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A BILL TO BE ENTITLED
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AN ACT
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relating to changing statutory references to hearing officer and |
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hearings officer to administrative law judge under the workers' |
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compensation system. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1305.356(b), Insurance Code, is amended |
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to read as follows: |
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(b) At a contested case hearing held under Subsection (a), |
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the administrative law judge [hearing officer] conducting the |
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hearing shall consider evidence-based treatment guidelines adopted |
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by the network under Section 1305.304. |
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SECTION 2. Section 409.0091(m), Labor Code, is amended to |
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read as follows: |
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(m) In a dispute filed under Chapter 410 that arises from a |
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subclaim under this section, an administrative law judge [a hearing
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officer] may issue an order regarding compensability or eligibility |
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for benefits and order the workers' compensation insurance carrier |
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to reimburse health care services paid by the health care insurer as |
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appropriate under this subtitle. Any dispute over the amount of |
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medical benefits owed under this section, including medical |
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necessity issues, shall be determined by medical dispute resolution |
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under Sections 413.031 and 413.032. |
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SECTION 3. Section 410.152, Labor Code, is amended to read |
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as follows: |
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Sec. 410.152. ADMINISTRATIVE LAW JUDGES [HEARING
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OFFICERS]; QUALIFICATIONS. (a) An administrative law judge [A
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hearing officer] shall conduct a contested case hearing. |
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(b) An administrative law judge [A hearing officer] must be |
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licensed to practice law in this state. |
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SECTION 4. Section 410.156(b), Labor Code, is amended to |
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read as follows: |
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(b) A party commits an administrative violation if the |
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party, without good cause as determined by the administrative law |
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judge [hearing officer], does not attend a contested case hearing. |
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SECTION 5. Section 410.158(a), Labor Code, is amended to |
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read as follows: |
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(a) Except as provided by Section 410.162, discovery is |
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limited to: |
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(1) depositions on written questions to any health |
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care provider; |
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(2) depositions of other witnesses as permitted by the |
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administrative law judge [hearing officer] for good cause shown; |
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and |
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(3) interrogatories as prescribed by the |
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commissioner. |
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SECTION 6. Section 410.162, Labor Code, is amended to read |
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as follows: |
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Sec. 410.162. ADDITIONAL DISCOVERY. For good cause shown, |
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a party may obtain permission from the administrative law judge |
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[hearing officer] to conduct additional discovery as necessary. |
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SECTION 7. Section 410.163, Labor Code, is amended to read |
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as follows: |
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Sec. 410.163. POWERS AND DUTIES OF ADMINISTRATIVE LAW JUDGE |
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[HEARING OFFICER]. (a) At a contested case hearing the |
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administrative law judge [hearing officer] shall: |
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(1) swear witnesses; |
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(2) receive testimony; |
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(3) allow examination and cross-examination of |
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witnesses; |
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(4) accept documents and other tangible evidence; and |
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(5) allow the presentation of evidence by affidavit. |
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(b) An administrative law judge [A hearing officer] shall |
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ensure the preservation of the rights of the parties and the full |
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development of facts required for the determinations to be made. An |
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administrative law judge [A hearing officer] may permit the use of |
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summary procedures, if appropriate, including witness statements, |
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summaries, and similar measures to expedite the proceedings. |
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SECTION 8. Section 410.164(c), Labor Code, is amended to |
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read as follows: |
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(c) At each contested case hearing, as applicable, the |
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insurance carrier shall file with the administrative law judge |
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[hearing officer] and shall deliver to the claimant a single |
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document stating the true corporate name of the insurance carrier |
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and the name and address of the insurance carrier's registered |
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agent for service of process. The document is part of the record of |
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the contested case hearing. |
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SECTION 9. Section 410.165, Labor Code, is amended to read |
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as follows: |
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Sec. 410.165. EVIDENCE. (a) The administrative law judge |
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[hearing officer] is the sole judge of the relevance and |
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materiality of the evidence offered and of the weight and |
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credibility to be given to the evidence. Conformity to legal rules |
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of evidence is not necessary. |
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(b) An administrative law judge [A hearing officer] may |
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accept a written statement signed by a witness and shall accept all |
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written reports signed by a health care provider. |
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SECTION 10. Section 410.167, Labor Code, is amended to read |
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as follows: |
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Sec. 410.167. EX PARTE CONTACTS PROHIBITED. A party and an |
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administrative law judge [a hearing officer] may not communicate |
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outside the contested case hearing unless the communication is in |
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writing with copies provided to all parties or relates to |
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procedural matters. |
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SECTION 11. Sections 410.168(a), (c), (d), and (e), Labor |
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Code, are amended to read as follows: |
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(a) The administrative law judge [hearing officer] shall |
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issue a written decision that includes: |
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(1) findings of fact and conclusions of law; |
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(2) a determination of whether benefits are due; and |
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(3) an award of benefits due. |
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(c) The administrative law judge [hearing officer] may |
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enter an interlocutory order for the payment of all or part of |
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medical benefits or income benefits. The order may address accrued |
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benefits, future benefits, or both accrued benefits and future |
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benefits. The order is binding during the pendency of an appeal to |
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the appeals panel. |
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(d) On a form that the commissioner by rule prescribes, the |
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administrative law judge [hearing officer] shall issue a separate |
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written decision regarding attorney's fees and any matter related |
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to attorney's fees. The decision regarding attorney's fees and the |
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form may not be made known to a jury in a judicial review of an |
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award, including an appeal. |
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(e) The commissioner by rule shall prescribe the times |
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within which the administrative law judge [hearing officer] must |
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file the decisions with the division. |
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SECTION 12. Section 410.169, Labor Code, is amended to read |
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as follows: |
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Sec. 410.169. EFFECT OF DECISION. A decision of an |
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administrative law judge [a hearing officer] regarding benefits is |
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final in the absence of a timely appeal by a party and is binding |
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during the pendency of an appeal to the appeals panel. |
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SECTION 13. Sections 410.202(a) and (c), Labor Code, are |
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amended to read as follows: |
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(a) To appeal the decision of an administrative law judge [a
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hearing officer], a party shall file a written request for appeal |
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with the appeals panel not later than the 15th day after the date on |
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which the decision of the administrative law judge [hearing
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officer] is received from the division and shall on the same date |
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serve a copy of the request for appeal on the other party. |
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(c) A request for appeal or a response must clearly and |
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concisely rebut or support the decision of the administrative law |
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judge [hearing officer] on each issue on which review is sought. |
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SECTION 14. Section 410.203(b), Labor Code, is amended to |
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read as follows: |
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(b) The appeals panel may: |
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(1) reverse the decision of the administrative law |
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judge [hearings officer] and render a new decision; |
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(2) reverse the decision of the administrative law |
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judge [hearings officer] and remand the case to the administrative |
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law judge [hearing officer] for further consideration and |
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development of evidence; or |
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(3) affirm the decision of the administrative law |
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judge [hearings officer] in a case described by Section |
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410.204(a-1). |
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SECTION 15. Sections 410.204(a-1) and (c), Labor Code, are |
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amended to read as follows: |
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(a-1) An appeals panel may only issue a written decision in |
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a case in which the panel affirms the decision of an administrative |
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law judge [a hearings officer] if the case: |
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(1) is a case of first impression; |
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(2) involves a recent change in law; or |
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(3) involves errors at the contested case hearing that |
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require correction but do not affect the outcome of the hearing, |
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including: |
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(A) findings of fact for which insufficient |
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evidence exists; |
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(B) incorrect conclusions of law; |
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(C) findings of fact or conclusions of law |
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regarding matters that were not properly before the administrative |
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law judge [hearings officer]; and |
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(D) legal errors not otherwise described by this |
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subdivision. |
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(c) If the appeals panel does not issue a decision in |
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accordance with this section, the decision of the administrative |
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law judge [hearing officer] becomes final and is the final decision |
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of the appeals panel. |
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SECTION 16. Sections 413.0311(b), (c), and (d), Labor Code, |
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are amended to read as follows: |
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(b) A party to a medical dispute described by Subsection (a) |
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is entitled to a contested case hearing. A contested case hearing |
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under this section shall be conducted by an administrative law |
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judge [a hearings officer] in the manner provided for contested |
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case hearings under Subchapter D, Chapter 410. Notwithstanding |
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Section 410.024, a benefit review conference is not a prerequisite |
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to a contested case hearing under this section. |
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(c) The decision of an administrative law judge [a hearings
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officer] under this section is final in the absence of a timely |
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appeal by a party for judicial review under Subsection (d). |
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(d) A party who has exhausted all administrative remedies |
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under Section 413.031 and this section and who is aggrieved by a |
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final decision of the administrative law judge [hearings officer] |
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under Subsection (c) may seek judicial review of the decision. |
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Judicial review under this subsection shall be conducted in the |
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manner provided for judicial review of a contested case under |
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Subchapter G, Chapter 2001, Government Code, except that the party |
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seeking judicial review under this section must file suit not later |
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than the 45th day after the date on which the division mailed the |
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party the decision of the administrative law judge [hearings
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officer]. For purposes of this subsection, the mailing date is |
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considered to be the fifth day after the date the decision of the |
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administrative law judge [hearings officer] was filed with the |
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division. |
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SECTION 17. Section 504.054(b), Labor Code, is amended to |
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read as follows: |
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(b) The administrative law judge [hearing officer] |
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conducting the contested case hearing under Subsection (a) shall |
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consider any treatment guidelines adopted by the political |
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subdivision or pool that provides medical benefits under Section |
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504.053(b)(2) if those guidelines meet the standards provided by |
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Section 413.011(e). |
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SECTION 18. This Act takes effect September 1, 2017. |
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