What are the options after the last benefit review conference?
If you go to a benefit review conference and do not reach an agreement on all disputed issues, a hearing will be scheduled. You will be sent a notice about how to attend the hearing.
Even if a hearing is scheduled, you have the option of choosing arbitration. To learn more, see About arbitration.
Sometimes parties reach an agreement before the hearing. If you do, send a copy of the agreement to the administrative law judge (ALJ) for review. If the ALJ approves an agreement on all issues, the hearing may be cancelled.
What happens at a contested case hearing?
At the hearing, the ALJ listens as the parties offer evidence about the issues. The employer is not required to go to the hearing unless it filed the dispute. If the employer does attend, it can offer evidence. Witnesses answer questions under oath, and each party explains its side of the case. After the hearing, the ALJ reviews the evidence and makes a decision on each issue.
Is the ALJ’s decision binding?
Yes. The ALJ’s decision is binding on all parties. If there is an appeal, the ALJ’s decision will remain in effect until the Appeals Panel makes its decision.
What if you don’t agree with the ALJ’s decision?
If either side disagrees with any part of the ALJ’s decision, they can ask the DWC Appeals Panel to review it. Learn more about appeals in Chapter 410, Subchapter E of the Texas Labor Code and in 28 Texas Administrative Code §§142.16 through 143.5.
What will the Appeals Panel do?
They will review the evidence from the hearing. The Appeals Panel may:
- agree with the ALJ’s decision (affirm);
- reach a new decision (reverse and render);
- send the ALJ’s decision back to the ALJ for more action (reverse and remand); or a combination of the above.
What if you don’t agree with the decision of the Appeals Panel?
If either side disagrees with any part of the Appeals Panel's decision, they may ask for judicial review by filing an appeal in district court. Learn more about judicial review in the Texas Labor Code §§410.208 and 410.251 through 410.308.
Prepare for your hearing.
The ALJ makes a decision based only on the evidence admitted at your hearing. It is important that you obtain all needed information, timely exchange it, and have it available at the hearing.
The CCH Set Notice and the practices and procedures for contested case hearings explain in more detail how to prepare for the hearing.Learn more about hearings in Chapter 410, Subchapter D of the Texas Labor Code and in Chapter 142 of 28 Texas Administrative Code.
- If you want an attorney and need help finding one, call the State Bar of Texas at 800-252-9690.
- If you do not have an attorney and want help from an ombudsman, call the Office of Injured Employee Counsel at 866-393-6432, ext. 44186.
Call 800-252-7031, Monday through Friday, 8 a.m. to 5 p.m., Central time.