Under the Texas workers’ compensation system, disputes involving payment or non-payment of medical benefits, as well as disputes over the medical necessity of a treatment proposed or performed, are resolved under a process known as Medical Dispute Resolution.  The procedure is separate from the dispute resolution related to income or death benefits under the Texas Workers’ Compensation Act.  Medical Dispute Resolution can involve the use of Independent Review Organizations and Designated Doctor Examinations. Certain disputes are removed from the Texas Department of Insurance, Division of Workers’ Compensation and are heard by Administrative Law Judges at the State Office of Administrative Hearings. All types of Medical Dispute Resolution may be decided by judicial review if a party is not satisfied with the final outcome in the administrative process.

Brandi Prejean, an attorney based in our Austin office, handles all Medical Dispute Resolution for the firm, in addition to other matters arising from the Texas Workers’ Compensation Act.

Contact Brandi Prejean at  bprejean@thorntonfirm.com