Texas Labor Code Title 5, Chapter 410 - Adjudication Of Disputes

SUBCHAPTER A GENERAL PROVISIONS

• Texas Section 410.002 - Law Governing Liability Proceedings
  A proceeding before the division to determine the liability of an insurance carrier for compensation for an injury or death under this subtitle is governed...
• Texas Section 410.003 - Application Of Administrative Procedure And Texas Register Act
  Except as otherwise provided by this chapter, Chapter 2001, Government Code does not apply to a proceeding under this chapter. Acts 1993, 73rd Leg., ch....
• Texas Section 410.005 - Venue For Administrative Proceedings
  (a) Unless the division determines that good cause exists for the selection of a different location, a benefit review conference or a contested case hearing...
• Texas Section 410.006 - Representation At Administrative Proceedings
  (a) A claimant may be represented at a benefit review conference, a contested case hearing, or arbitration by an attorney or may be assisted by...

SUBCHAPTER B BENEFIT REVIEW CONFERENCE

• Texas Section 410.007 - Information List
  (a) The division shall determine the type of information that is most useful to parties to help resolve disputes regarding income benefits. That information may...
• Texas Section 410.021 - Purpose
  A benefit review conference is a nonadversarial, informal dispute resolution proceeding designed to: (1) explain, orally and in writing, the rights of the respective parties...
• Texas Section 410.022 - Benefit Review Officers; Qualifications
  (a) A benefit review officer shall conduct a benefit review conference. (b) A benefit review officer must: (1) be an employee of the division; (2)...
• Texas Section 410.023 - Request For Benefit Review Conference
  (a) On receipt of a request from a party or on its own motion, the division may direct the parties to a disputed workers' compensation...
• Texas Section 410.024 - Benefit Review Conference As Prerequisite To Further Proceedings On Certain Claims
  (a) Except as otherwise provided by law or commissioner rule, the parties to a disputed compensation claim are not entitled to a contested case hearing...
• Texas Section 410.025 - Scheduling Of Benefit Review Conference; Notice
  (a) The commissioner by rule shall prescribe the time within which a benefit review conference must be scheduled. (b) The division shall schedule a contested...
• Texas Section 410.026 - Powers And Duties Of Benefit Review Officer
  (a) A benefit review officer shall: (1) mediate disputes between the parties and assist in the adjustment of the claim consistent with this subtitle and...
• Texas Section 410.027 - Rules
  (a) The commissioner shall adopt rules for conducting benefit review conferences. (b) A benefit review conference is not subject to common law or statutory rules...
• Texas Section 410.028 - Failure To Attend; Administrative Violation
  (a) A scheduled benefit review conference shall be conducted even though a party fails to attend unless the benefit review officer determines that good cause,...
• Texas Section 410.029 - Resolution At Benefit Review Conference; Written Agreement
  (a) A dispute may be resolved either in whole or in part at a benefit review conference. (b) If the conference results in the resolution...
• Texas Section 410.030 - Binding Effect Of Agreement
  (a) An agreement signed in accordance with Section 410.029 is binding on the insurance carrier through the conclusion of all matters relating to the claim,...
• Texas Section 410.031 - Incomplete Resolution; Report
  (a) If a dispute is not entirely resolved at a benefit review conference, the benefit review officer shall prepare a written report that details each...
• Texas Section 410.032 - Payment Of Benefits Under Interlocutory Order
  (a) The benefit review officer who presides at the benefit review conference shall consider a request for an interlocutory order and shall give the opposing...
• Texas Section 410.032 - Payment Of Benefits Under Interlocutory Order
  (a) The benefit review officer who presides at the benefit review conference shall: (1) consider a written or verbal request for an interlocutory order for...
• Texas Section 410.033 - Multiple Carriers
  (a) If there is a dispute as to which of two or more insurance carriers is liable for compensation for one or more compensable injuries,...

SUBCHAPTER C ARBITRATION

• Texas Section 410.034 - Filing Of Agreement And Report
  (a) The benefit review officer shall file the signed agreement and the report with the division. (b) The commissioner by rule shall prescribe the times...
• Texas Section 410.101 - Purpose
  The purpose of arbitration is to: (1) enter into formal, binding stipulations on issues on which the parties agree; (2) resolve issues on which the...
• Texas Section 410.102 - Arbitrators; Qualifications
  (a) An arbitrator must be an employee of the division, except that the division may contract with qualified arbitrators on a determination of special need....
• Texas Section 410.103 - Duties Of Arbitrator
  An arbitrator shall: (1) protect the interests of all parties; (2) ensure that all relevant evidence has been disclosed to the arbitrator and to all...
• Texas Section 410.104 - Election Of Arbitration; Effect
  (a) If issues remain unresolved after a benefit review conference, the parties, by agreement, may elect to engage in arbitration in the manner provided by...
• Texas Section 410.105 - Lists Of Arbitrators
  (a) The division shall establish regional lists of arbitrators who meet the qualifications prescribed under Sections 410.102(a) and (b). Each regional list shall be initially...
• Texas Section 410.106 - Selection Of Arbitrator
  The division shall assign the arbitrator for a particular case by selecting the next name after the previous case's selection in consecutive order. The division...
• Texas Section 410.107 - Assignment Of Arbitrator
  (a) The division shall assign an arbitrator to a pending case not later than the 30th day after the date on which the election for...
• Texas Section 410.108 - Rejection Of Arbitrator
  (a) Each party is entitled, in its sole discretion, to one rejection of the arbitrator in each case. If a party rejects the arbitrator, the...
• Texas Section 410.109 - Scheduling Of Arbitration
  (a) The arbitrator shall schedule arbitration to be held not later than the 30th day after the date of the arbitrator's assignment and shall notify...
• Texas Section 410.110 - Continuance
  (a) A request by a party for a continuance of the arbitration to another date must be directed to the director. The director may grant...
• Texas Section 410.111 - Rules
  The commissioner shall adopt rules for arbitration consistent with generally recognized arbitration principles and procedures. Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept....
• Texas Section 410.112 - Exchange And Filing Of Information; Administrative Violation
  (a) Not later than the seventh day before the first day of arbitration, the parties shall exchange and file with the arbitrator: (1) all medical...
• Texas Section 410.113 - Duties Of Parties At Arbitration; Attendance; Administrative Violation
  (a) Each party shall attend the arbitration prepared to set forth in detail its position on unresolved issues and the issues on which it is...
• Texas Section 410.114 - Testimony; Record
  (a) The arbitrator may require witnesses to testify under oath and shall require testimony under oath if requested by a party. (b) The division shall...
• Texas Section 410.115 - Evidence
  (a) The parties may offer evidence as they desire and shall produce additional evidence as the arbitrator considers necessary to an understanding and determination of...
• Texas Section 410.116 - Closing Statements; Briefs
  The parties may present closing statements as they desire, but the record may not remain open for written briefs unless requested by the arbitrator. Acts...
• Texas Section 410.117 - Ex Parte Contacts Prohibited
  A party and an arbitrator may not communicate outside the arbitration unless the communication is in writing with copies provided to all parties or relates...
• Texas Section 410.118 - Award
  (a) The arbitrator shall enter the arbitrator's award not later than the seventh day after the last day of arbitration. (b) The arbitrator shall base...
• Texas Section 410.119 - Effect Of Award
  (a) An arbitrator's award is final and binding on all parties. Except as provided by Section 410.121, there is no right to appeal. (b) An...
• Texas Section 410.120 - Clerical Error
  For the purpose of correcting a clerical error, an arbitrator retains jurisdiction of the award for 20 days after the date of the award. Acts...

SUBCHAPTER D CONTESTED CASE HEARING

• Texas Section 410.121 - Court Vacating Award
  (a) On application of an aggrieved party, a court of competent jurisdiction shall vacate an arbitrator's award on a finding that: (1) the award was...
• Texas Section 410.151 - Contested Case Hearing; Scope
  (a) If arbitration is not elected under Section 410.104, a party to a claim for which a benefit review conference is held or a party...
• Texas Section 410.152 - Hearing Officers; Qualifications
  (a) A hearing officer shall conduct a contested case hearing. (b) A hearing officer must be licensed to practice law in this state. Acts 1993,...
• Texas Section 410.153 - Application Of Administrative Procedure Act
  Chapter 2001, Government Code, applies to a contested case hearing to the extent that the commissioner finds appropriate, except that the following do not apply:...
• Texas Section 410.154 - Scheduling Of Hearing
  The division shall schedule a contested case hearing in accordance with Section 410.024 or 410.025(b). Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept....
• Texas Section 410.155 - Continuance
  (a) A written request by a party for a continuance of a contested case hearing to another date must be directed to the division. (b)...
• Texas Section 410.156 - Attendance Required; Administrative Violation
  (a) Each party shall attend a contested case hearing. (b) A party commits an administrative violation if the party, without good cause as determined by...
• Texas Section 410.157 - Rules
  The commissioner shall adopt rules governing procedures under which contested case hearings are conducted. Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1,...
• Texas Section 410.158 - Discovery
  (a) Except as provided by Section 410.162, discovery is limited to: (1) depositions on written questions to any health care provider; (2) depositions of other...
• Texas Section 410.159 - Standard Interrogatories
  (a) The commissioner by rule shall prescribe standard form sets of interrogatories to elicit information from claimants and insurance carriers. (b) Standard interrogatories shall be...
• Texas Section 410.160 - Exchange Of Information
  Within the time prescribed by commissioner rule, the parties shall exchange: (1) all medical reports and reports of expert witnesses who will be called to...
• Texas Section 410.161 - Failure To Disclose Information
  A party who fails to disclose information known to the party or documents that are in the party's possession, custody, or control at the time...
• Texas Section 410.162 - Additional Discovery
  For good cause shown, a party may obtain permission from the hearing officer to conduct additional discovery as necessary. Acts 1993, 73rd Leg., ch. 269,...
• Texas Section 410.163 - Powers And Duties Of Hearing Officer
  (a) At a contested case hearing the hearing officer shall: (1) swear witnesses; (2) receive testimony; (3) allow examination and cross-examination of witnesses; (4) accept...
• Texas Section 410.164 - Record
  (a) The proceedings of a contested case hearing shall be recorded electronically. A party may request a transcript of the proceeding and shall pay the...
• Texas Section 410.165 - Evidence
  (a) The hearing officer is the sole judge of the relevance and materiality of the evidence offered and of the weight and credibility to be...
• Texas Section 410.166 - Stipulations
  A written stipulation or agreement of the parties that is filed in the record or an oral stipulation or agreement of the parties that is...
• Texas Section 410.167 - Ex Parte Contacts Prohibited
  A party and a hearing officer may not communicate outside the contested case hearing unless the communication is in writing with copies provided to all...
• Texas Section 410.168 - Decision
  (a) The hearing officer shall issue a written decision that includes: (1) findings of fact and conclusions of law; (2) a determination of whether benefits...

SUBCHAPTER E APPEALS PANEL

• Texas Section 410.169 - Effect Of Decision
  A decision of a hearing officer regarding benefits is final in the absence of a timely appeal by a party and is binding during the...
• Texas Section 410.201 - Appeals Judges; Qualifications
  (a) Appeals judges, in a three-member panel, shall conduct administrative appeals proceedings. (b) An appeals judge must be licensed to practice law in this state....
• Texas Section 410.202 - Request For Appeal; Response
  (a) To appeal the decision of a hearing officer, a party shall file a written request for appeal with the appeals panel not later than...
• Texas Section 410.203 - Powers And Duties Of Appeals Panel; Priority Of Hearing On Remand
  (a) The appeals panel shall consider: (1) the record developed at the contested case hearing; and (2) the written request for appeal and response filed...
• Texas Section 410.204 - Decision
  (a) The appeals panel shall review each request and issue a written decision on each reversed or remanded case. The appeals panel may issue a...
• Texas Section 410.205 - Effect Of Decision
  (a) A decision of the appeals panel regarding benefits is final in the absence of a timely appeal for judicial review. (b) The decision of...
• Texas Section 410.206 - Clerical Error
  The division may revise a decision in a contested case hearing on a finding of clerical error. Acts 1993, 73rd Leg., ch. 269, Sec. 1,...
• Texas Section 410.207 - Continuation Of Division Jurisdiction
  During judicial review of the appeals panel decision on any disputed issue relating to a workers' compensation claim, the division retains jurisdiction of all other...
• Texas Section 410.208 - Judicial Enforcement Of Order Or Decision; Administrative Violation
  (a) If a person refuses or fails to comply with an interlocutory order, final order, or decision of the commissioner, the division may bring suit...

SUBCHAPTER F JUDICIAL REVIEW--GENERAL PROVISIONS

• Texas Section 410.209 - Reimbursement For Overpayment
  The subsequent injury fund shall reimburse an insurance carrier for any overpayments of benefits made under an interlocutory order or decision if that order or...
• Texas Section 410.251 - Exhaustion Of Remedies
  A party that has exhausted its administrative remedies under this subtitle and that is aggrieved by a final decision of the appeals panel may seek...
• Texas Section 410.252 - Time For Filing Petition; Venue
  (a) A party may seek judicial review by filing suit not later than the 45th day after the date on which the division mailed the...
• Texas Section 410.253 - Service; Notice
  (a) A party seeking judicial review shall simultaneously: (1) file a copy of the party's petition with the court; (2) serve any opposing party to...
• Texas Section 410.254 - Intervention
  On timely motion initiated by the commissioner, the division shall be permitted to intervene in any judicial proceeding under this subchapter or Subchapter G. Acts...
• Texas Section 410.255 - Judicial Review Of Issues Other Than Compensability Or Income Or Death Benefits
  (a) For all issues other than those covered under Section 410.301(a), judicial review shall be conducted in the manner provided for judicial review of a...
• Texas Section 410.256 - Court Approval Of Settlement
  (a) A claim or issue may not be settled contrary to the provisions of the appeals panel decision issued on the claim or issue unless...
• Texas Section 410.257 - Judgment After Judicial Review
  (a) A judgment entered by a court on judicial review of the appeals panel decision under this subchapter or Subchapter G must comply with all...

SUBCHAPTER G JUDICIAL REVIEW OF ISSUES REGARDING COMPENSABILITY OR INCOME OR DEATH BENEFITS

• Texas Section 410.258 - Notification Of Division Of Proposed Judgments And Settlements; Right To Intervene
  (a) The party who initiated a proceeding under this subchapter or Subchapter G must file any proposed judgment or settlement made by the parties to...
• Texas Section 410.301 - Judicial Review Of Issues Regarding Compensability Or Income Or Death Benefits
  (a) Judicial review of a final decision of the appeals panel regarding compensability or eligibility for or the amount of income or death benefits shall...
• Texas Section 410.302 - Admissibility Of Records; Limitation Of Issues
  (a) The records of a contested case hearing conducted under this chapter are admissible in a trial under this subchapter in accordance with the Texas...
• Texas Section 410.303 - Burden Of Proof
  The party appealing the decision on an issue described in Section 410.301(a) has the burden of proof by a preponderance of the evidence. Acts 1993,...
• Texas Section 410.304 - Consideration Of Appeals Panel Decision
  (a) In a jury trial, the court, before submitting the case to the jury, shall inform the jury in the court's instructions, charge, or questions...
• Texas Section 410.305 - Conflict With Rules Of Civil Procedure
  (a) To the extent that this subchapter conflicts with the Texas Rules of Civil Procedure or any other rules adopted by the supreme court, this...
• Texas Section 410.306 - Evidence
  (a) Evidence shall be adduced as in other civil trials. (b) The division on payment of a reasonable fee shall make available to the parties...
• Texas Section 410.307 - Substantial Change Of Condition
  (a) Evidence of the extent of impairment is not limited to that presented to the division if the court, after a hearing, finds that there...
• Texas Section 410.308 - Certified Copy Of Notice Securing Compensation
  (a) The division shall furnish any interested party in the claim with a certified copy of the notice of the employer securing compensation with the...

Last modified: September 28, 2016