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 remand because of a lost record on October 22, 2001. The appellant (self-insured) appeals the hearing officer’s determination that the first certification of maximum medical improvement (MMI) and impairment rating (IR) assigned by the treating doctor, Dr. S, on April 27, 1999, did not become final under Tex. W.C. Comm’n, 28 TEX. ADMIN. CODE § Rule 130.5(e) (Rule 130.5(e). The claimant has filed no response.
DECISION
We affirm.
The hearing officer did not err in determining that the first certification of the claimant’s MMI and IR had not become final because the MMI date was prospective. The claimant’s treating doctor, Dr. S, saw the claimant on November 30, 1998, the date of his ankle injury. The claimant was equivocal and indefinite about when he saw Dr. S again; he said that he believed he saw him once or twice within the two months following the injury, during which period of time he was on light duty. He was eventually referred for surgery which he had in December 2000.
In the record, there is a Report of Medical Evaluation (TWCC-69) from Dr. S certifying that the claimant reached MMI on January 1, 1999, and that he had a zero percent impairment. While this TWCC-69 was signed on April 27, 1999 (in apparent response to a letter from the Texas Workers’ Compensation Commission (Commission) asking for a certification of MMI) the report states that it is based on a December 18, 1998, examination. These are the last complete records in the file for an examination by Dr. S, although a follow-up examination date of January 4, 1999, is noted on one of the notes for the December 18 examination. The hearing officer could infer, however, that Dr. S would not have cited the December 18 date in the TWCC-69 he signed in April 1999 if there had been another examination after that date.
We note that the hearing officer determined that the treating doctor’s report was “facially invalid” because it included a prospective date of MMI. We agree. Absent an indication that Dr. S actually saw or continued to treat the claimant after December 18, 1998,[1] the MMI date would be prospective even if the TWCC-69 was signed and dated at a date after the certified MMI date, absent proof of treatment following that date. The Appeals Panel has not applied Rule 130.5(e) to finalize a prospective date of MMI and related IR. Texas Workers’ Compensation Commission Appeal No. 941098, decided September 29, 1994. We affirm the hearing officer’s decision and order.
The true corporate name of the insurance carrier is (SELF-INSURED) and the name and address of its registered agent for service of process is
CT CORPORATION
811 DALLAS AVENUE
HOUSTON, TEXAS 77002.
Susan M. Kelley – Appeals Judge
CONCUR:
Robert W. Potts – Appeals Judge
Thomas A. Knapp – Appeals Judge
- Compare Texas Workers’ Compensation Commission Appeal No. 950359, decided April 24, 1995, where there was evidence that the doctor was continuing to see the injured worker. ↑