Home/Case Law/Leticia Avila vs. University of California Irvine Medical Center, SEDGWICK CMS
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Leticia Avila vs. University of California Irvine Medical Center, SEDGWICK CMS

Filed: May 28, 2015
Anaheim
ADJ6907549, ADJ9156151

CompFox AI Summary

This case clarifies that an employee must receive their Independent Medical Review (IMR) application within 30 days of the Utilization Review (UR) denial, plus a 5-day extension if the denial was served by mail. The applicant's IMR application was deemed untimely because it was received by the Administrative Director one day after the extended deadline. This decision affirms the WCJ's finding that the applicant's IMR application was not filed within the mandatory statutory timeframe. The concurring opinion stresses the importance of timely adherence to all timeframes within the UR/IMR process.

Full Decision Text1 Pages

This case clarifies that an employee must receive their Independent Medical Review (IMR) application within 30 days of the Utilization Review (UR) denial, plus a 5-day extension if the denial was served by mail. The applicant's IMR application was deemed untimely because it was received by the Administrative Director one day after the extended deadline. This decision affirms the WCJ's finding that the applicant's IMR application was not filed within the mandatory statutory timeframe. The concurring opinion stresses the importance of timely adherence to all timeframes within the UR/IMR process.

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Leticia Avila vs. University of California Irvine Medical Center, SEDGWICK CMS (2015) – Anaheim | CompFox