Texas: Maximum Medical Improvement/Impairment Rating Appeals Decision No. 100152

Texas: Maximum Medical Improvement/Impairment Rating Appeals Decision No. 100152

 The Designated Doctor evaluated the injured worker and determined she was not at maximum medical improvement because she was considering surgery.  The Claimant did not have surgery.  Subsequently, DWC sent a letter of clarification to the Designated Doctor indicating the Claimant reached statutory maximum medical improvement.  The Designated Doctor certified the Claimant reached maximum medical improvement earlier than the statutory date because she did not have surgery.  The Appeals Panel explained the earlier date of maximum medical improvement was appropriate because the Claimant did not have the surgery she contemplated. 

The Appeals Panel [in APD No. 100152] distinguished APD No. 010297-S, when the Designated Doctor changed the date of maximum medical improvement without conducting an examination, and claimant's medical condition had changed after the date of examination.  In the present case, the Designated Doctor examined Claimant and certified maximum medical improvement date prior to the examination.  The Designated Doctor did not find any evidence Claimant improved since she had not undergo surgery.  Therefore, the Appeals Panel found the Designated Doctor's report was entitled to presumptive weight.