Wasinski v. PECO II, Inc. ( 2009 )


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  • [Cite as Wasinski v. PECO II, Inc., 2009-Ohio-2615.]
    IN THE COURT OF APPEALS OF OHIO
    THIRD APPELLATE DISTRICT
    CRAWFORD COUNTY
    JODI D. WASINSKI,
    APPELLEE,
    CROSS-APPELLANT,                               CASE NO. 3-08-14
    v.
    ADMINISTRATOR, BUREAU OF
    WORKERS’ COMPENSATION,
    APPELLANT,
    CROSS-APPELLEE,
    -AND-                                          OPINION
    PECO II, INC.,
    APPELLEE.
    JODI D. WASINSKI,
    APPELLEE,
    CROSS-APPELLANT,                               CASE NO. 3-08-16
    v.
    ADMINISTRATOR, BUREAU OF
    WORKERS’ COMPENSATION,
    APPELLANT,
    CROSS-APPELLEE,
    -AND-                                          OPINION
    PECO II, INC.,
    APPELLEE.
    Case No. 3-08-14 and 3-08-16
    Appeal from Crawford County Common Pleas Court
    Trial Court No. 06-CV-0068
    Judgments Affirmed
    Date of Decision:   June 8, 2009
    APPEARANCES:
    Nancy H. Rogers and Kevin J. Reis for Appellant/Cross-Appellee,
    Administrator, Ohio Bureau of Workers’ Compensation
    Jetta Mencer for Appellee/Cross-Appellee, Jodi D. Wasinski
    -2-
    Case No. 3-08-14 and 3-08-16
    SHAW, P.J.
    {¶1} Appellant/Cross-Appellee, Administrator, Ohio Bureau of Workers’
    Compensation (“BWC”) appeals from the June 2, 2008 Judgment Entry of the
    Court of Common Pleas, Crawford County, Ohio ordering that Appellee/Cross-
    Appellant Jodi D. Wasinski (“Wasinski”) is entitled to participate in the benefits
    of the workers’ compensation fund for postural tachycardia syndrome and major
    depression, single episode.
    {¶2} Appellee/Cross-Appellant Wasinski cross-appeals from the February
    8, 2008 Order of the Crawford County Court of Common Pleas dismissing the
    issue of autonomic neuropathy, excluding the testimony of Robert Jones, M.D.,
    and determining that the issues of concussion and loss of consciousness were
    barred by the doctrine of res judicata and collateral estoppel. Wasinski also cross-
    appeals from a separate February 8, 2008 Order of the Crawford County Court of
    Common Pleas denying her motions in limine to exclude the testimony of Dr.
    Satish Raj, M.D., Dr. Gerald Steiman, M.D., and Dr. Donald Weinstein, Ph.D.
    Additionally, Wasinski cross-appeals from the February 11, 2008 Journal Entry of
    the Crawford County Court of Common Pleas excluding the testimony of Dr. Blair
    Grubb, M.D.
    {¶3} This matter involves a workers’ compensation case arising as an
    appeal to the Crawford County Court of Common Pleas filed pursuant to Ohio
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    Case No. 3-08-14 and 3-08-16
    Revised Code section 4123.512.       Wasinski was employed by PECO II, Inc.
    (“PECO”), a company doing business in Crawford County, Ohio. On or about
    January 20, 2001 Wasinski was injured in an automobile accident while in Dallas,
    Texas on a business trip in the course of her employment with PECO. Wasinski
    filed an application for payment of compensation and benefits with the Industrial
    Commission of Ohio under the Ohio Workers’ Compensation Act. This claim was
    assigned Claim No. 01-318906 and was allowed by the Industrial Commission of
    Ohio (“Industrial Commission”) for injuries described as contusion to scalp and
    left knee, cervicothoracic strain, and lumbosacral strain. These conditions are not
    in dispute in the present appeal.
    {¶4} On February 7, 2003 Wasinski moved to have Claim No. 01-
    0318906 modified to include the following additional allowances:        (1) major
    depression single episode and moderate conversion disorder; (2) deferred with
    dependent traits; (3) multiple pain sites and neurological symptoms; and (4) pain
    symptoms and neurological symptoms, moderate.          Wasinski’s motion for the
    additional allowances was heard by a District Hearing Officer on July 23, 2003
    and was denied. Wasinski’s motion was then heard by a Staff Hearing Officer on
    September 15, 2003 and was denied.            Wasinski’s appeal to the Industrial
    Commission was refused on October 11, 2003.
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    Case No. 3-08-14 and 3-08-16
    {¶5} On December 8, 2003 Wasinski filed an appeal of the October 11,
    2003 decision of the Industrial Commission with the Cuyahoga County Court of
    Common Pleas pursuant to R.C. 4123.512.        This case was transferred to the
    Crawford County Court of Common Pleas and assigned Case No. 04-CV-011.
    However, on February 23, 2004 this case was dismissed without prejudice
    pursuant to Civ.R. 41(a)(1).     On February 14, 2006 Wasinski re-filed her
    complaint and jury demand in the Crawford County Court of Common Pleas
    wherein she alleged the right to participate in the benefits of the workers’
    compensation fund for major depression, single episode. This matter was assigned
    Case No. 06-CV-0068.
    {¶6} On May 12, 2006 Wasinski filed another motion with the BWC
    requesting that Claim No. 01-318906 be additionally allowed for postural
    tachycardia syndrome and autonomic neuropathy. On August 11, 2006 a District
    Hearing Officer for the Industrial Commission issued an order granting Wasinski’s
    motion. However, Wasinski’s employer appealed the decision of the District
    Hearing Officer and on September 22, 2006, a Staff Hearing Officer vacated the
    previous order and denied Wasinski’s motion for the additional allowances.
    Wasinski appealed the order of the Staff Hearing Officer, and on October 6, 2006
    the Industrial Commission refused further appeal.
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    {¶7} On November 27, 2006 Wasinski filed a notice of appeal of the
    October 6, 2006 decision of the Industrial Commission with the Crawford County
    Court of Common Pleas. On this same date Wasinski also filed a complaint and
    jury demand, wherein she alleged the right to participate in the benefits of the
    workers’ compensation fund for the conditions of postural tachycardia syndrome
    and autonomic neuropathy. This matter was assigned Case No. 06-CV-0508.
    {¶8} On January 3, 2007 Wasinski filed a motion to consolidate Case No.
    06-CV-0508 with Case No. 06-CV-0068. On January 19, 2008 the trial court
    issued a Judgment Entry consolidating the two cases for trial purposes.
    {¶9} These matters proceeded to a jury trial on May 13, 2008. At the
    close of all the evidence, the jury returned a verdict in favor of Wasinski in both
    causes of action. Specifically, the jury determined that Wasinski was entitled to
    participate in the benefits of the Workers’ Compensation Law for the condition
    described as postural tachycardia syndrome [as contained in Case No. 06-CV-
    0508] and for the condition described as major depression, single episode [as
    contained in Case No. 06-CV-0068]. See also June 2, 2008 Judgment Entry.
    {¶10} The BWC now appeals, asserting four assignments of error.
    ASSIGNMENT OF ERROR NO. 1
    A. THE TRIAL COURT ABUSED ITS DISCRETION BY
    PERMITTING THE HEARSAY OPINION REPORT OF A
    NON-TESTIFYING PHYSICIAN TO BE PRESENTED TO
    THE JURY.
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    B. THE TRIAL COURT ABUSED ITS DISCRETION BY
    PERMITTING CROSS-EXAMINATION THAT PRESENTED
    TO THE JURY THE HEARSAY OPINION OF A NON-
    TESTIFYING PHYSICIAN.
    C. THE TRIAL COURT ABUSED ITS DISCRETION BY
    PERMITTING THE JURY TO CONSIDER THE HEARSAY
    OPINION  OF   A   NON-TESTIFYING   PHYSICIAN
    CONCERNING THE DIAGNOSIS OF A MEDICAL
    CONDITION NOT ALLEGED OR ADVANCED PRIOR TO
    TRIAL.
    ASSIGNMENT OF ERROR NO. 2
    THE TRIAL COURT ABUSED ITS DISCRETION BY
    OVERRULING DEFENDANT’S MOTION TO EXCLUDE
    THE OPINION TESTIMONY OF TERESA EGAN, PH.D.
    ASSIGNMENT OF ERROR NO. 3
    THE TRIAL COURT ABUSED ITS DISCRETION BY
    FAILING TO REDACT THE WORDS “CONCUSSION”,
    “LOSS OF CONSCIOUSNESS”, AND “POST CONCUSSIVE
    SYNDROME” FROM MEDICAL RECORDS PRESENTED
    TO THE JURY.
    ASSIGNMENT OF ERROR NO. 4
    THE TRIAL COURT ERRED BY GIVING A JURY
    INSTRUCTION ON “AGGRAVATION” AND “FLOW
    THROUGH” WHICH THEORIES ARE NOT RELEVANT TO
    THE ISSUES AT TRIAL.
    {¶11} Additionally, Wasinski cross-appeals, asserting 11 assignments of
    error.
    ASSIGNMENT OF ERROR I
    THE TRIAL COURT IMPROPERLY PERMITTED CROSS
    EXAMINATION OF DRS. STEIMAN AND RAJ REGARDING
    THE HEARSAY REPORT OF A NON-TESTIFYING
    PHYSICIAN.
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    ASSIGNMENT OF ERROR II
    DR. EGAN RELIED ON A MISTAKEN UNDERSTANDING
    OR DR. FOUAD-TARAZI’S HEARSAY REPORT TO
    CONCLUDE THAT WASINSKI’S DEPRESSION WAS
    CAUSED BY THE INDUSTRIAL INJURY.
    ASSIGNMENT OF ERROR III
    THE TRIAL COURT ERRED BY PERMITTING THE JURY
    TO HEAR DR. EGAN’S TESTIMONY BECAUSE IT FAILS
    TO SATISFY THE REQUIREMENTS OF EVID.R. 702(B)
    AND (C).
    ASSIGNMENT OF ERROR IV
    THE TRIAL COURT ABUSED ITS DISCRETION BY
    SHOWING THE JURY DIAGNOSES OF CONCUSSION AND
    POST-CONCUSSION     SYNDROME     FROM   NON-
    TESTIFYING PHYSICIANS.
    ASSIGNMENT OF ERROR V
    THE TRIAL COURT ERRED BY INSTRUCTING THE JURY
    THAT WASINSKI IS ENTITLED TO PARTICIPATE FOR
    “AGGRAVATION” (OF A PRE-EXISTING CONDITION)
    AND “FLOW THROUGH” THEORIES WHICH WERE
    NEVER ALLEGED, DIAGNOSED OR ADVANCED PRIOR
    TO TRIAL.
    ASSIGNMENT OF ERROR VI
    THE TRIAL COURT ERRED IN EXCLUDING THE
    TESTIMONY OF ROBERT JONES, M.D.
    ASSIGNMENT OR ERROR VII
    THE TRIAL COURT ERRED IN ALLOWING THE OPINION
    TESTIMONY OF GERALD STEIMAN, M.D. AND DONALD
    WEINSTEIN.
    ASSIGNMENT OF ERROR VIII
    THE TRIAL COURT ERRED IN ALLOWING THE OPINION
    TESTIMONY OF SATISH RAJ, M.D.
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    ASSIGNMENT OF ERROR IX
    THE TRIAL COURT ERRED IN DISMISSING THE CAUSE
    OF ACTION OF AUTONOMIC NEUROPATHY.
    ASSIGNMENT OF ERROR X
    THE TRIAL COURT ERRED IN FINDING THAT THE ISSUE
    OF CONCUSSION AND LOSS OF CONSCIOUSNESS WAS
    BARRED BY THE DOCTRINE OF RES JUDICATA AND
    COLLATERAL ESTOPPEL.
    ASSIGNMENT OF ERROR XI
    THE TRIAL COURT ERRED IN EXCLUDING THE
    DEPOSITION TESTIMONY OF BLAIR GRUBB, M.D.
    {¶12} Prior to addressing the merits of the BWC’s and Wasinski’s
    assignments of error, we must first address various procedural issues occurring in
    the present appeal. First, we note that Rule 16(A) of the Ohio Rules of Appellate
    Procedure governs the filing of the appellant’s brief and provides, in relevant part,
    as follows:
    The appellant shall include in its brief, under the headings and
    in the order indicated, all of the following:
    ***
    (7) An argument containing the contentions of the appellant with
    respect to each assignment of error presented for review and the
    reasons in support of the contentions, with citations to the
    authorities, statutes, and parts of the record on which appellant
    relies. The argument may be preceded by a summary.
    {¶13} Next, we note that our Local Appellate Rule 11 governs assignments
    of error and provides as follows:
    (A) Each assignment of error must be separately argued in the
    briefs unless the same argument, and no other, pertains to more
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    than one assignment of error. “Propositions of law” may not be
    substituted for assignments of error.
    (B) Assignments of error, to the degree reasonably possible,
    should not be general in terms but should be specifically applied
    to the error claimed. A general assignment of error that “the
    judgment is contrary to law” will be disposed of adversely to the
    appellant for failure to be specific.
    {¶14} In the present case, we find that the BWC’s brief does not comply
    with App. R. 16(A)(7) as the “Law and Argument” portion of the BWC’s brief
    does not match the assignments of error set forth on page iv of its brief. We also
    find that the “Law and Argument” portion of the BWC’s brief is not numbered
    and/or lettered so as to correspond with the assignments of error. Furthermore, we
    note that the information set forth by the BWC prior to its “Law and Argument”
    portion of the brief (purportedly as a “summary” of the arguments and/or evidence
    to be discussed) also does not comply with App.R. 16(A)(7).           Instead, this
    information is simply comprised of approximately eight pages of testimony,
    objections to testimony, and motions in limine that do not specifically correspond
    to the BWC’s assignments of error. Additionally, we find that the brief submitted
    by the BWC does not comply with Loc.R. 11 as the BWC’s assignments of error
    are not separately argued in the brief so as to correspond to the assignments of
    error as set forth on page iv of its brief.
    {¶15} An egregious failure to comply with App.R. 16 may prompt the
    outright dismissal of an appeal. In re Estate of Wilhelm (Aug. 19, 2003), 7th Dist.
    -10-
    Case No. 3-08-14 and 3-08-16
    No. 02CA134.      Additionally, pursuant to App.R. 12(A)(2), “[t]he court may
    disregard an assignment of error presented for review if the party raising it fails to
    identify in the record the error on which the assignment of error is based or fails to
    argue the assignment separately in the brief, as required under App.R. 16(A).”
    However, in the interest of justice, we choose not to disregard the BWC’s
    assignments of error. Instead, we shall use the assignments of error as set forth on
    page iv of the BWC’s brief as a starting point for our analysis of the assignments
    of error as we decide to characterize them.
    {¶16} Additionally, our review of the 11 assignments of error set forth by
    Wasinski in her cross-appeal reveals that Wasinski’s first five assignments of error
    are simply responses to the BWC’s assignments of error and argument on appeal.
    Accordingly, we shall confine our discussion and analysis of Wasinski’s
    assignments of error to those arguments set forth as numbers VI through XI.
    BWC Assignment of Error No. 1
    {¶17} In its first assignment of error, the BWC sets forth three separate
    allegations: (A) that the trial court abused its discretion by permitting the hearsay
    report of a non-testifying physician (Dr. Fouad-Tarazi) to be presented to the jury;
    (B) that the trial court abused its discretion when it permitted the cross-
    examination of Dr. Steiman and Dr. Raj specifically regarding the hearsay report
    of Fouad-Tarazi; and (C) that the trial court abused its discretion by permitting the
    -11-
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    jury to consider the opinion of Fouad-Tarazi concerning the diagnosis of a medical
    condition not alleged or advanced by Wasinski prior to trial. As these allegations
    are substantially related, we shall address them together.
    {¶18} We note that decisions regarding the admissibility of evidence are
    within the sound discretion of the trial court and will not be reversed absent a
    showing of an abuse of discretion. State v. Yohey (Mar. 18, 1996), 3rd Dist. No. 9-
    95-46, unreported, citing State v. Graham (1979), 
    58 Ohio St. 2d 350
    , 
    390 N.E.2d 805
    and State v. Lundy (1987), 
    41 Ohio App. 3d 163
    . An abuse of discretion
    “connotes more than an error of law or judgment; it implies that the court’s
    attitude is unreasonable, arbitrary, or unconscionable.” Blakemore v. Blakemore
    (1983), 
    5 Ohio St. 3d 217
    , 219, 
    450 N.E.2d 1140
    .
    {¶19} The Ohio Rules of Evidence forbid the use of hearsay evidence at
    trial absent a recognized exception. See Evid.R. 802. Hearsay evidence is defined
    as “a statement, other than one made by the declarant while testifying at the trial or
    hearing, offered in evidence to prove the truth of the matter asserted.” Evid.R.
    801(C). Additionally, Evid.R. 803 sets forth certain exceptions to the hearsay
    rule, and provides in relevant part, as follows:
    The following are not excluded by the hearsay rule, even though
    the declarant is available as a witness:
    ***
    (6) Records of regularly conducted activity. A memorandum,
    report, record, or data compilation, in any form, of acts, events,
    or conditions, made at or near the time by, or from information
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    transmitted by, a person with knowledge, if kept in the course of
    a regularly conducted business activity, and if it was the regular
    practice of that business activity to make the memorandum,
    report, record, or data compilation, all as shown by the
    testimony of the custodian or other qualified witness or as
    provided by Rule 901(B)(1), unless the source of information or
    the method or circumstances of preparation indicate lack of
    trustworthiness. The term “business” as used in this paragraph
    includes business, institution, association, profession, occupation,
    and calling of every kind, whether or not conducted for profit.1
    {¶20} We note that the Tenth District has previously held that “Evid.R.
    803(6) does not preclude the admissibility of opinions or diagnoses contained in
    medical records or reports as long as they satisfy the foundational authentication
    requirements of Evid.R. 803(6) and do not violate other evidentiary rules (e.g.
    R.C. 2317.02(B); Evid.R. 402 and Evid.R. 702).” Smith v. Dillard’s Dept. Stores,
    Inc. 8th Dist. No. 75787, 2000-Ohio-2689 [footnotes omitted]. Additionally, as
    applied to medical records, “the Supreme Court noted in Weis v. Weis (1947), 
    147 Ohio St. 416
    , 
    72 N.E.2d 245
    , that the purpose of the statute [R.C. 2317.40] was to
    ‘liberalize and broaden the shop-book rule, recognized at common law as an
    exception to the general rule excluding hearsay evidence, and to permit the
    admissions of records regularly kept in the course of business…’” 
    Smith, supra
    ,
    citing 
    Weis, 147 Ohio St. at 425
    . Additionally, in Weis, the Supreme Court of
    Ohio stated, in relevant part, as follows:
    1
    The statutory equivalent of the business records exception to the hearsay rule is contained in Ohio
    Revised Code section 2317.40.
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    [T]hose portions of hospital records made in the regular course
    of business and pertaining to the business of hospitalization and
    recording observable acts, transactions, occurrences or events
    incident to the treatment of a patient are admissible, in the
    absence of privilege, as evidence of the facts therein recorded,
    insofar as such records are helpful to an understanding of the
    medical or surgical aspects of the case, provided such records
    have been prepared, identified and authenticated in the manner
    specified in the statute itself. (Citations omitted).
    Such a hospital or physician’s office record may properly
    include case history, diagnosis by one qualified to make it,
    condition and treatment of the patient covering such items as
    temperature, pulse, respiration, symptoms, food and medicines
    given, analysis of the tissues or fluids of the body and the
    behavior of and complaints made by the patient. (Citations
    omitted).
    
    Weis, 147 Ohio St. at 424-425
    .
    {¶21} In the present case, we note that the allegations contained in the
    BWC’s first assignment of error all relate to the admission, cross-examination
    related to, and the jury’s consideration of Fouad-Tarazi’s April 2, 2003 report,
    entered into evidence as Wasinski’s Exhibit A. However, prior to addressing the
    merits of the BWC’s first assignment of error, we must review the relevant facts
    and subsequent issues at trial concerning the April 2, 2003 report.
    {¶22} After returning to Ohio after the January 20, 2001 motor vehicle
    accident, Wasinski sought medical treatment from Dr. Paveer Kumar at Midwest
    Internal Medicine in Marion, Ohio. Dr. Kumar referred Wasinski to Dr. Blake
    Kellum, and Wasinski began treating with Kellum in Marion, Ohio on February
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    Case No. 3-08-14 and 3-08-16
    23, 2001.    On March 16, 2001 Wasinski began treating with Dr. Raymond
    Baddour of Central Ohio Neurology, Inc. in Mansfield, Ohio.
    {¶23} In October, 2001 Wasinski began treating at the Cleveland Clinic
    due to her continuing problems with falling, blackouts, dizziness, and problems
    walking. While being treated at the Cleveland Clinic, Wasinski began seeing Dr.
    Robert Jones as her primary care physician. As Wasinski continued having back
    and neck pain, she was also treated by Dr. Oas at the pain clinic at the Cleveland
    Clinic. Wasinski also saw Dr. Fouad-Tarazi at the Cleveland Clinic’s Syncope
    Clinic who performed a passive tilt table test on Wasinski on March 26, 2003. Dr.
    Jones subsequently referred Wasinski to Dr. Blair Grubb at the University of
    Toledo Medical Center. Grubb first saw Wasinski on November 15, 2005 and
    diagnosed Wasinski as suffering from postural orthostatic tachycardia syndrome,
    or POTS.
    {¶24} In support of the allegations contained in its first assignment of
    error, specifically sub-sections (A) and (C), the BWC directs this Court’s attention
    to the language of Fouad-Tarazi’s April 2, 2003 report which provides, in relevant
    part, as follows:
    The patient [Wasinski] tolerated 70 degrees of tilt for 45
    minutes. During the tilt, patient complained of no symptoms.
    The SBT declined gradually and moderately during HUT…the
    DBP showed an initial normal response to HUT followed by a
    mild relative with oscillation in late 70 degree tilt…The heart
    rate response to HUT was diagnostic of Progressive Orthostatic
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    Tachydcardia Syndrome (POTS)…At maximum tilt, BP=145/65
    and HR=109. The test was terminated due to end of protocol.
    Recovery was rapid and uneventful.
    {¶25} On appeal, the BWC argues that because Fouad-Tarazi’s report
    states that Wasinski had “progressive orthostatic tachycardia syndrome,” it
    conflicts with other testimony that Wasinski had “postural tachycardia syndrome.”
    Additionally, the BWC states that because Fouad-Tarazi did not testify, there is no
    testimony or additional statement from her that Wasinski was suffering from
    “postural orthostatic tachycardia syndrome” and not “progressive orthostatic
    tachycardia syndrome” as stated in her April 2, 2003 report. Therefore, the BWC
    argues that the trial court should not have permitted the jury to see Fouad-Tarazi’s
    report.
    {¶26} Our review of the record reveals that during trial, Wasinski provided
    the video deposition testimony of Dr. Grubb. Grubb testified that he is licensed to
    practice medicine in Ohio, and that he is board certified in the areas of internal
    medicine, cardiology, and electrophysiology. Grubb testified that he is a physician
    at the University of Toledo Medical Center and that he specifically practices in the
    Electrophysiology and Autonomic Function Clinic.
    {¶27} Grubb testified that his initial visit with Wasinski was on November
    15, 2005 after she was referred by Dr. Jones for a “second opinion as to whether or
    not she had a type of disorder called postural tachycardia syndrome.” Grubb
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    testified that during his initial visit with Wasinski he took her medical history and
    examined her, which revealed that her blood pressure and heart rate control did not
    appear to be normal. Additionally, Grubb testified as follows:
    We also—she [Wasinski] had been previously evaluated at the
    Cleveland Clinic and had undergone an extensive series of
    evaluations of her autonomic function by one of the—one of the
    physicians there and in reviewing that data as well as her history
    and other findings we concurred with the Cleveland Clinic
    diagnosis that she had postural tachycardia syndrome.
    (Grubb, Tr. p. 8).
    {¶28} Grubb also testified that “the full name is postural orthostatic
    tachycardia syndrome and rather than say that people abbreviate it as POTS.”
    Additionally, Grubb testified at length regarding the symptoms of POTS, and
    stated that people that sometimes suffer from POTS “are those who suffer some
    kind of trauma, motor vehicle accidents, but also things, sometimes surgeries and
    similar things can seem to…provoke symptoms.”            In speaking about people
    suffering from POTS after experiencing trauma, Grubb testified that “[u]sually
    injury that occurs to the brain and more particularly the brain stem appears to be
    the most common site where these injuries will lead to a thing like postural
    tachycardia syndrome.” When asked how one would sustain an injury to the brain
    or brain stem, Grubb answered, “[a]nything that would provide a sudden
    movement or blow to the head such as in an automobile accident…” Grubb also
    testified that it would not be unusual for tests such as a MRI, CAT scan, or x-rays
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    taken around the time of the accident to be normal, and an individual still develop
    POTS as a result of a motor vehicle accident.
    {¶29} Additionally, Grubb testified regarding the importance of and
    procedures used in conducting a tilt table test when determining whether a patient
    is suffering from POTS. Grubb testified that “heart rate and blood pressure are the
    typical things measured during the course of the test.”      In reviewing Fouad-
    Tarazi’s report and being asked what specifically happened with respect to
    Wasinski’s heart and blood pressure during the tilt table test, Grubb testified as
    follows:
    Her heart rate initially was 66 beats a minute. The—it’s—POTS
    is defined by an increase of about at least 30 beats a minute in
    the first 10 minutes of upright posture or a peak heart rate that
    exceeds 120, so she had in those very early minutes a greater
    than 30 beats per minute increase and that was the define—
    that’s the—that’s the usual definition that’s employed in
    diagnosing the condition.
    (Grubb, Tr. p. 14).
    {¶30} Grubb also testified that based on the information Wasinski
    provided, he was able to determine that her POTS “appeared to temporally be
    related to her motor vehicle accident.”         Specifically, Grubb testified that
    “according to the information she [Wasinski] provided to us, that her symptoms
    did not begin until after the motor vehicle accident had occurred.” Grubb testified
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    that in his opinion, Wasinski suffers from POTS and autonomic neuropathy as a
    result of the January 20, 2001 motor vehicle accident.
    {¶31} Our review of the record reveals that Fouad-Tarazi’s April 2, 2003
    report was a record kept in the regular course of treatment, in a regularly
    conducted business activity (i.e. by the Cleveland Clinic), that it contained
    relevant, probative evidence of Wasinski’s medical condition, and there was no
    question concerning its authenticity. Additionally, we note that this report was
    used by Grubb in his treatment of Wasinski and in making his own diagnosis that
    Wasinski was suffering from POTS. Furthermore, it is clear from the testimony
    presented that Dr. Grubb did not rely solely on Fouad-Tarazi’s report in
    diagnosing Wasinski with POTS, and that Fouad-Tarazi’s report was clearly not
    the sole basis for Grubb’s subsequent diagnosis of POTS. Additionally, we note
    that when Grubb specifically testified regarding Wasinski’s evaluation at the
    Cleveland Clinic and his concurrence with the diagnosis of POTS, counsel for the
    BWC did not object to this testimony being presented.
    {¶32} Based on the foregoing, we find that Fouad-Tarazi’s April 2, 2003
    report itself falls within a recognized exception to the hearsay rule. See Evid.R.
    803(6). Therefore, we find that the trial court did not abuse its discretion by
    permitting Fouad-Tarazi’s report to be admitted into evidence and considered by
    the jury during their deliberations.
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    {¶33} Turning our attention to the allegations contained in sub-section (B)
    of the BWC’s first assignment of error, we note that the BWC alleges that the trial
    court abused its discretion by permitting Wasinski to cross-examine the BWC’s
    expert witnesses regarding Fouad-Tarazi’s April 2, 2003 report. Specifically, the
    BWC alleges that Wasinski introduced the hearsay testimony of Fouad-Tarazi
    through Wasinski’s cross-examination of Dr. Steiman and Dr. Raj.
    {¶34} In support of this allegation, the BWC argues that the diagnoses or
    opinions of a non-testifying physician witness are not admissible as evidence.
    However, we note that in its appellate brief, the BWC concedes that “statements
    by non-testifying physicians may sometimes be admitted under the business
    records exception to the hearsay rule, the proponent of such evidence must
    establish that the business records exception applies.”
    {¶35} As we have previously determined, Fouad-Tarazi’s April 2, 2003
    report falls within a recognized exception to the hearsay rule. See Evid.R. 803(6).
    Additionally, our review of the record reveals that Grubb testified that Wasinski
    was suffering from postural tachycardia syndrome on November 7, 2007, which
    was well before Steiman testified on January 22, 2008 and Raj testified on January
    23, 2008.    Furthermore, our review of the record also reveals that Grubb’s
    testimony was presented to the jury prior to the presentation of Steiman and Raj’s
    testimony. In reviewing the record we find nothing prejudicial to the BWC as
    -20-
    Case No. 3-08-14 and 3-08-16
    related to Steiman or Raj’s testimony and, in light of our previous determination
    that the trial court did not abuse its discretion by allowing Fouad-Tarazi’s report to
    be admitted into evidence, we find that the BWC was not prejudiced by the trial
    court’s admission of Steiman and Raj’s cross-examination testimony. Therefore,
    we find that the trial court did not abuse its discretion by permitting Wasinski to
    cross-examine the BWC’s expert witnesses regarding Fouad-Tarazi’s April 2,
    2003 report.
    {¶36} Based on the foregoing, the BWC’s first assignment of error is
    overruled.
    BWC Assignment of Error No. 2
    {¶37} In its second assignment of error, the BWC alleges that the trial
    court abused its discretion by overruling the BWC’s motion to exclude the opinion
    testimony of Teresa Egan, Ph.D. as Egan’s testimony fails to satisfy the
    requirements set forth in Ohio Evidence Rule 702(B) and (C).
    {¶38} The trial court has sound discretion to determine an expert witness’
    qualifications to testify on a particular subject. State v. Jones (2000), 90 Ohio
    St.3d 403, 414, 
    739 N.E.2d 300
    citing State v. Awkal (1996), 
    76 Ohio St. 3d 324
    ,
    331, 
    667 N.E.2d 960
    .       Therefore, any decision concerning the admission or
    exclusion of expert testimony will not be disturbed absent an abuse of discretion.
    
    Jones, supra
    , citing State v. Bidinost (1994), 
    71 Ohio St. 3d 449
    , 453, 644 N.E.2d
    -21-
    Case No. 3-08-14 and 3-08-16
    318. An abuse of discretion constitutes more than an error of law or judgment and
    implies that the trial court acted unreasonably, arbitrarily, or unconscionably.
    Blakemore v. Blakemore (1983), 
    5 Ohio St. 3d 217
    , 219, 
    450 N.E.2d 1140
    . When
    applying the abuse of discretion standard, a reviewing court may not simply
    substitute its judgment for that of the trial court. 
    Id. {¶39} Expert
    testimony must meet the criteria of Evid.R. 702 which
    provides that a witness may testify as an expert if all of the following apply:
    (A) The witness’ testimony either relates to matters beyond the
    knowledge or experience possessed by lay persons or dispels a
    misconception common among lay persons;
    (B) The witness is qualified as an expert by specialized
    knowledge, skill, experience, training, or education regarding
    the subject matter of the testimony;
    (C) The witness’ testimony is based on reliable scientific,
    technical, or other specialized information…
    Evid.R. 702; see also State v. Rowe, 3rd Dist. Nos. 14-05-31, 14-05-46, 2006-Ohio-
    1883, citing State v. Hartman (2001), 
    93 Ohio St. 3d 274
    , 283-84, 
    754 N.E.2d 1150
    .
    {¶40} Our review of the record reveals that Teresa Egan, Ph.D. (“Egan”)
    provided her deposition testimony on April 21, 2008.2 Egan testified that she is a
    clinical psychologist and that she is licensed to practice psychology in the State of
    Ohio. Egan testified that she treats a range of patients for a variety of mental
    2
    Our review of the record reveals that Egan was deposed by both the BWC (at 9:05 a.m.) and Wasinski (at
    11:00 a.m.) on April 21, 2008.
    -22-
    Case No. 3-08-14 and 3-08-16
    health issues such as anxiety, depression, and adjustment issues. Egan testified
    that in the course of her training in psychology, she received training concerning
    determining the cause of certain types of psychological conditions. Egan also
    testified that in treating a patient, it is important to know the cause or have an idea
    of the cause of the patient’s psychological issues.
    {¶41} Egan testified that she began treating Wasinski as a patient in April
    2001, after Wasinski was referred for mental health counseling by her neurologist.
    Egan testified during Wasinski’s first office visit she obtained a detailed history
    from Wasinski, conducted a mental status exam, and diagnosed Wasinski as
    suffering from major depressive disorder, single episode. Egan testified that her
    opinion is that the physical aliments that resulted from Wasinski’s injury (on
    January 21, 2001) are a cause of her major depression. Egan also testified as
    follows:
    I think part of treatment, being a treating psychologist is trying
    to discern what causes or things may have set this particular set
    of problems in motion so that we can understand a little more
    about that and that that may help guide some of our treatment
    decisions, coping strategies that we would work with the client
    and so on. So to that extent, part of treatment is assessment and
    evaluation, which includes looking at causation.
    {¶42} In addressing the criteria contained in Evid.R. 702 in the context of
    the facts of the present case, we find that the issue of diagnosis and treatment of
    depression are matters outside of the scope of knowledge or experience possessed
    -23-
    Case No. 3-08-14 and 3-08-16
    by an ordinary lay person, such as a member of a jury. We also find that Egan’s
    testimony directly related to Wasinski’s depression and was necessary to
    determine Wasinski’s psychiatric condition.      Accordingly, Egan’s testimony
    satisfies the requirements of Evid.R. 702(A).
    {¶43} Turning our attention to the second criteria set forth in Evid.R. 702,
    we note that Egan’s testimony reveals that she has earned a Ph.D. in clinical
    psychology from Kent State University as well as a Master’s degree in clinical and
    community psychology from Cleveland State University and has been licensed to
    practice psychology in Ohio since 1989. Additionally, Egan testified that she
    currently practices in the field of clinical psychology and has been treating
    Wasinski since 2001. Accordingly, we find that Egan is qualified to testify as an
    expert by specialized knowledge, experience, training, and education regarding the
    subject matter of her testimony provided. Therefore, Egan’s testimony satisfies
    the requirements of Evid.R. 702(B).
    {¶44} Finally, regarding the third criteria set forth in Evid.R. 702, our
    review of the record reveals that Egan’s testimony was based on other specialized
    information.    Egan testified regarding her detailed knowledge concerning
    Wasinski, her complaints, and her history. Additionally, Egan based both her
    diagnosis of major depression, single episode, and her opinion concerning the
    cause of Wasinski’s depression, on several factors. These factors specifically
    -24-
    Case No. 3-08-14 and 3-08-16
    include the mental status examination she performed on Wasinski, Wasinski’s
    medical history, numerous office visits and interviews of Wasinski, and her
    general observations of Wasinski over the course of her therapy sessions.
    Furthermore, as specifically related to Evid.R. 702(C) we note that the record
    reflects that Egan evaluated and diagnosed Wasinski pursuant to accepted
    psychological standards and did not create or use a new scientific method in her
    treatment of Wasinski. Accordingly, Egan’s testimony satisfies the requirements
    of Evid.R. 702(C).
    {¶45} Based on the foregoing, we find that the trial court did not act
    unreasonably, arbitrarily, or unconscionably by overruling the BWC’s motion to
    exclude the opinion testimony of Teresa Egan, Ph.D. Accordingly, the BWC’s
    second assignment of error is overruled.
    BWC Assignment of Error No. 3
    {¶46} In its third assignment of error, the BWC alleges that the trial court
    abused its discretion by failing to redact the words “concussion,” “loss of
    consciousness” and “post concussive syndrome” from the medical records
    admitted into evidence and presented to the jury as the only medical expert to
    testify for Wasinski did not find a loss of consciousness at the accident scene, nor
    did he diagnose a concussion or post-concussion syndrome.
    -25-
    Case No. 3-08-14 and 3-08-16
    {¶47} Prior to addressing the merits of the BWC’s third assignment of
    error, we note that the BWC failed to present any citations to legal authority or
    statutes in its initial brief to this court specifically pertaining to its third
    assignment of error, contrary to the requirements of App.R. 16(A)(7). However,
    we do note that minimal citations to legal authority are contained in the BWC’s
    reply brief.
    {¶48} Trial courts have broad discretion in determining whether to admit
    or exclude evidence. Deskins v. Cunningham, 3rd Dist. No. 14-05-29, 2006-Ohio-
    2003 citing Huffman v. Hair Surgeon, Inc. (1984), 
    19 Ohio St. 3d 83
    , 
    482 N.E.2d 1248
    . An appellate court will not reverse a trial court’s decision to admit or
    exclude evidence absent an abuse of discretion. State v. Osborn, 3rd Dist. No. 9-
    05-35, 2006-Ohio-1890 citing State v. Bronlow, 3rd Dist. No. 1-02-95, 2003-Ohio-
    5757; Wightman v. Consol. Rail Corp. (1999), 
    86 Ohio St. 3d 431
    , 437, 
    735 N.E.2d 546
    . Additionally, Civ.R. 61 provides, in relevant part, as follows:
    No error in either the admission or exclusion of evidence *** is
    ground for granting a new trial or for setting aside a verdict or
    for vacating, modifying or otherwise disturbing a judgment or
    order, unless refusal to take such action appears to the court
    inconsistent with substantial justice.
    See also, In re Matthews, 3rd Dist. Nos. 9-07-28, 9-07-29, 9-07-34, 2008-Ohio-
    276. An abuse of discretion constitutes more than an error of law or judgment and
    implies that the trial court acted unreasonably, arbitrarily, or unconscionably.
    -26-
    Case No. 3-08-14 and 3-08-16
    Blakemore v. Blakemore (1983), 
    5 Ohio St. 3d 217
    , 219, 
    450 N.E.2d 1140
    . When
    applying the abuse of discretion standard, a reviewing court may not simply
    substitute its judgment for that of the trial court. 
    Id. {¶49} Our
    review of the record reveals that on February 4, 2008 the BWC
    filed a motion in limine requesting that the trial court prohibit any evidence or
    argument by Wasinski alleging a “loss of consciousness” or “concussion.” In
    support of this motion, the BWC alleged that there was no expert testimony
    presented concerning a diagnosis of concussion, nor was there any expert
    testimony presented alleging that either a concussion or loss of consciousness was
    the proximate cause of Wasinski’s alleged conditions. The BWC also alleged that
    Wasinski’s claim of “post-concussion syndrome” was previously denied by the
    Industrial Commission because there was no credible evidence of a loss of
    consciousness at the scene of the accident and therefore, these claims were barred
    by the doctrines of res judicata and collateral estoppel.
    {¶50} On February 8, 2008 the trial court issued an Order granting the
    BWC’s motions in limine as related to the prohibition of any evidence or
    argument alleging a “loss of consciousness,” “concussion” and “post-concussion
    syndrome.” In its Order, the trial court referred to these specific motions in limine
    as “Branches 4&5” and granted said motions “based on the doctrine of res judicata
    and collateral estoppel.” On February 11, 2008 Wasinski filed a response to the
    -27-
    Case No. 3-08-14 and 3-08-16
    BWC’s motions in limine, and on May 9, 2008 Wasinski filed a motion for
    reconsideration of the trial court’s February 8, 2008 Order.
    {¶51} In response to the allegations set forth in the BWC’s third
    assignment of error, Wasinski submits that the records containing the issues of
    “concussion,” “loss of consciousness” and “post-concussion syndrome” also
    contained detailed descriptions of her complaints and the diagnostic tests that
    occurred immediately after her industrial injury. Accordingly, Wasinski argues
    that the medical records documenting her physical condition near the time of her
    industrial injury were relevant to her diagnosis and opinion concerning the
    causation of her problems. Therefore, Wasinski argues that the records were
    properly admissible in the present case and the trial court did not abuse its
    discretion in admitting the medical records containing the words “concussion,”
    “loss of consciousness” and “post-concussion syndrome” and presenting the same
    to the jury.
    {¶52} It is well established that a decision on a motion in limine is a
    “tentative, preliminary or presumptive ruling about an evidentiary issue that is
    anticipated but has not yet been presented in its full context. State v. Geboy
    (2001), 
    145 Ohio St. 3d 706
    , 726, 
    764 N.E.2d 451
    citing State v. Grubb (1986), 
    28 Ohio St. 3d 199
    , 203, 
    503 N.E.2d 142
    . Because a ruling on a motion in limine is
    not considered final, “[a]n appellate court need not review the propriety of such an
    -28-
    Case No. 3-08-14 and 3-08-16
    order unless the claimed error is preserved by an objection, proffer, or ruling on
    the record when the issue is actually reached and the context is developed at trial.”
    
    Id. See, also,
    Gollihue v. Consol. Rail Corp. (1997), 
    120 Ohio App. 3d 378
    , 288,
    
    697 N.E.2d 1109
    .
    {¶53} At the close of her case-in-chief, Wasinski’s counsel moved to have
    Exhibit B (office notes of Dr. Jones regarding his December 14, 2001 office visit
    with Wasinski) admitted into evidence. Counsel for the BWC objected to the
    admission of Exhibit B and the following exchange occurred:
    Mr. Reis: Loss of consciousness has been stricken by the Court.
    There’s references to loss of consciousness. She said she woke
    up by a fireman tapping on her window.               That’s also
    objectionable, Your Honor, because of this Court’s previous
    ruling that no loss of consciousness or concussion or evidence of
    that nature would be admissible in this case.
    The Court: Yeah, Dr.—Jetta, Dr. Jones’s notes, I think he’s
    right, they were covered by something else by a previous ruling.
    But I’ll let you put what you want on the record.
    Ms. Mencer: I’m not sure they were covered. I know you struck
    the deposition and I—again, I was unclear as to the reason all
    the deposition was struck. I understand there might have been
    issues concerning his opinion testimony.
    The Court: Sure.
    Ms. Mencer: But again, it’s a medical record.
    The Court: Did any of the other doctors use it whose testimony
    we did hear or are going to hear?
    -29-
    Case No. 3-08-14 and 3-08-16
    Ms. Mencer: I –you know, I’m not certain that I didn’t ask—I
    don’t recall whether I asked—Dr. Grubb did not use it, no. Did
    I ask questions in cross? I’m not certain whether I did. Did the
    other doctors have that record and, you know, use it as part of
    the—their opinions, I’m certain they have had to.
    The Court: Did your doctors have access to Dr. Jones’s notes as
    part of their records that they reviewed?
    Mr. Reis: Yes, Your Honor.
    The Court: All right, overruled. B will be admitted.
    (Tr. Vol. III, pp. 368-369).
    {¶54} Wasinski also moved to have Exhibit E (records of Dr. Baddour
    regarding his care of Wasinski beginning March 16, 2001) admitted into evidence.
    Counsel for the BWC objected to the admission of Exhibit E and the following
    exchange occurred:
    The Court: Go ahead, put them on the record. Once again, are
    these—were the records in the form they’re in now given to the
    doctors that are testifying?
    Ms. Mencer: Other than the top page.
    The Court: Other than the front page; do you agree with that?
    All the doctors had access to everything you’ve got in your hand
    here before they testified?
    Mr. Reis: Yes, Your Honor.
    The Court: Okay, well put your objections in the record.
    Mr. Reis: Again, loss of consciousness is in the letter of April 26,
    2001, Dr. Baddour’s record. Again, this court ruled subsequent,
    Your Honor, to my doctors having reviewed these records. And
    -30-
    Case No. 3-08-14 and 3-08-16
    I would submit that part of the independent medical
    examination process is to provide the expert with all records. At
    that point in time we don’t know what the Court’s ruling is
    going to be on the admissibility of these diagnoses or phrase
    contained in the reports.
    So therefore, even though they reviewed them, that doesn’t make
    it admissible. Counsel could have questioned that doctor about
    loss of consciousness or concussion or words to that effect.
    She did not do that; therefore, by providing the record to the
    doctor and that pertains to all exhibits we’re talking about, A, B,
    C, D, and E, the Defendant is not thereby waiving the objection
    because this Court did not rule upon the motion in limine until
    February 11, 2008. So for the record, I understand the Court’s
    ruling, but, for the record, loss of consciousness is contained in
    this record various places…
    ***
    The Court: Well, you made your record. I understand where
    you’re coming from. But they’re overruled. Baddour’s will be
    admitted as is.
    (Tr. Vol. III, pp. 373-376).
    {¶55} The power to grant a motion in limine lies within the inherent power
    and discretion of a trial court to control its proceedings. State v. Grubb, 28 Ohio
    St.3d at 201 citing State v. Spahr (1976), 
    47 Ohio App. 2d 221
    , 224, 
    353 N.E.2d 624
    .   Additionally, the function of a motion in limine as a precautionary
    instruction is to avoid error, prejudice, and possibly a mistrial by prohibiting
    opposing counsel from raising or making reference to an evidentiary issue until the
    trial court is better able to rule upon its admissibility outside the presence of a jury
    once the trial has commenced. 
    Id. -31- Case
    No. 3-08-14 and 3-08-16
    {¶56} We also note that “[t]he sustaining of a motion in limine does not
    determine the admissibility of the evidence to which it is directed. Rather it is
    only a preliminary interlocutory order precluding questions being asked in a
    certain area until the court can determine from the total circumstances of the case
    whether the evidence would be admissible.” (Emphasis added). 
    Id. referencing State
    v. Leslie (1984), 
    14 Ohio App. 3d 343
    , 
    471 N.E.2d 503
    . Therefore, should
    circumstances subsequently develop at trial, the trial court is certainly at liberty to
    consider the admissibility of the disputed evidence in its actual context. 
    Grubb, 28 Ohio St. 3d at 202
    citing State v. White (1982), 
    6 Ohio App. 3d 1
    , 4, 
    451 N.E.2d 533
    .
    {¶57} In the present case, our review of the record reveals that Wasinski’s
    medical records admitted into evidence were all provided to the BWC’s expert
    witnesses for their review and were also authenticated by counsel for the BWC.
    (See also Tr. Vol. III pp. 372-373). Furthermore, we note that the BWC has not
    indicated on appeal how the trial court’s failure to redact the words “concussion,”
    loss of consciousness,” and “post-concussive syndrome” has materially prejudiced
    the BWC.
    {¶58} Based on the foregoing, we find that the trial court did not act
    unreasonably, arbitrarily, or unconscionably by failing to redact the words
    “concussion,” “loss of consciousness,” and “post concussive syndrome” from the
    -32-
    Case No. 3-08-14 and 3-08-16
    medical records presented to the jury and therefore find that the trial court did not
    abuse its discretion.    Accordingly, the BWC’s third assignment of error is
    overruled.
    BWC Assignment of Error No. 4
    {¶59} In its fourth assignment of error, the BWC alleges that the trial court
    erred and abused its discretion by giving jury instructions on “aggravation” and
    “flow through” as these theories were not relevant to the issues presented at trial.
    {¶60} It is well established that the trial court will not instruct the jury
    where there is no evidence to support an issue. Murphy v. Carrolton Mfg. Co.
    (1991), 
    61 Ohio St. 3d 585
    , 591, 
    575 N.E.2d 828
    citing Riley v. Cincinnati (1976),
    
    46 Ohio St. 2d 287
    , 
    348 N.E.2d 135
    . In general, requested instructions should be
    given if they are correct statements of the law applicable to the facts in the case
    and reasonable minds might reach the conclusion sought by the instruction. 
    Id. “In reviewing
    a record to ascertain the presence of sufficient evidence to support
    the giving of a[n]…instruction, an appellate court should determine whether the
    record contains evidence from which reasonable minds might reach the conclusion
    sought by the instruction.” 
    Id. citing Feterle
    v. Huettner (1971), 
    28 Ohio St. 2d 54
    ,
    
    275 N.E.2d 340
    at syllabus.
    {¶61} In reviewing the sufficiency of jury instructions given by a trial
    court, an appellate court must not disturb the trial court’s instructions unless the
    -33-
    Case No. 3-08-14 and 3-08-16
    record demonstrates an abuse of discretion, as it is within the sound discretion of
    the trial court to instruct the jury. State v. Wright, 3rd Dist. No. 5-01-10, 2001-
    Ohio-2258 citing State v. Dailey, 3rd Dist. No. 5-99-56, 2000-Ohio-1818. An
    abuse of discretion occurs when the court’s attitude is unreasonable, arbitrary, or
    unconscionable. Blakemore v. 
    Blakemore, 5 Ohio St. 3d at 219
    . When applying
    the abuse of discretion standard, a reviewing court may not simply substitute its
    judgment for that of the trial court. 
    Id. {¶62} In
    the present case, the BWC filed its proposed jury instructions with
    the trial court on February 4, 2008 and on February 5, 2008 Wasinski filed her
    request for jury instructions with the trial court. Wasinski’s request for jury
    instructions requested an instruction on the issue of “aggravation” which read as
    follows:
    Employers take their employees as they find them and assume
    the risk of having an employee’s pre-existing condition made
    worse by some injury which would not hurt or bother a perfectly
    healthy person. It is not necessary for the employee to prove
    that the aggravation is substantial in order to participate in the
    Workers’ Compensation fund. (3 OJI 365.13).
    {¶63} Wasinski also requested an instruction on the issue of “flow through
    condition” wherein Wasinski advised the court that “[a] “flow through condition”
    occurs when the employee’s work-related injury generates a medical condition in
    a body part other than that which the employee originally specified.”
    -34-
    Case No. 3-08-14 and 3-08-16
    {¶64} On appeal, the BWC alleges that Wasinski never asserted the theory
    of “aggravation” in her complaint filed with the Crawford County Court of
    Common Pleas, nor did she seek to amend her complaint to include this theory.
    The BWC also alleges that Wasinski did not elicit expert witness testimony to
    assert the theories of “aggravation” and “flow through” prior to or during trial.
    Therefore, the BWC alleges that because jury instructions must be consistent with
    the theory of causation for the medical condition appealed to the common pleas
    court, and because the theories of “aggravation” and “flow through” were not set
    forth by Wasinski nor testified to during trial, the trial court abused its discretion
    by providing the jury with instructions on “aggravation” and “flow through.”
    {¶65} In response, Wasinski alleges that her major depression arose from
    the pain and the disability she suffered due to her industrial injury, not that her
    major depression was caused by her industrial injury. Additionally, Wasinski
    alleges that psychological injuries are only allowed in the claim as flow-through
    injuries—that the injury generates a medical condition in a body part other than
    that which the employee originally specified.
    {¶66} In support of her allegations, Wasinski directs this court’s attention
    to R.C. 4123.01(C) which provides as follows3:
    3
    We note that R.C. 4123.01 was amended by 2008 Ohio Laws File 97 (Am. Sub. S.B.) which was
    approved on June 11, 2008. However, we note that the language of subsection (C) was not changed or
    otherwise amended by 2008 Ohio Laws File 97.
    -35-
    Case No. 3-08-14 and 3-08-16
    (C) “Injury” includes any injury, whether caused by external
    accidental means or accidental in character and result, received
    in the course of, and arising out of, the injured employee’s
    employment. “Injury” does not include:
    (1) Psychiatric conditions except where the claimant’s
    psychiatric conditions have arisen from an injury or
    occupational disease sustained by the claimant or where the
    claimant’s psychiatric conditions have arisen from sexual
    conduct in which the claimant was forced by threat of physical
    harm to engage or participate;
    (2) Injury or disability caused primarily by the natural
    deterioration of tissue, an organ, or part of the body;
    (3) Injury or disability incurred in voluntary participation in
    an employer-sponsored recreation or fitness activity if the
    employee signs a waiver of the employee’s right to compensation
    or benefits under this chapter prior to engaging in the recreation
    or fitness activity;
    (4) A condition that pre-existed an injury unless that pre-
    existing condition is substantially aggravated by the injury.
    Such a substantial aggravation must be documented by objective
    diagnostic findings, objective clinical findings, or objective test
    results. Subjective complaints may be evidence of such a
    substantial aggravation.      However, subjective complaints
    without objective diagnostic findings, objective clinical findings,
    or objective test results are insufficient to substantiate a
    substantial aggravation.
    {¶67} Wasinski also directs this court’s attention to Ohio Jury Instruction
    CV 427.134 which provides as follows:
    Aggravation. Employers take their employees as they find them
    and assume the risk of having an employee’s pre-existing
    4
    We note that in her brief to this court, Wasinski directs our attention to 3 OJI 365.13. However, the
    instruction cited by Wasinski has been updated and accordingly, we cite to OJI CV 427.13, which contains
    language substantially similar to the language set forth by Wasinski.
    -36-
    Case No. 3-08-14 and 3-08-16
    condition (aggravated) (made worse) by some injury which
    would not hurt or bother a perfectly healthy person. It is not
    necessary for the employee to prove that the aggravation is
    substantial in order to (participate) (continue to participate) in
    the Workers’ Compensation fund.
    {¶68} Our review of the record reveals that during the jury trial in this
    matter, the jury was presented with the video deposition testimony of Teresa Egan,
    Ph.D. (“Egan”). Egan testified that she is a licensed clinical psychologist who
    treats mental health issues including anxiety and depression disorders.                                  Egan
    testified that she has treated Wasinski since April 2001 and that she diagnosed
    Wasinski with major depressive disorder, single episode.5 Egan also testified that
    “the onset of [Wasinski’s] symptoms of depression occurred with the motor
    vehicle accident in January, ‘01 and the subsequent effect that those physical
    problems had on her ability to work and to function in other areas of her life.”
    Egan also testified that a cause of Wasinski’s major depression is the effect that
    her physical ailments and symptoms that resulted from her automobile injury, have
    had on her life.
    {¶69} Our review of the record also reveals that at the close of the BWC’s
    case-in-chief, the trial court discussed jury instructions with counsel for both
    parties and the following exchange occurred:
    5
    Regarding the diagnosis of “major depressive disorder, single episode” Egan specifically testified that
    “major depressive episode represents a set of symptoms that include factors such as impaired concentration,
    sadness, tearfulness, irritability, sleep disruption, sometimes appetite disruption, feelings of hopelessness or
    helplessness, sometimes suicidal thoughts.”
    -37-
    Case No. 3-08-14 and 3-08-16
    The Court: I’ve been told by Ms. Mack that, apparently, the
    parties are in agreement except for one instruction that was
    requested by the Plaintiff; is that correct? And that would be
    the one on flow through conditions. Is that the one you want to
    be heard on, Mr. Reis?
    ***
    The Court: I just want to hear your objection, if any, on the
    proposed instructions.
    ***
    Mr. Reis: And then the next objection I had concerning
    proximate cause, Ms. Mencer has shown me the OJI from which
    she obtained that instruction. We have an objection—our next
    objection is Page 18. I’m looking at the original copy. It talks
    about aggravation. This is not an aggravation case so, therefore,
    that jury instruction is not appropriate at all.
    ***
    The Court: Aggravation.
    Mr. Reis: I think it will be confusing, Your Honor. I don’t
    think it’s appropriate.
    The Court: Well, I think based on the evidence I heard, that fits
    in close enough and so your objection is noted but overruled.
    I’m gonna leave that in. And then let’s see, do you have an
    objection on new Page 19 as to the flow through?
    Mr. Reis: Okay, I didn’t see that one. That was just added.
    Again, this is not a flow through case. Again, that has to do
    with—
    Ms. Mencer: Depression is flow through.
    Mr. Reis: Well, again, it goes back to my objection on
    aggravation. For the benefit of the Court, a Worker’s Comp
    case has to be brought as, for instance—examples, I aggravated
    my degenerative disc disease. That is the condition that’s
    brought at administrative level. So we’re not a Moore v. Kroger
    situation where Plaintiff has changed the nature of their case.
    There’s no testimony from the expert that this is an aggravation
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    Case No. 3-08-14 and 3-08-16
    case or a flow through case and, therefore, it would be improper
    to have any instruction on either aggravation or flow through.
    Ms. Mencer: Your Honor, depression by nature is a flow
    through injury. Psychological injuries that result from a specific
    incident are not allowable. This is clearly flow through. I mean,
    depression is—
    The Court: I agree with her. I think this instruction—I mean,
    and your objection, once again is there on the record, but I gotta
    make a decision. And based on what I’ve heard, I do think this
    is a reasonable request by the Plaintiff and I’m going to allow
    that one in.
    (Tr. Vol. IV, pp. 436-438).
    {¶70} When subsequently providing oral instructions to the jury the trial
    court instructed the jury, in relevant part, as follows:
    A “flow through condition” occurs when the employee’s work-
    related injury generates a medical condition in a body part other
    than that which the employee originally specified.
    Employers take their employees as they find them and assume
    the risk of having an employee’s pre-existing condition
    aggravated by some injury which would not hurt or bother a
    perfectly healthy person.
    (Tr. p. 510).6
    {¶71} Based on the foregoing, we find that the jury instructions given on
    “aggravation” and “flow through” were proper statements of the law. However,
    upon review of the record, we do not believe there was sufficient evidence,
    6
    Our review of the record reveals that the written instructions provided to the jury were exactly the same as
    the oral instructions provided by the court.
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    Case No. 3-08-14 and 3-08-16
    argument, or other indication of a pre-existing condition that was “aggravated” by
    the industrial injury to support the jury instruction on “aggravation.” On the other
    hand, there was expert testimony that Wasinski’s alleged depression was directly
    caused by the disabilities resulting from the previously allowed industrial injury.
    {¶72} Accordingly, we find that the trial court’s jury instruction as to “flow
    through” was supported in the evidence. However, we find that on this record, it
    was error for the trial court to instruct the jury as to the “aggravation” of a pre-
    existing injury. Nevertheless, in view of the ample evidence supporting the “flow
    through” instruction, the error as to the “aggravation” instruction was harmless.
    Therefore, the BWC’s fourth assignment of error is overruled.
    Wasinski’s Cross-Appeal/Assignments of Error VI-XI
    {¶73} Prior to addressing the merits of Wasinski’s assignments of error, we
    must first address a discussion that occurred during oral argument in this matter.
    On December 9, 2007 counsel for the BWC and Wasinski appeared before this
    court for oral argument. During Wasinski’s argument, this court inquired as to the
    status of Wasinski’s assignments of error, should the court ultimately overrule the
    BWC’s assignments of error in its written opinion.         In response, Wasinski’s
    counsel stated that she would withdraw assignments of error 6-9 and 11 should
    this court overrule the BWC’s assignments of error and affirm the judgment of the
    trial court. Accordingly, as we have overruled all of the BWC’s assignments of
    -40-
    Case No. 3-08-14 and 3-08-16
    error, we shall confine our analysis of Wasinski’s cross-appeal to her argument
    contained in Assignment of Error X.
    Assignment of Error X
    {¶74} In her tenth assignment of error, Wasinski alleges that the trial court
    erred by finding that the issues of “concussion” and “loss of consciousness” were
    barred by the doctrine of res judicata and collateral estoppel. In support of this
    allegation, Wasinski submits that the issues of concussion and loss of
    consciousness have never been adjudicated by the Industrial Commission or any
    other court.
    {¶75} Our review of the record reveals that on February 4, 2008 the BWC
    filed motions in limine wherein the BWC requested that the trial court prohibit, in
    relevant part, as follows:
    4. To prohibit any evidence, argument alleging a “loss of
    consciousness” or “concussion.” First, there is no expert
    testimony concerning a diagnosis of “concussion.” Second,
    Plaintiff’s (sic) Claim of “post concussion syndrome” was
    previously denied by the Industrial Commission for the reason
    that there was no credible evidence of a loss of consciousness at
    the accident scene. Furthermore, there is no expert testimony
    from either Dr. Grubb or Dr. Jones of alleging a “concussion” (a
    medical condition) or “loss of consciousness” to be the proximate
    cause of her alleged conditions. Finally, evidence or argument of
    a “loss of consciousness” or “concussion” is barred by the
    doctrine of res judicata and collateral estoppel. McCabe v. Zeller
    Corp. (1997), 
    117 Ohio App. 3d 209
    .
    -41-
    Case No. 3-08-14 and 3-08-16
    {¶76} In support of these requests, the BWC argued that it was anticipated
    that during trial Wasinski and her witnesses would refer to a loss of consciousness
    or concussion occurring at the accident scene in Dallas, Texas in January 2001.
    The BWC also argued that it was anticipated that Wasinski’s counsel would argue
    that the conditions that, Wasinski was seeking to participate in the benefits of the
    workers’ compensation fund, were caused by a concussion or loss of
    consciousness at the accident scene. However, the BWC alleged that these claims
    and/or theories of causation have been denied and never appealed and therefore
    “[t]hat claim, diagnosis, mechanism of injury and/or description of injury is barred
    by res judicata and collateral estoppel.” Finally, the BWC argued that no expert
    has described, diagnosed, or causally related a concussion or loss of consciousness
    to the alleged condition or the mechanism of injury for the industrial injury.
    {¶77} On February 8, 2008 the trial court issued an Order granting the
    BWC’s motions in limine as related to the prohibition of any evidence or
    argument alleging a “loss of consciousness,” “concussion” and “post-concussion
    syndrome.” In its Order, the trial court specifically referred to these motions in
    limine as “Branches 4&5” and granted said motions “based on the doctrine of res
    judicata and collateral estoppel.”
    {¶78} Our review of the record reveals that on February 11, 2008 Wasinski
    filed a notice of filing with the trial court which included a copy of the Industrial
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    Case No. 3-08-14 and 3-08-16
    Commission’s Record of Proceedings, as typed May 30, 2001. This Record of
    Proceedings provides, in relevant part, as follows:
    The order of the District Hearing Officer, from the hearing
    dated 04/17/2001 is affirmed.
    The claim remains allowed for the following conditions:
    contusion to scalp and left knee; cervicothoracic strain;
    lumbosacral strain.
    The claim remains specifically disallowed for “post-concussion
    syndrome.” *** Claimant was injured in a motor vehicle
    accident was on business, out-of-state, on 1/20/2001. No
    treatment was rendered at the scene or on the date of injury.
    The claimant testified she lost consciousness following or during
    the accident but there is no contemporaneous medical evidence
    to verify that statement. *** The Staff Hearing Officer finds the
    medical evidence is not persuasive on which to allow the post
    concussion syndrome. *** He [Dr. Baddour] does not diagnose
    post-concussive syndrome. Dr. Kellum notes claimant has
    ailments of post-concussive syndrome but he does not
    specifically relate this to the motor vehicle accident.
    {¶79} Our review of the record reveals that the Industrial Commission
    denied Wasinski’s claimed medical condition of post-concussion syndrome
    because there was no contemporary evidence presented regarding a loss of
    consciousness at the scene of the January 21, 2001 motor vehicle accident. Our
    review of the record also reveals that Wasinski did not appeal the Industrial
    Commission’s May 30, 2001 decision to the court of common pleas as required or
    allowed under R.C. 4123.512.
    -43-
    Case No. 3-08-14 and 3-08-16
    {¶80} Additionally, it appears that Wasinski does not attempt to re-litigate
    the May 30, 2001 decision and factual findings of the Industrial Commission until
    2008, and it appears that Wasinski attempts to do so without any medical
    testimony contained in the record formally diagnosing her with a concussion.
    Furthermore, we note that the facts surrounding Wasinski’s medical condition as
    specifically related to suffering from a concussion, or post-concussive syndrome
    have not changed between the January 20, 2001 motor vehicle accident and the
    trial court’s finding that the issues of “concussion” and “loss of consciousness”
    were barred by the doctrine of res judicata and collateral estoppel.
    {¶81} Based on the foregoing, we find that the trial court did not err or
    abuse its discretion in determining that the issues of “concussion” and “loss of
    consciousness” were barred by the doctrine of res judicata and collateral estoppel.
    Moreover, the trial court’s decision not to allow these issues to become the basis
    for separate claims before the jury is distinguishable from the trial court’s decision
    not to require the terms “concussion” and “loss of consciousness” to be redacted
    from medical records that were testified to and introduced in support of entirely
    different claims as discussed in the BWC’s third assignment of error.
    Accordingly, Wasinski’s tenth assignment of error is overruled.
    {¶82} Based on the foregoing, the BWC’s assignments of error one
    through four are overruled in their entirety. Therefore, Wasinski’s assignments of
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    Case No. 3-08-14 and 3-08-16
    error one through five are rendered moot.           Additionally, as Wasinski’s
    assignments of error six through nine and eleven have been withdrawn, they are
    also rendered moot. Finally, Wasinski’s assignment of error ten is overruled.
    {¶83} Accordingly, the Judgment Entries of the Court of Common Pleas,
    Crawford County, Ohio are affirmed.
    Judgments Affirmed
    WILLAMOWSKI and ROGERS, J.J., concurs.
    /jlr
    -45-