Workers Compensation Disputes

Disputes in Texas Workers Compensation Claims

Any party in a Texas Workers Comp Claim can initiate a dispute. A party in a workers comp case can be:

• The injured workers (the claimant)
• The Employer
• The Insurance Carrier
• The Treating Doctor
• Other Medical Providers
• Beneficiary or Survivor (of the injured worker)
• …Others

Aside from certain types of medical disputes, the disputes resolution process usually follows the steps below:

1. Attempts to resolve the dispute without TDI intervention – In other words, trying to “settle out of court”, so to speak. The state wants disputing parties to try to resolve things on their own.
2. Benefit Review Conference (BRC) – The BRC is an informal attempt to resolve and define dispute issues before a hearing is set. At the BRC, the parties will sit with a Benefit Review Officer that works for the Texas Department of Insurance.
3. Contested Case Hearing (CCH) – If no resolution is made at the BRC, then a date will be set for a Contested Case Hearing. A CCH is a formal hearing before the Division of Workers Compensation. The CCH is very adversarial, meaning that a defense lawyer will be present to represent the insurance company. Claimants are well-advised to seek the advice of a qualified Texas Workers Comp Lawyer before trying to handle a dispute at a CCH.
4. Appeal – Following the decision by the Hearing Officer at a CCH, either party may appeal the decision by submitting a written appeal to the Division of Workers Compensation.
5. District Court – After all of the above steps have been taken to settle the dispute, an aggrieved party may file a lawsuit in district court.

If you have questions about the Texas Workers Compensation program please don’t hesitate to contact us at 281-804-6882 and we will answer your questions right away.