reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 143 - DISPUTE RESOLUTION REVIEW BY THE APPEALS PANEL › Section 143.5 - Decision of the Appeals Panel

Current through Reg. 49, No. 28; July 12, 2024
(a) Not later
				than the 45th day after the date the response was filed with the division, the
				appeals panel will issue its written decision, concluding with a separate
				paragraph stating words to the effect: "The true corporate name of the
				insurance carrier is (NAME IN BOLD PRINT) and the name and address of its
				registered agent for service of process is (NAME AND ADDRESS IN BOLD PRINT)",
				and file a copy with the division.
(b) If the appeals panel does not issue a
				written decision by the 45th day after the date the response was filed with the
				division, the administrative law judge's decision becomes final, constitutes
				the decision of the appeals panel, and, for the purpose of establishing the
				time for seeking judicial review, is deemed filed with the division on that
				day.
(c) Not later than the seventh
				day after the appeals panel files its decision with the division, or a decision
				is deemed filed, as provided in subsection (b) of this section, the division
				shall send to each party a copy of the decision, or a notice that the
				administrative law judge's decision has become final and constitutes the
				decision of the appeals panel.
(d)
				A decision of the appeals panel that is not appealed for judicial review, as
				provided by the Texas Labor Code §
									410.252,
				et seq., becomes final on the 46th day after the division mailed the party the
				decision of the appeals panel. For purposes of this section the mailing date is
				considered to be the fifth day after the date the decision of the appeals panel
				was filed by the division.
(e) A
				decision of the appeals panel that is appealed for judicial review is binding
				on the parties for the duration of the judicial review.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 144 - DISPUTE RESOLUTION › Subchapter A - ARBITRATION › Section 144.1 - Authority and Duties of Arbitrators

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  arbitrator is authorized but not limited to:
(1) set the time and location of the
				  arbitration proceeding pursuant to the applicable provisions of Labor Code
				  §
											410.005
				  and §
											410.109;
(2) compel the parties to exchange all
				  pertinent medical reports and other documentary evidence, and proposals for
				  resolving the issues in dispute;
(3) conduct, at the arbitrator's discretion,
				  preliminary conferences to identify issues to resolve questions concerning
				  evidence and witnesses, and to otherwise expedite the arbitration
				  proceeding;
(4) exclude individuals
				  other than the parties and the employer from the arbitration
				  proceeding;
(5) administer
				  oaths;
(6) take official notice of
				  the law of Texas and other jurisdictions, Texas city and county ordinances, the
				  content of the
Texas Register,
the rules of state agencies,
				  facts that are judicially cognizable, and generally recognized facts within the
				  division's specialized knowledge;
(7) determine the relevancy and materiality
				  of the evidence offered, without a requirement to conform to legal rules of
				  evidence; and
(8) accept
				  stipulations by the parties on uncontested issues.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 144 - DISPUTE RESOLUTION › Subchapter A - ARBITRATION › Section 144.2 - Ex Parte Communications

Current through Reg. 49, No. 28; July 12, 2024
(a) On any
				  substantive matter regarding facts, issues, law, or rules, an arbitrator may
				  not communicate with any party outside the arbitration unless the communication
				  is:
(1) in writing; and
(2) a copy is delivered to all parties to the
				  arbitration.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 144 - DISPUTE RESOLUTION › Subchapter A - ARBITRATION › Section 144.3 - Delivery of Copies of Documents

Current through Reg. 49, No. 28; July 12, 2024
A party who sends a document relating to the arbitration
					 proceeding to the division's chief clerk of proceedings or the arbitrator shall
					 also deliver copies of the document to all other parties, or their
					 representatives or attorneys. Delivery shall be accomplished by presenting in
					 person, mailing by certified mail, or electronic transmission. The document
					 sent to the division's chief clerk of proceedings or the arbitrator shall
					 contain a statement certifying delivery using the following format: "I hereby
					 certify that I have on the ____ day of ____________, _____, delivered a copy of
					 the attached document to _______________________________ by
					 _______________________________ (state manner of delivery)."
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 144 - DISPUTE RESOLUTION › Subchapter A - ARBITRATION › Section 144.4 - Election To Engage in Arbitration

Current through Reg. 49, No. 28; July 12, 2024
(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).
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 144 - DISPUTE RESOLUTION › Subchapter A - ARBITRATION › Section 144.5 - Statement of Disputes

Current through Reg. 49, No. 28; July 12, 2024
(a) Statement of
				  disputes. The statement of disputes is a written description of the dispute(s)
				  to be considered by the arbitrator. A dispute not expressly included in the
				  statement of disputes will not be considered by the arbitrator.
(b) Statement of disputes after a benefit
				  review conference. The statement of disputes for an arbitration proceeding
				  conducted after a benefit review conference includes:
(1) the benefit review officer's report,
				  identifying the disputes remaining unresolved at the close of the benefit
				  review conference;
(2) the parties'
				  responses to the benefit review officer's report, if any; and
(3) additional disputes by unanimous consent,
				  as provided by subsections (c) and (d) of this section.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 144 - DISPUTE RESOLUTION › Subchapter A - ARBITRATION › Section 144.6 - Assignment of Arbitrator

Current through Reg. 49, No. 28; July 12, 2024
(a) The division
				  will maintain, in random name order, lists of qualified arbitrators established
				  by the division. Not later than the 30th day after an election to engage in
				  arbitration is filed, an arbitrator will be assigned from the appropriate list.
				  Each party will be notified immediately either personally or by certified
				  mail.
(b) Assignment from the list
				  of arbitrators shall be from the top of the list. When the list has been
				  exhausted by assignment of each arbitrator to a case, the list will be randomly
				  reordered.
(c) Each party to the
				  arbitration proceeding is entitled to one rejection of an assigned arbitrator
				  and must exercise such rejection not later than the third day following receipt
				  of notification of an arbitrator's assignment. Once a rejection is exercised,
				  the next arbitrator from the top of the list will be assigned.
(d) A rejection exercised by a party must be:
(1) in writing;
(2) signed by the party or authorized
				  representative;
(3) personally
				  delivered, sent by certified mail or electronic transmission, not later than
				  the third day following receipt of notice of an arbitrator's assignment, to the
				  division's chief clerk of proceedings with a copy to all parties.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 144 - DISPUTE RESOLUTION › Subchapter A - ARBITRATION › Section 144.7 - Setting the Arbitration Proceeding

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Following any rejections as set forth in §
										144.6 of
				  this title (relating to Assignment of Arbitrator), the arbitrator shall
				  schedule arbitration to be held not later than the 30th day following the
				  assignment of the arbitrator.
(b)
				  The arbitrator shall notify, in writing, all parties and the employer of the
				  time and place scheduled for the arbitration. The notification shall be by
				  personal delivery or certified mail.
(c) Unless the assigned arbitrator determines
				  that good cause exists for the selection of a different location, arbitration
				  proceedings may not be conducted at a site more than 75 miles from the injured
				  employee's residence at the time of injury.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 144 - DISPUTE RESOLUTION › Subchapter A - ARBITRATION › Section 144.8 - Expediting Procedures

Current through Reg. 49, No. 28; July 12, 2024
(a) In addition to
				  the use of affidavits, medical reports, stipulations, and agreements, the
				  arbitrator may allow, to the maximum extent possible and with due consideration
				  to completeness and fairness, expediting procedures, including, but not limited
				  to, the use of:
(1) unsworn witness
				  statements; and
(2) summaries of
				  evidence.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 144 - DISPUTE RESOLUTION › Subchapter A - ARBITRATION › Section 144.9 - Exchange of Evidence and Proposed Resolution

Current through Reg. 49, No. 28; July 12, 2024
(a) Not later than the seventh day preceding
				  the arbitration proceeding, each party is required to exchange with the other
				  party, and file with the arbitrator:
(1) all
				  pertinent medical reports and other documentary evidence in the party's
				  possession not previously exchanged or filed; and
(2) written proposals for resolving the
				  issues in dispute.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 144 - DISPUTE RESOLUTION › Subchapter A - ARBITRATION › Section 144.10 - Stipulations, Agreements, and Settlements

Current through Reg. 49, No. 28; July 12, 2024
(a) Except as provided by subsections (d) and
				  (e) of this section, at any time before or during the arbitration proceeding,
				  parties may:
(1) enter into stipulations,
				  defined as a voluntary accord between parties to an arbitration regarding any
				  matter relating to the arbitration that does not constitute an agreement or a
				  settlement, as defined by Labor Code §
											401.011;
(2) resolve one or more benefit disputes by
				  agreement; or
(3) resolve all
				  benefit disputes by settlement.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 144 - DISPUTE RESOLUTION › Subchapter A - ARBITRATION › Section 144.11 - Continuance

Current through Reg. 49, No. 28; July 12, 2024
(a) Any request for a continuance by a party
				  must be directed to the division's chief clerk of proceedings and served
				  personally by certified mail, or by electronic transmission, on all other
				  parties.
(b) A continuance may be
				  granted for up to 30 days only upon a determination of good cause.
				  Notwithstanding the existence of good cause, not more than one continuance will
				  be granted to each party.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 144 - DISPUTE RESOLUTION › Subchapter A - ARBITRATION › Section 144.12 - Failure To Attend Arbitration

Current through Reg. 49, No. 28; July 12, 2024
A party who fails to attend any session of the arbitration
					 proceeding after electing arbitration commits an administrative violation
					 unless the arbitrator determines that the party had good cause not to
					 attend.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 144 - DISPUTE RESOLUTION › Subchapter A - ARBITRATION › Section 144.13 - Rights of Parties

Current through Reg. 49, No. 28; July 12, 2024
(a) Each party to
				  the arbitration proceeding is entitled to be present, to have a full, fair, and
				  impartial hearing of all relevant evidence, and to present the party's
				  respective position on the issue(s) in dispute.
(b) Parties to the arbitration are entitled
				  to be represented by counsel or other representative authorized under and in
				  accordance with the Texas Workers' Compensation Act and division
				  rules.
(c) Each party, and the
				  arbitrator, is permitted to call witnesses who have relevant information to
				  testify (under oath if required by the arbitrator or requested by a party) and
				  to ask questions of any witnesses called.
(d) A party desiring to have a record made of
				  the arbitration proceeding by stenographic means may do so and is responsible
				  for arranging for and the expense of making a record by such means. A copy of
				  the stenographic report shall be provided to the division's chief clerk of
				  proceedings at no charge and may be made available to the other
				  parties.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 144 - DISPUTE RESOLUTION › Subchapter A - ARBITRATION › Section 144.14 - Usual Order of Proceedings

Current through Reg. 49, No. 28; July 12, 2024
(a) The arbitration
				  proceeding will begin with preliminary matters including the introduction of
				  copies of the election of arbitration and the assignment of the arbitrator, the
				  introduction of all parties and representatives, statements for the record of
				  the date, time, and place of the proceedings, and a concise statement of the
				  disputed issue(s).
(b) An
				  electronic recording of the proceeding will be made by the
				  arbitrator.
(c) The arbitrator will
				  allow and may assist each party to make a brief opening statement setting forth
				  its position on unresolved issues and the issues with respect to which it is
				  prepared to stipulate.
(d) The
				  requestor shall be the first party to present all relevant evidence desired in
				  support of the claim including the testimony of witnesses.
(e) Following the requestor's presentation of
				  evidence, the other party to the proceeding may present evidence desired to be
				  considered by the arbitrator, including the calling of witnesses.
(f) After each party has presented the
				  evidence desired, the arbitrator may call for additional evidence that the
				  arbitrator considers necessary for a proper understanding and determination of
				  the issues.
(g) Each party may
				  present closing statements as desired, but the record may not remain open for
				  written briefs unless requested by the arbitrator.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 144 - DISPUTE RESOLUTION › Subchapter A - ARBITRATION › Section 144.15 - Award of the Arbitrator

Current through Reg. 49, No. 28; July 12, 2024
(a) Not later than
				  the seventh day after the last day of arbitration, the arbitrator shall enter
				  the final award which must:
(1) be in
				  writing;
(2) be signed and dated by
				  the arbitrator;
(3) include a
				  statement of the arbitrator's decision on the contested issues and the parties'
				  stipulations on uncontested issues;
(4) be sent to the division and all parties
				  by certified mail, or personal delivery; and
(5) be filed as a part of the permanent claim
				  file.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 144 - DISPUTE RESOLUTION › Subchapter A - ARBITRATION › Section 144.16 - Requesting a Copy of the Record

Current through Reg. 49, No. 28; July 12, 2024
A party or the employer may request a copy of the
					 electronic recording of the arbitration proceeding from the division. The
					 requestor shall pay the cost of the duplication, as established by the
					 division.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 147 - DISPUTE RESOLUTION-AGREEMENTS, SETTLEMENTS, COMMUTATIONS › Section 147.1 - Form and Execution

Current through Reg. 49, No. 28; July 12, 2024
(a) A settlement or
				a written agreement must be on a form prescribed by the division.
(b) In addition to the parties, the
				employee's representative, if any, must sign the written agreement or
				settlement.
(c) Unless the division
				finds that an extraordinary circumstance applies, an employee's representative
				must not sign a written agreement or settlement on behalf of the
				employee.
(d) The insurance
				carrier's representative must sign a written agreement or settlement as the
				agent of the insurance carrier, and the insurance carrier will be bound by the
				written agreement or settlement.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 147 - DISPUTE RESOLUTION-AGREEMENTS, SETTLEMENTS, COMMUTATIONS › Section 147.4 - Agreements; Filing and Effective Dates

Current through Reg. 49, No. 28; July 12, 2024
(a) An agreement
				may be reduced to writing and sent to the division. The agreement is effective
				and binding on the date the division approves it.
(b) An oral agreement reached during a
				benefit contested case hearing and preserved in the record is effective and
				binding on the date made.
(c) A
				signed written agreement, or one made orally, as provided by subsection (b) of
				this section, is binding on:
(1) an insurance
				carrier and a claimant represented by an attorney through the final conclusion
				of all matters relating to the claim, whether before the division or in court,
				unless set aside by the division or court on a finding of fraud, newly
				discovered evidence, or other good and sufficient cause; and
(2) a claimant not represented by an attorney
				through the final conclusion of all matters relating to the claim while the
				claim is pending before the division, unless set aside by the division for good
				cause.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 147 - DISPUTE RESOLUTION-AGREEMENTS, SETTLEMENTS, COMMUTATIONS › Section 147.5 - Settlements: Requirements, Effective Dates, and Informal Settlement Conferences

Current through Reg. 49, No. 28; July 12, 2024
(a) A settlement must be sent to the
				division.
(b) The division may
				approve or reject it before the 16th day after the date the settlement is
				submitted to the division.
(c) A
				settlement must:
(1) establish that the
				insurance carrier is liable for the claim;
(2) establish that the claim is compensable;
(3) establish that the employee is
				entitled to benefits;
(4)
				incorporate by reference all prior oral and written agreements between the
				parties; and
(5) state that a final
				resolution has been reached on all issues in the claim, and that the parties
				waive their rights to subsequent division proceedings, other than those
				necessary to resolve medical benefit disputes or to enforce compliance with the
				terms of the settlement.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 147 - DISPUTE RESOLUTION-AGREEMENTS, SETTLEMENTS, COMMUTATIONS › Section 147.7 - Agreements and Settlements: Effect on Previously Entered Decisions and Orders

Current through Reg. 49, No. 28; July 12, 2024
(a) A written
				agreement on one or more disputed issues addressed in a presiding officer's
				decision or order, including an interlocutory order, sets aside the decision or
				order, as it relates to the agreement, on the date the agreement is approved by
				the presiding officer.
(b) A
				settlement filed before a presiding officer's decision becomes final sets aside
				a presiding officer's decision or order, except for an interlocutory order, on
				the date received by the division. If the division rejects the settlement, the
				decision or order will be immediately reentered.
(c) A settlement sets aside an interlocutory
				order on the date the settlement becomes effective.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 147 - DISPUTE RESOLUTION-AGREEMENTS, SETTLEMENTS, COMMUTATIONS › Section 147.10 - Notification to the Division of Proposed Judgments and Settlements

Current through Reg. 49, No. 28; July 12, 2024
(a) A
				request to commute impairment income benefits must:
(1) be in writing on a form prescribed by the
				division;
(2) state the date the
				employee reached maximum medical improvement, the impairment rating, and the
				employee's weekly impairment income benefit;
(3) be sent to the insurance carrier;
				and
(4) be filed with the
				division.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 147 - DISPUTE RESOLUTION-AGREEMENTS, SETTLEMENTS, COMMUTATIONS › Section 147.11 - Notification to Division of Proposed Judgments and Settlements

Current through Reg. 49, No. 28; July 12, 2024
The insurance carrier or its representative must file a copy
				  of a final judgment or settlement with the division no later than the 10th day
				  after a court approves the agreement or settlement.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.1 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this chapter,
				  shall have the following meanings, unless the context clearly indicates
				  otherwise:
(1) Act--The Texas Workers'
				Compensation Act, Labor Code, §§
									401.001 et
				seq.
(2) ALJ--The administrative
				law judge designated by the State Office of Administrative Hearings to preside
				over the hearing.
(3) APA--The
				Administrative Procedure Act, as specified in the Government Code, Chapter
				2001.
(4) Chief Clerk of
				Proceedings--The Chief Clerk of Proceedings within the hearings section in the
				central office of the Texas Department of Insurance, Division of Workers'
				Compensation.
(5) Contested Case--A
				proceeding held by the State Office of Administrative Hearings in which the
				legal rights, duties, or privileges of a party are to be determined by an
				agency after an opportunity for adjudicative hearing as defined in Government
				Code, §
									2001.003.
(6) Division Representative--The attorney or
				any representative that may be designated by the commissioner or his designee
				to represent the division.
(7)
				Party--A person or state agency named or admitted as a party.
(8) Person--An individual, partnership,
				corporation, association, governmental subdivision, or public or private
				organization that is not a state agency as defined in the APA.
(9) Petitioner--
(A) The division is the petitioner in a
				contested case in which the division seeks to impose a sanction or has issued
				an emergency cease and desist order.
(B) In all other cases, the petitioner is the
				person who has filed a written request for a hearing in accordance with these
				procedures.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.2 - Scope and Applicability

Current through Reg. 49, No. 28; July 12, 2024
(a) Scope. This
				chapter governs contested case hearings, which adjudicate disputes before SOAH
				as authorized under the Act.
(b)
				Coordination with SOAH's Procedural Rules. This chapter governs the following
				procedural matters and also provides related policies of the division on the
				following:
(1) matters arising before a case
				is transferred by the division to SOAH;
(2) matters arising after a proposal for
				decision or after the entire case is received from SOAH;
(3) requests for the issuance of a subpoena
				and related matters; and
(4)
				requests for issuance of a commission requiring deposition and related
				matters.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.3 - Requesting a Hearing

Current through Reg. 49, No. 28; July 12, 2024
(a) Hearings
				Requested by the Division. The division may request a hearing before SOAH as
				permitted by the APA, the Act, and division rules.
(b) Requests for Hearing by Other Parties.
				Other Parties may file requests for hearings before SOAH as permitted by the
				APA, the Act, and division rules. The request for hearing must be in writing.
				The request for hearing must be filed with the Chief Clerk of
				Proceedings.
(c) Date Deemed Filed
				or Received. When a request for a hearing is addressed to the Chief Clerk of
				Proceedings but is sent to an office other than the Chief Clerk of Proceedings,
				the date filed or received shall be the date the request is received by the
				division. The request for hearing will be forwarded to the division's Chief
				Clerk of Proceedings, but this may result in delay of processing the request.
				When a request for a hearing is not addressed to the Chief Clerk of
				Proceedings, it will not be considered filed or received by the division unless
				it is actually received by the Chief Clerk of Proceedings. Otherwise, a request
				for a hearing is deemed filed as of the date of the division date stamp placed
				on the document or other evidence of receipt.
(d) Deadlines for Filing. A request for
				hearing before SOAH must be filed with the Chief Clerk of Proceedings within
				the following time periods:
(1) medical fee
				dispute under Labor Code §
										413.031
				and §
										413.0312:
				20 days after the conclusion of the benefit review conference under Chapter 141
				of this title (concerning Dispute Resolution--Benefit Review
				Conference);
(2) administrative
				violation: 20 days after receipt of a notice of possible administrative
				violation under Labor Code § 415.032 and §
										180.8
				of this title (concerning Notices of Violation; Notices of Hearing; Default
				Judgments);
(3) interlocutory
				order: 20 days after receipt of an interlocutory order for payment under Labor
				Code §
										413.055;
(4) emergency cease and desist order: not
				later than the 30th day after the date the affected person receives the
				order;
(5) division audit or
				review: 20 days after receipt of a division refund order issued pursuant to a
				division audit or review; or
(6)
				requests for hearing not specified in this subsection: the time for filing a
				request for hearing before SOAH is 20 days after receipt of a notice of the
				action that the party is requesting a hearing on, unless specified in other
				law.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.4 - Correction of Clerical Error

Current through Reg. 49, No. 28; July 12, 2024
(a) Correction
				of Clerical Error Discovered by the Division. The division may at any time
				revise an order or decision to correct a clerical error. The division may enter
				a nunc pro tunc order after an order or decision has become final. To initiate
				the correction, the division will notify the parties to the order or decision
				of the proposed correction. If a party objects to the proposed clerical
				correction, it must do so by the date and time specified by the division. The
				date and time specified by the division may not exceed the point at which the
				order or decision becomes final.
(b) Request for Correction of Clerical Error
				Discovered by a Party.
(1) A party to an
				order or decision may request the correction of a clerical error from the
				division prior to the point at which the order or decision becomes
				final.
(2) To initiate the
				correction, the division will notify the parties of the proposed correction. If
				a party objects to the proposed clerical correction, it must do so by the date
				and time specified by the division. The date and time specified by the division
				may not exceed the point at which the order or decision becomes
				final.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.5 - Notice of Hearing

Current through Reg. 49, No. 28; July 12, 2024
(a) Notice of
				Hearing. The Chief Clerk of Proceedings shall notify the parties in writing, by
				verifiable means, of the date, time, place, and nature of the hearing no later
				than 10 days before the hearing date. SOAH shall notify the parties of a
				hearing no later than 30 days before the hearing date for a hearing under Labor
				Code §
									407.046(b).
(b) Contents. The notice of hearing must
				include:
(1) a statement of the time, place,
				and nature of the hearing;
(2) the
				docket number;
(3) the legal
				authority and jurisdiction under which the hearing will be held;
(4) a reference to the particular sections of
				the statutes and any rules involved;
(5) a notice regarding failure to appear and
				default judgments; and
(6) a short,
				plain statement of the matters asserted.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.6 - Venue

Current through Reg. 49, No. 28; July 12, 2024
Hearings under this chapter are held in Austin, Travis
				  County, Texas.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.7 - Representation

Current through Reg. 49, No. 28; July 12, 2024
(a) Representation of Injured Employees or
				Insurance Carriers. Pursuant to Labor Code § 402.071 and §
									150.3
				of this title (relating to Representatives: Written Authorization Required), a
				person representing an injured employee or insurance carrier in a contested
				case hearing shall not receive a fee for providing representation under this
				subtitle unless the person is an adjuster representing an insurance carrier or
				licensed to practice law.
(b) Fee
				Defined. For the purposes of this section, "fee" means any remuneration
				received directly or indirectly, in cash or in kind. It includes voluntary
				contributions. The provision of representation before SOAH as an extension of,
				or in addition to, other services for which a fee was paid shall be considered
				receipt of a fee for providing representation as specified in Labor Code §
									401.011(37)
				and § 402.071 and §
									150.3
				of this title.
(c) Representation
				by Employee. The prohibitions in subsections (a) and (b) of this section do not
				preclude representation by a person who receives a salary as an employee of the
				person represented to perform services in the usual course and scope of the
				employer's business.
(1) For the purposes of
				this subsection, "employee" means a person in the service of another under a
				contract of hire, whether express or implied, or oral or written.
(2) The term "employee" does not include:
(A) an independent contractor or the employee
				of an independent contractor; or
(B) a person whose employment is not in the
				usual course and scope of the employer's business.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.8 - Withdrawal of Hearing Request

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				petitioner may, at any time before the decision or order is signed, submit a
				written request to withdraw the request for a hearing. The request must be sent
				to the Chief Clerk of Proceedings and to SOAH in accordance with its procedural
				rules in Title 1 TAC Chapter 155 (relating to Rules of Procedure).
(b) Notwithstanding the provisions of
				subsection (a) of this section, a decision of the division's medical fee
				dispute resolution section in a review of a medical fee under the Act may be
				withdrawn by the division within 15 working days after the division receives
				the request for hearing before SOAH if the request has not yet been delivered
				to SOAH.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.13 - Recording the Hearing

Current through Reg. 49, No. 28; July 12, 2024
(a) Arrangement for
				Court Reporter and Costs. In cases in which a court reporter is required, on
				the division's initiative, at the request of a party, or when required by SOAH
				rules or the ALJ of a case, the division will arrange for a court reporter. The
				Petitioner is responsible for all associated costs including the costs of the
				court reporter at the hearing and the costs associated with preparation of a
				verbatim record if one is required. In cases in which more than one party is
				seeking affirmative relief, the costs will be assessed equally. Nothing in this
				section precludes the parties from entering into their own agreement regarding
				arrangements for a court reporter or allocation of associated costs.
(b) Recording by a Party. A party electing to
				use a means of making a record that is in addition to the means specified in
				SOAH's rules or by the ALJ is responsible for all associated costs. If a
				verbatim record is made, the party shall provide the division and SOAH with a
				copy of the audiotape or videotape free of charge. If a transcript is made, the
				party shall provide the division with the original of the transcript free of
				charge.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.14 - Burden of Proof

Current through Reg. 49, No. 28; July 12, 2024
(a) Burden of Proof
				on the Division. The division has the burden of proof in a contested case in
				which the division seeks to impose a sanction or has issued an emergency cease
				and desist order.
(b) Burden of
				Proof on Party Seeking Relief. The burden of proof rests with the party seeking
				relief in hearings conducted pursuant to Labor Code §§
									408.024,
				413.031,
				413.0312,
				and
				413.055.
(c) Burden of Proof on the Certified
				Self-Insurer. The burden of proof rests with the certified self-insurer in
				hearings conducted pursuant to the following sections of the Labor Code:
(1) Section 407.043;
(2) Section 407.046;
(3) Section 407.133; and
(4) Section 407.066. The certified
				self-insurer has the burden of proof if they request the hearing to challenge
				the position of the division.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.15 - Final Decision by the ALJ

Current through Reg. 49, No. 28; July 12, 2024
(a) Decision or
				Order. The ALJ shall adjourn the hearing after all evidence has been received
				in contested cases held under Labor Code §§
									413.031,
				413.0312,
				and
				413.055.
(b) Decision or Order that May Become Final.
				The ALJ shall issue a decision or order that may become final.
(c) Contents of Decision or Order that May
				Become Final. The decision or order that may become final must include orders
				that are necessary to implement the decision or order. When the decision or
				order requires any action or compliance, it must contain a period of time for
				such action to be completed, normally not to exceed 30 days from the date the
				decision or order is received, for such action or compliance to be
				completed.
(d) Furnishing the
				Decision or Order that May Become Final.
(1)
				The decision or order that may become final will be sent immediately to the
				parties or their representatives by verifiable means that shall be documented
				in the hearing file.
(2) If the
				decision or order that may become final is furnished by personal delivery, a
				receipt verifying personal delivery and containing the date of delivery and the
				person, any business title, and person's business address that received the
				delivery shall be made by the person who makes the personal delivery, and shall
				be date-stamped and placed in the hearing file.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.16 - Proposal for Decision or Order by the ALJ

Current through Reg. 49, No. 28; July 12, 2024
(a) Proposal for Decision or Order. The ALJ
				shall adjourn the hearing after all evidence has been received in contested
				cases held under the Act not governed by §
									148.15
				of this title (relating to Final Decision by ALJ).
(b) Description of Proposal for Decision or
				Order. The proposal for decision or order must be based solely upon the record
				of the individual case. It must be in writing and include:
(1) a statement of the reasons upon which the
				decision is based;
(2) findings of
				fact based on the evidence presented and matters officially noticed. If there
				is evidence presented regarding the ability of a party to pay the amount of a
				proposed sanction or bonding amount in a hearing involving assessment of
				sanctions under Labor Code §
										415.021,
				the ALJ shall make findings of fact on those issues;
(3) conclusions of law based on the findings
				of fact and other legal requirements of the law;
(4) the sanction or order recommended by the
				ALJ;
(5) a conclusion of whether
				the division is authorized by the Act or division rules to take disciplinary or
				sanction action against the petitioner; and
(6) the proposal for decision or order may
				also contain:
(A) a summary of the evidence
				presented by each party; and
(B) a
				list of all mitigating circumstances and a list of all aggravating
				circumstances, separately stated, which are necessary for the commissioner to
				have a complete understanding of the case.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.17 - Special Provisions for Sanctions

Current through Reg. 49, No. 28; July 12, 2024
(a)
				Unless otherwise stated in a final, unappealable order from the commissioner or
				a court, a charged party must comply with a sanction no later than 30 days
				after the order becomes final and unappealable.
(b) If an order imposing a sanction assesses
				a penalty against the charged party, the charged party must file the amount of
				the penalty with the Chief Clerk of Proceedings in the form of a cashier's
				check, a certified check, a certified draft, or other form of payment
				authorized by the division.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.19 - Transcript or Duplicate of the Hearing Audiotape or Videotape

Current through Reg. 49, No. 28; July 12, 2024
(a) A party may submit a request to the
				division for a transcript of the hearing audiotape or videotape. The requestor
				shall pay the cost of the transcript, as established by the division.
(b) A party may submit a request to the
				division for a duplicate of the hearing audiotape or videotape. The requestor
				shall pay the cost of the duplication, as established by the
				division.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.20 - Reimbursement, Travel Expenses, and Fees for Witnesses and Deponents

Current through Reg. 49, No. 28; July 12, 2024
(a) Reimbursement of Witness or Deponent. A
				witness or deponent who is not a party and who is served with a subpoena or
				otherwise compelled to attend any hearing or proceeding to give a deposition or
				to produce books, records, papers, or other objects that are necessary for the
				proceeding is entitled to receive reimbursement for travel, meals, lodging, and
				other amounts as specified and limited in the Government Code §
									2001.103.
(b) Reasonable and Necessary Expenses and
				Service. The party requesting the subpoena or commission or otherwise
				compelling the attendance of a witness at any hearing or proceeding to give a
				deposition or produce books, records, papers, or other objects shall be
				responsible for the payment, of any expense, incurred in serving the subpoena,
				as well as reasonable and necessary expenses incurred by a nonparty witness who
				appears in response to the subpoena.
(c) Failure to Pay Expenses. The party
				requesting the subpoena or commission or otherwise compelling the attendance of
				a witness at any hearing or proceeding to give a deposition or produce books,
				records, papers, or other objects shall pay the witness the amount accrued
				under this section. Failure to pay the witness the amount accrued when sought
				is an administrative violation.
(d)
				Return of Deposit. After the Chief Clerk of Proceedings has received, from the
				party requesting the subpoena or commission to take deposition, sufficient
				documentation of all requests by the witness for payment of witness expenses
				and sufficient proof of payment of all amounts due to the non-party witness or
				deponent, the division will return the amount of any deposit required under
				§
									148.10(b)(3)
				and §
									148.11(d)(3)
				of this title (relating to Hearings Subpoenas To Compel Attendance and
				Subpoenas Duces Tecum and Commissions To Compel Attendance For Deposition),
				respectively.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.21 - Expenses to be Paid by Party Seeking Judicial Review

Current through Reg. 49, No. 28; July 12, 2024
(a) Upon receiving a copy of a petition filed
				in district court which seeks judicial review of a final decision in a
				contested case decided under this chapter, the division shall prepare a
				certified copy of the entire record of the proceeding under review, including a
				transcript of the hearing audiotape, and transmit it to the reviewing
				court.
(b) The division shall
				assess to the party seeking judicial review, expenses incurred by the division
				in preparing this copy, including transcription costs, in accordance with the
				Government Code §
									2001.177.
				Upon request, the division shall consider the financial ability of the party to
				pay the costs or any other factor that is relevant to a just and reasonable
				assessment of costs. If the party seeking judicial review is an injured
				employee, the division shall not charge for duplicating the record.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.22 - Failure to Appear or Comply with Order or Decision, Administrative Violation

Current through Reg. 49, No. 28; July 12, 2024
A person commits an administrative violation if that person
				  in the status of a party, or otherwise within the jurisdiction of SOAH (for
				  example, a witness), in a contested case hearing or proceeding before SOAH,
				  fails to comply with an order of the ALJ to include any final decisions
				  issued.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 148 - HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS › Section 148.23 - Division Enforcement of Orders

Current through Reg. 49, No. 28; July 12, 2024
Any final order of SOAH is a final order of the division and
				  may be enforced by the division in any manner permitted by the Act, the APA, or
				  division rules. After conclusion of the administrative process, any SOAH order
				  which survives the entry of a final order, the sending of a proposal for
				  decision to the division, or the dismissal or withdrawal of the case from the
				  SOAH docket, regardless of upon whose motion the dismissal or withdrawal was
				  granted, is an order of the commissioner and may be enforced by the division in
				  any manner permitted by the Act, the APA, or division rules. Examples of
				  enforceable orders include, but are not limited to, orders to reimburse, orders
				  to pay reasonable and necessary medical costs, orders to pay administrative
				  fines, orders to refund, orders assessing attorney fees, orders assessing
				  costs, and orders imposing discovery sanctions.
Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 150 - REPRESENTATION OF PARTIES BEFORE THE AGENCY - QUALIFICATIONS FOR REPRESENTATIVES › Section 150.1 - Minimum Standards of Practice for an Attorney

Current through Reg. 49, No. 28; July 12, 2024
(a) An attorney, in practice before the
				commission, shall observe:
(1) these
				rules;
(2) the Texas Disciplinary
				Rules of Professional Conduct; and
(3) the Texas Lawyer's Creed, promulgated by
				the Supreme Court of Texas on November 7, 1989.