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 November 6, 2025, in (city), Texas, with (administrative law judge) presiding as the administrative law judge (ALJ). The ALJ resolved the disputed conditions by determining that: (1) the compensable injury of (date of injury), extends to brain fog, long term memory loss, vertigo, thought disorganization, episodic confusion, and cognitive challenges, but does not extend to chronic insomnia, nausea, or fatigue; (2) the respondent/cross-appellant (claimant) reached maximum medical improvement (MMI) on December 5, 2024; and (3) the claimant’s impairment rating (IR) is 10%. The appellant/cross-respondent (carrier) appealed, disputing the ALJ’s extent-of-injury determinations in favor of the claimant, as well as the ALJ’s MMI and IR determinations. The claimant cross-appealed, disputing the ALJ’s extent-of-injury determination adverse to him, as well as the ALJ’s MMI and IR determination. The carrier responded, urging affirmance of the ALJ’s extent-of-injury determination adverse to the claimant. There is no response from the claimant to the carrier’s appeal.
DECISION
Affirmed on other grounds in part and reversed and rendered in part.
The parties stipulated, in part, that the claimant sustained a compensable injury on (date of injury), in the form of at least a concussion with loss of consciousness, short term memory loss, and headaches; (Dr. B) was the designated doctor selected by the Texas Department of Insurance, Division of Workers’ Compensation on extent of injury, MMI, and IR; and the statutory date of MMI is August 5, 2025. The claimant, a senior head field service technician, was injured when a large latch swung down and hit him on the left side of his head.
EXTENT OF INJURY
That portion of the ALJ’s determination that the compensable injury does not extend to chronic insomnia, nausea, or fatigue is supported by sufficient evidence and is affirmed.
The ALJ also determined that the compensable injury extends to brain fog, long term memory loss, vertigo, thought disorganization, episodic confusion, and cognitive challenges. The ALJ noted in his discussion statements made by Dr. B in his reports that the claimant’s mental status examinations were “consistent with typical symptoms of a concussion including brain fog, persistent headaches, concentration, and memory difficulty, dizziness, and word finding problems. These symptoms are termed neurocognitive deficits and can be commonly found after a concussion.” The ALJ also pointed out that Dr. B had reported the claimant did have mental status impairments of memory loss, and Dr. B stated that “short-term memory loss and headaches are common after a significant concussion and are considered to be inclusive under the umbrella diagnosis of concussion.” The ALJ concluded that, “[c]onsidering the evidence as a whole, including [Dr. B’s] reports, the evidence was sufficient to establish a causal relationship” between the compensable injury and the disputed conditions he found in favor for the claimant.
Dr. B examined the claimant on February 12, 2025, and on that date certified the claimant reached MMI on December 5, 2024, with a 10% IR based on a concussion with loss of consciousness. Dr. B did make the statements attributed to him by the ALJ regarding the claimant’s mental status examinations being consistent with typical symptoms of a concussion including brain fog, concentration, memory difficulty, and word finding problems. Dr. B was not at that time asked to opine on the extent of the claimant’s injury.
Dr. B then examined the claimant on August 12, 2025, for the issues of MMI, IR, and extent of the claimant’s compensable injury. Dr. B included a table summarizing his opinion on the disputed conditions in which he indicated the conditions of concussion with loss of consciousness, short term memory loss, and headaches were a result of the compensable injury. We note these are the conditions stipulated to by the parties as being part of the compensable injury.
However, Dr. B’s table reflects that the remaining disputed conditions of brain fog, long term memory loss, vertigo, thought disorganization, episodic confusion, and cognitive changes are not the result of the compensable injury. Dr. B noted in his report that the claimant had a brain MRI scan before the compensable injury for complaints of persistent dizziness and disequilibrium for six months. Dr. B noted this brain MRI was abnormal and showed that the claimant had cerebrovascular disease and small strokes before the work injury. Dr. B noted a brain CT scan and two brain MRI scans after the injury did not show any new acute changes from the head injury. Dr. B opined that “[a] one-time concussion diagnosis and recovery does not deteriorate over time, but stabilizes, so it is my opinion that his brain disorder that (sic) may be causing increasing neurocognitive symptoms and deficits are not from his work injury, but due to unrelated brain pathology and likely due to cerebrovascular disease.”
Regarding brain fog, Dr. B noted this is not really a diagnosis but a symptom which can be due to a variety of metabolic, brain, or toxic disorders. Dr. B also noted that no healthcare provider in the record had specified it as a distinct separate diagnosis, and he does not consider this a separate compensable diagnosis.
Regarding long term memory loss, Dr. B noted the claimant demonstrated intact long term memory and he did not see any credible evidence in the claimant’s medical records of long term memory loss that was consistent or tied to the work injury. Dr. B noted that long term memory losses are not characteristic of a concussion diagnosis but rather points to other brain disorders.
Regarding vertigo, Dr. B acknowledged that symptoms of vertigo can be seen in early stages after a concussion with loss of consciousness, but it almost always gradually resolves over time. Dr. B noted vertigo is a common ordinary condition of life and persistent vertigo is not characteristic of concussion and, given the September 2022 MRI, the claimant had been having this condition prior to the work injury and therefore concluded vertigo is not part of the compensable injury.
Regarding thought disorganization, Dr. B stated this is a symptom that can be seen in the early stages after a concussion with loss of consciousness, but it gradually resolves over time. Dr. B noted that the symptom is vague and not specific as to its meaning, though it is a common symptom seen in serious mental disorders such as cerebrovascular diseases and brain degenerative disorders, among other disorders. Dr. B also pointed out that the claimant’s healthcare providers had not specified this symptom as a diagnosis.
Regarding episodic confusion, Dr. B also acknowledged this is a symptom that can be seen in the early stages after a concussion with loss of consciousness, but it gradually resolves over time and is a symptom rather than a specific diagnosis. Dr. B noted that review of the claimant’s medical records failed to show credible evidence of this complaint or symptom, and persistent episodic confusion is not characteristic of a concussion with loss of consciousness but can be seen in other brain disorders.
Regarding cognitive challenges, Dr. B stated this is a symptom and not specific as to its meaning. Dr. B acknowledged the symptom can be seen in the early stages after a concussion, but it gradually resolves over time, are common ordinary conditions of life and not unique to concussions, and if persistent, various medical, neurological, and psychological diagnoses need to be considered.
There was no other causation for the disputed conditions in evidence. Given Dr. B’s reports regarding the disputed conditions, that portion of the ALJ’s determination that the compensable injury extends to brain fog, long term memory loss, vertigo, thought disorganization, episodic confusion, and cognitive challenges is so against the great weight and preponderance of the evidence as to be clearly wrong and manifestly unjust. Accordingly, we reverse the ALJ’s determination and render a new decision that the compensable injury does not extend to brain fog, long term memory loss, vertigo, thought disorganization, episodic confusion, and cognitive challenges.
MMI/IR
The ALJ determined the claimant reached MMI on December 5, 2024, with a 10% IR in accordance with Dr. B’s certification. In evidence are multiple certifications from Dr. B from examinations conducted on February 12, 2025, and August 12, 2025. In each of these certifications Dr. B certified the claimant reached MMI on December 5, 2024, with a 10% IR, based on various conditions. One of the certifications from the August 12, 2025, examination considered the compensable injury in this case, which is a concussion with loss of consciousness, short term memory loss, and headaches, and was made in accordance with 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). There were no other certifications in evidence that rate the compensable injury. We affirm on other grounds the ALJ’s determinations that the claimant reached MMI on December 5, 2024, and that the claimant’s IR is 10%.
SUMMARY
We affirm that portion of the ALJ’s determination that the compensable injury does not extend to chronic insomnia, nausea, or fatigue.
We reverse that portion of the ALJ’s determination that the compensable injury extends to brain fog, long term memory loss, vertigo, thought disorganization, episodic confusion, and cognitive challenges, and we render a new decision that the compensable injury does not extend to brain fog, long term memory loss, vertigo, thought disorganization, episodic confusion, and cognitive challenges.
We affirm on other grounds the ALJ’s determinations that the claimant reached MMI on December 5, 2024, and that the claimant’s IR is 10%.
The true corporate name of the insurance carrier is HARTFORD UNDERWRITERS 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.
Carisa Space-Beam
Appeals Judge
CONCUR:
Cristina Beceiro
Appeals Judge
Margaret L. Turner
Appeals Judge