APD 250273
The Appeals Panel affirmed the Administrative Law Judge’s (ALJ) determination that the claimant reached Maximum Medical Improvement (MMI) on December 21, 2023. However, the Panel reversed and remanded the Impairment Rating (IR) of 11% because the designated doctor’s calculation did not conform to the AMA Guides and lacked necessary range of motion data. The issue of IR was remanded for further clarification or reassessment, and the ALJ was also instructed to correct the carrier information in the decision on remand.
APD 241330
The Appeals Panel reversed the Administrative Law Judge’s decision regarding maximum medical improvement and impairment rating. The Appeals Panel noted that there was only one certification in evidence that came from a referral doctor. They further noted that section 408.125 requires a designated doctor to be appointed in all disputes regarding impairment rating.
APD 240748
The Appeals Panel reversed the Administrative Law Judge’s decision on finality. The Appeals Panel found that a “Return to Sender – Unclaimed” sticker on an envelope is evidence that the Claimant was provided certification by verifiable means.
APD 240429
The Appeals Panel reversed the Administrative Law Judge’s decision because the file did not contain an AMA Guide Figure 1 worksheet, which was relied upon by the Administrative Law Judge.
APD 231595
The Appeals Panel reversed the decision of the Administrative Law Judge to make a mathematical correction to the certification of maximum medical improvement and impairment rating.
APD 231438
The Appeals Panel reversed the Administrative Law Judge’s decision regarding finality. The Appeals Panel noted that simply sending the certification by fax to a correct fax number without verification of delivery does not establish delivery by verifiable means.
APD 231436
The Appeals Panel reversed the decision because the Administrative Law Judge failed to make a finding of fact that the adopted certification was supported by the preponderance of the evidence.
APD 231290
The Appeals Panel reversed the decision on finality because the Administrative Law Judge failed notify the parties on the record that he was going to take official notice of any of the DRIS notes and such DRIS note was not admitted into evidence.
APD 231122
The Appeals Panel reversed the administrative law judge’s decision regarding maximum medical improvement and impairment rating because the adopted certification failed to rate the compensable injury.
APD 230999
The Appeals Panel reversed the administrative law judge’s opinion on impairment rating because the certifying doctor did not have the required values to appropriately use Table 8 of the AMA Guides because the claimant could not undergo a pulmonary function test.