In what context is the term "Independent Medical Review" used in California Workers Compensation?

The term "Independent Medical Review" (IMR) is specifically used in the context of determining medical necessity in California Workers' Compensation. This process is implemented to resolve disputes regarding the appropriateness of medical treatment requested by an injured worker.

When a claim involves a disagreement over whether a specific medical treatment is necessary and appropriate for the worker's injury, the IMR process allows an independent third-party physician, who is expert in the relevant medical field, to review the case and render an unbiased opinion. This ensures that treatment decisions are based on objective medical evidence rather than on the opinions of either the employer's representatives or the injured worker.

The IMR process is an essential mechanism in ensuring that injured workers receive the necessary medical treatment while also protecting the interests of employers in managing claims and costs associated with workers' compensation. By focusing on medical necessity, IMR helps streamline the treatment process and clarify the obligations and rights of all parties involved in the claim.