CompFox AI Summary
This case concerns whether medical treatment proposed by an injured worker's physician, chosen from the employer's Medical Provider Network (MPN), is subject to Utilization Review (UR) and Independent Medical Review (IMR). The Workers' Compensation Appeals Board (WCAB) rescinded the administrative law judge's award of treatment, holding that MPN treatment is indeed subject to UR and IMR. The WCAB clarified that statutory provisions for UR and IMR apply to all medical treatment disputes, regardless of whether the physician is within an MPN. The matter was returned to the trial level for further proceedings consistent with this decision.
Full Decision Text1 Pages
This case concerns whether medical treatment proposed by an injured worker's physician, chosen from the employer's Medical Provider Network (MPN), is subject to Utilization Review (UR) and Independent Medical Review (IMR). The Workers' Compensation Appeals Board (WCAB) rescinded the administrative law judge's award of treatment, holding that MPN treatment is indeed subject to UR and IMR. The WCAB clarified that statutory provisions for UR and IMR apply to all medical treatment disputes, regardless of whether the physician is within an MPN. The matter was returned to the trial level for further proceedings consistent with this decision.
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