Texas Workers' Compensation

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§ 144.4. Election to Engage in Arbitration

(a) Following a benefit review conference where disputed benefit issue(s) remain unresolved, the parties may mutually agree to engage in arbitration on those issues.

(b) Parties agreeing to engage in arbitration must complete and sign a form prescribed by the division and file it with the division’s chief clerk of proceedings not later than the 20th day after the last day of the benefit review conference.

(c) A party may submit a response to the disputes identified as unresolved in the benefit review officer’s report. The response shall:

(1) be in writing;

(2) describe and explain the party’s position on the unresolved dispute or disputes;

(3) be sent to the division’s chief clerk of proceedings no later than 20 days after receiving the benefit review officer’s report; and

(4) be delivered to all other parties, as provided by § 144.3 of this title (relating to Delivery of Copies of Documents).

(d) Except as provided by § 144.10 of this title (relating to Stipulations, Agreements, and Settlements), the decision to proceed with arbitration in place of a division contested case hearing, once filed with the division’s chief clerk of proceedings, is binding and irrevocable for the resolution of all disputes arising out of the claims that are under the jurisdiction of the division. For medical fee disputes arising from Labor Code § 413.0312, except as provided by § 144.10 of this title, the decision to proceed with arbitration in place of a contested case hearing at the State Office of Administrative Hearings is binding and irrevocable for the resolution of that dispute.

The provisions of this §144.4 adopted to be effective December 31, 1991, 16 TexReg 7358; amended to be effective May 31, 2012, 37 TexReg 3856.

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At a Glance:

Title:

§ 144.4. Election to Engage in Arbitration

Title:

Title 28. Insurance

Status:

Current

Usage:

New Law Rule

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