APD 260515
The Appeals Panel affirmed the ALJ’s determination that the claimant had disability from May 1, 2025, through the contested case hearing. It reversed the finding that Dr. R’s February 1, 2024 MMI/IR certification was not delivered by verifiable means, holding that delivery occurred on February 24, 2024, and remanded for findings on whether the certification became final, including the dispute date and any Section 408.123(f) exceptions.
APD 260534
The Appeals Panel reversed and remanded the ALJ’s determination that Dr. G’s May 8, 2025 MMI/IR certification did not become final under Section 408.123 and Rule 130.12. The Panel held that the certification was valid despite a typographical error in the certification date because it was signed by an authorized doctor, assigned a zero percent IR, and used a non-prospective MMI date.
APD 260323
The Appeals Panel affirmed the ALJ’s determination that the claimant had disability from July 10, 2025, through December 28, 2025, while the unappealed finding of no disability from December 29, 2025, through the CCH became final. It reversed the ALJ’s determination that Dr. L’s July 1, 2024 MMI/IR certification did not become final, holding that it was the first valid subsequent certification after the prior final decision overturned the earlier certification.
APD 260490
The Appeals Panel affirmed the ALJ’s finding that the compensable injury did not include an L5-S1 disc protrusion but found the decision incomplete for failing to address whether it included an L5-S1 disc herniation. The case was reversed in part and remanded for further findings on that unresolved extent-of-injury issue.
APD 260449
The Appeals Panel reversed the ALJ’s decision denying extent of injury to multiple left shoulder conditions after finding the ALJ abused her discretion by failing to issue a Presiding Officer’s Directive to the designated doctor. Because the designated doctor never evaluated the disputed conditions due to administrative error, the case lacked necessary medical evidence. The matter was remanded for the ALJ to obtain a new designated doctor opinion addressing the disputed conditions and then issue a new extent-of-injury determination.
APD 260374
The Appeals Panel reversed the ALJ’s denial of supplemental income benefits after finding the decision was based on a material misstatement of the evidence regarding the claimant’s job search efforts. The record showed the claimant met the required number of weekly job searches, contrary to the ALJ’s finding.
APD 260223
The Appeals Panel reversed the ALJ’s determinations on extent of injury, maximum medical improvement (MMI), and impairment rating (IR), and remanded the case for further proceedings. The reversal was based on procedural error, as the ALJ closed the record and issued a decision before the agreed two-week period for submitting additional evidence—specifically a neuropsychological evaluation—had expired. Because the claimant was not afforded a full opportunity to present this evidence, the prior findings (including a zero percent IR and MMI date) could not stand.
APD 260120
The Appeals Panel affirmed the ALJ’s determination that the compensable injury did not extend to additional right shoulder conditions and that Dr. F’s certification of MMI and impairment rating did not become final. However, it reversed the ALJ’s MMI determination and rendered a new finding that the claimant reached MMI on August 8, 2023, based on a valid designated doctor certification that considered only the compensable injury. The Panel also affirmed the zero percent impairment rating but reformed it to rely on the proper certification from the designated doctor.
APD 252109
The Appeals Panel affirmed the ALJ’s extent-of-injury determinations, including that the compensable injury extended to a 5th metatarsal fracture and metatarsalgia but did not include other disputed foot conditions. However, the Panel reversed the ALJ’s finding that the claimant had not reached MMI because the designated doctor’s certification improperly included non-compensable conditions.
APD 252111
The Appeals Panel affirmed the ALJ’s determination that the claimant reached maximum medical improvement (MMI) on December 30, 2024. However, the Panel reversed the 4% impairment rating (IR) because the designated doctor’s calculation contained errors under the AMA Guides and could not be adopted. After reviewing a corrected clarification report from the designated doctor, the Panel rendered a new decision that the claimant’s IR is 11%.