Implicit Compliance with Adm.Code 4121-3-34(D)(3)(i): Hearing Officers Need Not Itemize Every Psychological Restriction in PTD Orders

Introduction

In State ex rel. Urban v. Wano Expiditing, Inc., 2025-Ohio-3009, the Supreme Court of Ohio addressed how detailed Industrial Commission orders must be when denying permanent-total-disability (PTD) compensation in claims that include allowed psychiatric (psychological) conditions. The case arose after the Tenth District Court of Appeals issued a writ of mandamus directing the Commission to vacate its order denying PTD, holding the staff hearing officer (SHO) failed to comply with Ohio Adm.Code 4121-3-34(D)(3)(i) by not expressly acknowledging all psychological limitations, particularly a task-related need for breaks identified by a Commission psychologist.

The claimant, Randall Urban, sustained a serious back injury in 2006 and has claim allowances for multiple lumbar conditions along with depressive and anxiety disorders. After undergoing several surgeries and not returning to work, he applied for PTD in 2021. The Commission obtained medical examinations: a physical-capacity evaluation (Dr. Harvey Popovich) and a psychological evaluation (Dr. Mark Babula). Both opined Mr. Urban could perform work at a sedentary level with restrictions. A vocational consultant retained by Urban disagreed. The SHO denied PTD, relying on the Popovich and Babula reports, and found nonmedical factors did not preclude return to work.

On mandamus, the Tenth District faulted the SHO for not fully reciting the psychologist’s task-related break restriction and for not citing the psychiatric-combination rule (Adm.Code 4121-3-34(D)(3)(i)), and it ordered a new adjudication. The Commission appealed. The Supreme Court reversed, clarifying the scope of the hearing officer’s duty under the rule and emphasizing longstanding “some evidence” and order-explanation principles.

Summary of the Judgment

The Supreme Court of Ohio reversed the Tenth District and denied the writ of mandamus.
Holding: The Industrial Commission complied with Adm.Code 4121-3-34(D)(3)(i) by considering Urban’s psychological conditions together with his physical conditions before concluding that he could engage in sustained remunerative employment, even though the SHO did not enumerate every specific restriction noted in the psychological report.
Key clarifications:
- Adm.Code 4121-3-34(D)(3)(i) requires consideration of psychiatric conditions in combination with physical conditions; it does not require itemization of every recommended restriction in relied-upon medical reports.
- Commission orders must identify the evidence relied on and briefly explain the decision (Noll), but need not list each piece of evidence considered or every limitation within a report (Buttolph; presumption of regularity and of consideration applies).
- Reliance on separate physical and psychological medical reports suffices to demonstrate combined consideration (Zollner; Jackson).
Terminology: For this case, the Court treated “psychological” and “psychiatric” conditions as interchangeable under the administrative rule, noting the allowed depressive and anxiety disorders plainly qualify as psychiatric conditions.

Analysis

Precedents Cited and Their Influence

State ex rel. Zarbana Industries, Inc. v. Indus. Comm., 2021-Ohio-3669: Restates the mandamus standard—clear legal right, clear legal duty, and lack of adequate remedy. The Court applies this threshold and reviews the Commission's action for abuse of discretion.
State ex rel. Pressley v. Indus. Comm., 11 Ohio St.2d 141 (1967): Direct appeals from mandamus actions are reviewed as if originally filed in the Supreme Court, setting the posture for the Court’s de novo review of the Tenth District’s writ.
State ex rel. Gen. Motors Corp. v. Indus. Comm., 2008-Ohio-1593, and State ex rel. Mobley v. Indus. Comm., 1997-Ohio-181: Reinforce the “some evidence” rule—Commission orders supported by some evidence and adequately explained will not be disturbed, even if contradicted by other evidence (e.g., a vocational report).
State ex rel. Kidd v. Indus. Comm., 2023-Ohio-2975; R.C. 4123.512(A): PTD extent-of-disability determinations are not appealable and are challenged via mandamus, framing the procedural route for Urban’s claim.
State ex rel. Gen. Motors v. Indus. Comm., 42 Ohio St.2d 278 (1975), and State ex rel. Baker Material Handling Corp. v. Indus. Comm., 1994-Ohio-437: State the purpose of PTD—compensating impairment of earning capacity; a permanently and totally disabled worker has no earning capacity and receives an award for life. These contextualize why the PTD threshold is significant.
State ex rel. Noll v. Indus. Comm., 57 Ohio St.3d 203 (1991): Requires Commission orders to identify the evidence relied upon and to briefly explain the reasoning. The Court anchors its conclusion that the SHO’s order was sufficient under Noll even without reciting every limitation.
State ex rel. Buttolph v. Gen. Motors Corp., Terex Div., 1997-Ohio-34: The Commission need not list every piece of evidence it considered; it must identify the evidence relied on. This undercuts the Tenth District’s criticism that the order omitted the vocational consultant’s report.
State ex rel. Lovell v. Indus. Comm., 1996-Ohio-321: Presumption of regularity and presumption that the Commission considered all evidence apply. The Court uses this presumption to reject the inference that omission equals non-consideration.
State ex rel. Zollner v. Indus. Comm., 1993-Ohio-49, and State ex rel. Jackson v. Indus. Comm., 1997-Ohio-152: When the Commission relies on separate physical and psychiatric reports, it demonstrates consideration of both conditions. This is the direct analogue supporting the Court’s conclusion that relying on Popovich and Babula sufficed as combined consideration.
State ex rel. Rothkegel v. Westlake, 2000-Ohio-364: Omission of a vocational report from the “relied on” list does not imply it was overlooked. This rebuts the Tenth District’s concern about the absence of the vocational report in the SHO order.
State ex rel. Cassens Corp. v. Indus. Comm., 2024-Ohio-526: Guides plain-meaning interpretation when terms are undefined in the Code. Applied to equate “psychiatric” and “psychological” for this case, given common usage and dictionary definitions.
State ex rel. Pate v. Indus. Comm., 2002-Ohio-5444: Illustrates that depression and anxiety are treated as psychiatric conditions in Ohio workers’ compensation jurisprudence, buttressing applicability of Adm.Code 4121-3-34(D)(3)(i).

Legal Reasoning

The Court framed the central question narrowly: Did the SHO comply with Adm.Code 4121-3-34(D)(3)(i), which requires consideration of allowed psychiatric conditions in combination with allowed physical conditions where the claimant retains some physical work capacity? The Court answered “yes,” based on three pillars of reasoning.

Combined consideration shown through reliance on both medical domains. The SHO’s order expressly identified the allowed physical and psychological conditions, summarized the Popovich (physical) and Babula (psychological) reports, and found Urban capable of sustained remunerative employment “with limitations contained in the doctors’ reports,” at least at a sedentary level. That phrasing, coupled with explicit reliance on the two reports, sufficiently demonstrated consideration of both sets of conditions in combination. The Court analogized to Zollner and Jackson, where similar reliance on dual-domain reports showed combined consideration.
No duty to itemize every restriction under Adm.Code 4121-3-34(D)(3)(i). The rule speaks in terms of “consider[ing]” psychiatric and physical conditions together; it does not require transcription or enumeration of every recommended restriction contained in the medical evidence. Noll requires identification of relied-on evidence and a brief explanation—not comprehensive recitation of all limitations. The Court emphasized the presumption that the Commission considered all evidence (Lovell). Therefore, the SHO’s omission of a single phrase from the psychologist’s report in her summary did not establish non-consideration or analytical error.
Omission of vocational evidence and explicit rule citation is not dispositive. The Commission need not list every item considered (Buttolph), and omission of the vocational report from the “relied-on” evidence does not imply it was overlooked (Rothkegel). Nor does an order’s failure to cite Adm.Code 4121-3-34(D)(3)(i) itself establish noncompliance; what matters is whether the content of the order demonstrates the required consideration. The SHO’s statement that “all of the evidence was reviewed and considered” triggers the presumption of regularity.

Against this backdrop, the Court found the Tenth District’s insistence that the SHO specifically recite the psychologist’s “task” break restriction over-read the rule and departed from Noll and the presumption of regularity. The SHO incorporated all of the report limitations by reference and grounded the final capacity finding on both medical reports. That was enough.

Impact and Prospective Significance

Drafting of PTD orders: Hearing officers can satisfy Adm.Code 4121-3-34(D)(3)(i) without enumerating every psychological limitation, so long as the order identifies the physical and psychiatric evidence relied upon and explains the outcome. Using language that the claimant can work “with the limitations contained in the doctors’ reports” is now expressly affirmed as sufficient to demonstrate combined consideration.
Litigation strategy:
- Claimants arguing noncompliance with (D)(3)(i) now face an uphill battle unless they can show the Commission failed to consider psychological evidence at all, or relied on evidence that by its terms excludes psychological conditions.
- Mandamus challenges premised on incomplete summaries are less likely to succeed absent a demonstrable analytical gap or violation of Noll (e.g., failure to identify relied-on evidence or provide any reasoning).
Administrative efficiency: The ruling reduces the need for highly granular order writing in mixed physical/psychiatric PTD cases, which may streamline adjudications and limit remands based on drafting omissions rather than substantive errors.
Boundaries of Noll compliance: The decision underscores that Noll demands clarity about relied-on evidence and a brief rationale, not exhaustive exegesis. However, orders should still make plain that both physical and psychiatric limitations were considered in reaching the capacity conclusion—best achieved by identifying the relevant reports from both domains and expressly tying the capacity finding to them.
Vocational evidence: While not necessary to list every item considered, hearing officers and counsel should remember that when the Commission concludes a claimant can work despite limitations, its discussion of nonmedical factors (age, education, work history) still must appear and be connected to the medical impairments as required by Adm.Code 4121-3-34(D)(3)(h).
Terminology: The Court avoided drawing a substantive distinction between “psychiatric” and “psychological” in this context, noting the ordinary meaning of psychiatric embraces depression and anxiety. Future disputes over wording alone are unlikely to carry the day where clinical content is clear and properly considered.

Complex Concepts Simplified

Permanent-total-disability (PTD): A workers’ compensation benefit paid when injury-related impairment prevents the worker from engaging in sustained remunerative employment using skills they have or can reasonably develop. It compensates for loss of earning capacity and generally continues for life.
Sustained remunerative employment: Work that is steady and pays wages in the competitive labor market, not sporadic or de minimis activity. The focus is on capacity to perform such work, not mere theoretical jobs.
Maximum medical improvement (MMI): A state where the condition has plateaued and no fundamental change is expected despite ongoing care. MMI does not mean symptom-free; it signals medical stability for disability assessment.
Adm.Code 4121-3-34(D)(3)(i): In PTD claims with allowed psychiatric conditions and some residual physical capacity, the adjudicator must consider whether psychiatric conditions, in combination with physical conditions, prevent sustained remunerative employment.
Noll compliance: From State ex rel. Noll, Commission orders must identify the evidence relied upon and provide a brief explanation of why that evidence supports the result. It is a floor, not a mandate for meticulous detail.
Presumption of regularity: Courts presume the Commission performed its duties properly and considered all evidence unless there is clear proof otherwise.
“Some evidence” standard: If the Commission’s order is adequately explained and supported by some evidence, courts will not reweigh contradictory evidence on mandamus review.
Nonmedical (vocational) factors: Age, education, and work history must be assessed when the claimant has some work capacity, and the order should state how these factors interact with medical impairments (Adm.Code 4121-3-34(D)(3)(h)).
Sedentary work and position-change accommodations: Sedentary work involves primarily sitting with occasional lifting. Medical opinions may include accommodations like the ability to alternate sitting and standing; these can coexist with a finding of capacity for sedentary work.

Conclusion

State ex rel. Urban v. Wano Expiditing, Inc. establishes a practical and important clarification in Ohio PTD jurisprudence: compliance with Adm.Code 4121-3-34(D)(3)(i) is satisfied when a hearing officer’s order reflects reliance on medical opinions addressing both physical and psychiatric conditions and concludes the claimant can work with the limitations in those reports. The rule does not require an adjudicator to list every limitation contained in a relied-upon medical report, nor to cite the rule expressly or enumerate every piece of evidence considered.

The decision harmonizes (D)(3)(i) with the Noll requirement of identifying relied-on evidence and providing a brief rationale, reaffirming the presumption of regularity and the “some evidence” standard that constrain mandamus review. For practitioners, the case underscores the continued importance of presenting robust, domain-specific medical evidence while recognizing that challenges based on omissions in summaries, without more, will rarely warrant extraordinary relief. For adjudicators, it signals that concise orders tethered to both physical and psychiatric evaluations are adequate, provided they connect medical impairments with the capacity determination and address the required nonmedical factors.

In short, Urban recalibrates expectations for the level of detail demanded in PTD orders involving mental health impairments, enhancing administrative efficiency without diluting the substantive requirement that both physical and psychiatric limitations be genuinely weighed—together—in determining whether a claimant can perform sustained remunerative employment.