2022
Findings Mailed: 01/28/2023
DHOSFCT2 Page 1 kb/kb
Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766
0G402 - y5 Ohio Industrial Commission
RECORD OF PROCEEDINGS
Claim Number: 21-172247
Electronically signed by
Kevin W. Bencl
whe parties and representatives listed below have been sent this record of
proceedings. If you are not an authorized representative of one of the
parties, please notify the Industrial Commission.
21-172247 ID No: 219048-90
Gregory N. Thacker Bainbridge Firm, LLC
62183 Forestview Dr 900 Michigan Ave
Cambridge OH 43725-9399 Columbus OH 43215-1165
Risk No: 1575309-0 ID No: 1706-80
Warner Express LLC Group Management Services
11354 E Pike Rd 3750 Timberlake Dr
Cambridge OH 43725-9669 Richfield OH 44286-9187
ID No: 218961-80
Trident Risk
6480 Rockside Woods Blvd $ Ste 350
Cleveland OH 44131-2224
BWC, LAW DIRECTOR
NOTE: INJURED WORKERS, EMPLOYERS, AND THEIR AUTHORIZED REPRESENTATIVES MAY
REVIEW THEIR ACTIVE CLAIMS INFORMATION THROUGH THE INDUSTRIAL COMMISSION WEB
SITE AT www.ic.ohio.gov. ONCE ON THE HOME PAGE OF THE WEB SITE, PLEASE CLICK
ICON AND FOLLOW THE INSTRUCTIONS FOR OBTAINING A PASSWORD. ONCE YOU HAVE
OBTAINED A PASSWORD, YOU SHOULD BE ABLE TO ACCESS YOUR ACTIVE CLAIM(S).
DHOSFCT2 Page 2 kb/kb
An Equal Opportunity Euployer
Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766
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Exhibit B
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Ohio Industrial Commission
RECORD OF PROCEEDINGS
Claim Number: 21-172247 Claims Heard: 21-172247
Lit ACC-OSIF-COv
PON: 2223621 Gregory N. Thacker
GREGORY N. THACKER
62183 FORESTVIEW DR
CAMBRIDGE OH 43725-9399
Date of Injury: 9/02/2021 Risk Number: 1575309-0
This claim has been previously allowed for: RUPTURE DISTAL BICEPS, RIGHT.
This matter was heard on 03/06/2023 before Staff Hearing Officer Gary Frame
pursuant to the provisions of R.C. Sections 4121.35 (B) and 4123.511(D) on the
following:
APPEAL of District Hearing Officer order from the hearing dated 01/26/2023,
filed by Injured Worker on 02/08/2023.
Issue: 1) Additional Allowance - RIGHT ELBOW STRAIN
2) Additional Allowance - RIGHT ELBOW SPRAIN
Notices were mailed to the Injured Worker, the Employer, their respective
representatives and the Administrator of the Bureau of Workers' Compensation not
less than 14 days prior to this date, and the following were present for the
hearing:
APPEARANCE FOR THE INJURED WORKER: Ms. Johnson (via Webex)
APPEARANCE FOR THE EMPLOYER: No Appearance
APPEARANCE FOR THE ADMINISTRATOR: No Appearance
The Injured Worker voluntarily waived the right to appear in person for today's
hearing.
The order of the District Hearing Officer, issued 01/28/2023, is vacated.
It is the order of the Staff Hearing Officer that the Injured Worker's C-86
Motion, filed 12/15/2022, is denied.
The District Hearing Officer dismissed the issue of additional allowance,
finding that there was no medical evidence on file to support the request.
However, the Injured Worker has now filed the 02/13/2023 report of Bhuskar
Reddy, M.D., in support of these conditions. Therefore, the Staff Hearing
Officer finds that there is sufficient evidence to address the merits of the
request.
It is the order of the Staff Hearing Officer that the claim is DISALLOWED for
the condition of "RIGHT ELBOW SPRAIN/STRAIN."
his order is based upon the 12/20/2022 Independent Medical Review of Stephen
voto, M.D., who opines that this condition is not supported by the mechanism of
injury or the medical records contemporaneous with this injury.
All of the evidence was reviewed and considered in rendering this decision.
An IC-12 Notice of Appeal from this order may be filed within 14 days of the
receipt of the order. The IC-12 Notice of Appeal may be filed online at
www.ic.ohio.gov or the IC-12 Notice of Appeal may be sent to the Industrial
Commission, Cambridge District Office 2130 B Wheeling Ave, Cambridge, OH 43725.
SHOL Page 1 rgh/gf
Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766
0G402 - Y6 Ohio Industrial Commission
RECORD OF PROCEEDINGS
Claim Number: 21-172247
typed By: rgh
Date Typed: 03/06/2023 Gary Frame
Staff Hearing Officer
Findings Mailed: 03/08/2023
Electronically signed by
Gary Frame
The parties and representatives listed below have been sent this record of
proceedings. If you are not an authorized representative of one of the
parties, please notify the Industrial Commission,
21-172247 ID No 219048-90
Gregory N. Thacker Bainbridge Firm, LLC
62183 Forestview Dr 900 Michigan Ave
Cambridge OH 43725-9399 Columbus OH 43215-1165
Risk No: 1575309-0 ID No: 1706-80
Warner Express LLC Group Management. Services
11354 B Pike Rd 3750 Timberlake Dr
Cambridge OH 43725-9669 Richfield OH 44286-9187
ID No: 218961-80
Trident Risk
6480 Rockside Woods Blvd $ Ste 350
Cleveland OH 44131-2224
BWC, LAW DIRECTOR
NOTE INJURED WORKERS, EMPLOYERS, AND THEIR AUTHORIZED REPRESENTATIVES MAY
REVIEW THEIR ACTIVE CLAIMS INFORMATION THROUGH THE INDUSTRIAL COMMISSION WEB
SITE AT www.ic.ohio.gov. ONCE ON THE HOME PAGE OF THE WEB SITE, PLEASE CLICK
ICON AND FOLLOW THE INSTRUCTIONS FOR OBTAINING A PASSWORD. ONCE YOU HAVE
OBTAINED A PASSWORD, YOU SHOULD BE ABLE TO ACCESS YOUR ACTIVE CLAIM(S) .
SHOL Page 2 rgh/gt
An Equal Opportunity Euployer
Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766
0G402 - Y6
Ohio Industrial Commission Exhibit C
RECORD OF PROCEEDINGS
Claim Number: 21-172247 Claims Heard: 21-172247
Lit ACC-OSIF-COv
PON: 2223621 Gregory N. Thacker
GREGORY N. THACKER
62183 FORESTVIEW DR
CAMBRIDGE OH 43725-9399
Date of Injury: 9/02/2021 Risk Number: 1575309-0
APPEAL filed by Injured Worker on 03/21/2023.
Issue: 1) Additional Allowance - RIGHT ELBOW STRAIN
2) Additional Allowance RIGHT ELBOW SPRAIN
Pursuant to the authority of the Industrial Commission under R,C. 4123.511(E),
it is ordered that the Injured Worker's appeal, filed 03/21/2023, from the Staff
Hearing Officer order, issued 03/08/2023, be refused and that copies of this
order be mailed to all interested parties.
ANY PARTY MAY APPEAL AN ORDER OF THE COMMISSION, OTHER THAN A DECISION AS TO
EXTENT OF DISABILITY, TO THE COURT OF COMMON PLEAS WITHIN SIXTY (60) DAYS AFTER
RECEIPT OF THE ORDER, UBJECT TO THE LIMITATIONS CONTAINED IN R.C, 4123.512.
Typed By: e
Date Typed: 03/27/2023 Jon Grandon
Staff Hearing Officer
Findings Mailed: 03/29/2023
Electronically signed by
Jon Grandon
The parties and representatives listed below have been sent this record of
proceedings. If you are not an authorized representative of one of the
parties, please notify the Industrial Commission.
21-172247 ID No: 219048-90
Gregory N. Thacker Bainbridge Firm, LLC
62183 Forestview Dr 900 Michigan Ave
Cambridge OH 43725-9399 Columbus OH 43215-1165
Risk No: 1575309-0 ID No: 1706-80
Warner Express LLC Group Management Services
11354 E Pike Rd 3750 Timberlake Dr
Cambridge OH 43725-9669 Richfield OH 44286-9187
SHREFUSE Page 1 ey/ey
Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766
0G402 - Y6: Ohio Industrial Commission
RECORD OF PROCEEDINGS
Claim Number: 21-172247
ID No: 218961-80
Trident Risk
6480 Rockside Woods Blvd $ Ste 350
Cleveland OH 44131-2224
BWC, LAW DIRECTOR
NOTE: INJURED WORKERS, EMPLOYERS, AND THEIR AUTHORIZED REPRESENTATIVES MAY
REVIEW THEIR ACTIVE CLAIMS INFORMATION THROUGH THE INDUSTRIAL COMMISSION WEB
SITE AT www.ic.ohio.gov. ONCE ON THE HOME PAGE OF THE WEB SITE, PLEASE CLICK
ICON AND FOLLOW THE INSTRUCTIONS FOR OBTAINING A PASSWORD. ONCE YOU HAVE
OBTAINED A PASSWORD, YOU SHOULD BE ABLE TO ACCESS YOUR ACTIVE CLAIM(S).
SHREFUSE, Page 2 ey/ey
An Equal Opportunity Euployer
Preview
Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766 0G402 - Y5 IN THE COURT OF COMMON PLEAS FRANKLIN COUNTY, OHIO Gregory N. Thacker Case No. 62183 Forestview Dr. Cambridge, OH 43725 BWC Claim No. 21-172247 Plaintiff, Jury Demand Endorsed Hereon vs. Judge Warner Express, LLC 11354 E. Pike Rd. Cambridge, OH 43725 and Administrator, Ohio Bureau of Workers’ Compensation 30 West Spring Street, 6" Floor Columbus, OH 43215 Defendants. COMPLAINT 1 On or about September 2, 2021, Plaintiff, Gregory N. Thacker (“Plaintiff”), was employed by the Defendant, Warner Express, LLC (Employer). 2 On that date, Warner Express, LLC was an Ohio employer amenable to Chapter 4123 of the Ohio Revised Code. 3 The Administrator of the Bureau of Workers’ Compensation is the duly authorized agent entrusted with overseeing Ohio Workers’ Compensation claims. 4 On or about «Next Record», Plaintiff accidentally sustained an injury and/or was diagnosed with having contracted an occupational disease in the course of and arising out of «Next Record» employment with the employer. Said injury was sustained in Williamsburg, Kentucky. Venue is proper in Franklin County pursuant to Rule 3 of the Ohio Rules of Civil Procedure. Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766 0G402 - Y5 5 Thereafter, the Plaintiff filed with the Ohio Bureau of Workers’ Compensation a claim to which was assigned claim number 21-172247 6 As a result of the Plaintiff's work injury, the Plaintiffs claim was recognized for the condition of rupture distal biceps, right. 7 On December 15, 2022, the Plaintiff filed a Motion with the Bureau of Workers’ Compensation requesting that the claim be additionally allowed for the conditions of right elbow strain and right elbow sprain 8 On January 26, 2023, a hearing was held before a District Hearing Officer of the Industrial Commission of Ohio who issued an order (Exhibit A) dismissing the Plaintiff's claim for the additional condition 9 On February 8, 2023, the Plaintiff filed an Appeal to the District Hearing Officer’s order. 10. On March 6, 2023, a hearing was held before a Staff Hearing Officer who issued an order (Exhibit B) vacating the District Hearing Officer’s order by disallowing the Plaintiffs claim for the additional conditions 11. On March 21, 2023, the Plaintiff filed a Notice of Appeal to the Staff Hearing Officer’s decision. 12. On March 29, 2023, the Industrial Commission of Ohio mailed an order (Exhibit C) typed March 27, 2023, refusing the Plaintiff’s appeal from the Staff Hearing Officer’s decision. 13. The March 29, 2023, order is a final order disallowing the Plaintiff the right to participate in her workers’ compensation claim for the additional conditions of right elbow strain and right elbow sprain Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766 0G402 - Y5 WHEREFORE, Plaintiff now prays for the right to participate in the workers’ compensation fund for the additional conditions of right elbow strain and right elbow sprain, for a jury trial, for costs, statutory attorney’s fees and for such relief as this Court may deem equitable. Respectfully submitted, 4S/ Kara §. Dolan-West Kara S. Dolan-West (0093431) Jacob B. Brandt (0097639) The Bainbridge Firm, LLC 900 Michigan Ave. Columbus, Ohio 43215 Telephone: (614) 545-9990 Fax: (614) 224-9300 kdolan@bainbridgefirm.com jbrandt@bainbridgefirm.com Attorneys for Plaintiff Gregory N. Thacker JURY DEMAND Plaintiff demands a trial of this cause by Jury. 4S/ Kara S. Dolan-West Kara S. Dolan-West (0093431) Jacob B. Brandt (0097639) Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766 0G402 - Y5 REQUEST FOR SERVICE Please serve a copy of the foregoing Complaint in accordance with O.R.C. Section 4123.512 upon the following: Warner Express, LLC 11354 E. Pike Rd Cambridge, OH 43725 and Administrator, Ohio Bureau of Workers’ Compensation 30 West Spring Street, 6" Floor Columbus, OH 43215 4S/ Kara S. Dolan-West Kara S. Dolan-West (0093431) Jacob B. Brandt (0097639) Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766 - Exhibit A 0G402 y5 Ohio Industrial Commission RECORD OF PROCEEDINGS Claim Number: 21-172247 Claims Heard: 21-172247 Lit ACC-OSIF-COv PON: 2223621 Gregory N. Thacker GREGORY N. THACKER 62183 FORESTVIEW DR CAMBRIDGE OH 43725-9399 Date of Injury: 9/02/2021 Risk Number: 1575309-0 This claim has been allowed for: RUPTURE DISTAL BICEPS, RIGHT. This matter was heard on 01/26/2023 before District Hearing Officer Kevin W. Bench pursuant to the provisions of R.C. Sections 4121.34 and 4123.511 on: €-86 Motion filed by Injured Worker on 12/15/2022. Issue: 1) Additional Allowance - RIGHT ELBOW STRAIN 2) Additional Allowance - RIGHT ELBOW SPRAIN Notices were mailed to the Injured Worker, the Employer, their respective representatives and the Administrator of the Bureau of Workers!’ Compensation not less than 14 days prior to this date and the following were present: APPEARANCE FOR THE INJURED WORKER: Atty. Dolan-West via Webex APPEARANCE FOR THE EMPLOYER: No Appearance APPEARANCE FOR THE ADMINISTRATOR: No Appearance The Injured Worker voluntarily waived the right to appear in person for hearing. It is the order of the District Hearing Officer that the C-86 Motion filed 12/15/2022 is dismissed. Based on Ohio Administrative Code 4121-3-16(D) stating that a C-86 Motion filed by a party with a claim shall be used to request action from the Bureau of Workers! Compensation or the Industrial Commission but the C-86 Motion "shall be accompanied by substantial competent proof conforming to the standards established in paragraph (C) of rule 4123-3-09 of the Administrative Code" to support that request, the fact that the medical evidence listed on the face of the C-86 Motion filed by Injured Worker on 12/15/2022 does not document any substantial competent proof supporting the actual presence of today's requested additional allowances with Injured worker, plus Injured Worker's attorney has failed to provide or cite any other medical evidence at today's hearing or within the claim file which actually diagnoses the requested additional allowances with Injured Worker, District Hearing Officer orders that the C-86 Motion filed by Injured Worker on 12/15/2022 is now dismissed in accordance with Ohio Admin. Code 4121-3-16(G). All of the evidence was reviewed and considered in rendering this decision. An IC-12 Notice of Appeal from this order may be filed within 14 days of the receipt of the order. The IC-12 Notice of Appeal may be filed online at www.ic.ohio.gov or the TC-12 Notice of Appeal may be sent to the Industrial Commission, Cambridge District Office 2130 E Wheeling Ave, Cambridge, OH 43725 Typed By: kb Date Typed: 01/26/2023 Kevin W. Bench District Hearing Officer Notice of Contested Claim: 12/23/2022 Findings Mailed: 01/28/2023 DHOSFCT2 Page 1 kb/kb Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766 0G402 - y5 Ohio Industrial Commission RECORD OF PROCEEDINGS Claim Number: 21-172247 Electronically signed by Kevin W. Bencl whe parties and representatives listed below have been sent this record of proceedings. If you are not an authorized representative of one of the parties, please notify the Industrial Commission. 21-172247 ID No: 219048-90 Gregory N. Thacker Bainbridge Firm, LLC 62183 Forestview Dr 900 Michigan Ave Cambridge OH 43725-9399 Columbus OH 43215-1165 Risk No: 1575309-0 ID No: 1706-80 Warner Express LLC Group Management Services 11354 E Pike Rd 3750 Timberlake Dr Cambridge OH 43725-9669 Richfield OH 44286-9187 ID No: 218961-80 Trident Risk 6480 Rockside Woods Blvd $ Ste 350 Cleveland OH 44131-2224 BWC, LAW DIRECTOR NOTE: INJURED WORKERS, EMPLOYERS, AND THEIR AUTHORIZED REPRESENTATIVES MAY REVIEW THEIR ACTIVE CLAIMS INFORMATION THROUGH THE INDUSTRIAL COMMISSION WEB SITE AT www.ic.ohio.gov. ONCE ON THE HOME PAGE OF THE WEB SITE, PLEASE CLICK ICON AND FOLLOW THE INSTRUCTIONS FOR OBTAINING A PASSWORD. ONCE YOU HAVE OBTAINED A PASSWORD, YOU SHOULD BE ABLE TO ACCESS YOUR ACTIVE CLAIM(S). DHOSFCT2 Page 2 kb/kb An Equal Opportunity Euployer Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766 - Exhibit B 0G402 y5 Ohio Industrial Commission RECORD OF PROCEEDINGS Claim Number: 21-172247 Claims Heard: 21-172247 Lit ACC-OSIF-COv PON: 2223621 Gregory N. Thacker GREGORY N. THACKER 62183 FORESTVIEW DR CAMBRIDGE OH 43725-9399 Date of Injury: 9/02/2021 Risk Number: 1575309-0 This claim has been previously allowed for: RUPTURE DISTAL BICEPS, RIGHT. This matter was heard on 03/06/2023 before Staff Hearing Officer Gary Frame pursuant to the provisions of R.C. Sections 4121.35 (B) and 4123.511(D) on the following: APPEAL of District Hearing Officer order from the hearing dated 01/26/2023, filed by Injured Worker on 02/08/2023. Issue: 1) Additional Allowance - RIGHT ELBOW STRAIN 2) Additional Allowance - RIGHT ELBOW SPRAIN Notices were mailed to the Injured Worker, the Employer, their respective representatives and the Administrator of the Bureau of Workers' Compensation not less than 14 days prior to this date, and the following were present for the hearing: APPEARANCE FOR THE INJURED WORKER: Ms. Johnson (via Webex) APPEARANCE FOR THE EMPLOYER: No Appearance APPEARANCE FOR THE ADMINISTRATOR: No Appearance The Injured Worker voluntarily waived the right to appear in person for today's hearing. The order of the District Hearing Officer, issued 01/28/2023, is vacated. It is the order of the Staff Hearing Officer that the Injured Worker's C-86 Motion, filed 12/15/2022, is denied. The District Hearing Officer dismissed the issue of additional allowance, finding that there was no medical evidence on file to support the request. However, the Injured Worker has now filed the 02/13/2023 report of Bhuskar Reddy, M.D., in support of these conditions. Therefore, the Staff Hearing Officer finds that there is sufficient evidence to address the merits of the request. It is the order of the Staff Hearing Officer that the claim is DISALLOWED for the condition of "RIGHT ELBOW SPRAIN/STRAIN." his order is based upon the 12/20/2022 Independent Medical Review of Stephen voto, M.D., who opines that this condition is not supported by the mechanism of injury or the medical records contemporaneous with this injury. All of the evidence was reviewed and considered in rendering this decision. An IC-12 Notice of Appeal from this order may be filed within 14 days of the receipt of the order. The IC-12 Notice of Appeal may be filed online at www.ic.ohio.gov or the IC-12 Notice of Appeal may be sent to the Industrial Commission, Cambridge District Office 2130 B Wheeling Ave, Cambridge, OH 43725. SHOL Page 1 rgh/gf Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766 0G402 - Y6 Ohio Industrial Commission RECORD OF PROCEEDINGS Claim Number: 21-172247 typed By: rgh Date Typed: 03/06/2023 Gary Frame Staff Hearing Officer Findings Mailed: 03/08/2023 Electronically signed by Gary Frame The parties and representatives listed below have been sent this record of proceedings. If you are not an authorized representative of one of the parties, please notify the Industrial Commission, 21-172247 ID No 219048-90 Gregory N. Thacker Bainbridge Firm, LLC 62183 Forestview Dr 900 Michigan Ave Cambridge OH 43725-9399 Columbus OH 43215-1165 Risk No: 1575309-0 ID No: 1706-80 Warner Express LLC Group Management. Services 11354 B Pike Rd 3750 Timberlake Dr Cambridge OH 43725-9669 Richfield OH 44286-9187 ID No: 218961-80 Trident Risk 6480 Rockside Woods Blvd $ Ste 350 Cleveland OH 44131-2224 BWC, LAW DIRECTOR NOTE INJURED WORKERS, EMPLOYERS, AND THEIR AUTHORIZED REPRESENTATIVES MAY REVIEW THEIR ACTIVE CLAIMS INFORMATION THROUGH THE INDUSTRIAL COMMISSION WEB SITE AT www.ic.ohio.gov. ONCE ON THE HOME PAGE OF THE WEB SITE, PLEASE CLICK ICON AND FOLLOW THE INSTRUCTIONS FOR OBTAINING A PASSWORD. ONCE YOU HAVE OBTAINED A PASSWORD, YOU SHOULD BE ABLE TO ACCESS YOUR ACTIVE CLAIM(S) . SHOL Page 2 rgh/gt An Equal Opportunity Euployer Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766 0G402 - Y6 Ohio Industrial Commission Exhibit C RECORD OF PROCEEDINGS Claim Number: 21-172247 Claims Heard: 21-172247 Lit ACC-OSIF-COv PON: 2223621 Gregory N. Thacker GREGORY N. THACKER 62183 FORESTVIEW DR CAMBRIDGE OH 43725-9399 Date of Injury: 9/02/2021 Risk Number: 1575309-0 APPEAL filed by Injured Worker on 03/21/2023. Issue: 1) Additional Allowance - RIGHT ELBOW STRAIN 2) Additional Allowance RIGHT ELBOW SPRAIN Pursuant to the authority of the Industrial Commission under R,C. 4123.511(E), it is ordered that the Injured Worker's appeal, filed 03/21/2023, from the Staff Hearing Officer order, issued 03/08/2023, be refused and that copies of this order be mailed to all interested parties. ANY PARTY MAY APPEAL AN ORDER OF THE COMMISSION, OTHER THAN A DECISION AS TO EXTENT OF DISABILITY, TO THE COURT OF COMMON PLEAS WITHIN SIXTY (60) DAYS AFTER RECEIPT OF THE ORDER, UBJECT TO THE LIMITATIONS CONTAINED IN R.C, 4123.512. Typed By: e Date Typed: 03/27/2023 Jon Grandon Staff Hearing Officer Findings Mailed: 03/29/2023 Electronically signed by Jon Grandon The parties and representatives listed below have been sent this record of proceedings. If you are not an authorized representative of one of the parties, please notify the Industrial Commission. 21-172247 ID No: 219048-90 Gregory N. Thacker Bainbridge Firm, LLC 62183 Forestview Dr 900 Michigan Ave Cambridge OH 43725-9399 Columbus OH 43215-1165 Risk No: 1575309-0 ID No: 1706-80 Warner Express LLC Group Management Services 11354 E Pike Rd 3750 Timberlake Dr Cambridge OH 43725-9669 Richfield OH 44286-9187 SHREFUSE Page 1 ey/ey Franklin County Ohio Clerk of Courts of the Common Pleas- 2023 May 25 2:01 PM-23CV003766 0G402 - Y6: Ohio Industrial Commission RECORD OF PROCEEDINGS Claim Number: 21-172247 ID No: 218961-80 Trident Risk 6480 Rockside Woods Blvd $ Ste 350 Cleveland OH 44131-2224 BWC, LAW DIRECTOR NOTE: INJURED WORKERS, EMPLOYERS, AND THEIR AUTHORIZED REPRESENTATIVES MAY REVIEW THEIR ACTIVE CLAIMS INFORMATION THROUGH THE INDUSTRIAL COMMISSION WEB SITE AT www.ic.ohio.gov. ONCE ON THE HOME PAGE OF THE WEB SITE, PLEASE CLICK ICON AND FOLLOW THE INSTRUCTIONS FOR OBTAINING A PASSWORD. ONCE YOU HAVE OBTAINED A PASSWORD, YOU SHOULD BE ABLE TO ACCESS YOUR ACTIVE CLAIM(S). SHREFUSE, Page 2 ey/ey An Equal Opportunity Euployer