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 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 250546
The Appeals Panel affirmed the administrative law judge’s decision that the compensable injury did not extend to Charcot’s arthropathy, that the claimant did not have disability from December 15, 2023, through the hearing date, and that the claimant reached maximum medical improvement on November 2, 2023, with a two percent impairment rating. The Panel reformed one factual finding to correct a clerical error regarding the designated doctor’s certification but upheld all substantive determinations based on the evidence.
APD 250568
The Appeals Panel affirmed the ALJ’s determinations that the compensable injury does not include an L4-5 disc bulge, that the claimant reached maximum medical improvement on January 23, 2024, and that no disability existed thereafter. It reversed only the impairment rating, correcting the ALJ’s typographical error and rendering a five-percent rating in line with the designated doctor’s report instead of the zero-percent rating.
APD 250535
The Appeals Panel affirmed the Administrative Law Judge’s (ALJ) determination that the claimant had disability from November 2, 2023, through the date of the contested case hearing. However, the panel reversed the ALJ’s findings that the claimant had not reached Maximum Medical Improvement (MMI) and thus an Impairment Rating (IR) could not be assigned. It remanded the issues of MMI and IR for further proceedings, directing the ALJ to establish the statutory MMI date and to seek a new evaluation by the designated doctor for an updated opinion consistent with the statutory MMI date.
APD 250466
The Appeals Panel affirmed the Administrative Law Judge’s (ALJ) determinations that the compensable injury did not extend to additional claimed conditions and that the claimant did not have disability during the disputed period. However, the Panel reversed the ALJ’s findings regarding the finality of the initial certification of Maximum Medical Improvement (MMI) and Impairment Rating (IR), as the ALJ had not addressed possible exceptions to finality. These issues, along with the MMI date and IR assignment, were remanded to the ALJ for further proceedings to address whether exceptions to the finality rule applied.