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§ 141.2. Canceling or Rescheduling a Benefit Review Conference

(a) In this subsection, “good cause” will be determined at the discretion of the benefit review officer on a case-by-case basis, including consideration of prejudice to parties, and means:

(1) objective facts beyond the control of a party, which reasonably:

(A) prevent a party from attending the benefit review conference; or

(B) would prevent the benefit review conference from accomplishing its purpose, such as the need for a reasonable amount of additional time to secure necessary evidence for the dispute; or

(2) objective facts which make the benefit review conference unnecessary.

(b) The division may cancel a benefit review conference at any time before the benefit review conference:

(1) on its own motion;

(2) at the request of the party who requested the conference; or

(3) at the mutual request of the parties.

(c) The division may reschedule a benefit review conference at any time before the benefit review conference:

(1) on its own motion, or

(2) at the request of a party.

(d) A request for cancellation or rescheduling under subsection (b) or (c) of this section shall be made by notifying the division in writing, with a copy to all parties, within 10 days of the date the notice of setting is received.

(1) The first request to reschedule a benefit review conference under subsection (d) of this section does not have to demonstrate good cause for the request but must comply with §140.9 of this title (relating to Requests by Parties).

(2) A request to reschedule or cancel a benefit review conference made outside of the 10-day period, as well as all subsequent rescheduling requests under subsection (c) of this section by any party, must:

(A) be in writing and in the form prescribed by the division;

(B) demonstrate good cause for canceling or rescheduling, as defined by subsection (a) of this section;

(C) be sent to the division and opposing party or parties no later than five days before the scheduled benefit review conference unless good cause is demonstrated for filing later; and

(D) comply with the requirements of §140.9 of this title.

(3) A claimant who is neither represented by an attorney nor assisted by OIEC may request that a benefit review conference be rescheduled or cancelled by contacting the division in any manner.

(4) A cancellation of a benefit review conference without simultaneous rescheduling constitutes a withdrawal of the dispute on the issue. A request to cancel a benefit review conference subject to §130.12 of this title (relating to Finality of the First Certification of Maximum Medical Improvement and/or First Assignment of Impairment Rating) must comply with the provisions of §130.12(b)(3) of this title.

(5) Unless otherwise directed by a presiding officer, a party opposing the rescheduling or cancellation of a benefit review conference must file any written opposition with the division within three days of receiving the cancellation or rescheduling request.

(6) The division will notify the parties of a cancellation or rescheduling of a benefit review conference in a timely manner.

(7) If the benefit review officer denies a request to cancel or reschedule a benefit review conference under this section, the benefit review officer will notify the parties in writing and state the reasons for the denial.

The provisions of this §141.2 adopted to be effective June 7, 1991, 16 TexReg 2876; amended to be effective October 1, 2010, 35 TexReg 7430; amended to be effective November 20, 2011, 36 TexReg 7867; amended to be effective January 7, 2019, 44 TexReg 107.

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At a Glance:

Title:

§ 141.2. Canceling or Rescheduling a Benefit Review Conference

Title:

Title 28. Insurance

Status:

Current

Usage:

New Law Rule

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