A contested case hearing was held in (city), Texas, on September 21, 1993, with the record closing on October 22, 1993, to determine the impairment rating (IR) of the appellant (claimant). The hearing officer, (hearing officer), finding that the report of the designated doctor selected by the Texas Workers’ Compensation Commission (Commission) was not against the great weight of the other medical evidence, determined that claimant’s IR was 13% based on the designated doctor’s report. Claimant’s request for review asserts that the great weight of the other medical evidence established that claimant’s IR was 15%. The respondent (carrier) filed no response.
DECISION
Finding the evidence sufficient to support the challenged factual findings and legal conclusion, we affirm.
Claimant testified that he was injured on (date of injury), while employed by (employer), when he picked up some sheetrock and felt a pull in his back. He said he could not continue to work. Claimant also stated that his treating doctor was (Dr. B) and that she had assigned him an IR of 15% with which he agreed. According to the carrier’s exhibits, the carrier paid claimant temporary income benefits (TIBS) for 104 weeks from “(date)” to “12-30-92.” The carrier averred that it thereafter paid claimant impairment income benefits (IIBS) based on the 13% IR assigned by the designated doctor.
In evidence was a Report of Medical Evaluation (TWCC-69), signed by (Dr. D) which stated that claimant reached MMI on September 15, 1992, with an IR of zero percent. In an accompanying narrative report of September 15th, Dr. D stated that he had examined claimant on that date, that claimant’s lumbar spine films showed no abnormality, that an MRI showed some degeneration of the L5-S1 disc with some slight bulging but of no significance, that the neurological exam was normal, that he did not regard claimant as a candidate for surgery, and that he felt that claimant had reached MMI and could be released to return to his usual work without permanent impairment of function.
Claimant introduced various records of Dr. B which showed a long course of physiotherapy, various referrals, and disagreement with the report of Dr. D. These records also contained several forms from Dr. B entitled “Report of Medical Evaluation” (TWCC-69) which checked “No” to the question whether claimant had reached MMI and stated the estimated date of MMI as “deferred.” The last such TWCC-69, signed by Dr. B on March 15, 1993, not only answered “No” to the MMI question and “deferred” to the estimated date, but purported to assign an IR of 15% with no reference to any documentation of objective laboratory or clinical findings of impairment and no reference to the specific body part/system included in the rating. While the hearing officer did not discuss this rating, it was in evidence and listed in the decision as one of the exhibits.
Also in evidence was a TWCC-69 from (Dr. G) signed on March 12, 1993, which stated that claimant reached MMI on March 11, 1993, with a 12% IR. No narrative report nor records of Dr. G accompanied this TWCC-69 which contained no documentation of objective findings of impairment nor reference to the specific body part/system involved. Claimant expressed concern that the hearing officer’s findings created the appearance that claimant was referred to Dr. G solely for an IR whereas Dr. G had also treated claimant. We find no merit to this assertion nor error in the hearing officer’s finding pertaining to Dr. G.
The May 20, 1993, TWCC-69 from the designated doctor, (Dr. J), stated that claimant had reached MMI on “1-3-93 (statutory MMI)” and assigned an IR of 13% for claimant’s lumbar spine which consisted of seven percent for an unoperated L5-S1 disc lesion and six percent for abnormal range of motion (ROM) of the lumbosacral spine. In his narrative report accompanying the TWCC-69 Dr. J stated that he had reviewed claimant’s medical records and diagnostic films and his diagnosis was degenerated disc disease, L5-S1, lumbosacral spondylosis, and recurrent lumbosacral strain. Dr. J also stated that he found no strong indication for surgical intervention and believed claimant’s symptoms “have already stabilized.”
Claimant introduced a TWCC-69 dated September 3, 1993, and signed by (Dr. D) which stated that claimant reached MMI on August 10, 1993, with an IR of 14%. Claimant averred that he obtained Dr. D’s examination and rating at no expense to the carrier. Claimant argued both at the hearing and on appeal, however, that the 14% IR was in error and should be 15% based on a correct application of the combined values chart in the Guides to the Evaluation of Permanent Impairment published by the American Medical Association (AMA Guides). The narrative report accompanying Dr. D’s TWCC-69 stated that the 14% IR was based on the AMA Guides “3rd edition (revised), 1990.” See Section 408.124(b) requiring the Commission to determine the existence and degree of an employee’s impairment based on the AMA Guides, third edition, second printing, dated February 1989.
With respect to the determination of an employee’s IR, Section 408.125(e) provides that the report of the designated doctor chosen by the Commission shall have presumptive weight and the Commission shall base the IR on that report unless the great weight of the other medical evidence is to the contrary. This “great weight” determination amounts to more than a mere balancing or preponderance of the medical evidence. Texas Workers’ Compensation Commission Appeal No. 92412, decided September 28, 1992. A designated doctor’s report should not be rejected “absent a substantial basis to do so.” Texas Workers’ Compensation Commission Appeal No. 93039, decided March 1, 1993. And medical conclusions are not reached by counting the number of doctors who take a particular position. The opinions must be weighed according to their “thoroughness, accuracy, and credibility with consideration given to the basis it provides for opinions asserted.” Texas Workers’ Compensation Commission Appeal No. 93493, decided July 30, 1993.
We are satisfied that the hearing officer’s determinations that the designated doctor’s report was entitled to presumptive weight and that claimant’s IR was 13% are sufficiently supported by the evidence. We do not agree with claimant’s assertion that the 15% IR found by Dr. G and the 14% IR found by Dr. D (even assuming the latter’s 14% was miscalculated and should be 15% as claimant argues) constituted the great weight of the other medical evidence against the designated doctor’s report and therefore that claimant’s IR should be 15%. Section 410.165(a) provides that the hearing officer is the sole judge of the weight and credibility to be given to the evidence. The hearing officer resolves conflicts and inconsistencies in the evidence. Garza v. Commercial Insurance Co. of Newark, N.J., 508 S.W.2d 701 (Tex. Civ. App.-Amarillo 1974, no writ). We will not disturb the hearing officer’s findings unless they are so against the great weight and preponderance of the evidence as to be manifestly unjust. In re King’s Estate, 150 Tex. 662, 244 S.W.2d 660 (1951); Pool v. Ford Motor Co., 715 S.W.2d 629 (Tex. 1986).
The challenged findings and conclusions being sufficiently supported by the evidence, we affirm the hearing officer’s decision.
Philip F. O’Neill – Appeals Judge
CONCUR:
Joe Sebesta – Appeals Judge
Susan M. Kelley – Appeals Judge