A contested case hearing was held on October 14, 1992, at (city), Texas, (hearing officer) presiding as hearing officer. The case was considered under the provisions of the Texas Workers’ Compensation Act, TEX. REV. CIV. STAT. ANN. art. 8308-1.01 et seq. (Vernon Supp. 1992) (1989 Act). She determined that the appellant (claimant) reached maximum medical improvement (MMI) on July 22, 1992, with a 4% whole body impairment rating. The appellant urges that the designated doctor did not properly follow the Commission rules or the American Medical Association’s Guides to the Evaluation of Permanent Impairment, third edition (AMA Guides) and that the report of one of her treating doctors should be recognized which indicates an anticipated MMI date of “11/30/94” and an impairment rating of 16%. Respondent (carrier) outlines the numerous doctors seen and examinations that have been accomplished on claimant, including the reports of a medical examination ordered (MEO) doctor and the designated doctor, and urges that the decision of the hearing officer be upheld.
DECISION
Finding the evidence sufficient to support the determination of the hearing officer and a correct application of the law, we affirm.
The single issue in this case as announced and agreed to by the parties at the beginning of the hearing was: what is claimant’s correct impairment rating for her injury of (date of injury)? That the claimant sustained a wrist injury when she was carrying a box and collided with another employee was not in question. She remained on the job until sometime in April 1991 and over the ensuing months saw a number of doctors and underwent a number of examinations including x-ray, EMG, and MRI, some of which were performed more than once. The hearing officer’s Decision and Order summarizes the pertinent exhibits and is set out below:
A review of the exhibits indicates that CLAIMANT was first seen by (Dr. H) on June 27, 1991. Prior to that time, on April 30, 1991, CLAIMANT had an arthrogram of her left wrist and a bone scan, both of which were normal. On June 5, 1991, CLAIMANT had a normal EMG and normal nerve conduction studies of her left cervical paraspinal area, left shoulder girdle, and left upper extremity. On July 5, 1991, CLAIMANT had another bone scan which showed mildly increased uptake in her left wrist but was otherwise normal. On July 24, 1991, CLAIMANT had a second EMG and nerve conduction studies of both arms, all of which were normal. (Dr. H) notes, on August 22, 1991, that he has referred CLAIMANT to (Dr. M) on CLAIMANT’S request. (Dr. H) also notes that CLAIMANT’S blood work indicates alterations in her liver function which is not caused by her injury but which may have a negative impact on her discomfort and injured joint. CLAIMANT had a negative MRI on left wrist on October 22, 1991. On October 29, 1991, (Dr. R) performed a third EMG and nerve conduction studies. As a result, he diagnosed bilateral carpal tunnel syndrome and thoracic outlet syndrome on the left. On March 4, 1992, CLAIMANT was seen by (Dr. C). In (Dr. C’s) narrative report, he disputes the findings of (Dr. R) indicating that the results of (Dr. R’s) tests on CLAIMANT are normal. (Dr. C) indicated that CLAIMANT had reached maximum medical improvement with a 3% whole body impairment rating. A copy of (Dr. C’s) report was sent to (Dr. Ca), CLAIMANT’S treating doctor at the time, but (Dr. Ca) did not respond to (Dr. C’s) report. On June 11, 1992, the commission appointed (Dr. W) as designated doctor. (Dr. W) examined CLAIMANT and certified that she had reached maximum medical improvement on July 22, 1992, with a 4% whole body impairment rating. On August 18, 1992, (Dr. M), CLAIMANT’S treating doctor, indicated that she had a 16% whole body impairment rating.
We have reviewed all the evidence of record and find no basis to conclude either that the MEO doctor or the designated doctor, an orthopaedic surgeon, failed to perform proper examinations, consider pertinent medical records and tests or to follow appropriate guidelines in rendering their reports. Indeed, it is apparent they considered and rejected the opinion of the claimant’s latest treating doctor. There is no requirement that such reports specifically spell out each paragraph, section or table in the AMA Guides that were considered in arriving at the doctors opinion. See Texas Workers’ Compensation Commission Appeal No. 92393, decided September 17, 1992. The claimant’s assertion of error lacks merit.
The 1989 Act clearly states (Article 8308-4.26) and we have repeatedly held that a designated doctor’s opinion is accorded presumptive weight and is the basis for the impairment rating unless the great weight of the other medical evidence is to the contrary. Texas Workers’ Compensation Commission Appeal No. 92412, decided September 28, 1992, and cases cited therein. See also Texas Workers’ Compensation Commission Appeal No. 92514, decided November 5, 1992; Texas Workers’ Compensation Commission Appeal No. 92553, decided November 30, 1992; Texas Workers’ Compensation Commission Appeal No. 92366, decided September 10, 1992. We fully agree with the hearing officer basing the MMI and impairment rating on the report of the designated doctor and her conclusion the great weight of the other medical evidence is not contrary thereto. Accordingly, the decision is affirmed.
Stark O. Sanders, Jr. – Chief Appeals Judge
CONCUR:
Joe Sebesta – Appeals Judge
Robert W. Potts – Appeals Judge