Title: 

APD 041112

Significant Decision

Date: 

June 15, 2004

Issues: 

Spinal Surgery Issue Code

Table of Contents

APD 041112

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 April 27, 2004. The hearing officer determined that the decision of the independent review organization that appellant (claimant herein) should not have spinal surgery is supported by a preponderance of the evidence. Claimant appealed this determination, contending that surgery is necessary. Respondent self-insured (carrier herein) responded that the Appeals Panel should affirm the hearing officer’s decision and order.

DECISION

We affirm.

We have reviewed the complained-of determination and conclude that the issue involved a fact question for the hearing officer. The hearing officer reviewed the record and decided what facts were established. We conclude that the hearing officer’s determination is supported by the record and 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).

We affirm the hearing officer’s decision and order.

The true corporate name of the insurance carrier is STATE OFFICE OF RISK MANAGEMENT (a self-insured governmental entity) and the name and address of its registered agent for service of process is

For service in person the address is:

RON JOSSELET, EXECUTIVE DIRECTOR

STATE OFFICE OF RISK MANAGEMENT

300 W. 15TH STREET

WILLIAM P. CLEMENTS, JR. STATE OFFICE BUILDING, 6TH FLOOR

AUSTIN, TEXAS 78701.

For service by mail the address is:

RON JOSSELET, EXECUTIVE DIRECTOR

STATE OFFICE OF RISK MANAGEMENT

P.O. BOX 13777

AUSTIN, TEXAS 78711-3777.

Judy L. S. Barnes

CONCUR:

Daniel R. Barry – Appeals Judge

Elaine M. Chaney – Appeals Judge