Texas Administrative Code (Last Updated: March 27,2024) |
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
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(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. Source Note: The provisions of this §141.5 adopted to be effective June 7, 1991, 16 TexReg 2876; amended to be effective September 4, 2006, 31 TexReg 7127