Appeals Panel Reverses and Remands on IR; Emphasizes Distinction Between 0% IR and No Permanent Impairment
In Texas Division of Workers’ Compensation Appeals Panel Decision No. 211412, decided October 21, 2021, the AP noted that the designated doctor, Dr. H, placed the claimant in Diagnosis-Related Estimate (DRE) Thoracolumbar Category I for a zero percent (0%) IR; however, on his corresponding Report of Medical Evaluation (DWC-69), Dr. H marked that the claimant did not have any permanent impairment as a result of the compensable injury.
The ALJ subsequently determined after the CCH that Claimant’s IR was 0%. The ALJ reversed that decision, and remanded the case, on the basis that “[b]ecause there is an internal inconsistency between the IR in Dr. H’s narrative report and the corresponding DWC-69, his assignment of IR is not adoptable.” On remand, the ALJ was instructed to inform the DD about the internal inconsistency in his prior certification, and request the DD to give an opinion on the claimant’s IR by rating the entire compensable injury in accordance with the AMA Guides and considering the medical record and the certifying examination.
Editor’s Note: Although not explained in this AP decision, a finding of “no impairment” simply means that there are no anatomic or functional abnormalities or loss existing after MMI that are reasonably presumed to be permanent, which is the definition of “impairment” under Sec. 401.011(23). This may or may not equate to a 0% IR. A 0% IR means that the claimant may or may not have actual impairment, but that the AMA Guides do not provide for a rating associated with the impairment. Importantly, the evaluating doctor must be certified to perform MMI/IR examinations in order to assign a 0% IR. Such is not required for the evaluating doctor to find “no permanent impairment.”
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