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TITLE 28INSURANCE
PART 2TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION
CHAPTER 42MEDICAL BENEFITS
SUBCHAPTER DDISPUTE RESOLUTION
RULE §42.310Board Review and Resolution

(a) After all required information has been filed, the board will commence to review the dispute.

(b) No later than 31 days after commencing the review, the executive director or designee shall issue findings and conclusions in writing to the disputing parties.

(c) If the merits of the injured worker's claim have not been previously resolved by final award, judgment, or settlement, the findings and conclusions of the executive director or designee will be issued as a recommendation, to be filed pending final resolution of the merits of the injured worker's claim.

(d) If the merits of the injured worker's claim have been previously resolved by final award, judgment, or settlement, or if the injured worker is entitled to lifetime benefits under Texas Civil Statutes, Article 8306, §10(b), the board may, upon request of a disputing party, issue an award of medical benefits, based on the findings and conclusions of the executive director or designee.

(e) If the award is entered against the carrier on the issue of fees and charges only, it shall include an assessment of the statutory interest due.


Source Note: The provisions of this §42.310 adopted to be effective October 20, 1988, 13 TexReg 4998.

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