It is no secret that the IMR process implemented as a part of SB 863, which took effect on January 1, 2013, is a complete disaster. IMR is an Independent Medical Review process that reviews all denied treatment and upholds denials by the insurance company a majority of the time. Injured workers across California, including San Diego, are facing extensive delays for their medical treatment as a result of this inefficient system. Workers’ Compensation lawyers in California battle these changes to medical authorization everyday.
However, SB 863 is still touted on the Department of Industrial Relations Website as:
One of Governor Brown’s landmark reforms, Senate Bill 863 passed on August 1, 2012, and was signed into law on Sept. 18, 2012. The bill makes wide-ranging changes to California’s workers’ compensation system, including increased benefits to injured workers and cost-saving efficiencies.
The IMR process neither increases benefits to injured workers, nor does it provide cost-saving efficiencies. Instead, it causes unprecedented delays in getting injured workers in the Workers’ Compensation system in San Diego, and through California, medical treatment that they need. According to one source at CAAA.com, as many as many as 3.5 million denials have passed through the IMR process. See https://www.caaa.org/index.cfm?pg=Release_ProPublica.
This has lead to delays where injured workers in San Diego have waited as long as six months to receive a response from IMR as to whether their treatment has been approved. The Department of Industrial Relations released a bulletin on March 18, 2015 for contact information to find out the status of your IMR application. The contact information is: Toll free (855) 865-8873; Fax: (916) 605-4270; email: firstname.lastname@example.org.
If you are an injured worker, your best bet is to hire a competent Workers’ Compensation lawyer. Whether you are an injured worker in San Diego or anywhere in California, you need an experienced attorney in your corner to help tip the odds in your favor.