Texas Workers' Compensation

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§ 141.7. Division Actions After a Benefit Review Conference

(a) All Issues Resolved. Division actions if all issues are resolved at the benefit review conference.

(1) If all issues in dispute are resolved at the benefit review conference by agreement or settlement, the agreement or settlement must be reduced to writing and signed by each party and their designated representative, if any, and the benefit review officer.

(2) The benefit review officer shall make the agreement part of the claim file. If all issues in dispute are resolved at the benefit review conference by settlement, the benefit review officer shall submit the signed settlement to the commissioner or commissioner’s designee for handling as provided by Chapter 147 of this title (relating to Dispute Resolution–Agreements, Settlements, Commutations). If the commissioner or commissioner’s designee rejects the settlement, the parties may request:

(A) a second benefit review conference, if a second benefit review conference has not already been held; or

(B) a contested case hearing.

(b) Issues Not Resolved. Division actions if issues are not resolved at the benefit review conference.

(1) After First Benefit Review Conference. If all issues in dispute are not resolved at the first benefit review conference, the benefit review officer may set a second benefit review conference or a contested case hearing.

(2) After Second Benefit Review Conference. If all issues in dispute are not resolved at the second benefit review conference, a contested case hearing will be scheduled by the benefit review officer.

(c) Written Report. Within five days after the benefit review conference is closed, the benefit review officer shall submit the written report and any signed agreements to the division’s central office in Austin in accordance with Labor Code § 410.031 and § 410.034.

(d) Copies of Report and Hearing Notice. The division shall send to the injured employee; injured employee’s representative, if any; the insurance carrier; subclaimants; and the employer the following:

(1) a file-stamped copy of the report; and

(2) notice of the date, time, and location of the contested case hearing.

(e) Effective date. The effective date of this section is October 1, 2010.

The provisions of this §141.7 adopted to be effective June 7, 1991, 16 TexReg 2876; amended to be effective May 10, 2000, 25 TexReg 3988; amended to be effective September 4, 2006, 31 TexReg 7127; amended to be effective October 1, 2010, 35 TexReg 7430.

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At a Glance:

Title:

§ 141.7. Division Actions After a Benefit Review Conference

Title:

Title 28. Insurance

Status:

Current

Usage:

New Law Rule

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