The Morris Law Firm Blog

May 20, 2014

Texas Workers Compensation Benefit Review Conference Scheduling Order

Filed under: Workers' Compensation — Tags: , , , , , — The Morris Law Firm 702 S. Beckley, Dallas, Texas, 75203 (214)357-1782 @ 5:12 pm

Many cases in the Texas Workers’ Compensation system arrive at a Benefit Contested Case hearing, only to find that the case is not ready to litigate.  This generally arises when there are incomplete medical records or the insurance carrier changes what medical conditions they have accepted or disputed.  The Division of Workers’ Compensation is creating Scheduling Order to allow more uniformity in the hearing process.

Starting on June 1, 2014, Texas Department of Insurance, Division of Workers’ Compensation will begin issuing scheduling orders at the conclusion of an initial Benefit Review Conference (BRC) when the Benefit Review Officer determines that a second BRC should be set.

The scheduling order may direct either or both parties to:

-Exchange existing pertinent information not exchanged at the initial BRC

-Exchange new information necessary to an informed disposition of the dispute.

If the information is not obtained prior to the second BRC, the party may file a DWC-45 form to reschedule the BRC; to allow more time to exchange the necessary information.  If the information is not exchanged, the Benefit Review Officer may cancel the BRC and schedule a Benefit Contested Case Hearing.

Unfortunately I feel that the Scheduling Orders will have little real effect on the hearing process.  Unless, the Division of Workers’ Compensation provides a means for the injured worker to have more control over selecting their treating doctor and the insurance carriers are required to specify the medical conditions they have accepted as part of the compensable injury.

Daniel L Morris, The Morris Law Firm, (214)357-1782, info@themorrisfirm.net

October 10, 2011

Disputing Maximum Medical Improvement and Impairment Ratings in Texas Workers’ Compensation Claims

Filed under: Workers' Compensation — Tags: , , , , , , , — The Morris Law Firm 702 S. Beckley, Dallas, Texas, 75203 (214)357-1782 @ 8:16 pm

The Appeals Panel for the Texas Division of Workers’ Compensation has just made it more difficult for both parties to dispute maximum medical improvement and impairment ratings for workers’ compensation injuries.  In Appeal No. 111006-S, the Panel reversed a rendered the judge’s decision and found that the insurance carrier failed to comply with Rule §141.1(d).

In the case, the injured worker had a pending appointment with the designated doctor, when he received an impairment rating from the treating doctor.

The insurance carrier filled out the Request for a Benefit Review Conference to preserve the 90 day window to dispute.  However, they failed to provide documentation of efforts to resolve the disputed issues before requesting the Benefit Review Conference.

Therefore, the Appeals Panel found that the insurance carrier failed to submit a complete request and the date of maximum medical improvement and the impairment rating from the treating doctor became final.

The Division of Workers’ Compensation is strictly applying the rules regarding disputing impairment ratings.  If you are not in agreement with your date of maximum medical improvement and/or your impairment rating, make sure that you complete all the requirements to maintain your dispute.

The Morris Law Firm (214)357-1782 email: info@themorrisfirm.net.

October 7, 2010

Disputing Impairment Ratings

Filed under: Workers' Compensation — Tags: , , , , , , , , , , — The Morris Law Firm 702 S. Beckley, Dallas, Texas, 75203 (214)357-1782 @ 8:50 pm

Traditionally, a claimant could dispute their impairment rating by completing a DWC-32 form requesting a designated doctor for maximum medical improvement (MMI) and/or impairment rating (IR).  If the rating came from a designated doctor, the claimant had ninety (90) days (from the date of receipt) to fill out a DWC-45, stating that they wished to dispute the MMI and IR.  No evidence or even a hearing was required to stop the ninety (90) day window from expiring.

With the changes in Rule §141, disputing impairment ratings have become more complicated.  Claimant’s can still dispute rating by filling out a request for a designated doctor.  However, if the rating is from a designated doctor, the claimant must request a Benefit Review Conference (BRC) by providing a complete DWC-45 disputing the MMI and/or IR.  For the form to be considered complete there must be sufficient evidence to support the claimant’s position along with evidence of attempts to resolve the issue prior to requesting the hearing.

If the claimant does not submit a complete request, the ninety (90) day window could run thereby eliminating injured workers’ right to dispute the rating.  This could result in an injured worker being stuck with an inaccurate IR.  If the ninety (90) days has already run, ratings may only be disputed if there is compelling medical evidence meeting one of the statutory exceptions under Texas Labor Code §408.123(f).

To dispute MMI and IR, claimant’s legal counsel and treatment provider must coordinate quickly to prepare evidence to protect the claimant’s rights.  If you have any questions about disputing an impairment rating call our Dallas office at (214)357-1782.

October 1, 2010

Benefit Review Conference, The New Rules

Filed under: Workers' Compensation — Tags: , , , , , , , — The Morris Law Firm 702 S. Beckley, Dallas, Texas, 75203 (214)357-1782 @ 9:43 pm

Beginning October 1, 2010, The Division of Workers’ Compensation (DWC) will change how they grant Benefit Review Conferences (BRC).  Prior to the change, an injured worker could fill out a DWC-45 requesting a BRC along with some information as to their position, and one would be set.

Under Rule §141.1, the DWC will now review the DWC-45 for completeness.  If the form is found to be incomplete, the hearing will be denied.  In a workers’ compensation claim, there are many time sensitive issues.  If the DWC-45 is denied, the injured worker may lose the ability to have the issue addressed.

The injured worker must show documented evidence as to how they attempted to resolve the issue with the insurance company prior to requesting the hearing.  Additionally, the DWC’s position is that if the reviewer feels that the party did not make sufficient efforts to resolve the issue, the request will be denied.

The documentation that is relevant to the issue must be exchanged with the insurance carrier and the DWC prior to the BRC.  Once the BRC has been set, either party may request that the hearing be rescheduled within ten days of the receipt of the set notice.  After the tenth day, the party must show good cause for their continuance to be granted.

The DWC is clearly making it harder to get a hearing.  Do not attempt to go through the hearing process without an attorney that is experienced in the Texas Workers’ Compensation system.  At the Morris Law Firm, PLLC, we have been helping injured workers in the DFW area and all of North Texas,  for the last 15 years.  Call us at (214)357-1782 or contact us at info@themorrisfirm.net.

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