CompFox AI Summary
The Appeals Board reversed the WCJ's decision, holding that the statutory timeframes for Independent Medical Review (IMR) determinations are directory, not mandatory. Therefore, IMR decisions issued late are still valid and binding on the applicant. The Board concluded that the Legislature's intent was for IMR to be the sole avenue for resolving medical treatment disputes post-utilization review, ensuring consistent application of evidence-based standards. The case was returned to the trial level for further proceedings consistent with this decision.
Full Decision Text1 Pages
The Appeals Board reversed the WCJ's decision, holding that the statutory timeframes for Independent Medical Review (IMR) determinations are directory, not mandatory. Therefore, IMR decisions issued late are still valid and binding on the applicant. The Board concluded that the Legislature's intent was for IMR to be the sole avenue for resolving medical treatment disputes post-utilization review, ensuring consistent application of evidence-based standards. The case was returned to the trial level for further proceedings consistent with this decision.
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