CompFox AI Summary
This case addresses whether a worker can receive penalties for delayed medical treatment when the delay stems from the utilization review (UR) process. The Board granted reconsideration, rescinding the original decision and finding that Labor Code section 4610.1 bars penalties for delays occurring during UR. Furthermore, the Board determined it lacks jurisdiction to assess the accuracy of UR decisions when those decisions are timely, deferring such disputes to the Independent Medical Review (IMR) process. Therefore, the applicant's petitions for penalties were denied.
Full Decision Text1 Pages
This case addresses whether a worker can receive penalties for delayed medical treatment when the delay stems from the utilization review (UR) process. The Board granted reconsideration, rescinding the original decision and finding that Labor Code section 4610.1 bars penalties for delays occurring during UR. Furthermore, the Board determined it lacks jurisdiction to assess the accuracy of UR decisions when those decisions are timely, deferring such disputes to the Independent Medical Review (IMR) process. Therefore, the applicant's petitions for penalties were denied.
Read the full decision
Join + legal professionals. Create a free account to access the complete text of this decision and search our entire database.