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MEDICAL CONTESTED CASE HEARING NO 09147 M6-09-16882-01 DECISION AND ORDER This case is decided pursu

MEDICAL CONTESTED CASE HEARING NO 09147 M6-09-16882-01 DECISION AND ORDER This case is decided pursu 2025

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The document is a decision and order from a contested case hearing regarding a claimant's request for a knee arthrotomy with autologous cultured chondrocyte implantation following a compensable injury. The Independent Review Organization (IRO) denied the procedure, stating it was not reasonable or necessary based on evidence-based guidelines. The hearing concluded that the claimant did not meet the criteria for the surgery due to previous unsuccessful procedures and complications involving both cartilage and bone, leading to the decision that the insurance carrier is not liable for the requested benefits.

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What is a contested case hearing?

The UAPA defines contested case to mean a proceeding that an agency is required by law to hold to determine the legal rights, duties, or privileges of a party, including but not limited to rate-making, price fixing, and licensing. The agency must hold a hearing or provide the opportunity for one.

What is the purpose of a hearing?

Hearings start early in the lawsuit to determine whether a case should proceed to trial. Even the meeting to schedule court dates between a judge, the plaintiff (or plaintiffs attorney), and the defendant (or defendants attorney) is a type of hearing. Hearings are generally less formal when compared to a trial.

Is a hearing the same as going to court?

Notice of Hearing. (a) Notice of Hearing. The Chief Clerk of Proceedings shall notify the parties in writing, by verifiable means, of the date, time, place, and nature of the hearing no later than 10 days before the hearing date.

What is a hearing in Texas?

General hearings, also known as contested case or general docket hearings, include cases in which a State of Texas agency decides to take certain action against a person or business. In these cases, the law often allows the person or business to request an administrative hearing to challenge the agencys action.

What is a notice of hearing in Texas?

The public hearing must be held at least five days after the date notice of public hearing is given. This hearing must be held on a weekday that is not a public holiday and must take place in a public building inside the taxing units boundaries or a suitable building to which the public have normal access.