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 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.