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 June 18, 2025, with the record closing on July 24, 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 sustained on (date of injury), does not extend to a left shoulder rotator cuff tear, disc bulges at C3-4, C4-5, or C5-6, thoracic strain, or dysphagia; (2) the appellant (claimant) reached maximum medical improvement (MMI) on October 29, 2022; and (3) the claimant’s impairment rating (IR) is 12%. The claimant appealed, disputing the ALJ’s determinations of extent of injury, MMI, and IR. The claimant contends on appeal that the ALJ made a misstatement of the evidence describing (Dr. C) opinion on extent of injury. The respondent (carrier) responded, urging affirmance of the ALJ’s 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 includes at least a left shoulder strain, cervical strain, and cervical sprain. The claimant testified that she was injured when she was hit by a door injuring her left shoulder, neck, and back.
EXTENT OF INJURY
The ALJ’s determination that the compensable injury does not extend to a left shoulder rotator cuff tear, disc bulge at C3-4, thoracic strain, or dysphagia is supported by sufficient evidence and is affirmed.
The ALJ in her discussion of the evidence states, in part, that Dr. C, a treating doctor referral, opined that the disc bulges at C4-5 and C5-6 were not related to the compensable injury. However, in his narrative report dated May 16, 2025, Dr. C stated that in his medical opinion the designated doctor was correct in determining that the mechanism of injury was the substantial factor in causing the compensable injury and its sequelae to her C4-5 and C5-6 disc protrusions resulting in spine surgery.
In this case, The ALJ has misstated the opinion of Dr. C regarding the compensability of the C4-5 and C5-6 disc bulges. 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, her determination is based upon the incorrect belief that Dr. C opined the C4-5 and C5-6 disc bulges were 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 disc bulges at C4-5 or C5-6, and we remand the issue of whether the compensable injury of (date of injury), extends to disc bulges at C4-5 or C5-6 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 disc bulges at C4-5 or C5-6, we also reverse the ALJ’s determinations that the claimant reached MMI on October 29, 2022, and that the claimant’s IR is 12%, and we remand the issues of MMI and IR 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 left shoulder rotator cuff tear, disc bulge at C3-4, thoracic strain, or dysphagia.
We reverse the ALJ’s determination that the compensable injury of (date of injury), does not extend to disc bulges at C4-5 or C5-6, and we remand the issue of whether the compensable injury of (date of injury), extends to disc bulges at C4-5 or C5-6 for further action consistent with this decision.
We reverse the ALJ’s determination that the claimant reached MMI on October 29, 2022, 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 12%, and we remand the IR issue to the ALJ for further action consistent with this decision.
REMAND INSTRUCTIONS
On remand the ALJ is to correct her misstatement of the evidence regarding Dr. C’s opinion on the compensability of disc bulges at C4-5 and C5-6. 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 disc bulges at C4-5 or C5-6. The ALJ is then to make findings of fact, conclusions of law, and a determination on the 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 MERIDIAN SECURITY INSURANCE COMPANY 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.
Margaret L. Turner
Appeals Judge
CONCUR:
Cristina Beceiro
Appeals Judge
Carisa Space-Beam
Appeals Judge