AI Generated Opinion Summaries

Decision Information

Decision Content

This summary was computer-generated without any editorial revision. It is not official, has not been checked for accuracy, and is NOT citable.

Facts

  • The Worker suffered accidents on August 22, 2008, and September 14 or 30, 2008, while employed, resulting in injuries to his lower back and left testicle. Following these incidents, the Worker filed a complaint seeking temporary total disability benefits until reaching maximum medical improvement and permanent partial disability benefits thereafter (para 2).

Procedural History

  • Workers’ Compensation Administration, Gregory D. Griego, Workers Compensation Judge: A compensation order was entered, which was appealed by the Employer, and a cross-appeal was filed by the Worker (para 1).

Parties' Submissions

  • Worker-Appellee/Cross-Appellant: Argued that several factual findings by the Workers Compensation Judge (WCJ) were incorrect, including the authorization of healthcare providers, the determination of maximum medical improvement, and the calculation of whole body impairment rating (paras 4, 6, 8, 12, 13, 15, 18, 21).
  • Employer/Insurer-Appellants/Cross-Appellees: Contended that the WCJ's findings and conclusions were supported by substantial evidence, including the authorization of healthcare providers, the Worker's maximum medical improvement status, and the assigned impairment ratings (paras 6, 9, 10, 13, 16, 19, 22).

Legal Issues

  • Whether Dr. Aswad was an unauthorized healthcare provider and if his bill should be paid by the Employer (para 6).
  • Whether the Worker is entitled to an updated lumbar MRI and a psychological evaluation (para 8).
  • Whether the Worker should be entitled to treatment by a urologist in Las Cruces (para 12).
  • Whether the Worker was at maximum medical improvement from September 10, 2010, through December 21, 2011 (para 13).
  • Whether the WCJ erred in finding an 8% whole body impairment as a result of the Worker's back injury (para 15).
  • Whether the Worker is entitled to one point for "training" or "vocational pursuit" pursuant to Section 52-1-26.3(D) (para 18).
  • Whether the WCJ erred by determining that the Worker could perform light duty work (para 21).
  • Whether the WCJ erred in finding that the Worker’s combined whole person rating impairment was only 11% (para 24).

Disposition

  • The Workers Compensation Judge's determination on seven issues was affirmed, but the determination that the Worker had a whole body impairment rating of 11% was not supported by substantial evidence. The case was remanded for the entry of a modified compensation order reflecting a 14% impairment rating for the Worker (para 25).

Reasons

  • JAMES J. WECHSLER, Judge (RODERICK T. KENNEDY, Chief Judge, MICHAEL D. BUSTAMANTE, Judge concurring): The court found substantial evidence supporting the WCJ's findings on most issues, including the authorization of healthcare providers, the Worker's maximum medical improvement, and the assigned impairment ratings. However, it was agreed that the Worker's combined whole person impairment rating should have been 14% as per Dr. Gallardo's assignment, not 11% as found by the WCJ. The case was therefore remanded for correction of this error (paras 6-24).
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