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TITLE 28INSURANCE
PART 2TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION
CHAPTER 141DISPUTE RESOLUTION--BENEFIT REVIEW CONFERENCE
RULE §141.5Description of the Benefit Review Conference

(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

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