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, 2025, with the record closing on May 5, 2025, 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 C3-4 disc bulge or protrusion or a T4-5 disc bulge or protrusion; (2) the appellant (claimant) reached maximum medical improvement (MMI) on June 4, 2024; (3) the claimant’s impairment rating (IR) is zero percent; and (4) the claimant did not have disability from June 5, 2024, through the date of the CCH, resulting from the compensable injury sustained on (date of injury). The claimant appealed the ALJ’s determinations regarding extent of injury, MMI, IR, and disability. The claimant argued on appeal that the ALJ incorrectly stated the facts in his decision. The respondent (carrier) responded, urging affirmance of the appealed determinations.
DECISION
Affirmed in part and reversed and remanded in part.
The parties stipulated, in part, that the claimant sustained a compensable injury on (date of injury), that extends to at least a cervical strain and a lumbar strain; and that the Texas Department of Insurance, Division of Workers’ Compensation (Division) appointed (Dr. S) as designated doctor to address the issues of extent of the compensable injury, MMI, and IR. The claimant, a distribution driver, was injured on (date of injury), when his co-worker suddenly lowered the lift he was standing on and the weight of the furniture he was unloading injured his shoulder and spine.
EXTENT OF INJURY
The ALJ determined the compensable injury does not extend to a C3-4 disc bulge or protrusion or a T4-5 disc bulge or protrusion. In the Discussion portion of his decision, the ALJ stated that Dr. S determined that the disputed conditions were not compensable, as the medical evidence did not support such a finding. He further stated that (Dr. Sm) testified at the hearing that he agreed with the designated doctor that neither condition is related to the compensable injury. The ALJ’s determination that the compensable injury does not extend to a T4-5 disc bulge or protrusion is supported by sufficient evidence and is affirmed.
However, a review of the record in this case indicates that while Dr. Sm testified that the T4-5 disc bulge or protrusion was part of a degenerative process and not compensable, he stated that the C3-4 level is causally related to the work injury. Dr. Sm stated that he agreed with Dr. Marshall, the treating doctor, regarding this level, not the designated doctor as stated by the ALJ.
In this case, The ALJ has misstated the testimony of Dr. Sm regarding the compensability of the C3-4 disc bulge or protrusion. We view the ALJ’s misstatement of the evidence as a material misstatement of fact. While the ALJ can accept or reject in whole or in part the evidence in this case, his determination is based upon the incorrect belief that Dr. Sm testified the C3-4 disc bulge or protrusion is not causally related to the compensable injury. See Appeals Panel Decision (APD) 172522, decided December 6, 2017, and APD 210449, decided May 24, 2021. Accordingly, we reverse the ALJ’s determination that the compensable injury of (date of injury), does not extend to a C3-4 disc bulge or protrusion, and we remand the issue of whether the compensable injury of (date of injury), extends to a C3-4 disc bulge or protrusion for further action consistent with this decision.
MMI AND IR
Because we have reversed and remanded the issue of whether the compensable injury of (date of injury), extends to a C3-4 disc bulge or protrusion, we also reverse the ALJ’s determinations that the claimant reached MMI on June 4, 2024, and that the claimant’s IR is zero percent, and we remand the issues of MMI and IR to the ALJ for further action consistent with this decision.
DISABILITY
Because we have reversed and remanded the issue of whether the compensable injury of (date of injury), extends to a C3-4 disc bulge or protrusion, we also reverse the ALJ’s determination that claimant did not have disability from June 5, 2024, through the date of the CCH, resulting from the compensable injury sustained on (date of injury), and we remand the disability issue to the ALJ for further action consistent with this decision.
SUMMARY
We affirm the ALJ’s determination that the compensable injury of (date of injury), does not extend to a T4-5 disc bulge or protrusion.
We reverse the ALJ’s determination that the compensable injury of (date of injury), does not extend to a C3-4 disc bulge or protrusion, and we remand the issue of whether the compensable injury of (date of injury), extends to a C3-4 disc bulge or protrusion.
We reverse the ALJ’s determination that the claimant reached MMI on June 4, 2024, and we remand the MMI issue 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 IR issue to the ALJ for further action consistent with this decision.
We reverse the ALJ’s determination that claimant did not have disability from June 5, 2024, through the date of the CCH, resulting from the compensable injury sustained on (date of injury), and we remand the disability issue to the ALJ for further action consistent with this decision.
REMAND INSTRUCTIONS
On remand the ALJ is to correct his misstatement of the evidence regarding Dr. Sm’s opinion on the compensability of a C3-4 disc bulge or protrusion. The ALJ shall consider all of the evidence and make findings of fact, conclusions of law, and a determination on whether the compensable injury of (date of injury), extends to a C3-4 disc bulge or protrusion. The ALJ is then to make findings of fact, conclusions of law, and a determination on the claimant’s disability from June 5, 2024, through the date of the CCH; date of MMI; and IR that is supported by the evidence and consistent with this decision.
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 TEXAS MUTUAL INSURANCE COMPANY and the name and address of its registered agent for service of process is
JEANETTE WARD, PRESIDENT AND CEO
2200 ALDRICH ST.
AUSTIN, TEXAS 78723.
Cristina Beceiro
Appeals Judge
CONCUR:
Carisa Space-Beam
Appeals Judge
Margaret L. Turner
Appeals Judge