APD 250877
The Appeals Panel affirmed the ALJ’s determinations that the claimant reached maximum medical improvement (MMI) on November 5, 2024, and did not have disability on that date. However, the Panel reversed and remanded the impairment rating (IR) determination because the designated doctor’s report contained inconsistent range-of-motion measurements for supination of the left elbow, and clarification was needed.
APD 250740
The Appeals Panel reversed and remanded this case because the audio record from the contested case hearing was incomplete.
APD 250785
The Appeals Panel affirmed that the claimant’s compensable injury included shortness of breath, pulmonary symptoms, and loss of consciousness but did not include other alleged conditions such as rib fracture, panic attacks, or depression. The Panel also affirmed that the claimant had disability from April 26, 2023, through the date of the hearing. However, the decision was reversed and remanded on the issues of maximum medical improvement (MMI), impairment rating (IR), and whether the initial MMI/IR certification became final, because the ALJ failed to issue the required findings of fact and conclusions of law.
APD 250725
The Appeals Panel affirmed in part and reversed in part the ALJ’s decision. The panel upheld the ruling that the claimant’s compensable injury did not extend to an L5-S1 annular tear or lumbar spine degenerative disc disease. However, it reversed the ALJ’s findings on the L5-S1 disc bulge and lumbar facet syndrome, noting the ALJ misstated the evidence regarding the designated doctor’s opinion. The panel also reversed the determinations of maximum medical improvement and impairment rating, remanding all three issues—extent of injury, MMI, and IR—for further proceedings consistent with the ruling.
APD 250824
The Appeals Panel reversed and remanded the ALJ’s decision that the claimant reached maximum medical improvement on August 8, 2024, with a four percent impairment rating. The claimant failed to attend the contested case hearing and did not respond to a 10-day letter, later explaining she was in a rehabilitation facility due to spine surgery. Because her allegations, if true, could establish good cause for her absence, the panel remanded the case for the ALJ to determine good cause and, if found, to allow the parties to present evidence on the merits of the claim.
APD 250653
The Appeals Panel affirmed the ALJ’s determination that the claimant reached maximum medical improvement on February 20, 2023, but reversed the impairment rating. The designated doctor had assigned a 4% impairment rating, but the Appeals Panel found that this rating did not accurately reflect the claimant’s right knee range of motion measurements under the AMA Guides. After mathematically correcting the impairment rating based on those measurements, the Panel rendered a new decision assigning an 8% impairment rating.
APD 250669
The Appeals Panel affirmed the administrative law judge’s decision that the claimant’s compensable injury included a right shoulder strain but did not include other alleged spine and radiculopathy conditions. The Appeals Panel reversed and rendered the determinations on maximum medical improvement and impairment rating, deciding that the claimant reached MMI on December 6, 2024, with a six percent impairment rating, rather than on November 27, 2023, with zero percent as previously found. The Panel also affirmed there was no disability for the period from November 10, 2023, through August 1, 2024.
APD 250669
The Appeals Panel affirmed the ALJ’s findings that the compensable injury did not extend to several disputed spine conditions and that the claimant did not have disability for a specific time period. However, the Panel reversed the ALJ’s determinations on maximum medical improvement and impairment rating, finding that the designated doctor’s report failed to rate the full extent of the compensable injury. The panel rendered a new decision that the claimant reached MMI on December 6, 2024, with a six percent impairment rating based on a certification that properly rated all accepted injury components.
APD 250615
The Appeals Panel affirmed the ALJ’s determination that the compensable injury did not extend to numerous additional diagnoses, including various shoulder, knee, wrist, and spinal conditions. However, the Panel reversed the ALJ’s determinations of maximum medical improvement and impairment rating, finding that the adopted certification improperly included non-compensable conditions. The Panel rendered a new decision, concluding that the claimant reached MMI on August 30, 2023, with a 0% impairment rating based on a certification that correctly rated only the compensable injuries.
APD 250637
The Appeals Panel reversed the administrative law judge’s decision that the claimant reached maximum medical improvement (MMI) on October 31, 2023, with a 12% impairment rating, because the designated doctor failed to rate the entire compensable injury as required by Texas workers’ compensation law.