Q: I was denied medical treatment and there is an IMR form attached to my denial that says it needs be filled out within 30 days. Do I need to fill-out this form and how does it affect my case?
In order for treatment to be denied, it must first be reviewed by a Utilization Review (UR) company. If UR does deny the requested treatment, the next step is to apply for Independent Medical Review (IMR). This application is the form that is attached to your UR denial. The IMR form needs to be filled out and submitted to Maximus, the IMR company, through the administrative director within 30 days.
Once the IMR application is received by Maximus they will request information and review the treatment. They will either uphold the denial, in which case the treatment remains denied and cannot be requested again for a year after the original request. Or they will overturn the denial, in which case the treatment is required to be authorized by the workers’ compensation carrier.