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Workers' Compensation Utilization Review

Oakland Work Accident Attorneys

Utilization review is a method that enables the workers' compensation insurance claims administrators to review proposed medical treatment before it occurs. That sounds harmless, but in reality, insurance companies often use this process to deny needed medical treatment to injured workers.

If you have been denied medical treatment however, there may be ways around the utilization review process. At Boxer & Gerson, LLP, we have a comprehensive understanding of the utilization review process and its rules. Our firm workers diligently to help our clients obtain all of the medical care they need to recover to the greatest extent possible.

If your workers' compensation insurance company has denied you medical care or a medical testing procedure, contact our firm.

In a typical case, a treating physician may put in a request for an MRI, which then is sent to the utilization review doctor. After 2-3 weeks, the request is denied. In the meantime, the injured person's condition has not improved or gotten worse.

The Utilization Review Process

Under California law, the insurance adjuster can send request for treatment to a utilization review doctor who never sees you or treats you. Often the doctors who do utilization review has a general bias toward denying treatment or tests. The result is that needed treatment or medical tests are often denied or delayed by the utilization review process.

How We Can Help

Boxer & Gerson, LLP helps injured workers get the medical tests and treatment they need. Insurance companies must abide by certain regulations and time frames in doing utilization review of treatment requests. We know how the system works and we can challenge treatment denials. In every case, or firm works diligently, using the law and medical science, to protect our clients' rights. Boxer & Gerson, LLP will use our knowledge and experience to help you get all of the medical care and services you deserve.

Free Consultation With a Lawyer

Contact Boxer & Gerson, LLP for a free, no-obligation consultation about a workers' compensation case.

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