The program that claims administrators use to make sure that the treatment you receive is medically necessary is known as utilization review (UR). It is required by law that all claims administrators have a utilization review program to decide whether or not to approve the medical treatment recommended by your doctor. California has rules about how a UR must be conducted. If you feel that the UR company that is reviewing your doctors plan is not following the state rules you can file a complaint with the Division of Workers Compensation. You have the right to be seen on an expedited basis by a workers compensation administrative law judge if there is a dispute over your medical care in order to resolve the dispute.

What is California Workers Compensation Utilization Review?

 

A:

The program that claims administrators use to make sure that the treatment you receive is medically necessary is known as utilization review (UR). It is required by law that all claims administrators have a utilization review program to decide whether or not to approve the medical treatment recommended by your doctor.

California has rules about how a UR must be conducted. If you feel that the UR company that is reviewing your doctor’s plan is not following the state rules you can file a complaint with the Division of Workers’ Compensation.

You have the right to be seen on an expedited basis by a workers’ compensation administrative law judge if there is a dispute over your medical care in order to resolve the dispute. 




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The San Diego, California personal injury law firm of The Turley Law Firm serves clients across  Southern California area. We give you straight talk about your legal options. We have handled cases from San Diego to Imperial Beach to Oceanside to Escondido to El Cajon, everywhere in between, such as: Alpine, Camp Pendleton, Cardiff, Carlsbad, Chula Vista, Coronado,  Del Mar, Eastlake, Encinitas, La Mesa, La Costa, La Jolla, Lakeside, Lemon Grove, Mission Bay, NAS San Diego, National City, Naval Station San Diego, North Island, North County, Pacific Beach, Point Loma, Port of San Diego, Poway, Ramona, Rancho Bernardo, Rancho Santa Fe, San Marcos, San Diego Harbor, Santee, Solana Beach, South Bay, Spring Valley, Vista.

We handle cases across California, including: Riverside County, San Bernardino County, Orange County, Imperial County, Los Angeles County, and Ventura County, Colorado River, Mexico, Cabo, Pacific Ocean and all the Oceans and waterways across California and the World.


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