APD 211091-s
The Appeals Panel reversed the Administrative Law Judge’s decision that the certification of maximum medical improvement became final. The Appeals Panel found that there was compelling evidence of a significant error in applying the AMA Guides. Specifically, the Appeals Panel determined that impairments in the same lower extremity part must be added rather than combined. This decision overturned prior Appeals Panel decisions.
APD 210939
The Appeals Panel reversed the Administrative Law Judge’s decision regarding impairment rating for CRPS. The Appeals Panel found that, while the doctor used Table 68 on page 3/89 to assess an impairment for the claimant’s left lower extremity CRPS, the doctor failed to use the Causalgia and RSD Section 3.1k on page 3/56 of the AMA Guides. Because of this, the doctor’s impairment rating could not be adopted.
APD 211148
The Appeals Panel reversed the administrative law judge’s decision on maximum medical improvement and impairment rating because there was no certification that rated the entire compensable injury.
APD 211157
The Appeals Panel reversed the decision of the Administrative Law Judge to make a mathematical correction to the certification of maximum medical improvement / impairment rating.
APD 211064
The Appeals Panel reversed the Administrative Law Judge’s decision regarding the issue of Timely Filing of a Claim. The Appeals Panel noted that, although the Administrative Law Judge made a conclusion of law, decision, and discussed the timely filing of a claim in the discussion of the evidence, the Administrative Law Judge failed to make a finding of fact whether the claimant timely filed a claim for compensation with the Division.
APD 210916
The Appeals Panel reversed the administrative law judge’s decision on impairment rating because there was no certification that rated the entire compensable injury or matched the date of maximum medical improvement.
APD 211000
The Appeals Panel reversed the administrative law judge’s decision on impairment rating because there was no certification that rated the entire compensable injury or matched the date of maximum medical improvement.
APD 211005
The Appeals Panel reversed the Administrative Law Judge’s decision that the claimant did not sustain an occupational injury in the form of COVID-19. The Appeals Panel reasoned that because this claim was pending at the time S.B. 22 went into effect, the new presumption provisions set forth in Sections 607.0545 and 607.058 of the Government Code apply.
APD 211085
The Appeals Panel reformed the decision because the Administrative Law Judge failed to modify the disability issue as agreed to by the parties.
APD 211026-s
The Appeals Panel reversed the administrative law judge’s decision that the claimant suffered a compensable COVID-19 injury. The Appeals Panel found that the administrative law judge improperly applied Section 607.054 of the Texas Government Code (presumption for first responders) in making the determination. However, the Appeals Panel noted that a new presumption created by Senate Bill 22 (Section 607.0545 of the Government Code) applies to claims that were pending at the time the law went into effect (June 14, 2021). Since the case at bar was pending at the time the new law went into effect, the Appeals Panel remanded the matter for further consideration applying the new presumption.