1. (a) When requests are due. The person requesting a hearing shall file a written request addressed to the TWCC Chief Clerk, in accordance with the instructions provided in the TWCC notice letter regarding submission of an appeal, not later than 20 days after:

   1. (1) receipt of a findings and decision from the medical review division on a review of a medical service or a medical fee under the Act, §413.031(a), (b), (c), (f), and (k), or;
   2. (2) receipt of an IRO decision under the Act, §413.031, except with respect to a prospective necessity dispute regarding spinal surgery in which case the request shall be filed in accordance with §133.308 of this title (relating to Medical Dispute Resolution by Independent Review Organization), or;
   3. (3) receipt of a commission refund order issued pursuant to a commission audit or review;
   4. (4) issuance of an interlocutory order for payment under the Act, §413.055, or;
   5. (5) receipt of a notice of administrative violation under the Act, §415.032; or
   6. (6) receipt of a notice of identification as a hazardous employer under the Act, §411.042; or
   7. (7) receipt of a notice of sanction under the Act, §408.0231; or
   8. (8) receipt of a notice of the intent of the commission to determine the legal rights, duties, or privileges of a party within the scope of §148.2 of this title (relating to Scope and Applicability).
2. (b) Date deemed filed or received. When a request for a hearing is addressed to the TWCC Chief Clerk but is sent to an office other than the TWCC Chief Clerk, the date filed or received shall be the date the request is received in the central office. When a request for a hearing is not addressed to the TWCC Chief Clerk, it will not be considered as received by the Commission unless it is actually received by the TWCC Chief Clerk. Otherwise, a request for a hearing is deemed filed as of the date of the TWCC date stamp placed on the document or other evidence of receipt.

3. (c) Requests under §413.031 of the Act. If the request for a hearing is based on a receipt of a findings and decision from the medical review division on a review of a medical service or a medical fee under the Act, §413.031, or receipt of an IRO decision under the Act, §413.031, (except with respect to a prospective necessity dispute regarding spinal surgery in which case the request shall be filed in accordance with §133.308 of this title (relating to Medical Dispute Resolution by Independent Review Organization and except with respect to disputes handled in accordance with §133.309 of this title (relating to Alternate Medical Necessity Dispute Resolution by Case Review Doctor)), to be deemed a request for hearing the request shall:

   1. (1) contain a statement indicating that it is a request for a hearing;
   2. (2) include a copy of the findings and decision on which a hearing is being requested; and
   3. (3) be signed by a requestor or respondent as defined by §133.305 of this title (relating to Medical Dispute Resolution - General), or its representative.
   4. (4) include a certificate of service demonstrating that the request has been sent to the other party in accordance with the requirements of §133.307 of this title (relating to Medical Dispute Resolution of a Medical Fee Dispute), or §133.308 of this title (relating to Medical Dispute Resolution by Independent Review Organization) in substance as follows: "I hereby certify that I have on this ___ day of __________, 20 __, served a copy of the attached instrument on (state the name of the other parties on whom a copy was served) by (state the manner of service.)"
4. (d) Late filings. A written request for hearing filed with the TWCC Chief Clerk later than 20 days after the starting date specified in subsection (a) of a matter set forth in subsection (a) of this section shall be dismissed.

5. (e) Request for correction of clerical error. If the request for hearing is a request to correct a clerical error, the executive director, or the director's designee, may at any time prior to delivery of the request for a hearing to SOAH, revise the order or decision to correct the clerical error.

   1. (1) When a party requests a correction of clerical error and intends that request to constitute a request for hearing pursuant to this section, the request shall:

      1. (A) meet all of the requirements of subsection (c)(1) - (4) of this section;
      2. (B) include markings on a copy of the findings and decision indicating the alleged error;
      3. (C) state the requested correction, and the reasons for making it.
   2. (2) A party affected by the proposed correction to the order or decision may file a response to the request with the TWCC Chief Clerk no later than 10 days after receipt of a party's request for correction of clerical error.

   3. (3) After notice and opportunity to respond under paragraph (2) of this subsection, the commission shall either:

      1. (A) issue and deliver to the parties a corrected order or decision; or
      2. (B) deliver the request for hearing to SOAH.

6. (f) Correction of clerical error discovered by commission. Upon receipt of a request for hearing, the executive director, or the director's designee, may at any time prior to delivery of the request for a hearing to SOAH, advise the parties in writing by verifiable means of the commission's intent to revise the order or decision to correct the clerical error.

   1. (1) Any party affected by the proposed correction to the order or decision may file a response to the notice with the TWCC Chief Clerk no later than 10 days after receipt of the notice of the commission's intent to revise the order or decision.

   2. (2) Following notice of the commission's intent to revise the order or decision, and after notice and opportunity to respond under paragraph (1) of this subsection, the commission shall either:

      1. (A) issue and send to the parties a corrected order or decision; or
      2. (B) send the request for hearing to SOAH.
7. (g) Delivery of request. The commission shall send the request for a hearing to SOAH within twenty working days of receipt, if the decision has not been withdrawn under the provisions contained in §148.8 of this title (relating to Withdrawal of Hearing Request), unless the parties have been notified of the commission's intent to revise the order or decision pursuant to subsections (e) or (f) of this section.
8. (h) Notice of alleged violation. If the notice is a notice of alleged violation, the person charged shall file an answer not later than the 20th day after the date of receipt of the notice. The answer must either consent to the proposed sanction, and remit the amount of the penalty, if any, or request a hearing.
9. (i) Commission request for hearing. Notwithstanding the provisions of subsection (a) of this section, the commission may request a hearing as permitted by the Act and the implementing rules to the Act, including, but not limited to the Act, §407.046(b) and §411.0415(c).

Source Note:The provisions of this §148.3 adopted to be effective June 9, 2005, 30 TexReg 3237.