This appeal arises pursuant to the Texas Workers’ Compensation Act, TEX. LAB. CODE ANN. § 401.001 et seq. (1989 Act). A contested case hearing was held on September 13, 1999, in_________, Texas, with ________presiding as hearing officer. With respect to the issues before her, the hearing officer determined that: (1) the ganglion cyst of the appellant/cross-respondent (claimant) is a result of the _________, compensable injury; and (2) the first certification of maximum medical improvement (MMI) and impairment rating (IR) assigned by Dr. V (Dr. V) on August 27, 1997, became final under the 90-day rule. Claimant appeals the 90-day rule determination, contending that he disputed the first certification within 90 days. Respondent/cross-appellant (carrier) responds that the hearing officer’s determination regarding the 90-day rule is correct. In its cross-appeal, carrier appealed the determination that the ganglion cyst was a result of the _________, compensable injury. Claimant responds that the Appeals Panel should affirm the hearing officer’s determination in that regard.
DECISION
We affirm.
Claimant contends the hearing officer erred in determining that the first certification of MMI and IR (the “first certification”) became final pursuant to the 90-day rule. Claimant asserts that he timely disputed the first certification when he filed his September 1997 Employee’s Request to Change Treating Doctors (TWCC-53).
The parties stipulated that on _________, claimant sustained a compensable injury. On August 27, 1997, Dr. V certified that claimant reached MMI on that same date, with a one percent IR. Claimant testified that he injured his hand and wrist when a drum crushed his hand between the drum and a truck. Claimant’s TWCC-53 stated, “I am not satisfied with treatment from [Dr. V]. [Dr. V] does not understand my injury or pain.”
The hearing officer determined that: (1) Dr. V was the first doctor to certify MMI and IR; (2) Dr. V certified that claimant reached MMI on August 27, 1997, with a one percent IR; (3) in mid-September 1997, claimant filed a TWCC-53 requesting to change treating doctors from Dr. V to Dr. A (Dr. A); (4) claimant’s nephew signed for a copy of Dr. V’s Report of Medical Evaluation (TWCC-69), sent by carrier to claimant, on September 6, 1997; (5) 90 days from September 6, 1997, is December 5, 1997; (6) claimant did not file a dispute until January 20, 1998; and (7) the first certification became final pursuant to Tex. W.C. Comm’n, 28 TEX. ADMIN. CODE § 130.5(e) (Rule 130.5(e) or the “90-day rule”).
Rule 130.5(e) provides that the first IR assigned to an injured worker will become final if not disputed within 90 days after the doctor assigned it. The 90-day period starts to run from the date that written notice is received. Texas Workers’ Compensation Commission Appeal No. 92693, decided February 8, 1993. The filing of a TWCC-53 is not, in and of itself, a valid dispute of MMI and IR unless it mentions the claimant’s desire to dispute the first certification of MMI and IR. Texas Workers’ Compensation Commission Appeal No. 961232, decided August 8, 1996.
The 1989 Act provides that the hearing officer is the sole judge of the weight and credibility of the evidence. Section 410.165(a). Where there are conflicts in the evidence, the hearing officer resolves the conflicts and determines what facts the evidence has established. As an appeals body, we will not substitute our judgment for that of the hearing officer when the determination is not so against the great weight and preponderance of the evidence as to be clearly wrong or manifestly unjust. Cain v. Bain, 709 S.W.2d 175, 176 (Tex. 1986); Texas Workers’ Compensation Commission Appeal No. 950456, decided May 9, 1995.
The hearing officer heard the testimony from claimant and reviewed the TWCC-53. The hearing officer determined whether claimant disputed the first certification by filing the TWCC-53. We have reviewed the language claimant used in his TWCC-53 and we conclude that the hearing officer’s determination that there was no valid dispute by claimant is not so against the great weight and preponderance of the evidence as to be clearly wrong or manifestly unjust. Cain, supra.
In its cross-appeal, carrier contends the hearing officer erred in determining that claimant’s ganglion cyst is a result of the _________, injury. Carrier asserts that claimant did not injure his wrist, that he did not seek immediate medical attention for the ganglion cyst, and that the report of Dr. P (Dr. P) shows that the ganglion cyst is not related to the injury.
Claimant testified that when the drum crushed his hand, his thumb was broken in two places, that the drum contacted his whole hand and wrist, and that his hand and wrist were swollen after the injury. In a December 11, 1997, letter, Dr. S (Dr. S) stated that claimant noticed a ganglion cyst in his wrist after his cast was removed, that the occurrence of a ganglion cyst generally follows trauma, that it is not conceivable that such a cyst would form immediately after the injury, and that a ganglion cyst would present itself several weeks or months later. Dr. S then said that “further work” on claimant’s hand is “compensable.”
Under the 1989 Act, the claimant has the burden of proving that he sustained a compensable injury and the extent of the injury. Texas Workers’ Compensation Commission Appeal No. 950537, decided May 24, 1995. The 1989 Act defines injury, in pertinent part, as “damage or harm to the physical structure of the body and a disease or infection naturally resulting from the damage or harm.” Existence and extent of injury are fact questions for the hearing officer. Texas Workers’ Compensation Commission Appeal No. 951959, decided January 3, 1996. The hearing officer is the sole judge of the weight and credibility to be given to the evidence and the relevance and materiality to assign to the evidence. Section 410.165(a). As the fact finder, the hearing officer is charged with the responsibility to resolve the conflicts in the evidence, including the medical evidence. Texas Employers Insurance Association v. Campos, 666 S.W.2d 286 (Tex. App.-Houston [14th Dist.] 1984, no writ). The hearing officer may believe all, none, or any part of any witness’s testimony and may properly decide what weight she should assign to the evidence before her. Campos. We will not substitute our judgment for the hearing officer’s where her determinations are supported by sufficient evidence. Cain, supra.
In this case, the hearing officer weighed the evidence and determined that claimant’s ganglion cyst is a result of the _________, injury. This extent-of-injury issue involved a fact question for the hearing officer, which she resolved. Appeal No. 951959, supra. The hearing officer could decide to believe all, none, or any part of the evidence and decided what weight to give to the evidence in this case. Campos, supra. There was medical evidence from Dr. S to support the hearing officer’s determination. The fact that there was also contrary medical evidence of causation was for the hearing officer to consider in resolving the fact issues in the case. After reviewing the evidence we conclude that the hearing officer’s determination is not so against the great weight and preponderance of the evidence as to be wrong or manifestly unjust. Cain, supra.
We affirm the hearing officer’s decision and order.
Judy Stephens – Appeals Judge
CONCUR:
Philip F. O’Neill – Appeals Judge
Dorian E. Ramirez – Appeals Judge