What are the potential outcomes of a Contested Case Hearing?

The potential outcomes of a Contested Case Hearing (CCH) in the Texas workers' compensation system can include:

1. Ruling in Favor of the Injured Worker:

   • The hearing officer may rule that the worker's claim is compensable and award the appropriate benefits, such as:

     • Medical expense coverage

     • Income replacement benefits (Temporary Income Benefits, Impairment Income Benefits, etc.)

     • Vocational rehabilitation services

     • Death benefits (if the injury resulted in the worker's death)

2. Ruling in Favor of the Insurance Carrier:

   • The hearing officer may side with the insurance carrier and deny the worker's claim or certain requested benefits.

   • This could be due to a determination that the injury is not work-related, the treatment was not reasonable and necessary, or the worker does not meet the eligibility criteria for the specific benefits claimed.

3. Partial Approval of the Claim:

   • The hearing officer may find that only certain aspects of the worker's claim are compensable, while denying others.

   • For example, the hearing officer may approve medical benefits but deny income replacement benefits, or vice versa.

4. Remand for Additional Evidence:

   • In some cases, the hearing officer may determine that more evidence or information is needed to make a final decision.

   • The case would then be remanded back to the parties to gather the additional evidence before a final ruling is issued.

Regardless of the outcome, the hearing officer must provide a written decision that explains the rationale for their ruling. This written decision can then be appealed by either the worker or the insurance carrier if they disagree with the findings.

It's important to note that having an experienced Texas workers' compensation attorney represent you at the CCH can greatly improve your chances of a favorable outcome. They can ensure your case is properly presented and that all relevant evidence and arguments are considered by the hearing officer.