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 February 13, 2019, 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 an annular bulge and mild facet arthrosis at L2-3, a disc bulge and stenosis at L4-5, foraminal narrowing and degenerative changes at L5-S1, or L5 radiculopathy; (2) the appellant (claimant) reached maximum medical improvement (MMI) on March 20, 2018; and (3) the claimant’s impairment rating (IR) is zero percent. The claimant appealed, disputing the ALJ’s determinations. The respondent (carrier) responded, urging affirmance of the ALJ’s determinations.
DECISION
Reversed and remanded.
The parties stipulated, in part, that the claimant sustained a compensable injury on (date of injury), that consisted of a mild concussion, cervical sprain/strain, lumbar sprain/strain, and contusions to the right arm and hand. The claimant testified she was injured when she fell backward onto a concrete floor while attempting to retrieve a mannequin from a shelf. We note the stipulation in Finding of Fact No. 1.C. incorrectly states the parties stipulated the compensable injury consists of “concussions” to the right arm and hand, when in fact the parties stipulated that the compensable injury consists of contusions to the right arm and hand. We also note the same mistake is made in the discussion.
EXTENT OF INJURY
Section 410.168 provides that an ALJ’s decision contain findings of fact and conclusions of law, a determination of whether benefits are due, and an award of benefits due. 28 TEX. ADMIN. CODE § 142.16 (Rule 142.16) provides that an ALJ’s decision shall be in writing and include findings of fact, conclusions of law, and a determination of whether benefits are due and if so, an award of benefits due.
The extent-of-injury issue as stated on the Benefit Review Conference Report and as agreed to by the parties at the CCH was whether the compensable injury of (date of injury), extends to an annular bulge and mild facet arthrosis at L2-3, a disc bulge and stenosis at L4-5, foraminal narrowing and degenerative changes at L5-S1, and L5 radiculopathy. Finding of Fact No. 3 states that “[t]he compensable injury of (date of injury) was not a producing case [sic] of (then list all the conditions), and was not a producing case [sic] of an acceleration, enhancement or worsening of those conditions.” Although Conclusion of Law No. 3 and the decision state that the compensable injury of (date of injury), does not extend to an annular bulge and mild facet arthrosis at L2-3, a disc bulge and stenosis at L4-5, foraminal narrowing and degenerative changes at L5-S1, or L5 radiculopathy, the ALJ made no specific finding of fact regarding the compensability of the disputed conditions as required by Section 410.168 and Rule 142.16. See Appeals Panel Decision (APD) 132339, decided December 12, 2013; APD 150510, decided April 21, 2015; APD 162262, decided January 10, 2017; APD 181349, decided August 15, 2018; see also Section 410.168 and Rule 142.16.
Accordingly, we reverse the ALJ’s determination that the compensable injury of (date of injury), does not extend to an annular bulge and mild facet arthrosis at L2-3, a disc bulge and stenosis at L4-5, foraminal narrowing and degenerative changes at L5-S1, or L5 radiculopathy as being incomplete, and we remand the issue of whether the compensable injury of (date of injury), extends to an annular bulge and mild facet arthrosis at L2-3, a disc bulge and stenosis at L4-5, foraminal narrowing and degenerative changes at L5-S1, and L5 radiculopathy to the ALJ to make findings of fact on that issue.
MMI AND IR
The ALJ determined that the claimant reached MMI on March 20, 2018, with a zero percent IR, as certified by (Dr. S), the designated doctor appointed by the Texas Department of Insurance, Division of Workers’ Compensation (Division). However, given that we have reversed the ALJ’s decision as being incomplete and have remanded the issue of whether the compensable injury of (date of injury), extends to an annular bulge and mild facet arthrosis at L2-3, a disc bulge and stenosis at L4-5, foraminal narrowing and degenerative changes at L5-S1, and L5 radiculopathy, we also reverse the ALJ’s determinations that the claimant reached MMI on March 20, 2018, with a zero percent IR. We remand the issues of MMI and IR to the ALJ for further action consistent with this decision.
SUMMARY
We reverse the ALJ’s determination that the compensable injury of (date of injury), does not extend to an annular bulge and mild facet arthrosis at L2-3, a disc bulge and stenosis at L4-5, foraminal narrowing and degenerative changes at L5-S1, or L5 radiculopathy, and we remand the issue of whether the compensable injury of (date of injury), extends to an annular bulge and mild facet arthrosis at L2-3, a disc bulge and stenosis at L4-5, foraminal narrowing and degenerative changes at L5-S1, and L5 radiculopathy for further action consistent with this decision.
We reverse the ALJ’s determination that the claimant reached MMI on March 20, 2018, and we remand the issue of MMI to the ALJ for further action consistent with this decision.
We reverse the ALJ’s determination that the claimant’s IR is zero percent and we remand the issue of IR to the ALJ for further action consistent with this decision.
REMAND INSTRUCTIONS
On remand the ALJ is to make findings of fact, conclusions of law, and a decision as to whether the compensable injury of (date of injury), extends to an annular bulge and mild facet arthrosis at L2-3, a disc bulge and stenosis at L4-5, foraminal narrowing and degenerative changes at L5-S1, and L5 radiculopathy. The ALJ is then to make a decision regarding the claimant’s date of MMI and IR. Additionally, the ALJ is to correct the stipulation in Finding of Fact No. 1.C. to reflect the stipulation made by the parties at the CCH.
Pending resolution of the remand, a final decision has not been made in this case. However, since reversal and remand necessitate the issuance of a new decision and order by the ALJ, a party who wishes to appeal from such new decision must file a request for review not later than 15 days after the date on which such new decision is received from the Division, pursuant to Section 410.202 which was amended June 17, 2001, to exclude Saturdays and Sundays and holidays listed in Section 662.003 of the Texas Government Code in the computation of the 15-day appeal and response periods. See APD 060721, decided June 12, 2006.
The true corporate name of the insurance carrier is SAFETY NATIONAL CASUALTY CORPORATION and the name and address of its registered agent for service of process is
CORPORATION SERVICE COMPANY
211 EAST 7TH STREET, SUITE 620
AUSTIN, TEXAS 78701-3218.
Carisa Space-Beam – Appeals Judge
CONCUR:
Cristina Beceiro – Appeals Judge
Margaret L. Turner – Appeals Judge