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APD 210723
June 25, 2021

APD 210723

June 25, 2021

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 March 1, 2021, with the record closing on April 20, 2021, 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 a left shoulder rotator cuff tear; (2) the appellant (claimant) reached maximum medical improvement (MMI) on May 29, 2018; and (3) the claimant’s impairment rating (IR) is zero percent.

The claimant appealed the ALJ’s determinations of extent of injury, MMI, and IR. The respondent (carrier) responded, urging affirmance of the ALJ’s determinations.


Reversed and remanded for reconstruction of the record.

The ALJ’s decision and order states that the following exhibits were admitted into evidence: ALJ’s Exhibits 1 through 3; Claimant’s Exhibits 1 through 6 and 8 through 15; and Carrier’s Exhibits A through O. The claimant’s exhibit list indicates that Exhibit 6 contains 21 pages of medical records from (Dr. S); however, the case file sent for review contains a blank page for claimant’s Exhibit 6, page 1. Additionally, the claimant’s exhibit list indicates that Exhibit 12 contains a 1-page Employee Report of Injury (DWC-41) dated November 23, 2018; however, the case file sent for review contains a blank page for claimant’s Exhibit 12, page 1. Because the record is incomplete, it must be remanded for the addition or reconstruction of the missing exhibits. See Appeals Panel Decision (APD) 030543, decided April 18, 2003.

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 Texas Department of Insurance, Division of Workers’ Compensation, 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 AMERICAN ZURICH INSURANCE COMPANY and the name and address of its registered agent for service of process is

AUSTIN, TEXAS 78701-3218.

Cristina Beceiro
Appeals Judge


Carisa Space-Beam
Appeals Judge

Margaret L. Turner
Appeals Judge