Appeals Panel Holds that Subclaimants Have the Right to Participate in CCHs
The Appeals Panel has reversed the decision and order of a benefit contested case Hearing Officer and rendered a decision that a subclaimant was entitled to participate in a Contested Case Hearing over the carrier’s objection. The case has been remanded to the Hearing Officer for a new Contested Case Hearing.
In Appeals Panel Decision Number 160721, decided June 22, 2016, the subclaimant requested the benefit review conference and CCH. At the CCH, however, the Hearing Officer refused to permit the subclaimant to present evidence and argument. The subclaimant appealed the Hearing Officer’s decision and order. It argued that because it was a party under Section 409.009 it should have been allowed to participate in the CCH. The carrier responded to the subclaimant’s appeal, urging affirmance of the Hearing Officer’s determination.
The Appeals Panel agreed with the subclaimant.
It is undisputed that the subclaimant is a subclaimant under Section 409.009. 28 TEX. ADMIN. CODE § 140.1(4) (Rule 140.1(4)) defines a “party to a proceeding” as a person entitled to take part in a proceeding because of a direct legal interest in the outcome. In Appeals Panel Decision (APD) 070647-s, decided July 18, 2007, the Appeals Panel held that a subclaimant is a party to the proceeding as having a direct legal interest in the outcome and was to be given the opportunity to participate in the dispute resolution process on the disputed extent-of-injury issue. See also APD 091305, decided November 4, 2009. In this case, the subclaimant alleges that it has rendered services to the claimant for the compensable injury and is seeking reimbursement for those services. As such, the subclaimant is seeking to show that the claimant’s compensable injury extends to the disputed conditions in the dispute resolution process. We note that whether the subclaimant had standing was not a disputed issue to be decided at the CCH.
The Hearing Officer erred in failing to allow the subclaimant, a party in this case, to participate in the CCH.
Consequently, the Appeals Panel reversed the Hearing Officer’s determination on the extent-of-injury issue before him and remanded the case to the Hearing Officer to allow the subclaimant the opportunity to participate in the dispute resolution process.
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