Section 43.1 - Administrative Review of Individual Requests(a) Organization. TRS is divided into administrative divisions, which are further divided into departments, for the efficient implementation of its duties. Any person who desires any action from TRS must consult with the proper department within TRS and comply with all proper requirements for completing forms and providing information to that department.(b) Final administrative decision by chief benefit officer. In the event that a person is adversely affected by a determination, decision, or action of department personnel, the person may appeal the determination, decision, or action to the appropriate manager within the department, and then to the chief benefit officer of TRS. The chief benefit officer shall mail a final written administrative decision, which shall include: (1) the chief benefit officer's determination regarding the person's appeal and reasons for denying the appeal, if applicable; and(2) a statement that if the person is adversely affected by the decision, the person may request an adjudicative hearing to appeal the decision and the deadline for doing so.(c) An appeal to the chief benefit officer as described by subsection (b) of this section must be submitted by the later of:(1) 45 days after the date the decision of the department manager is mailed; or(2) the number of days after the date the decision of the department manager is mailed equal to the number of days it took TRS to issue the decision of the department manager.(d) The number of days it took TRS to issue the decision of the department manager is calculated from the date TRS received the person's appeal of the determination, decision, or action of department personnel to the date TRS mailed the decision of the department manager.(e) A person adversely affected by a decision of the chief benefit officer may request an adjudicative hearing to appeal the decision of the chief benefit officer as provided in § 43.5 of this chapter (relating to Request for Adjudicative Hearing). The deputy director shall determine whether the appeal should be docketed and set for a contested case hearing pursuant to § 43.9 of this chapter (relating to Docketing of Appeal for Adjudicative Hearing and Dismissal for Failure to Obtain Setting).(f) Final administrative decision by Medical Board. In the event that the Medical Board does not certify disability of a member under Government Code, § 824.303(b), or the Medical Board certifies that a disability retiree is no longer mentally or physically incapacitated for the performance of duty under Government Code, § 824.307(a), the member or retiree may request reconsideration and submit additional information to the Medical Board. The Medical Board shall consider a request for reconsideration and additional information and make a determination on the disability of the member or retiree. If a request for reconsideration has been denied, a member or retiree may appeal the decision by requesting an adjudicative hearing as provided in § 43.5 of this chapter (relating to Request for Adjudicative Hearing). The deputy director shall determine whether the appeal should be docketed and set for a contested case hearing pursuant to § 43.9 of this chapter (relating to Docketing of Appeal for Adjudicative Hearing and Dismissal for Failure to Obtain Setting).(g) Applicability. The procedures of this chapter apply only to administrative decisions, appeals, and adjudicative hearings relating to the TRS pension plan, unless rules relating to other programs specifically adopt by reference the provisions of this chapter.34 Tex. Admin. Code § 43.1
The provisions of this §43.1 adopted to be effective April 20, 1988, 13 TexReg 1672; amended to be effective January 24, 1992, 17 TexReg 256; amended to be effective June 9, 1999, 24 TexReg 4249; amended to be effective March 12, 2003, 28 TexReg 2115; amended to be effective March 8, 2007, 32 TexReg 1095; amended to be effective April 1, 2011, 36 TexReg 2002; Amended by Texas Register, Volume 45, Number 11, March 13, 2020, TexReg 1862, eff. 3/19/2020; Amended by Texas Register, Volume 46, Number 41, October 8, 2021, TexReg 6945, eff. 10/17/2021