This appeal arises pursuant to the Texas Workers’ Compensation Act, Tex. Lab. Code Ann. § 401.001 et seq. (1989 Act). A contested case hearing (CCH) was held on March 13, 2025, in (city), Texas, with (administrative law judge) presiding as the administrative law judge (ALJ). The ALJ resolved the disputed issues by deciding that: (1) the compensable injury of (date of injury), does not extend to L4-5 lumbar disc bulge; (2) the appellant (claimant) reached maximum medical improvement (MMI) on January 23, 2024; (3) the claimant’s impairment rating (IR) is zero percent; and (4) the claimant did not have disability from January 23, 2024, through the date of the CCH resulting from the compensable injury sustained on (date of injury). The claimant appealed, disputing the ALJ’s determinations of extent of injury, MMI, IR, and disability. The respondent (carrier) responded, urging affirmance.
DECISION
Affirmed in part and reversed and rendered in part.
The parties stipulated that the claimant sustained a compensable injury on (date of injury), that extends to a lumbar strain and biomechanical back pain; and the Texas Department of Insurance, Division of Workers’ Compensation (Division) appointed (Dr. A) as designated doctor for the purposes of MMI and IR. The claimant testified that he was injured on (date of injury), after shoveling rocks.
EXTENT OF INJURY
The ALJ’s determination that the compensable injury of August 31, 2023, does not extend to L4-5 lumbar disc bulge is supported by sufficient evidence and is affirmed.
DISABILITY
The ALJ’s determination that the claimant did not have disability from January 23, 2024, through the date of the CCH resulting from the compensable injury sustained on (date of injury), is supported by sufficient evidence and is affirmed.
MMI
The ALJ’s determination that the claimant reached MMI on January 23, 2024, is supported by sufficient evidence and is affirmed.
IR
Section 408.125(c) provides that the report of the designated doctor shall have presumptive weight, and the Division shall base the IR on that report unless the preponderance of the other medical evidence is to the contrary, and that, if the preponderance of the medical evidence contradicts the IR contained in the report of the designated doctor chosen by the Division, the Division shall adopt the IR of one of the other doctors.
The ALJ determined that the claimant’s IR was zero percent. Dr. A, the designated doctor, examined the claimant on September 20, 2024, and certified the claimant reached MMI on January 23, 2024, and assessed a five percent IR for the compensable injury. Using the Guides to the Evaluation of Permanent Impairment, fourth edition (1st, 2nd, 3rd, or 4th printing, including corrections and changes as issued by the American Medical Association prior to May 16, 2000) (AMA Guides), Dr. A placed the claimant in Lumbosacral Diagnosis Related Estimate Category II: Minor Impairment. Dr. A noted that the assignment to this category is based upon dysmetria and nonverifiable radicular complaints.
The ALJ specifically found in Finding of Fact No. 4 that Dr. A certified that the claimant reached MMI on January 23, 2024, with a zero percent for the compensable injury and that this certification was not contrary to the preponderance of the other medical evidence. The ALJ then determined that the claimant’s IR is zero percent. It is clear from the discussion of the evidence that the ALJ was persuaded that the claimant’s IR is five percent as certified by the designated doctor but made a typographical error throughout his decision. The ALJ’s finding that the preponderance of the other medical evidence is not contrary to the certification of the designated doctor is supported by the evidence. However, there is no certification from Dr. A, the designated doctor, that the claimant’s IR is zero percent. The ALJ inadvertently determined the claimant’s IR is zero percent, rather than five percent, as actually certified by Dr. A. Accordingly, we reverse the ALJ’s determination that the claimant’s IR is zero percent and render a new decision that the claimant’s IR is five percent to conform to the evidence.
SUMMARY
We affirm the ALJ’s determination that the compensable injury of (date of injury), does not extend to an L4-5 lumbar disc bulge.
We affirm the ALJ’s determination that the claimant did not have disability from January 23, 2024, through the date of the CCH resulting from an injury sustained on (date of injury).
We affirm the ALJ’s determination that the claimant reached MMI on January 23, 2024.
We reverse the ALJ’s determination that the claimant’s IR is zero percent and render a new decision that the claimant’s IR is five percent.
The true corporate name of the insurance carrier is ACE AMERICAN INSURANCE COMPANY and the name and address of its registered agent for service of process is
CT CORPORATION SYSTEM
1999 BRYAN STREET, SUITE 900
DALLAS, TEXAS 75201-3136.
Margaret L. Turner
Appeals Judge
CONCUR:
Cristina Beceiro
Appeals Judge
Carisa Space-Beam
Appeals Judge