The Department of Industrial Relations (DIR) and its Division of Workers’ Compensation (DWC) remain committed to improving California’s workers’ compensation system to ensure that injured workers can receive timely and appropriate medical treatment. The independent medical review (IMR) process allows injured workers who have been denied a specific course of medical treatment by a claims administrator to request a review of that decision by an IMR physician.
Currently, IMR determinations are issued within 30 days from receipt of medical records. Any injured worker, or someone she or he designates, who has requested independent medical review and who has not received a resolution within the required 45-day period is urged to contact the IMR organization, Maximus Federal Services. The contact detail, as noted on DWC’s IMR information page, is as follows:
Toll free: 1-855-865-8873 FREE
Fax: (916) 605-4270
To request IMR, the injured worker or their representative must sign the application form sent by the claims administrator and mail the application with the utilization review (UR) denial letter to Maximus within 30 days of service of the written UR denial.
IMR was implemented as emergency regulations on January 1, 2013 and adopted as permanent regulations on February 12, 2014. It resolves medical treatment disputes by physicians utilizing evidence-based standards within 45 days for those workers whose treatment was denied at the utilization review. Information on IMR, showing how many requests have been received and how many are open or closed, is updated monthly on DIR’s website.
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