Texas Administrative Code
Title 28 - INSURANCE
Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION
Chapter 141 - DISPUTE RESOLUTION-BENEFIT REVIEW CONFERENCE
Section 141.5 - Description of the Benefit Review Conference
Universal Citation: 28 TX Admin Code ยง 141.5
Current through Reg. 49, No. 38; September 20, 2024
(a) Definitions. As used in this section, "participant" means an individual entitled or permitted to attend and take part in a benefit review conference. Participants include:
(1) the parties;
(2) the parties' representatives;
(3) the employer exercising the right to
present evidence relevant to the disputed issue or issues; and
(4) any other individual, at the discretion
of the benefit review officer.
(b) Overview of the benefit review conference. The benefit review conference consists of three parts: opening, mediation, and closing.
(c) Opening. The benefit review officer shall:
(1)
identify the case and introduce the parties and other participants;
(2) thoroughly inform the parties and
participants of their rights and responsibilities under the Texas Workers'
Compensation Act;
(3) explain the
purpose of the conference and the procedures and time frame to be
observed;
(4) identify and describe
the disputed issues to be mediated; and
(5) elicit each party's statement of position
regarding each disputed issue.
(d) Mediation. The benefit review officer shall:
(1) ask and answer questions of the
parties and other participants;
(2)
encourage the parties to discuss the disputed issues and ask and answer
questions;
(3) permit the employer
to present evidence relevant to the disputed issues;
(4) permit other participants to discuss the
disputed issues and ask and answer questions, to the extent the benefit review
officer deems appropriate;
(5) if
necessary, caucus individually with each party;
(6) assist the parties to agree on specific
options for resolution; and
(7)
assist the parties in resolving disputed issues by agreement or
settlement.
(e) Closing. The benefit review officer shall:
(1) assist
the parties in reducing agreements or settlements to writing;
(2) identify any issues left unresolved;
and
(3) if available information
pertinent to the resolution of the disputed issue(s) was not produced at the
benefit review conference, require a second benefit review conference to be
scheduled if a second one has not already been conducted.
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