CompFox AI Summary
The Workers' Compensation Appeals Board (WCAB) rescinded a prior finding that the defendant's utilization review (UR) was defective regarding the applicant's shoulder surgery. The WCAB clarified its jurisdiction, stating it can only determine UR timeliness. All other disputes regarding the UR decision, including its compliance with Labor Code section 4610, must be resolved through Independent Medical Review (IMR). Therefore, the case was returned to the trial level to complete the IMR process.
Full Decision Text1 Pages
The Workers' Compensation Appeals Board (WCAB) rescinded a prior finding that the defendant's utilization review (UR) was defective regarding the applicant's shoulder surgery. The WCAB clarified its jurisdiction, stating it can only determine UR timeliness. All other disputes regarding the UR decision, including its compliance with Labor Code section 4610, must be resolved through Independent Medical Review (IMR). Therefore, the case was returned to the trial level to complete the IMR process.
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