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§ 143.3. Requesting the Appeals Panel to Review the Decision of the Administrative Law Judge

(a) A party to a benefit contested case hearing who is dissatisfied with the decision of the administrative law judge may request the appeals panel to review that decision. The request shall:

(1) be in writing;

(2) clearly and concisely rebut each issue in the administrative law judge’s decision that the appellant wants reviewed, and state the relief the appellant wants granted;

(3) be filed with the Chief Clerk of Proceedings in the division’s central office in Austin not later than the 15th day after receipt of the administrative law judge’s decision. The administrative law judge’s decision is deemed to have been received by the parties in accordance with §102.5 (relating to General Rules for Written Communications To and From the Commission) and §102.3 (relating to Computation of Time) of this title. Requests that are timely submitted to a division location other than the Chief Clerk of Proceedings, such as a local field office of the division, will be considered timely filed and forwarded to the division’s appeals panel for consideration, but this may result in delay in the processing of the request. Untimely requests, regardless of whether they are filed with the Chief Clerk of Proceedings in the division’s central office or in a different division field office, do not invoke the jurisdiction of the appeals panel and will not be reviewed by the appeals panel;

(4) be served on the other party or parties on the same day filed with the division; and

(5) contain a statement certifying that a copy has been served on the other party or parties in person, mailed by certified mail, return receipt requested, or transmitted by verifiable means. A certificate in substantially the following form shall be used: “I hereby certify that I have on this ____ day of ____________, _____, served a copy of the attached request for appeal on _______________________________ (state the name of the other party or parties on whom a copy was served) by _______________________________ (state the manner of service).” _______________________________ Signature

(b) If it is not clear from the request for review that the party has properly served a copy of the request on the other party or parties, the division will provide a copy of the request expeditiously.

(c) A party may make a conditional request for review by the appeals panel even if the overall contested case hearing decision is favorable. A timely request that indicates that the filing party seeks consideration only if the opposing party files a request for review will not be treated as a request for review unless an opposing party timely files a request. If an opposing party does file a timely request, the conditional request will be treated as a cross-appeal.

(d) A request for review by the appeals panel shall be filed not later than the 15th day after the appealing party is deemed to have received the administrative law judge’s decision. Saturdays and Sundays and holidays listed in Government Code §662.003 are not included in the computation of this 15-day period. A request made under this section shall be presumed to be timely filed or timely served with the division if it is:

(1) mailed on or before the 15th day after the date of deemed receipt of the administrative law judge’s decision, as provided in subsection (a) of this section; and

(2) received by the division not later than the 20th day after the date of deemed receipt of the administrative law judge’s decision.

The provisions of this §143.3 adopted to be effective March 7, 1991, 16 TexReg 1195; amended to be effective December 31, 1991, 16 TexReg 7358; amended to be effective March 14, 2001, 26 TexReg 2032; amended to be effective May 9, 2004, 29 TexReg 4223; amended to be effective December 13, 2009, 34 TexReg 8739; amended to be effective January 7, 2019, 44 TexReg 111.

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At a Glance:

Title:

§ 143.3. Requesting the Appeals Panel to Review the Decision of the Administrative Law Judge

Title:

Title 28. Insurance

Status:

Current

Usage:

New Law Rule

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