What Is a Contested Case Hearing and How Does It Work?
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What Is a Contested Case Hearing and How Does It Work?
When a Texas workers’ compensation dispute cannot be resolved at a Benefit Review Conference (BRC), the case moves to the next stage: a Contested Case Hearing (CCH). This is the most formal and decisive step in the Texas workers’ compensation system’s dispute resolution process. Unlike a BRC, which focuses on negotiation, a CCH functions much more like a trial. Evidence is presented, witnesses testify, and an administrative law judge (ALJ) issues a written decision that can dramatically affect your income, medical care, and long‑term benefits.
A contested case hearing is the single most important stage in a workers’ comp claim. Because the stakes are high, understanding how a CCH works — and how to prepare — is essential for protecting your rights.
What Is a Contested Case Hearing?
A Contested Case Hearing is a formal administrative hearing held by the Texas Department of Insurance, Division of Workers’ Compensation (DWC). It is presided over by an Administrative Law Judge who acts like a judge. The ALJ listens to both sides, reviews evidence, evaluates witness credibility, and issues a written decision called a Decision and Order.
Although a CCH is less formal than a courtroom trial, it follows a structured process and requires strong preparation.
Why a Case Goes to a CCH
A CCH is scheduled when the parties cannot resolve their dispute at a BRC. Common issues that proceed to a hearing include:
- Whether the injury is compensable
- Whether the injury extends to additional body parts (extent of injury)
- Whether disability exists
- Whether Temporary Income Benefits should be paid
- Whether a Bona Fide Offer of Employment was valid
- Whether the worker reached Maximum Medical Improvement
- Whether the impairment rating is correct
- Whether medical treatment should be approved
Because these issues determine the worker’s financial stability and medical future, the CCH often becomes the most important event in the entire claim.
FAQs: What Is a Contested Case Hearing and How Does It Work?
A CCH is a formal administrative hearing where a Hearing Officer reviews evidence, hears testimony, and issues a binding decision in a workers’ comp dispute.
A CCH is scheduled when the worker and the insurance carrier cannot resolve their dispute at a Benefit Review Conference.
While not required, legal representation significantly improves your chances because the carrier arrives with experienced attorneys.
The Hearing Officer issues a written Decision and Order. If either party disagrees, they may appeal.
Yes. A CCH can determine disability, income benefits, medical treatment, impairment ratings, and more.
Injured at work in Texas and your employer doesn’t have workers’ comp?
You may have the right to sue and recover full compensation.
Contact MLF Legal today for a free consultation. You pay nothing unless we win your case.
How a Contested Case Hearing Works
Although every hearing is unique, the process follows a predictable structure.
1. Opening the Hearing
The ALJ begins by identifying the disputed issues and confirming the positions of both parties.
2. Presentation of Evidence
Each side presents evidence to support its position. This may include:
- Medical records
- Work status reports
- Wage information
- Surveillance footage
- Job offers
- Witness statements
- Designated doctor reports
- Required Medical Exam (RME) reports
The judge may ask questions to clarify the facts.
3. Witness Testimony
Both sides may call witnesses, including:
- The injured worker
- Treating doctors
- Employer representatives
- Insurance testifying doctors
- Co‑workers
- Experts
Witnesses testify under oath, and each side may cross‑examine them.
4. Legal Arguments
After the evidence is presented, both sides make closing arguments. These arguments explain how the law applies to the facts and why the ALJ should rule in their favor.
5. The Hearing Officer’s Decision
The judge does not usually issue a decision on the spot. Instead, they review the evidence and mail a Decision and Order to both parties. This decision determines:
- Whether benefits must be paid
- Whether disability exists
- Whether the impairment rating stands
- Whether the injury extends to additional body parts
- Whether medical treatment must be approved
If either party disagrees, they may appeal to the Appeals Panel.
What to Expect at a CCH
A CCH is more formal than a BRC but less intimidating than a courtroom trial. You can expect:
- A structured hearing room
- A judge seated at the front
- Both sides presenting evidence
- Witnesses testifying under oath
- A clear focus on facts and credibility
Although the environment is controlled and professional, the outcome can significantly impact your future.
How to Prepare for a CCH
Preparation is critical. Before the hearing, you should:
- Gather all medical records
- Obtain updated DWC‑73 Work Status Reports
- Collect wage information and pay stubs
- Review any job offers or return‑to‑work documents
- Identify witnesses and prepare testimony
- Organize evidence chronologically
- Understand the exact issues in dispute
- Perform legal research to develop case strategy
Because the carrier arrives with experienced attorneys, injured workers benefit greatly from legal representation.
How MLF Legal Helps at a Contested Case Hearing
MLF Legal ensures you walk into the hearing fully prepared and protected. We:
- Build a strong, evidence‑based case
- Prepare you and your witnesses for testimony
- Cross‑examine the carrier’s witnesses
- Challenge improper medical opinions
- Present clear legal arguments based upon research and the law
- Protect you from unfair tactics
- Challenge inconsistent insurance doctor medical opinions
- Position your case for appeal if necessary
A CCH can determine the future of your benefits. You deserve an advocate who understands the system and fights for your rights.
Call MLF Legal today at 214‑357‑1782 for a free consultation with an experienced Texas workers’ comp lawyer.
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