APD 260490
The Appeals Panel affirmed the ALJ’s finding that the compensable injury did not include an L5-S1 disc protrusion but found the decision incomplete for failing to address whether it included an L5-S1 disc herniation. The case was reversed in part and remanded for further findings on that unresolved extent-of-injury issue.
APD 260449
The Appeals Panel reversed the ALJ’s decision denying extent of injury to multiple left shoulder conditions after finding the ALJ abused her discretion by failing to issue a Presiding Officer’s Directive to the designated doctor. Because the designated doctor never evaluated the disputed conditions due to administrative error, the case lacked necessary medical evidence. The matter was remanded for the ALJ to obtain a new designated doctor opinion addressing the disputed conditions and then issue a new extent-of-injury determination.
APD 260223
The Appeals Panel reversed the ALJ’s determinations on extent of injury, maximum medical improvement (MMI), and impairment rating (IR), and remanded the case for further proceedings. The reversal was based on procedural error, as the ALJ closed the record and issued a decision before the agreed two-week period for submitting additional evidence—specifically a neuropsychological evaluation—had expired. Because the claimant was not afforded a full opportunity to present this evidence, the prior findings (including a zero percent IR and MMI date) could not stand.
APD 260120
The Appeals Panel affirmed the ALJ’s determination that the compensable injury did not extend to additional right shoulder conditions and that Dr. F’s certification of MMI and impairment rating did not become final. However, it reversed the ALJ’s MMI determination and rendered a new finding that the claimant reached MMI on August 8, 2023, based on a valid designated doctor certification that considered only the compensable injury. The Panel also affirmed the zero percent impairment rating but reformed it to rely on the proper certification from the designated doctor.
APD 252109
The Appeals Panel affirmed the ALJ’s extent-of-injury determinations, including that the compensable injury extended to a 5th metatarsal fracture and metatarsalgia but did not include other disputed foot conditions. However, the Panel reversed the ALJ’s finding that the claimant had not reached MMI because the designated doctor’s certification improperly included non-compensable conditions.
APD 252111
The Appeals Panel affirmed the ALJ’s determination that the claimant reached maximum medical improvement (MMI) on December 30, 2024. However, the Panel reversed the 4% impairment rating (IR) because the designated doctor’s calculation contained errors under the AMA Guides and could not be adopted. After reviewing a corrected clarification report from the designated doctor, the Panel rendered a new decision that the claimant’s IR is 11%.
APD 251957
The Appeals Panel affirmed the ALJ’s determination that the compensable injury did not extend to chronic insomnia, nausea, or fatigue, but reversed the finding that it extended to additional cognitive conditions such as brain fog, vertigo, and thought disorganization. The Panel rendered a new decision that those additional disputed conditions were not part of the compensable injury, relying on the designated doctor’s causation analysis. The Panel affirmed on other grounds that the claimant reached MMI on December 5, 2024, with a 10% impairment rating.
APD 252067
The Appeals Panel affirmed the ALJ’s determination that the compensable injury did not extend to left elbow medial or lateral epicondylitis or to left wrist/hand ulnar nerve compression or Guyon’s canal conditions, finding sufficient evidence to support those extent-of-injury findings. However, it reversed by striking the portion of the decision addressing a left wrist/hand ulnar nerve transposition, holding that a surgical procedure is medical treatment, not an injury or condition, and therefore is not properly litigated as an extent-of-injury issue under the Texas Workers’ Compensation Act.
APD 251955
The Appeals Panel affirmed the ALJ’s determination that the compensable injury did not extend to lumbar ankylosing spondylitis. However, it reversed the ALJ’s finding that the first certification of maximum medical improvement and impairment rating became final, holding that a DRIS note was insufficient to establish delivery by verifiable means.
APD 251710
The Appeals Panel reversed and remanded the ALJ’s decision because the ALJ misstated the mechanism of injury—describing a fall over a drain instead of the actual electrocution while working on a powerline. Because this factual error affected the extent-of-injury determination, the Appeals Panel returned the case for a new decision on whether the compensable injury extends to traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD).