Utilization review denial for workers' compensation.

Filing for workers' compensation after suffering an injury at work in San Diego can sometimes be a laborious process. When you are filing a workers' compensation claim, there are several steps needed in order to verify the extent of the injury. One of the key steps in determining the severity of the injury and the treatment needed is a Utilization Review.

What is a Utilization Review?

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According to the California Department of Industrial Relations, a Utilization Review (UR) is the process used by employers or claims administrators to review treatment to determine if it is medically necessary. This program is used to decide whether or not to approve medical treatment recommended by a physician. If the treatment is not determined neccessary there will be an adjustment to the workers' compensation settlement.

When do you need a Utilization Review for workers' compensation?

A Utilization Review is required for every workers' compensation claim in which medical treatment is sought through the workers' compensation system. A UR will determine the most cost-effective and appropriate method of treatment for an injured employee. In some cases, those who are injured may claim more than they need in order to collect excessive compensation, so the job of the Utilization Review is to protect people from unjust claims.

Contact Us if Your Utilization Review is Denied

If treatment is denied or reduced, we will analyze the UR decision along with the doctor’s request and fight to obtain the medical treatment for you, appealing the decision and taking the decision to court, if necessary. If you feel you have been unjustly denied medical treatment by a Utilization Review, call our San Diego team of lawyers at the Law Office of Gerald D. Brody & Associates for a free consultation. Give us a call today at (619) 528-9800.