In Texas, workers’ compensation disputes are handled through the Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC). This process is in place in an attempt to avoid having workers’ comp cases in courtrooms.
Although you may think you do not need a lawyer, remember that you are allowed to have one with you during this process. An experienced attorney will know how to navigate compensation laws and will be able to represent your best interests.
Additionally, it may be tempting to use an ombudsman from The Office of Injured Employee Counsel (OIEC), but these people can only guide you through the process; they cannot give advice or make decisions on your behalf.
How Does the Dispute Resolution Process Work for Workers’ Compensation?
There are five steps to the workers’ comp resolution process:
- Benefit Review Conference (BRC)—this is the first step in the resolution process. A BRC is an informal meeting between the insurance company, the injured worker and a Benefit Review Officer (BRO). If the dispute can be resolved, both parties will sign an agreement.
- Arbitration—this part is optional after the BRC. Both parties must agree to go this route instead of having a Contested Case Hearing. An independent arbitrator hears both sides of the dispute and makes a ruling on the matter.
- Contested Case Hearing (CCH)—this is the next level of the resolution process if both parties decide not to use arbitration. This process is a formal hearing that is conducted before a Hearing Officer who will make a decision on the disputed issues.
- Appeals Panel—if a party disagrees with the CCH ruling, they may request a review of that decision by the Appeals Panel. This is the last step of the TDI-DWC dispute resolution process. If the parties are still in disagreement, they may appeal the decision to a court of law.
- Judicial Review—as mentioned in step four, if a dispute has gotten to this point, it will now be settled in the court of law.
The Law Offices of Aaron Allison – Austin Workers’ Compensation Attorney