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FAQs:

  1. What is IMR in medical terms?
    In medical terms, IMR refers to Independent Medical Review. It is a process within workers’ compensation where an impartial third party assesses medical decisions ensuring they align with established medical guidelines and standards.
  2. What is an IMR complaint?
    An IMR complaint, in the context of workers’ compensation, refers to a formal grievance or concern raised by an individual regarding the Independent Medical Review process. This could involve dissatisfaction with the outcome, procedural issues, or related matters.
  3. What is an independent medical review?
    An Independent Medical Review (IMR) is an unbiased evaluation of a medical decision reviewed by a workers’ compensation claims administrator. It involves an independent medical professional assessing the medical necessity and appropriateness of the proposed treatment.
  4. What is an independent medical review application?
    An IMR application is a formal request an injured worker or their representative submits to initiate the process. It serves as a means to challenge a claims administrator’s decision on the medical treatment provided.
  5. What is the difference between IME and IMR?
    The main difference between Independent Medical Examination (IME) and IMR lies in their nature and purpose. IME is a one-time examination and employer or insurer requests to evaluate an individual’s medical condition. In contrast, IMR is an ongoing process to review and resolve disputes about the medical treatment plan in the workers’ compensation system.
  6. How long does an IMR take?
    The duration of an Independent Medical Review (IMR) varies, but it typically takes around 30 days from the date the application is received. However, certain factors may influence the timeline, such as the complexity of the case or the need for additional information.
  7. What is the UR process in California?
    Utilization review (UR) is the process employers or claims administrators use to review treatment to determine if it is medically necessary. All employers or their workers’ compensation claims administrators are required by law to have a UR program.

    More Information on IMR / More Information on UR Process