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PAVAN PARIKH
HAMILTON COUNTY CLERK OF COURTS
COMMON PLEAS DIVISION
ELECTRONICALLY FILED
July 31, 2023 09:16 AM
PAVAN PARIKH
Clerk of Courts
Hamilton County, Ohio
CONFIRMATION 1350924
BRET D SMITH A 2303223
vs.
BUREAU OF WORKERS
COMPENSATION
FILING TYPE: COMPLAINT (WITH APPEAL ONLY)
PAGES FILED: 5
EFR200
E-FILED 07/31/2023 9:16 AM / CONFIRMATION 1350924 / A 2303223 / COMMON PLEAS DIVISION / COMQ
JN THE COMMON PLEAS COURT OF HAMILTON COUNTY, OHIO
CIVIL DIVISION
BRET D. SMITH, CASE NO.
5621 Kirby Ave., Apt. 1
Cincinnati, OH 45239
Plaintiff,
Vv
JOHN LOGUE, COMPLAINT AND DEMAND
ADMINISTRATOR, BUREAU FOR TRIAL BY JURY
OF WORKERS’ COMPENSATION,
30 West Spring Street
Columbus, OH 43215 (Workers' Compensation Case,
I.C. Claim No, 23-122209)
and
ADVANCEPIERRE FOODS INC.
TYSON FOODS, INC.,
231 W. Martin Luther King Jr. Blvd.
Fayetteville, AR 72701
Defendants,
Now comes Bret D. Smith, Plaintiff, and for his Complaint says the following:
1. That on or about March 7, 2023, and for some time prior thereto, Plaintiff, Bret D.
Smith, was an employee of Advancepierre Foods Inc. Tyson Foods, Inc., and was injured while
working in Hamilton County, Ohio;
2, That John Logue is the duly acting Administrator of the Ohio Bureau of Workers’
Compensation;
3. That on or about March 7, 2023, and for some time prior thereto, Advancepierre
Foods Inc. Tyson Foods, Inc. was an employer amenable to and in compliance with the
Workers' Compensation law of the State of Ohio;
HOCHMAN&PLUNKEFT
CO., LP.A.
3033 Kettering Blvd.
Suite 204
Dayton, Ohio 45439
1
E-FILED 07/31/2023)):16 AM / CONFIRMATION 1350924 / A 2303223 / COMMON PLEAS DIVISION / COMQ
4. That on or about March 7, 2023, Plaintiff, Bret D. Smith, while in the course of and
arising out of his employment with Defendant, Advancepierre Foods Inc. Tyson Foods, Inc.,
sustained an injury which was accidental in character and result;
5, That Plaintiff subsequently filed a claim for Workers' Compensation benefits to
which Claim No. 23-122209 was assigned by the Bureau of Workers' Compensation and this
claim was certified and was allowed for the conditions of “contusion right hip”;
6. That on March 21, 2023, Plaintiff filed a FROI-1 First Report of Injury, Occupational
Disease, or Death Application, requesting that the claim be also allowed for the conditions of
“right hip sprain and sacroiliac sprain”;
7. That the claim came on for hearing before a District Hearing Officer, who by an
order dated May 16, 2023, rendered the following decision:
«
It is the order of the District Hearing Officer that the Injured Worker’s FROI-1
First Report of an Injury, Occupational Disease, or Death, filed 03/21/2023, is
granted to the extent of this order.
The District Hearing Officer orders this claim ALLOWED for CONTUSION
RIGHT HIP.
>
8. That from the decision of the District Hearing Officer, Plaintiff, Bret D. Smith,
appealed to the Staff Hearing Officer, who by an order dated June 24, 2023, rendered the
following decision:
«
The order of the District Hearing Officer, issued 05/16/2023, is modified to the
following extent.
It is the order of the Staff Hearing Officer that this claim is ALLOWED for the
HOCHMAN&PLUNKETT
specific medical condition of “RIGHT HIP CONTUSION.” The Staff
CO,LP.A.
3033 Kettering Blvd,
Suite 201
Dayton, Ohio 45439
2
E-FILED 07/31/2023|9:16 AM / CONFIRMATION 1350924 / A 2303223 / COMMON PLEAS DIVISION / COMQ
Hearing Officer finds the Injured Worker sustained an injury in the course of
and arising out of his employment with this Employer on 03/07/2023. On that
date, the Injured Worker was employed as a material handler for the Employer
and stated at the hearing that he was working drilling meat. While performing
this job duty, the Injured Worker felt an impact on his right side by a box which
had been forcefully pushed into him inadvertently by a forklift, thereby causing
the injury now allowed in this claim.
The Staff Hearing Officer notes that the Injured Worker’s representative
specifically requested at the hearing that this claim also be allowed for the
specific medical conditions of “RIGHT HIP SPRAIN” and ‘SACROILIAC
SPRAIN.”
The Staff Hearing Officer hereby denies the Injured Worker’s request that this
claim be additionally allowed for the specific medical conditions of ‘RIGHT
HIP SPRAIN” and “SACROILIAC SPRAIN.” The Staff Hearing Officer finds
the Injured Worker failed to satisfy his burden of providing by a preponderance
of the evidence that these medical conditions are causally related, either directly
or via substantial aggravation, to the industrial injury in this claim.
Therefore, this claim is specifically DISALLOWED for the medical conditions
of “RIGHT HIP SPRAIN” and “SACROILIAC SPRAIN.”
>
9. That from the decision of the Staff Hearing Officer, Plaintiff, Bret D. Smith, appealed
to the Commission which by an order dated July 13, 2023, rendered the following decision:
«
Pursuant to the authority of the Industrial Commission under R.C. 4123.511(E),
it is ordered that the Injured Worker’s appeal, filed 07/05/2023, from the Staff
Hearing Officer order, issued 06/24/2023, be refused and that copies of this
order be mailed to all interested parties.
>
10. Plaintiff, Bret D, Smith, subsequently filed with the Common Pleas Court of
Hamilton County, Ohio, his Notice of Appeal in this claim;
11. That the issue before the Court is whether Plaintiff is entitled to participate in the
HOCHMAN&PLUNKETT
benefits provided by the Workers’ Compensation Fund of the State of Ohio and the Workers’
CO. LP.A.
3033 Kettering Blvd.
Suite 201
Dayton, Ohio 45439
3
E-FILED 07/31/2023}p:16 AM / CONFIRMATION 1350924 / A 2303223 / COMMON PLEAS DIVISION / COMQ
Compensation Law of the State of Ohio for the conditions of “right hip sprain and sacroiliac
sprain” which were the subject of FROI-1, or which conditions have developed subsequent to
Plaintiff's industrial injury, be those conditions on a direct basis, a flow-through basis, an
acceleration basis, or an aggravation of a pre-existing condition basis;
WHEREFORE, having set forth the basis of the jurisdiction of this Court over this
cause, Plaintiff, Bret D. Smith, prays that further proceedings be had in accordance with the
Ohio Rules of Civil Procedure and that judgment be entered in his favor and against
Defendants, entitling him to participate in the benefits provided by the Workers’ Compensation
Fund of the State of Ohio, and the Workers’ Compensation Law of the State of Ohio, for
conditions and for any and all other such relief to which he may be entitled under 4123.519
and/or 4123.512 of the Ohio Revised Code.
HOCHMAN&PLUNKEIT
CO., L.P.A.
3033 Kettering Blvd.
Suite 204
Dayton, Ohio 45439
4
E-FILED 07/31/2023}9:16 AM / CONFIRMATION 1350924 / A 2303223 / COMMON PLEAS DIVISION / COMQ
Respectfully submitted:
HOCHMAN & PLUNKETT CO., L.P.A.
A Gary 1). Pluntett
Gary D. Plunkett (0046805)
Shaun P. Omen (0083411)
Amy L. Metcalfe (0080173)
3033 Kettering Boulevard
Point West, Suite 201
Dayton, Ohio 45439
Phone: (937) 228-2666 | Fax: (937) 228-0508
Email: garyplunkett@hochmanplunkett.com
shaunomen@hochmanplunkett.com
Attorneys for Plaintiff — Bret D. Smith
JURY DEMAND
Plaintiff, Bret D. Smith, demands that the within matter be tried before a duly empaneled
and sworn jury.
W/QaryD. Plunket
Gary D, Plunkett (0046805)
Shaun P. Omen (0083411)
Amy L. Metcalfe (0080173)
Attorneys for Plaintiff
NOTICE TO THE CLERK
Please transmit by certified mail, return receipt requested, a copy of the foregoing to
Defendants, Advancepierre Foods Inc. Tyson Foods, Inc,, 231 W. Martin Luther King Jr. Bivd.,
Fayetteville, AR 72701, and John Logue, Administrator, Bureau of Workers' Compensation, 30
West Spring Street, Columbus, OH 43215, and make a return of service according to law.
Gary 2. Plunk
Gary D, Plunkett (0046805)
Shaun P. Omen (0083411)
Amy L. Metcalfe (0080173)
Attorneys for Plaintiff
HOCHMAN&PLUNKEIT
CO, L.P.A.
3033 Keitering Blvd,
Suite 201
Dayton, Ohio 45439
5
E-FILED 07/31/2023,p:16 AM / CONFIRMATION 1350924 / A 2303223 / COMMON PLEAS DIVISION / COMQ
Preview
i GE PF SOy 2 e Or cou PAVAN PARIKH HAMILTON COUNTY CLERK OF COURTS COMMON PLEAS DIVISION ELECTRONICALLY FILED July 31, 2023 09:16 AM PAVAN PARIKH Clerk of Courts Hamilton County, Ohio CONFIRMATION 1350924 BRET D SMITH A 2303223 vs. BUREAU OF WORKERS COMPENSATION FILING TYPE: COMPLAINT (WITH APPEAL ONLY) PAGES FILED: 5 EFR200 E-FILED 07/31/2023 9:16 AM / CONFIRMATION 1350924 / A 2303223 / COMMON PLEAS DIVISION / COMQ JN THE COMMON PLEAS COURT OF HAMILTON COUNTY, OHIO CIVIL DIVISION BRET D. SMITH, CASE NO. 5621 Kirby Ave., Apt. 1 Cincinnati, OH 45239 Plaintiff, Vv JOHN LOGUE, COMPLAINT AND DEMAND ADMINISTRATOR, BUREAU FOR TRIAL BY JURY OF WORKERS’ COMPENSATION, 30 West Spring Street Columbus, OH 43215 (Workers' Compensation Case, I.C. Claim No, 23-122209) and ADVANCEPIERRE FOODS INC. TYSON FOODS, INC., 231 W. Martin Luther King Jr. Blvd. Fayetteville, AR 72701 Defendants, Now comes Bret D. Smith, Plaintiff, and for his Complaint says the following: 1. That on or about March 7, 2023, and for some time prior thereto, Plaintiff, Bret D. Smith, was an employee of Advancepierre Foods Inc. Tyson Foods, Inc., and was injured while working in Hamilton County, Ohio; 2, That John Logue is the duly acting Administrator of the Ohio Bureau of Workers’ Compensation; 3. That on or about March 7, 2023, and for some time prior thereto, Advancepierre Foods Inc. Tyson Foods, Inc. was an employer amenable to and in compliance with the Workers' Compensation law of the State of Ohio; HOCHMAN&PLUNKEFT CO., LP.A. 3033 Kettering Blvd. Suite 204 Dayton, Ohio 45439 1 E-FILED 07/31/2023)):16 AM / CONFIRMATION 1350924 / A 2303223 / COMMON PLEAS DIVISION / COMQ 4. That on or about March 7, 2023, Plaintiff, Bret D. Smith, while in the course of and arising out of his employment with Defendant, Advancepierre Foods Inc. Tyson Foods, Inc., sustained an injury which was accidental in character and result; 5, That Plaintiff subsequently filed a claim for Workers' Compensation benefits to which Claim No. 23-122209 was assigned by the Bureau of Workers' Compensation and this claim was certified and was allowed for the conditions of “contusion right hip”; 6. That on March 21, 2023, Plaintiff filed a FROI-1 First Report of Injury, Occupational Disease, or Death Application, requesting that the claim be also allowed for the conditions of “right hip sprain and sacroiliac sprain”; 7. That the claim came on for hearing before a District Hearing Officer, who by an order dated May 16, 2023, rendered the following decision: « It is the order of the District Hearing Officer that the Injured Worker’s FROI-1 First Report of an Injury, Occupational Disease, or Death, filed 03/21/2023, is granted to the extent of this order. The District Hearing Officer orders this claim ALLOWED for CONTUSION RIGHT HIP. > 8. That from the decision of the District Hearing Officer, Plaintiff, Bret D. Smith, appealed to the Staff Hearing Officer, who by an order dated June 24, 2023, rendered the following decision: « The order of the District Hearing Officer, issued 05/16/2023, is modified to the following extent. It is the order of the Staff Hearing Officer that this claim is ALLOWED for the HOCHMAN&PLUNKETT specific medical condition of “RIGHT HIP CONTUSION.” The Staff CO,LP.A. 3033 Kettering Blvd, Suite 201 Dayton, Ohio 45439 2 E-FILED 07/31/2023|9:16 AM / CONFIRMATION 1350924 / A 2303223 / COMMON PLEAS DIVISION / COMQ Hearing Officer finds the Injured Worker sustained an injury in the course of and arising out of his employment with this Employer on 03/07/2023. On that date, the Injured Worker was employed as a material handler for the Employer and stated at the hearing that he was working drilling meat. While performing this job duty, the Injured Worker felt an impact on his right side by a box which had been forcefully pushed into him inadvertently by a forklift, thereby causing the injury now allowed in this claim. The Staff Hearing Officer notes that the Injured Worker’s representative specifically requested at the hearing that this claim also be allowed for the specific medical conditions of “RIGHT HIP SPRAIN” and ‘SACROILIAC SPRAIN.” The Staff Hearing Officer hereby denies the Injured Worker’s request that this claim be additionally allowed for the specific medical conditions of ‘RIGHT HIP SPRAIN” and “SACROILIAC SPRAIN.” The Staff Hearing Officer finds the Injured Worker failed to satisfy his burden of providing by a preponderance of the evidence that these medical conditions are causally related, either directly or via substantial aggravation, to the industrial injury in this claim. Therefore, this claim is specifically DISALLOWED for the medical conditions of “RIGHT HIP SPRAIN” and “SACROILIAC SPRAIN.” > 9. That from the decision of the Staff Hearing Officer, Plaintiff, Bret D. Smith, appealed to the Commission which by an order dated July 13, 2023, rendered the following decision: « Pursuant to the authority of the Industrial Commission under R.C. 4123.511(E), it is ordered that the Injured Worker’s appeal, filed 07/05/2023, from the Staff Hearing Officer order, issued 06/24/2023, be refused and that copies of this order be mailed to all interested parties. > 10. Plaintiff, Bret D, Smith, subsequently filed with the Common Pleas Court of Hamilton County, Ohio, his Notice of Appeal in this claim; 11. That the issue before the Court is whether Plaintiff is entitled to participate in the HOCHMAN&PLUNKETT benefits provided by the Workers’ Compensation Fund of the State of Ohio and the Workers’ CO. LP.A. 3033 Kettering Blvd. Suite 201 Dayton, Ohio 45439 3 E-FILED 07/31/2023}p:16 AM / CONFIRMATION 1350924 / A 2303223 / COMMON PLEAS DIVISION / COMQ Compensation Law of the State of Ohio for the conditions of “right hip sprain and sacroiliac sprain” which were the subject of FROI-1, or which conditions have developed subsequent to Plaintiff's industrial injury, be those conditions on a direct basis, a flow-through basis, an acceleration basis, or an aggravation of a pre-existing condition basis; WHEREFORE, having set forth the basis of the jurisdiction of this Court over this cause, Plaintiff, Bret D. Smith, prays that further proceedings be had in accordance with the Ohio Rules of Civil Procedure and that judgment be entered in his favor and against Defendants, entitling him to participate in the benefits provided by the Workers’ Compensation Fund of the State of Ohio, and the Workers’ Compensation Law of the State of Ohio, for conditions and for any and all other such relief to which he may be entitled under 4123.519 and/or 4123.512 of the Ohio Revised Code. HOCHMAN&PLUNKEIT CO., L.P.A. 3033 Kettering Blvd. Suite 204 Dayton, Ohio 45439 4 E-FILED 07/31/2023}9:16 AM / CONFIRMATION 1350924 / A 2303223 / COMMON PLEAS DIVISION / COMQ Respectfully submitted: HOCHMAN & PLUNKETT CO., L.P.A. A Gary 1). Pluntett Gary D. Plunkett (0046805) Shaun P. Omen (0083411) Amy L. Metcalfe (0080173) 3033 Kettering Boulevard Point West, Suite 201 Dayton, Ohio 45439 Phone: (937) 228-2666 | Fax: (937) 228-0508 Email: garyplunkett@hochmanplunkett.com shaunomen@hochmanplunkett.com Attorneys for Plaintiff — Bret D. Smith JURY DEMAND Plaintiff, Bret D. Smith, demands that the within matter be tried before a duly empaneled and sworn jury. W/QaryD. Plunket Gary D, Plunkett (0046805) Shaun P. Omen (0083411) Amy L. Metcalfe (0080173) Attorneys for Plaintiff NOTICE TO THE CLERK Please transmit by certified mail, return receipt requested, a copy of the foregoing to Defendants, Advancepierre Foods Inc. Tyson Foods, Inc,, 231 W. Martin Luther King Jr. Bivd., Fayetteville, AR 72701, and John Logue, Administrator, Bureau of Workers' Compensation, 30 West Spring Street, Columbus, OH 43215, and make a return of service according to law. Gary 2. Plunk Gary D, Plunkett (0046805) Shaun P. Omen (0083411) Amy L. Metcalfe (0080173) Attorneys for Plaintiff HOCHMAN&PLUNKEIT CO, L.P.A. 3033 Keitering Blvd, Suite 201 Dayton, Ohio 45439 5 E-FILED 07/31/2023,p:16 AM / CONFIRMATION 1350924 / A 2303223 / COMMON PLEAS DIVISION / COMQ