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 251308
The Appeals Panel affirmed the ALJ’s decision that the compensable injury did not extend to a left shoulder rotator cuff tear, a disc bulge at C3-4, thoracic strain, or dysphagia. However, it reversed the ALJ’s findings that the injury did not extend to disc bulges at C4-5 and C5-6, finding a misstatement of medical evidence, and remanded that issue for further consideration.
APD 251165
The Appeals Panel affirmed the ALJ’s determination that the claimant reached maximum medical improvement (MMI) on April 11, 2024. However, it reversed the finding that the claimant’s impairment rating (IR) was 5%, concluding that the designated doctor misapplied the AMA Guides regarding ankle motion impairment.
APD 251011
The Appeals Panel affirmed that the claimant reached maximum medical improvement (MMI) on May 11, 2024, but reversed the ALJ’s adoption of a 27% impairment rating (IR). The Panel found that the designated doctor improperly rated a thoracic fracture under the wrong AMA Guides category and failed to review key medical records.
APD 250998
The Appeals Panel reversed the ALJ’s finding that the first certification of MMI and 15% impairment rating from Dr. V did not become final, ruling instead that it did become final under Section 408.123 and Rule 130.12 because no valid exception applied. As a result, the Panel reversed the ALJ’s decision adopting the designated doctor’s later certification of MMI on May 30, 2024, with a 0% IR, and rendered a new decision that the claimant reached MMI on June 12, 2024, with a 15% IR.
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.
APD 250944
The Appeals Panel affirmed the ALJ’s decision that the compensable injury does not extend to multiple disputed spinal and shoulder conditions but does include a cervical sprain. However, the Panel reversed and remanded the determinations of maximum medical improvement (MMI) and impairment rating (IR) because the adopted certification was invalid—it was signed by someone other than the certifying doctor.
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.