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 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 251691
The Appeals Panel affirmed the ALJ’s extent-of-injury findings and the correct disability period but reversed other portions of the decision. The Panel held that the ALJ exceeded the scope of the disability issue by awarding disability outside the agreed dates, and those portions were struck. The Panel also ruled that the ALJ erred in finding the first MMI/IR certification was not delivered by verifiable means, concluding instead that delivery occurred on July 16, 2024, which required remand to determine whether finality applied under Labor Code §408.123.
APD 251621
The Appeals Panel reversed all disputed determinations because the designated doctor did not have the complete medical record, including the missing emergency department records he expressly requested, before issuing opinions on extent of injury, MMI, IR, and disability.
APD 251474
The Appeals Panel affirmed the ALJ’s findings that the worker’s compensable right knee injury extended to a complex tear of the medial meniscus and that the claimant had not reached maximum medical improvement, so an impairment rating could not yet be assigned. The panel also affirmed that the claimant had disability from December 9 through December 22, 2024. However, it reversed the ALJ’s finding of disability on December 23, 2024, ruling that the evidence showed the claimant had returned to work that day and was no longer disabled.
APD 251365
The Appeals Panel reversed and remanded the ALJ’s findings that the claimant reached maximum medical improvement (MMI) on the date of injury with a 0% impairment rating. The designated doctor had refused to consider the claimant’s compensable post-traumatic stress disorder (PTSD) in his MMI and IR determinations, which violated the requirement to evaluate the entire compensable injury. The panel ordered the appointment of a new designated doctor to reassess both MMI and IR, ensuring that PTSD and all related medical evidence are properly considered.
APD 251337
The Appeals Panel reversed the ALJ’s decision and held that the claimant was on a special mission when injured in a motor vehicle accident traveling to a mandatory orientation in a different city, making the injury compensable. The Panel struck findings that exceeded the scope of the issues but determined that the claimant did have disability from the date of injury through May 26, 2025.
APD 251222
The Appeals Panel affirmed the ALJ’s determination that the claimant sustained a compensable injury but reversed the disability determination due to inconsistencies in the findings and discussion.
APD 250853
The Appeals Panel affirmed the ALJ’s findings that the compensable injury did not extend to additional cervical spine conditions and that the claimant had no disability from October 24, 2023, through the date of the hearing. However, the Panel reversed the determinations of MMI and IR because the designated doctor relied on a misstatement of medical records—failing to note documented muscle spasms.
APD 250881
The Appeals Panel affirmed in part and reversed and remanded in part the ALJ’s decision. The Panel upheld the finding that the compensable injury does not extend to a T4-5 disc bulge or protrusion. However, it reversed the ALJ’s determination that the injury did not extend to a C3-4 disc bulge or protrusion due to a material misstatement of medical testimony.