Home/Case Law/Jose Dubon, Applicant vs. World Restoration, Inc. and State Compensation Insurance Fund
Significant DecisionEn Banc

Jose Dubon, Applicant vs. World Restoration, Inc. and State Compensation Insurance Fund

Filed: Feb 27, 2014
Anaheim
ADJ4274323 (ANA 0387677), ADJ1601669 (ANA 0388466)

CompFox AI Summary

The Appeals Board held that disputes over the timeliness and procedural compliance of utilization review (UR) are legal issues for the WCAB to decide, not matters for independent medical review (IMR). A UR decision is invalid if it has material procedural defects, such as failing to review adequate medical records.

Full Decision Text1 Pages

The Appeals Board held that disputes over the timeliness and procedural compliance of utilization review (UR) are legal issues for the WCAB to decide, not matters for independent medical review (IMR). A UR decision is invalid if it has material procedural defects, such as failing to review adequate medical records.

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