CHAPTER 410. ADJUDICATION OF DISPUTES - Texas Statutes

LABOR CODE

TITLE 5. WORKERS' COMPENSATION

SUBTITLE A. TEXAS WORKERS' COMPENSATION ACT

CHAPTER 410. ADJUDICATION OF DISPUTES

SUBCHAPTER A. GENERAL PROVISIONS

Sec. 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 by this chapter.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.150, eff. September 1, 2005.

Sec. 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. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49), eff.

Sept. 1, 1995.

Sec. 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 may not be conducted at a site more than

75 miles from the claimant's residence at the time of the injury.

(b) Unless the assigned arbitrator determines that good cause

exists for the selection of a different location, arbitration may

not be conducted at a site more than 75 miles from the claimant's

residence at the time of the injury.

(c) All appeals panel proceedings shall be conducted in Travis

County.

(d) Notwithstanding Subsection (a), the division may conduct a

benefit review conference telephonically on agreement by the

injured employee.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.151, eff. September 1, 2005.

Sec. 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 an individual of the claimant's choice who does not

work for an attorney or receive a fee. An employee of an attorney

may represent a claimant if that employee:

(1) is a relative of the claimant; and

(2) does not receive a fee.

(b) An insurance carrier may be represented by an attorney or

adjuster.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 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 include:

(1) reports regarding the compensable injury;

(2) medical information regarding the injured employee; and

(3) wage records.

(b) The division shall publish a list developed from the

information described under Subsection (a) in appropriate media,

including the division's Internet website, to provide guidance to

a party to a dispute regarding the type of information the party

should have available at a benefit review conference or a

contested case hearing.

(c) At the time a benefit review conference or contested case

hearing is scheduled, the division shall make available a copy of

the list developed under Subsection (b) to each party to the

dispute.

Added by Acts 2005, 79th Leg., Ch.

265, Sec. 3.152, eff. September 1, 2005.

SUBCHAPTER B. BENEFIT REVIEW CONFERENCE

Sec. 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 to a workers' compensation claim and the procedures

necessary to protect those rights;

(2) discuss the facts of the claim, review available information

in order to evaluate the claim, and delineate the disputed

issues; and

(3) mediate and resolve disputed issues by agreement of the

parties in accordance with this subtitle and the policies of the

division.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.153, eff. September 1, 2005.

Sec. 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) be trained in the principles and procedures of dispute

mediation; and

(3) have documentation satisfactory to the commissioner that

evidences the completion by the officer of at least 40 classroom

hours of training in dispute resolution techniques from an

alternative dispute resolution organization recognized by the

commissioner.

(c) The division shall institute and maintain an education and

training program for benefit review officers and shall consult or

contract with the Federal Mediation and Conciliation Service or

other appropriate organizations for this purpose.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.154, eff. September 1, 2005.

Sec. 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 claim to meet in a benefit review conference to

attempt to reach agreement on disputed issues involved in the

claim.

(b) The division shall require the party requesting the benefit

review conference to provide documentation of efforts made to

resolve the disputed issues before the request was submitted.

The commissioner by rule shall adopt guidelines regarding the

type of information necessary to satisfy this requirement.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.155, eff. September 1, 2005.

Sec. 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

or arbitration on the claim unless a benefit review conference is

conducted as provided by this subchapter.

(b) The commissioner by rule shall adopt guidelines relating to

claims that do not require a benefit review conference and may

proceed directly to a contested case hearing or arbitration.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.156, eff. September 1, 2005.

Sec. 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 case hearing to be

held not later than the 60th day after the date of the benefit

review conference if the disputed issues are not resolved at the

benefit review conference.

(c) The division shall send written notice of the benefit review

conference to the parties to the claim and the employer.

(d) The commissioner by rule shall provide for expedited

proceedings in cases in which compensability or liability for

essential medical treatment is in dispute.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.157, eff. September 1, 2005.

Sec. 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 the

policies of the division;

(2) thoroughly inform all parties of their rights and

responsibilities under this subtitle, especially in a case in

which the employee is not represented by an attorney or other

representative;

(3) ensure that all documents and information relating to the

employee's wages, medical condition, and any other information

pertinent to the resolution of disputed issues are contained in

the claim file at the conference, especially in a case in which

the employee is not represented by an attorney or other

representative; and

(4) prepare a written report that details each issue that is not

resolved at the benefit review conference, as required under

Section 410.031, including any issue raised for the first time at

the conclusion of an additional benefit review conference

conducted under Subsection (b).

(b) A benefit review officer may schedule an additional benefit

review conference if:

(1) the benefit review officer determines that any available

information pertinent to the resolution of disputed issues was

not produced at the initial benefit review conference; and

(2) a second benefit review conference has not already been

conducted.

(c) A benefit review officer may not take testimony but may

direct questions to an employee, an employer, or a representative

of an insurance carrier to supplement or clarify information in a

claim file.

(d) A benefit review officer may not make a formal record.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.158, eff. September 1, 2005.

Sec. 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 of evidence or procedure.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.159, eff. September 1, 2005.

Sec. 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 exists to reschedule the conference.

(b) A party commits an administrative violation if the party

fails to attend a benefit review conference without good cause as

determined by the benefit review officer.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.160, eff. September 1, 2005.

Sec. 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 of some disputed

issues by agreement or in a settlement, the benefit review

officer shall reduce the agreement or the settlement to writing.

The benefit review officer and each party or the designated

representative of the party shall sign the agreement or

settlement.

(c) A settlement takes effect on the date it is approved by the

director in accordance with Section 408.005.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 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, unless the division or a court, on a finding of

fraud, newly discovered evidence, or other good and sufficient

cause, relieves the insurance carrier of the effect of the

agreement.

(b) The agreement is binding on the claimant, if represented by

an attorney, to the same extent as on the insurance carrier. If

the claimant is not represented by an attorney, the agreement is

binding on the claimant through the conclusion of all matters

relating to the claim while the claim is pending before the

division, unless the commissioner for good cause relieves the

claimant of the effect of the agreement.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.161, eff. September 1, 2005.

Sec. 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 issue that is not resolved at the conference.

(b) The report must also include:

(1) a statement of each resolved issue;

(2) a statement of each issue raised but not resolved;

(3) a statement of the position of the parties regarding each

unresolved issue;

(4) a statement of the procedures required to request a

contested case hearing or arbitration and a complete explanation

of the differences in those proceedings and the rights of the

parties to subsequent review of the determinations made in those

proceedings; and

(5) the date of the contested case hearing scheduled in

accordance with Section 410.025(b).

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.162, eff. September 1, 2005.

Text of section as amended by Acts 2007, 80th Leg., R.S., Ch.

1177, Sec. 1

For text of section as amended by Acts 2007, 80th Leg., R.S., Ch.

1150, Sec. 4, see other Sec. 410.032.

Sec. 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 party the opportunity to respond

before issuing an interlocutory order.

(b) The interlocutory order may address the payment or

suspension of accrued benefits, future benefits, or both accrued

benefits and future benefits.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by Acts 1999, 76th Leg., ch. 955, Sec. 2, eff. Sept. 1,

1999.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.162, eff. September 1, 2005.

Acts 2007, 80th Leg., R.S., Ch.

1177, Sec. 1, eff. September 1, 2007.

Text of section as amended by Acts 2007, 80th Leg., R.S., Ch.

1150, Sec. 4

For text of section as amended by Acts 2007, 80th Leg., R.S., Ch.

1177, Sec. 1, see other Sec. 410.032.

Sec. 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 the payment of benefits; and

(2) if the benefit review officer determines that issuance of an

interlocutory order is appropriate, issue the interlocutory order

not later than the third day after the date of receipt of the

request under Subdivision (1).

(b) The interlocutory order may address accrued benefits, future

benefits, or both accrued benefits and future benefits.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by Acts 1999, 76th Leg., ch. 955, Sec. 2, eff. Sept. 1,

1999.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.162, eff. September 1, 2005.

Acts 2007, 80th Leg., R.S., Ch.

1150, Sec. 4, eff. September 1, 2007.

Sec. 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, the

commissioner may issue an interlocutory order directing each

insurance carrier to pay a proportionate share of benefits due

pending a final decision on liability. The proportionate share

is computed by dividing the compensation due by the number of

insurance carriers involved.

(b) On final determination of liability, an insurance carrier

determined to be not liable for the payment of benefits is

entitled to reimbursement for the share paid by the insurance

carrier from any insurance carrier determined to be liable.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.163, eff. September 1, 2005.

Sec. 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 within

which the agreement and report must be filed.

(c) The division shall furnish a copy of the file-stamped report

to:

(1) the claimant;

(2) the employer; and

(3) the insurance carrier.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.164, eff. September 1, 2005.

SUBCHAPTER C. ARBITRATION

Sec. 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 parties disagree; and

(3) render a final award with respect to all issues in dispute.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 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.

(b) An arbitrator must:

(1) be a member of the National Academy of Arbitrators;

(2) be on an approved list of the American Arbitration

Association or Federal Mediation and Conciliation Service; or

(3) meet qualifications established by the commissioner by rule.

(c) The division shall require that each arbitrator have

appropriate training in the workers' compensation laws of this

state. The commissioner shall establish procedures to carry out

this subsection.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.165, eff. September 1, 2005.

Sec. 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 parties; and

(3) render an award consistent with this subtitle and the

policies of the division.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.166, eff. September 1, 2005.

Sec. 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 this subchapter. Arbitration may be used only to

resolve disputed benefit issues and is an alternative to a

contested case hearing. A contested case hearing scheduled under

Section 410.025(b) is canceled by an election under this

subchapter.

(b) To elect arbitration, the parties must file the election

with the division not later than the 20th day after the last day

of the benefit review conference. The commissioner shall

prescribe a form for that purpose.

(c) An election to engage in arbitration under this subchapter

is irrevocable and binding on all parties for the resolution of

all disputes arising out of the claims that are under the

jurisdiction of the division.

(d) An agreement to elect arbitration binds the parties to the

provisions of Chapter 408 relating to benefits, and any award,

agreement, or settlement after arbitration is elected must comply

with that chapter.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.167, eff. September 1, 2005.

Sec. 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 prepared in a random name

order, and subsequent additions to a list shall be added

chronologically.

(b) The commissioner shall review the lists of arbitrators

annually and determine if each arbitrator is fair and impartial

and makes awards that are consistent with and in accordance with

this subtitle and the rules of the commissioner. The

commissioner shall remove an arbitrator if, after the review, the

commissioner determines that the arbitrator is not fair and

impartial or does not make awards consistent with this subtitle

and commissioner rules.

(c) The division's lists are confidential and are not subject to

disclosure under Chapter 552, Government Code. The lists may not

be revealed by any division employee to any person who is not a

division employee. The lists are exempt from discovery in civil

litigation unless the party seeking the discovery establishes

reasonable cause to believe that a violation of the requirements

of this section or Section 410.106, 410.107, 410.108, or

410.109(b) occurred and that the violation is relevant to the

issues in dispute.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by Acts 1995, 74th Leg., ch. 76, Sec. 5.95(88), eff.

Sept. 1, 1995.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.168, eff. September 1, 2005.

Sec. 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 may not change the order of names once the order is

established under this subchapter, except that once each

arbitrator on the list has been assigned to a case, the names

shall be randomly reordered.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.169, eff. September 1, 2005.

Sec. 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 arbitration is filed

with the division.

(b) When an arbitrator has been assigned to a case under

Subsection (a), the parties shall be notified immediately.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.170, eff. September 1, 2005.

Sec. 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

division shall assign another arbitrator as provided by Section

410.106.

(b) A rejection must be made not later than the third day after

the date of notification of the arbitrator's assignment.

(c) When all parties have exercised their right of rejection or

if no rejection is registered, the assignment is final.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.171, eff. September 1, 2005.

Sec. 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

the parties and the division of the scheduled date.

(b) If an arbitrator is unable to schedule arbitration in

accordance with Subsection (a), the division shall appoint the

next arbitrator on the applicable list. Each party is entitled

to reject the arbitrator appointed under this subsection in the

manner provided under Section 410.108.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.172, eff. September 1, 2005.

Sec. 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 a continuance only if the

director determines, giving due regard to the availability of the

arbitrator, that good cause for the continuance exists.

(b) If the director grants a continuance under this section, the

rescheduled date may not be later than the 30th day after the

original date of the arbitration.

(c) Without regard to whether good cause exists, the director

may not grant more than one continuance to each party.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 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. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.173, eff. September 1, 2005.

Sec. 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 reports and other documentary evidence not

previously exchanged or filed that are pertinent to the

resolution of the claim; and

(2) information relating to their proposed resolution of the

disputed issues.

(b) A party commits an administrative violation if the party,

without good cause as determined by the arbitrator, fails to

comply with Subsection (a).

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.174, eff. September 1, 2005.

Sec. 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 prepared to

stipulate.

(b) A party commits an administrative violation if the party

does not attend the arbitration unless the arbitrator determines

that the party had good cause not to attend.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.175, eff. September 1, 2005.

Sec. 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 make an electronic recording of the

proceeding.

(c) An official stenographic record is not required, but any

party may at the party's expense make a stenographic record of

the proceeding.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.176, eff. September 1, 2005.

Sec. 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 the dispute.

(b) The arbitrator is the judge of the relevance and materiality

of the evidence offered. Conformity to legal rules of evidence is

not required.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 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 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 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 to procedural matters.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 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 the award on the facts established

at arbitration, including stipulations of the parties, and on the

law as properly applied to those facts.

(c) The award must:

(1) be in writing;

(2) be signed and dated by the arbitrator; and

(3) include a statement of the arbitrator's decision on the

contested issues and the parties' stipulations on uncontested

issues.

(d) The arbitrator shall file a copy of the award as part of the

permanent claim file at the division and shall notify the parties

in writing of the decision.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.177, eff. September 1, 2005.

Sec. 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 arbitrator's award is a final order of the division.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.178, eff. September 1, 2005.

Sec. 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 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 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 procured by corruption, fraud, or

misrepresentation;

(2) the decision of the arbitrator was arbitrary and capricious;

or

(3) the award was outside the jurisdiction of the division.

(b) If an award is vacated, the case shall be remanded to the

division for another arbitration proceeding.

(c) A suit to vacate an award must be filed not later than the

30th day after:

(1) the date of the award; or

(2) the date the appealing party knew or should have known of a

basis for suit under this section, but in no event later than 12

months after an order denying compensation or after the

expiration of the income or death benefit period.

(d) Venue for a suit to vacate an award is in the county in

which the arbitration was conducted.

(e) In a suit to vacate an arbitrator's award, only the court

may make determinations, including findings of fact or

conclusions of law.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.179, eff. September 1, 2005.

SUBCHAPTER D. CONTESTED CASE HEARING

Sec. 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

eligible to proceed directly to a contested case hearing as

provided by Section 410.024 is entitled to a contested case

hearing.

(b) An issue that was not raised at a benefit review conference

or that was resolved at a benefit review conference may not be

considered unless:

(1) the parties consent; or

(2) if the issue was not raised, the commissioner determines

that good cause existed for not raising the issue at the

conference.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.180, eff. September 1, 2005.

Sec. 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, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 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:

(1) Section 2001.054;

(2) Sections 2001.061 and 2001.062;

(3) Section 2001.202; and

(4) Subchapters F, G, I, and Z, except for Section 2001.141(c).

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by Acts 1995, 74th Leg., ch. 76, Sec. 5.93, eff. Sept. 1,

1995.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.181, eff. September 1, 2005.

Sec. 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. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.182, eff. September 1, 2005.

Sec. 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) The division may grant a continuance only if the division

determines that there is good cause for the continuance.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.183, eff. September 1, 2005.

Sec. 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 the hearing officer, does not

attend a contested case hearing.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.184, eff. September 1, 2005.

Sec. 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, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.185, eff. September 1, 2005.

Sec. 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 witnesses as permitted by the hearing

officer for good cause shown; and

(3) interrogatories as prescribed by the commissioner.

(b) Discovery under Subsection (a) may not seek information that

may readily be derived from documentary evidence described in

Section 410.160. Answers to discovery under Subsection (a) need

not duplicate information that may readily be derived from

documentary evidence described in Section 410.160.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.186, eff. September 1, 2005.

Sec. 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 answered by each party and

served on the opposing party within the time prescribed by

commissioner rule, unless the parties agree otherwise.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.187, eff. September 1, 2005.

Sec. 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 testify at the hearing;

(2) all medical records;

(3) any witness statements;

(4) the identity and location of any witness known to the

parties to have knowledge of relevant facts; and

(5) all photographs or other documents that a party intends to

offer into evidence at the hearing.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.188, eff. September 1, 2005.

Sec. 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 disclosure is required by Sections 410.158-410.160 may not

introduce the evidence at any subsequent proceeding before the

division or in court on the claim unless good cause is shown for

not having disclosed the information or documents under those

sections.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.189, eff. September 1, 2005.

Sec. 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, Sec. 1, eff. Sept. 1, 1993.

Sec. 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 documents and other tangible evidence; and

(5) allow the presentation of evidence by affidavit.

(b) A hearing officer shall ensure the preservation of the

rights of the parties and the full development of facts required

for the determinations to be made. A hearing officer may permit

the use of summary procedures, if appropriate, including witness

statements, summaries, and similar measures to expedite the

proceedings.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 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 reasonable cost of

the transcription.

(b) A party may request that the proceedings of the contested

case hearing be recorded by a court reporter. The party making

the request shall bear the cost.

(c) At each contested case hearing, as applicable, the insurance

carrier shall file with the hearing officer and shall deliver to

the claimant a single document stating the true corporate name of

the insurance carrier and the name and address of the insurance

carrier's registered agent for service of process. The document

is part of the record of the contested case hearing.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by Acts 2001, 77th Leg., ch. 1456, Sec. 11.01, eff. June

17, 2001.

Sec. 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 given to the evidence.

Conformity to legal rules of evidence is not necessary.

(b) A hearing officer may accept a written statement signed by a

witness and shall accept all written reports signed by a health

care provider.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 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 preserved in the record is

final and binding.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 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 parties or relates to procedural matters.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 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 are due; and

(3) an award of benefits due.

(b) The decision may address accrued benefits, future benefits,

or both accrued benefits and future benefits.

(c) The hearing officer may enter an interlocutory order for the

payment of all or part of medical benefits or income benefits.

The order may address accrued benefits, future benefits, or both

accrued benefits and future benefits. The order is binding during

the pendency of an appeal to the appeals panel.

(d) On a form that the commissioner by rule prescribes, the

hearing officer shall issue a separate written decision regarding

attorney's fees and any matter related to attorney's fees. The

decision regarding attorney's fees and the form may not be made

known to a jury in a judicial review of an award, including an

appeal.

(e) The commissioner by rule shall prescribe the times within

which the hearing officer must file the decisions with the

division.

(f) The division shall send a copy of the decision to each

party.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by Acts 1999, 76th Leg., ch. 955, Sec. 3, eff. Sept. 1,

1999.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.190, eff. September 1, 2005.

Sec. 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 pendency of an appeal

to the appeals panel.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

SUBCHAPTER E. APPEALS PANEL

Sec. 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.

(c) An appeals judge may not conduct a benefit review conference

or a contested case hearing.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.191, eff. September 1, 2005.

Sec. 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 the 15th

day after the date on which the decision of the hearing officer

is received from the division and shall on the same date serve a

copy of the request for appeal on the other party.

(b) The respondent shall file a written response with the

appeals panel not later than the 15th day after the date on which

the copy of the request for appeal is served and shall on the

same date serve a copy of the response on the appellant.

(c) A request for appeal or a response must clearly and

concisely rebut or support the decision of the hearing officer on

each issue on which review is sought.

(d) Saturdays and Sundays and holidays listed in Section

662.003, Government Code, are not included in the computation of

the time in which a request for an appeal under Subsection (a) or

a response under Subsection (b) must be filed.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by Acts 2001, 77th Leg., ch. 1456, Sec. 12.01, eff. June

17, 2001.

Sec. 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 with the

appeals panel.

(b) The appeals panel may:

(1) reverse the decision of the hearings officer and render a

new decision; or

(2) reverse the decision of the hearings officer and remand the

case to the hearing officer for further consideration and

development of evidence.

(c) The appeals panel may not remand a case under Subsection

(b)(2) more than once.

(d) A hearing on remand shall be accelerated and the

commissioner shall adopt rules to give priority to the hearing

over other proceedings.

(e) The appeals panel shall issue and maintain a precedent

manual. The precedent manual shall be composed of

precedent-establishing decisions and may include other

information as identified by the appeals panel.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.192, eff. September 1, 2005.

Sec. 410.204. DECISION. (a) The appeals panel shall review

each request and issue a written decision on each reversed or

remanded case. The decision must be in writing and shall be

issued not later than the 45th day after the date on which the

written response to the request for appeal is filed. The appeals

panel shall file a copy of the decision with the commissioner.

(b) A copy of the decision of the appeals panel shall be sent to

each party not later than the seventh day after the date the

decision is filed with the division.

(c) If the appeals panel does not issue a decision in accordance

with this section, the decision of the hearing officer becomes

final and is the final decision of the appeals panel.

(d) Each final decision of the appeals panel shall conclude with

a separate paragraph stating: "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)."

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by Acts 2001, 77th Leg., ch. 1456, Sec. 11.02, eff. June

17, 2001.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.193, eff. September 1, 2005.

Sec. 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 the appeals panel regarding benefits is

binding during the pendency of an appeal under Subchapter F or G.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by Acts 1999, 76th Leg., ch. 955, Sec. 4, eff. Sept. 1,

1999.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.194, eff. September 1, 2005.

Sec. 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, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.195, eff. September 1, 2005.

Sec. 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 issues related to the claim.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.196, eff. September 1, 2005.

Sec. 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 in Travis County to

enforce the order or decision.

(b) If an insurance carrier refuses or fails to comply with an

interlocutory order, a final order, or a decision of the

commissioner, the claimant may bring suit in the county of the

claimant's residence at the time of the injury, or death if the

employee is deceased, or, in the case of an occupational disease,

in the county in which the employee resided on the date

disability began or any county agreed to by the parties.

(c) If the division brings suit to enforce an interlocutory

order, final order, or decision of the commissioner, the division

is entitled to reasonable attorney's fees and costs for the

prosecution and collection of the claim, in addition to a

judgment enforcing the order or decision and any other remedy

provided by law.

(d) A claimant who brings suit to enforce an interlocutory

order, final order, or decision of the commissioner is entitled

to a penalty equal to 12 percent of the amount of benefits

recovered in the judgment, interest, and reasonable attorney's

fees for the prosecution and collection of the claim, in addition

to a judgment enforcing the order or decision.

(e) A person commits an administrative violation if the person

fails or refuses to comply with an interlocutory order, final

order, or decision of the commissioner within 20 days after the

date the order or decision becomes final.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by Acts 2003, 78th Leg., ch. 397, Sec. 1, eff. Sept. 1,

2003.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.197, eff. September 1, 2005.

Sec. 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 decision is reversed or modified by

final arbitration, order, or decision of the commissioner or a

court. The commissioner shall adopt rules to provide for a

periodic reimbursement schedule, providing for reimbursement at

least annually.

Added by Acts 1999, 76th Leg., ch. 955, Sec. 5, eff. Sept. 1,

1999.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.198, eff. September 1, 2005.

SUBCHAPTER F. JUDICIAL REVIEW--GENERAL PROVISIONS

Sec. 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 judicial review under this subchapter and Subchapter G, if

applicable.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 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 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 with the division.

(b) The party bringing suit to appeal the decision must file a

petition with the appropriate court in:

(1) the county where the employee resided at the time of the

injury or death, if the employee is deceased; or

(2) in the case of an occupational disease, in the county where

the employee resided on the date disability began or any county

agreed to by the parties.

(c) If a suit under this section is filed in a county other than

the county described by Subsection (b), the court, on determining

that it does not have jurisdiction to render judgment on the

merits of the suit, shall transfer the case to a proper court in

a county described by Subsection (b). Notice of the transfer of a

suit shall be given to the parties. A suit transferred under this

subsection shall be considered for all purposes the same as if

originally filed in the court to which it is transferred.

(d) If a suit is initially filed within the 40-day period in

Subsection (a), and is transferred under Subsection (c), the suit

is considered to be timely filed in the court to which it is

transferred.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by Acts 2003, 78th Leg., ch. 663, Sec. 1, eff. Sept. 1,

2003.

Amended by:

Acts 2009, 81st Leg., R.S., Ch.

1200, Sec. 1, eff. September 1, 2009.

Sec. 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 the suit; and

(3) provide written notice of the suit or notice of appeal to

the division.

(b) A party may not seek judicial review under Section 410.251

unless the party has provided written notice of the suit to the

division as required by this section.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by Acts 2003, 78th Leg., ch. 397, Sec. 2, eff. Sept. 1,

2003.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.199, eff. September 1, 2005.

Sec. 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 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.200, eff. September 1, 2005.

Sec. 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 contested case under Subchapter G, Chapter 2001,

Government Code.

(b) Judicial review conducted under this section is governed by

the substantial evidence rule.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by Acts 1995, 74th Leg., ch. 76, Sec. 5.95(53), eff.

Sept. 1, 1995.

Sec. 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 a

party to the proceeding has filed for judicial review under this

subchapter or Subchapter G. The trial court must approve a

settlement made by the parties after judicial review of an award

is sought and before the court enters judgment.

(b) The court may not approve a settlement except on a finding

that:

(1) the settlement accurately reflects the agreement between the

parties;

(2) the settlement adheres to all appropriate provisions of the

law; and

(3) under the law and facts, the settlement is in the best

interest of the claimant.

(c) A settlement may not provide for:

(1) payment of any benefits in a lump sum except as provided by

Section 408.128; or

(2) limitation or termination of the claimant's right to medical

benefits under Section 408.021.

(d) A settlement or agreement that resolves an issue of

impairment may not be made before the claimant reaches maximum

medical improvement and must adopt one of the impairment ratings

under Subchapter G, Chapter 408.

(e) A party proposing a settlement before judgment is entered by

the trial court may petition the court orally or in writing for

approval of the settlement.

(f) Settlement of a claim or issue under this section does not

constitute a modification or reversal of the decision awarding

benefits for the purpose of Section 410.209.

(g) Settlement of a claim or issue must be in compliance with

all appropriate provisions of the law, including this section and

Section 410.258 of this subchapter. A settlement which on its

face does not comply with this section is void.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by Acts 1997, 75th Leg., ch. 1267, Sec. 1, eff. Sept. 1,

1997; Acts 2003, 78th Leg., ch. 397, Sec. 3, eff. Sept. 1, 2003.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.2001, eff. September 1, 2005.

Sec. 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 appropriate provisions of the law.

(b) A judgment under this section may not provide for:

(1) payment of benefits in a lump sum except as provided by

Section 408.128; or

(2) the limitation or termination of the claimant's right to

medical benefits under Section 408.021.

(c) A judgment that resolves an issue of impairment may not be

entered before the date the claimant reaches maximum medical

improvement. The judgment must adopt an impairment rating under

Subchapter G, Chapter 408, except to the extent Section 410.307

applies.

(d) A judgment under this section may not order reimbursement

from the subsequent injury fund.

(e) A judgment under this section based on default or on an

agreement of the parties does not constitute a modification or

reversal of a decision awarding benefits for the purpose of

Section 410. 209.

(f) A judgment that on its face does not comply with this

section is void.

Added by Acts 1997, 75th Leg., ch. 1267, Sec. 2, eff. Sept. 1,

1997. Amended by Acts 2003, 78th Leg., ch. 397, Sec. 4, eff.

Sept. 1, 2003.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.2002, eff. September 1, 2005.

Sec. 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 the

proceeding, including a proposed default judgment, with the

division not later than the 30th day before the date on which the

court is scheduled to enter the judgment or approve the

settlement. The proposed judgment or settlement must be mailed

to the division by certified mail, return receipt requested.

(b) The division may intervene in a proceeding under Subsection

(a) not later than the 30th day after the date of receipt of the

proposed judgment or settlement.

(c) The commissioner shall review the proposed judgment or

settlement to determine compliance with all appropriate

provisions of the law. If the commissioner determines that the

proposal is not in compliance with the law, the division may

intervene as a matter of right in the proceeding not later than

the 30th day after the date of receipt of the proposed judgment

or settlement. The court may limit the extent of the division's

intervention to providing the information described by Subsection

(e).

(d) If the division does not intervene before the 31st day after

the date of receipt of the proposed judgment or settlement, the

court shall enter the judgment or approve the settlement if the

court determines that the proposed judgment or settlement is in

compliance with all appropriate provisions of the law.

(e) If the division intervenes in the proceeding, the

commissioner shall inform the court of each reason the

commissioner believes the proposed judgment or settlement is not

in compliance with the law. The court shall give full

consideration to the information provided by the commissioner

before entering a judgment or approving a settlement.

(f) A judgment entered or settlement approved without complying

with the requirements of this section is void.

Added by Acts 1997, 75th Leg., ch. 1267, Sec. 2, eff. Sept. 1,

1997.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.201, eff. September 1, 2005.

Acts 2005, 79th Leg., Ch.

265, Sec. 3.202, eff. September 1, 2005.

SUBCHAPTER G. JUDICIAL REVIEW OF ISSUES REGARDING COMPENSABILITY

OR INCOME OR DEATH BENEFITS

Sec. 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

be conducted as provided by this subchapter.

(b) A determination of benefits before a court shall be in

accordance with this subtitle.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.203, eff. September 1, 2005.

Sec. 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 Rules of Evidence.

(b) A trial under this subchapter is limited to issues decided

by the appeals panel and on which judicial review is sought. The

pleadings must specifically set forth the determinations of the

appeals panel by which the party is aggrieved.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.204, eff. September 1, 2005.

Sec. 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, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 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 to the jury of the appeals panel decision on each

disputed issue described by Section 410.301(a) that is submitted

to the jury.

(b) In a trial to the court without a jury, the court in

rendering its judgment on an issue described by Section

410.301(a) shall consider the decision of the appeals panel.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Amended by:

Acts 2005, 79th Leg., Ch.

265, Sec. 3.205, eff. September 1, 2005.

Sec. 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 subchapter controls.

(b) Notwithstanding Section 22.004, Government Code, or any

other law, the supreme court may not adopt rules in conflict with

or inconsistent with this subchapter.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.

Sec. 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 a certified copy of the division's

record. All facts and evidence the record contains are

admissible to the extent allowed under the Texas Rules of

Evidence.

(c) Except as provided by Section 410.307, evidence of extent of

impairment shall be limited to that presented to the division.

The court or jury, in its determination of the extent of

impairment