Title: 

APD 010720

Significant Decision

Date: 

May 15, 2001

Issues: 

Spinal Surgery Issue Code

Table of Contents

APD 010720

This appeal arises pursuant to the Texas Workers’ Compensation Act, TEX. LAB. CODE ANN. § 401.001 et seq. (1989 Act). A spinal surgery contested case hearing was held on March 15, 2001. The hearing officer resolved the disputed issue by approving the respondent’s (claimant) request for spinal surgery. The appellant (carrier) appealed. No response was received from the claimant.

DECISION

The hearing officer’s decision is affirmed.

The hearing officer did not err in approving the claimant’s request for spinal surgery. The parties stipulated that the claimant sustained a compensable spinal injury. Dr. T, the claimant’s treating doctor, referred the claimant to Dr. P, a neurosurgeon, who recommended that the claimant have a laminectomy and disc excision at C5-6 for a herniated disc. Dr. V, the carrier’s second opinion doctor, did not concur with the recommended surgical procedure. Dr. M, the claimant’s second opinion doctor, concurred with the recommended surgical procedure. Tex. W.C. Comm’n, 28 TEX. ADMIN. CODE § 133.206(k)((4) provides that of the three recommendations and opinions (the surgeon’s, and the two second opinion doctors’), presumptive weight will be given to the two which had the same result, and they will be upheld unless the great weight of medical evidence is to the contrary. It is undisputed that Dr. M agreed with the surgery recommended by Dr. P. The carrier appeals the hearing officer’s finding that the great weight of the medical evidence is not contrary to the recommendation for spinal surgery. The carrier contends that the claimant should have undergone more physical therapy as recommended by Dr. V. However, Dr. M wrote that the claimant had had an adequate trial of conservative treatment and doubted that the claimant would improve without surgery. We conclude that the hearing officer’s decision is supported by sufficient evidence and that it is not so against the great weight and preponderance of the evidence as to be clearly wrong and unjust.

The hearing officer’s decision and order are affirmed.

Robert W. Potts – Appeals Judge

CONCUR:

Elaine M. Chaney – Appeals Judge

Susan M. Kelley – Appeals Judge