Texas Administrative Code
Title 28 - INSURANCE
Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION
Chapter 141 - DISPUTE RESOLUTION-BENEFIT REVIEW CONFERENCE
Section 141.3 - Failure to Attend a Benefit Review Conference
Universal Citation: 28 TX Admin Code ยง 141.3
Current through Reg. 49, No. 38; September 20, 2024
(a) Applicability. This subsection applies to a benefit review conference that is requested before December 1, 2011.
(1) When a party fails to attend a benefit
review conference without good cause, as determined by the benefit review
officer, the benefit review officer:
(A)
shall hold the conference as scheduled; and
(B) may recommend the issuance of an
administrative violation.
(2) A representative who fails to attend a
benefit review conference without good cause commits an administrative
violation.
(b) Applicability. This subsection applies to a benefit review conference that is requested on or after December 1, 2011.
(1) In
this subsection, "good cause" will be determined at the discretion of the
benefit review officer on a case-by-case basis and means objective facts beyond
the control of a party, which reasonably:
(A)
prevented the party from attending the benefit review conference;
(B) prevented the party from requesting the
division to cancel or reschedule in advance of the benefit review conference;
and
(C) if applicable, prevented
the party from filing a request to reschedule within the third business day
after failing to attend the scheduled benefit review conference and justifies
the subsequent delay in filing the request to reschedule.
(2) When a party fails to attend a benefit
review conference without good cause, as determined by the benefit review
officer, the benefit review officer shall hold the conference as
scheduled.
(3) A party who fails to
attend a scheduled benefit review conference may request to reschedule the
benefit review conference under the provisions of this subsection. The request
to reschedule must:
(A) be filed with the
division as soon as practicable, but no later than the close of the third
business day after the scheduled benefit review conference, unless good cause
exists for further delay;
(B) be in
writing and in the form prescribed by the division;
(C) establish good cause in accordance with
paragraph (1) of this subsection; and
(D) be sent to opposing party or
parties.
(4) Except as
provided by paragraph (5) of this subsection, if a party fails to attend a
benefit review conference without good cause, the party forfeits the party's
entitlement to attend a benefit review conference on the issue in dispute. If a
party forfeits this entitlement, the division will not reschedule the benefit
review conference on the issue in dispute.
(5) A party will not be considered to have
forfeited the party's entitlement to attend a benefit review conference on the
issue in dispute under paragraph (4) of this subsection if a benefit review
officer is authorized to schedule an additional benefit review conference under
Labor Code §
410.026(b).
(6) A party who forfeits the party's
entitlement to attend a benefit review conference on the issue in dispute does
not forfeit the party's right, as provided by the Workers' Compensation Act and
division rules, to a contested case hearing on the issue in dispute.
(7) Notwithstanding paragraph (3) of this
subsection, the division may refuse to reschedule a benefit review conference
under this section and may direct the parties to proceed to a contested case
hearing, if authorized under §
142.5(b)
of this title (relating to Sequence of Proceedings to Resolve Benefit
Disputes).
(8) A party who fails to
attend a benefit review conference without good cause commits an administrative
violation.
(9) If the benefit
review officer denies a request to 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.
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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