(a) A party to a medical dispute that remains unresolved after a review under § 1305.355 is entitled to a contested case hearing. A hearing under this subsection shall be conducted by the department’s division of workers’ compensation in the same manner as a hearing conducted under § 413.0311, Labor Code.
(b) At a contested case hearing held under Subsection (a), the administrative law judge conducting the hearing shall consider evidence-based treatment guidelines adopted by the network under § 1305.304.

Terms Used In Texas Insurance Code 1305.356

  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Rule: includes regulation. See Texas Government Code 311.005

(c) A party that has exhausted all administrative remedies under Subsection (a) and is aggrieved by a final decision of the department’s division of workers’ compensation may seek judicial review of the decision.
(d) Judicial review under Subsection (c) shall be conducted in the manner provided for judicial review of a contested case under Subchapter G, Chapter 2001, Government Code, and is governed by the substantial evidence rule.

  Previous section
Next section  
 Subchapter H Contents