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 260534
The Appeals Panel reversed and remanded the ALJ’s determination that Dr. G’s May 8, 2025 MMI/IR certification did not become final under Section 408.123 and Rule 130.12. The Panel held that the certification was valid despite a typographical error in the certification date because it was signed by an authorized doctor, assigned a zero percent IR, and used a non-prospective MMI date.
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 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 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 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 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 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 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.